tremely varied, and in fact it is now employed to relieve almost every known abnormal symptom or condition of body or mind. Dr. Richardson's report concludes with a warm tribute to the "genius and industry of the distinguished Professor of Berlin who has placed in our hands so admirable and scientific a remedy."

With regard to Cholera, the novelty is in the treatment alone; its nature is universally understood. A poison is absorbed into and infects the blood, spoiling certain of its constituents, which are ejected through the mucous membrane of the alimentary canal. A primary blood disease is thus produced, undergoing enormous multiplication in the body; and the direct results of the alteration are changes in the function of respiration, while the copious discharges are the efforts of nature to throw off the noxious material, as a necessary process to recovery. From no other cause than a virulent blood poison does a person in full health become in a few minutes, and utterly without warning, shrivelled up, his whole body icy-cold, his face and hands turned purple, while death comes on in a few hours. We cannot refrain from reproducing the quotation very happily brought in by Dr. Aitkin:

"Its effect

Holds such an enmity with blood of man
That, swift as quicksilver, it courses through
The natural gates and alleys of the body;
And, with a sudden vigor, it doth posset
And curd, like eager droppings into milk,
The thin and wholesome blood."

The well-known and especial danger in cholera is also its proper and distinctive symptom, characterized by the French pathologists by the term "algide," the sensation and fact of cold being one of the most remarkable and constant phenomena; the thermometer in the axilla falling to 92°, more than six degrees below the natural standard in health, while under the tongue it is known to have fallen to 79°. Vomiting, purging, and cramps have long ceased to be regarded as essential phenomena. Hale and hearty men have been suddenly seized, and have collapsed, and died within five minutes, without any evacuation; and death has repeatedly occurred within two or VOL. CXVII. - NO. 240. 3

three hours after access, without any other cause than stagnation of the blood.

Dr. George Johnson, long known to the profession in connection with the correct pathology of kidney diseases, communicated to the Medico-Chirurgical Society of London, in 1868, the doctrine that the poison of cholera was received into the system from without, by inhalation or in food and water, and absorbed into the circulation; that if the vascular excretion was checked, the risk of fatal collapse was greatly increased; and that the object in treatment should be, not to excite discharges from the mucous surface, but to facilitate the removal of matters lodged there, and that elimination of the poison from the system was the condition of recovery.

Half a century ago the English physicians in India" aimed to get rid of the offensive morbid secretions" in cholera, but it was quite natural to attribute collapse to the drain of fluid matters from the blood by the profuse and repeated fluxes from the bowels and stomach; and the treatment this view suggested was the "locking-up" plan by opium and astringents and by stimulants. Dr. Johnson's opinions were not well received, and violent controversy grew out of them. It was soon settled that the collapse was not due to the evacuations, but that these were, in fact, eliminative of the poison. To establish relations of cause and effect between them, it should happen that the more profuse the discharge the more decided and certain should be the collapse; while in fact the most hopeless cases were those of scanty evacuations or of none at all. Also the continuance of the discharge should cause a more prolonged, deeper, and more dangerous collapse. But, on the contrary, patients not only emerge from the collapse while the evacuations are going on, but a cessation of them is always a fatal sign. If a vein is opened in cholera, after a moment or so, the dark treacly blood grows brighter, and the patient has been known to cry out that "it had made a new man of him"; therefore collapse has nothing in common with ordinary syncope, which is relieved by stimulants, but would be disastrously affected by blood-letting. Dr. Johnson's own paper in the "Transactions" is immediately followed by another, containing details of treatment upon his plan, on a large scale, in which the re

sults corroborated the theory, and which demonstrated the remarkable fact that recovery never occurred without a continuance of the discharges or their restoration, if previously arrested.

So great a change in medical opinion was effected by the new views, that Sir Thomas Watson, the president of the society, upon a careful revision, has fully recanted his own published opinions and adopted those of Dr. Johnson in the last edition of his well-known work on the Principles and Practice of Physic, and he pays their author a noble tribute by declaring that "he has by his methodical display of facts, by his close and conclusive reasoning, now triumphantly established his own views of the pathology and treatment of cholera."

