tem, but are able to reproduce generation scattered and removed out of the way in to liquids not originally forming part of actual substance of the textures of the the organization from which they are de- living frame can be changed into a degradrived; and, what is of further importance ed form of existence in which, although to the argument, physiological science can the proper powers of constructive activity show also that almost every kind of text-are lost, a lower kind of vital activity is ure of which the organized structures of still retained. Now the most recent and the living body is composed, is capable of perhaps, upon the whole, the most reasonhaving its vital energy diverted from the able notion of the nature of the propagaordinary work of generating vesicles re- tion-germs of infectious diseases is that quired for constructive purposes, to the they are in all the essential particulars of extraordinary work of producing these the same character as vaccine and pusrapidly-multiplying aggregations of bio- corpuscles; minute aggregations of lifeplasm. The little bodies which are thus plasm, primarily derived from the perverproduced are what are termed “ puscles." They are the indispensable base transformed into a new state of vital existpus-cor- sion of ordinary and healthy bioplasm, and of what is known as purulent matter. ence in which restless impulse in self-reWhen these products of disease, the pus-production takes the place of proper co corpuscles, were first detected and observ-structive work; where the same kind of ed, they were described as little "vesicu-action that is so beneficently brought into lar "bodies of a spherical shape, surround-play for a reparative and remedial end in ed by a filmy investment or cell-coat, and the case of the pus-corpuscle and purulent containing within the cell-wall granular matter runs riot, and is enlisted in the substance. It is now, however, well known work of destruction and death. that the pus-corpuscles most ordinarily con There is no difficulty whatever in under seen are merely the dead débris of the liv-standing how disease-germs of this characing and active pus-corpuscle. They are ter can become the potential cause of the aggregations of granules, and of oil-glob- communication of specific disease, and can ules resulting from the disintegration and destruction of living matter and enclosed in a kind of cerement of coagulated albumen that has formed around them. The actually living pus-corpuscle is, like the colourless blood-corpuscle, devoid of all vesicular investment, and a mere naked mass, or aggregation, of life-plasm. But it is an aggregation in which a notable change has been brought about. It is bioplasm which has lost its constructive capacity and energy, and which has acquired in its place a remarkable increase of a lower reproductive power. The constructive force which, in ordinary circumstances, is directed to the development of cells and to structural achievement, is turned to the generating of a countless myriad of incoherent and, so to speak, degraded though still living spherules. It may perhaps be well to remark, in passing, that the object of the conversion of true bioplasm into the pus-globule is a beneficent one. It is principally by means of this degradation of the ordinary state that the hurtful stagnations and coagulations of inflammatory disorders are removed. Masses of adhesive bioplasm, that have clogged some important track of texture and plugged the channels of the blood-stream, are changed into loose and unadherent pus-corpuscles, which are easily find their way from the interior of one living creature into the interior of others of like organization. The inlets and outlets through which bodies of even such fineness as the corpuscular aggregations that have been actually seen by the microscope could pass are practically infinite in number. Dr. Beale states that he has, in favourable circumstances when working with the fiftieth of an inch focus objectglass, distinctly seen corpuscular aggregations in pus with dimensions not exceeding in breadth the hundred thousandth part of an inch, presenting all the distinctive characters of bioplastic life, and throwing off continually subordinate spherules and corpuscular germs that were just, even with those advanced powers of the microscope, upon the margin of invisibility. would have scarcely a fiftieth part of the Even the largest of these aggregations breadth of the blood-corpuscle, and would float about in currents of air, a thousandfold more readily than the minute particles of dust that are carried by the same agency to every nook and cranny of dwellinghouses to be deposited there in constantly accumulating heaps. Dr. Beale, in pursuing the line of thought suggested by the observation of these minute objects, very strikingly remarks that there are probably living creatures of such exquisite most way. tenuity that they can actually climb, with- from it in a too partially reduced and oxyout muscles or limbs, not only through dized state. It is now clearly understood fluids, but even upon the particles of air that in every form of grave disease there itself. Disease-germs, of even such tenuity is a preparation for the outbreak of the as appear to have been traced in the re- more advanced and palpable phase of the searches of Dr. Beale, would ride with the disorder, through the slow, gradual, and utmost facility in the interior of the blood-insidious derangement of the condition of corpuscles. One colourless blood-corpuscle the blood, and consequently also of the could accommodate thousands of the pig-most important textures and organs of the mies in its comparatively vast sphere. frame; and that it is this early stage of Such disease-germs would be easily poured threatening derangement which is most through the actual films of the ultimate within the reach of, and which most calls capillary vessels of the blood-channels into for, the exercise of the physician's controlsurrounding textures, and also into open ling power. On the other hand, it is the and external air-filled space, almost as free- various methods by which disease-germs ly as if they were not imprisoned in any are preserved and perpetuated when they have once been generated in the bodies of The capability of infectious disease to people affected by specific blood-contamibe communicated from an affected to a nation; the means by which they are previously unaffected frame, by the direct raised in mischievous power and virulence passage of material substance from one to as they are in the act of dissemination; the other, is an affair of actual demonstra- and the contrivances by which they may tion when the matter of the vaccine pus- be caught the instant they issue from their tule, or of the pustule of small-pox, is source in diseased organism and destroyed taken upon the point of a lancet and before they can further pursue their banepassed by it through a puncture of the ful career, which it belongs properly to skin into the blood of a vaccinated, or in- the governing department of the State noculated, person. It is almost as mani- to deal with by well-considered sanitary fest that cholera coutagion can be introduced by the use, as a drink, of water containing the excreta of persons who have suffered from choleraic disease. The proof has been made quite as complete in the case of contaminated air by German physiologists, for they have been at the pains to communicate small-pox to sheep by making them breathe through a shirt that had been worn for twelve hours by a man ill with small-pox. regulations. It is certain that diseasegerms continue to live for long periods of time in the natural secretions and moist exudations of living bodies; often almost hybernating for a season, and then reawakening into renewed activity when favourable conditions for their growth and multiplication occur. The contagion of the cattle-plague unquestionably lurks in this way in the milk of the cow. Many kinds of disease-germs even retain their Very commonly a relaxed and weakened potential vitality in water, and some, which - condition of the fine vessels of the organ-have been thrown out from the diseased ized textures, and a lowered power of body in a subdued state of activity for healthy resistance, are coincident with just evil, are roused by external conditions and that depraved condition of the blood which accidental influences into most deadly eninclines to congestion and stagnation in ergy and power. This certainly occurs the capillary channels of the circulation, with the germs of some kinds of infectious and to ready transudation through their fever. But the most remarkable illustrawalls. In such morbidly disposed blood tion of the fact has just been furnished by there is nearly always a deficiency of col- Dr. Burdon Sanderson in a direct experioured corpuscles, and consequently a de- ment. He has taken purulent matter from fective fulfilment of the reducing and oxy- an abscess in the spleen, and in the first dizing processes which are so necessary to instance innoculated the peritoneal cavity the maintenance of blood at the proper of a guinea-pig, and shown that the anistandard of health. In all feverish dis-mal suffers no material harm from the ineases constituents of the blood, which un-noculation. He has then inserted other der the more favourable circumstances of perfect health are rapidly oxydized and thrown out from the system through the eliminating outlets of the lungs, kidneys, digestive canal and skin, are retained in the channels of the circulation unoxydized, or are painfully and imperfectly removed portions of the same matter in the peritoneal cavity of a dog, and after forty-eight hours has taken fluid from that cavity and used it for again innoculating another dog; and deadly disease, closely resembling the worst collapse of cholera and malignant fever, is then found to be produced within six hours. The comparatively harmless | It may thus be accepted as a fact pretty matter is seen to be converted into a most well established by the investigations of virulent and energetic poison by the influ- physiological science that disease-germs, ence of an inflamed living organ exerted potential for infectious work, are living upon it during a couple of days. In seven bodies in the sense in which the colourless distinct experiments Dr. Sanderson found blood corpuscles are so; that is, that they identically the same results. In every case are capable of being generated in the the dog made subject to the secondary in-blood, and fed there out of its ordinary noculation was dying in collapse and with and normal constituents; and also of reterrific spasms at the expiration of six producing and multiplying themselves, and hours. It is also beyond dispute that the of carrying on this process of reproduction contagion of cholera when received into even when they pass from one living body water and exposed for a few hours to the to another. There is, indeed, a distinct hot sun, acquires intensely concentrated school of physiologists with whom these virulence, and that this condition of mis- leading facts weigh with such impressive chievous exaltation is only continued for a force that they incline to assert that wherebrief interval, perhaps such as two or three ever infectious disease of any kind appears, days, and that the distinct states, first of there must have been its own specific exalted morbific power, and then of com- germs already existent to produce its deparative harmlessness, of the infection, are velopment. Dr. Beale's investigations, on marked by the development in the water the other hand, seem to have led him to of different types of microscopic life, which the more comprehensive, and what we alcan be at once distinguished from each most venture to term the more philoother, and may therefore be taken as, the sophic doctrine