Lörstofer's Corpuscles. — During the past few years much attention has been given to the connection between what are called microscopic growths and contagious and infectious diseases. In Professor Stricker's laboratory in Vienna, especially, attempts have been making to explain different diseases, particularly the infectious ones, by the presence of fungous growths in the blood, and in the secretions and excretions, as well as in the tissues of the body, but with hitherto only negative results. In the blood of syphilitic patients especially it was hoped to find traces of a low grade of organism. Could such once be detected, the discovery would not only have a vast specialistic importance, but would give a positive basis to an assumed theory. Dr. Lörstofer conceived that the negative results were due to low magnifying powers, and to the fact that the experiments had all been made with fresh blood in which such bodies may have existed in a state too minute for detection, and that they might grow to be visible (this very idea of growth, we may remark in passing, being corollary to the very idea underlying the research), if the specimens could be preserved for examination without destroying the organisms. Lörstofer commenced his experiments in August, 1871; and in January, 1872, at a meeting of the Vienna Medical Society, he announced the discovery of a form of corpuscle peculiar to the blood of syphilitic patients, and through which the diagnosis of syphilis might be made by a microscopic examination of the blood.

In specimens properly prepared, in from one to three days, he averred that certain minute bright corpuscles became visi

ble, some immovable, others undulating; in a few days more they grew to the size of true blood corpuscles, of irregular shape, with one or more projections. In a few days longer a vacuola was found in the larger corpuscles, which soon extended over the whole body, and terminated the development of the growth, nor could their shrivelling and further retrograde development be arrested; their relations of causation were not asserted.

While Professors Hebra, Skoda, and Stricker indorsed Lörstofer's statement, and affirmed that they had tested it with almost uniform success, others who had long worked without success in the same direction were not satisfied. Wedl pronounced the bodies described to be nothing but fat cells, and declared that they could be seen a few hours after the preparation was made if water were added to the blood; but as Lörstofer's corpuscles do not acquire a visible size till the fourth day, and disappear at once if water is added, it was argued that Wedl could not have seen them at all, as he had violated Lörstofer's conditions. Professor Stricker here took up the controversy, and Lörstofer himself seems to have been left out of it. Letters from Vienna to the English and American journals stated that the war speedily became outrageously personal and offensive.

Stricker himself forms no opinion as to their true nature; but pronounces them to be formations hitherto unknown in the blood. Meantime a syphilitic patient in whose blood they had been uncommonly numerous began to show signs of phthisis, which drew attention to another point, namely, the possibility of a general ill-nutrition being concerned in their production, and in fact they were at once found in cases of cancer, of tuberculosis, of Bright's disease, and of anæmia after smallpox. The investigation therefore seems to be sufficiently advanced to pronounce the new organisms not exclusively pathognomonic of syphilis, but as existing in the blood in certain cases of defective nutrition from long-lasting chronic diseases, and more particularly from syphilis. As yet there is no warrant for denying their possible existence in the blood of persons suffering from acute diseases, or even in the blood of comparatively healthy subjects.

We have now completed our task upon a plan kept always in

view; commencing with the general and larger relations of medicine, and showing where it would be better to reduce it in study to its clinical phases alone. We have selected the special subjects which best illustrate the latest or the highest methods in diagnosis, in therapeutics, and in pathology, and which were most likely to lend a uniform coloring to the picture. The medicine of to-day aspires to nothing more, and is content with nothing less, than to be the sum and the harmonization of all that can be gathered from observation and all that can be added by induction. It has sometimes been difficult in the sketch to avoid the appearance of marshalling before the reader a parade of imposing generalities; it was not always easy to escape from tiring him with burdensome details. And the success may lag behind the aspiration. Be that as it may, enough if only he, to whom nothing that is human is foreign, shall any more clearly discern the spirit that controls the science of modern medicine, or any more wisely distinguish the forces that direct its art.

W. O. JOHNSON, M. D.

ART. II. ARTHUR SCHOPENHAUER AND HIS PESSIMISTIC

PHILOSOPHY.

WE often hear people complain of the abstruseness of philosophy, and it may be no fault of theirs if philosophy remains unintelligible to them. But then, there are many other abstruse things, celestial mechanics, for instance. Yet those who could not understand a single line of Laplace's work never think of denying the truth of mathematics, or the usefulness of astronomical induction, or the legitimacy even of astronomical speculation. This shows at once that the popular dread of philosophy cannot be due to what philosophy has in common with mathematics, namely, an abstruse terminology. Such a superficial difficulty would be as easily overcome in the one case as it is in the other, and the many attempts at popularizing philosophy would have been more successful than they have been if this were the only difficulty. Moreover, there is hardly any science