that disease-germs, of distinctive symbols, on the one hand of whatever kind, can at any time be genimminent danger, and on the other of erated de novo from healthy bioplasm by comparative safety. the mere influence of extraneous circumIt is a very remarkable and obviously an stances, and that infectious diseases may important and practical fact that many again and again break out with a fresh of the most deadly forms of infection- and independent start when specific orgerms, which can remain alive and hurt-ganic and material conditions obtain. fully influential in liquids extraneous to Towards the conclusion of his monograph the living body, and which can even be on "Disease-germs," he says in reference rendered more banefully energetic in such to this point: extraneous menstrua, are nevertheless inert and powerless in healthy human blood, and only come into efficient activity when the blood loses its well-adjusted balance and full perfection. It is also a consideration of the utmost practical moment that most of the disease-germs can be at once and summarily destroyed by special antagonistic agencies, if caught and acted upon as they pass out from the source of their production. Indeed, the most energetic and most actively multiplying corpuscular aggregations of life-plasm are so much the more readily and easily destroyed by antagonistic agencies of this class for the very reason that constitutes their energetic vitality-namely, the absence of investment of formed material around them. The various substances which are termed disinfectants, and which are designedly employed for the destruction of embryo disease-germs, are mostly reagents that are endowed with very considerable powers of reduction and chemical affinity, and that operate all the more certainly when they have to deal with naked and unprotected masses, such as these little organized germs of mischief are held to be. "Without therefore venturing to state positively from what particular kinds of germinal or living matter of the body the germs of contagious disease are actually derived, or attempting to decide definitely whether they come from the very minute bioplasts" (aggregations of bioplasm), “ or from ordinary white blood-corpuscles, or mucus, or epithelial, or other particles, I think I am justified in advancing the doctrine that the germs originate in man's organism, and that they have descended from the normal bioplasm of the body. A careful study of the course and symptoms of the various fevers, which have been prevalent at different periods leads to the suggestion of the probability that from time to time new germs are produced, and that old ones deteriorate and disappear. The new forms may be closely allied to already existing forms and to forms which have existed previously, but nevertheless the results occasioned by their development are so peculiar that we cannot but suppose they are occasioned by a poison of a special kind. It is even possible to discern differences between cases of the same type of contagious fever, which are sufficient to justify us varieties of a species." in arranging them as species of a genus or as The notion, then, which seems to be scribed. consumption. Infectious and consumptive diseases together claim 36 per cent. of those who die, and one death in every eight is due to consumption. gradually making way among physiolo- degradation of the white blood-corpuscle gists and growing into wider acceptance in actually occur, under the observation of the physiological mind, is, that whenever the microscope, as it has been here dea bioplastic constituent of the living body is transformed into what is termed a dis- But there is another group of diseases ease-germ that is, into the material which furuishes yet more telling proof of cause of the transmission of diseased ac- the influence of blood-degradation as an tion to otherwise healthy organization, the immediate cause of life-destroying disorder power of inherent individual vitality is - namely, the group which is known quickened and raised, but that the form under the generic term Consumption. of the resulting organic aggregation is de- This group is of scarcely inferior importgraded and lowered. Living portions of ance in a social and economic sense to the the organization which, under the proper group of Infectious Fevers. It kills yearly provisions of the health-rule, should con- in England and Wales nearly half as many cern themselves with the deliberate and people as all the great variety of infecorderly perfecting of their own construc- tious disorders taken togother, including tion for the accomplishment of some in the list typhus, scarlatina, measles, specific purpose, take in a mad way to small-pox, cholera, diptheria, and whoopmultiplying a restless, unduly energetic, ing-cough. For every 111,000 people who and disorderly progeny, which in no case are carried away by infectious diseases, attain to the intended state of perfection, out of 488,000 who, in round numbers, die and waste their vitality in mere reproduc- annually in England and Wales, 53.000 tion of the lower structural form. Gen- are carried away by consumption; 22.81 eration after generation of fresh aggrega- per cent. of the current death-rate is due tions of living plastic substance is formed, to infectious diseases, and 12.5 per cent. to each successive generation degrading in constructive skill, but quickening in mere reproductive activity more and more, and acquiring, in connexion with the change, the habit, so to speak, of preying upon That consumption, in every form, is and destroying the material substance substantially a result of the living textures which, under happier circumstances, it built up from the elaborated material conwould have supported and renewed. This tained in the blood being of low and deobviously is the exact description of what praved character, instead of having the occurs when purulent matter is formed as a finish of high perfection, is beyond dispute. result of some inflammatory disorganization The fact has been recognized for some of healthy texture. The healthy coherent considerable time, but it has, perhaps, life-plasm is loosened and dissolved into never before been so clearly demonstrated incoherent pus-corpuscles which rapidly and explained as now in a small volume multiply brood after brood. In some other recently printed by Dr. Charles J. B. Wilkinds of transformation and disintegration liams, and entitled "The Nature, Varieof texture resulting from disease, as for ties, and Treatment of Pulmonary Coninstance in what are known as cancerous sumption." The book bears a very modaffections, the corpuscular aggregations re-est aspect, and is of small dimensions, but produced in the process of the transforma- it is the crowning labour of a life-long tion hang more or less together in a con- work of nearly half a century. Dr. Wiltinuous mass, as generation after genera-liams began his investigations in this tion is added to the morbid growth, in- special branch of research under the guidstead of being scattered loosely asunder ance of Laennec, Andral, and Chomel. as they are formed. Dr. Beale is of opin- Thirty-two years ago he was teaching ion that in infectious fevers a similar per- from the chair of the Professor of Mediversion of vital and generative force is cine in University College, that lymph, carried into yet farther development, the pus, and tubercle differed only in the definal products of the progressive degrada- gree of their vitalization, and that they are tion being aggregations of perfected life- essentially the same principle and may plasm of infinite minuteness, but of pro- be continually seen passing into each portionally exalted energy; and he be- other. He now, with the strength which lieves that in some of the most grave and comes from a half century of close obserdeadly forms of peritonneal inflammation, vation and study, re-affirms this statement, which are unquestionably communicated and supports it by an elaborate reference by substantial contact and material trans- to the grounds of his own conviction. He mission, he has seen the process of organic holds that in consumptive disease, the corpuscular aggregations of bioplasm, The degraded bioplasm (phthinoplasm which are used in the construction of the or tubercle), when consumption sets in, is textures of the most important organs of sometimes widely diffused in the form of the body, have not the power of free vital thousands of minute masses like millet movement and plasticity which they ought seeds, and sometimes closely packed in to possess, and that they are, instead, hard. definite spots, and hedged round by firm indolent, and dry. The bioplasm, or life- membrane which tends to shut up the desubstance, becomes what Dr. Williams posit and to hinder its dispersion. In the happily terms "phthinoplasm," that is one case acute and rapidly progressing "bioplasm" in a state of premature waste consumption ensues. In the other the and decay. It will be observed how aptly consumption is of the chronic character the term "phthinoplasm," or "wasting and slow progress. plasm," expresses the state of the plastic textures of the body in the disease which is known as 66 phthisis," the "wasting disease. "In consumption the textures which have been built up from the blood decay even while they live. The " phthinoplasm of Dr. Williams is, of course, identical with the tubercle of older pathologists. Considerable attention has been given by Dr. Williams, and his son Dr. Theodore Williams, to the question of whether consumption is contagious, in the sense in which infectious fevers are so. Some seven years ago a distinguished physiolo gist induced consumption in guinea pigs and rabbits by inserting consumptive tubDr. Williams infers from a large series ercle beneath the skin through punctures of considerations, which he discusses care- made for the purpose. In these experifully and completely in the pages of his ments true tubercle was found in the book, that the great primary cause of the lungs liver, and in other glandular organs, particular blood-deterioration which en- after a few months. Similar experiments genders tubercle and leads to consump- have since been made, and with the same tion, is the depressing and degrading in- result, in France, Germany, and England, fluence of impure air, deficient and im- and physiologists of the Germ-Contagion proper nourishment, and other debilitat- school have claimed the results as proofs ing and exhausting agencies. Accidental of the contagiousness of the disease. On inflammation, especially of the respiratory the other band, an analogous development organs, which are of necessity very amen- of consumption has been also produced by able and open to the power of atmo- using with the same animals for the innocuspheric chill in inclement seasons, not un-lation diseased matter that is not confrequently acts as the first step in the de-sumptive tubercle; and from this it has velopment of the disease, determining the been argued that the production of tubercommencement of the noxious deposit, and cle is in all the instances due to the setting leading to its further dissemination and up of a low form of inflammation which growth. But inflammation alone cannot cau es degradation of blood-plasm, and produce the result unless the depraved not to the contagious communication of blood-condition is there. The depraved tubercle from body to body. Dr. Theoblood-condition, on the other hand, can dore Williams, who is steadily following lead to rapid consumption without any in the track that has been marked out by kind of inflammatory complication. When his father's investigations, and who is inflammation occurs in the unconsumptive formally associated with him in the procondition of the blood, the over plastic duction of this volume, and has taken deposits issuing from the derangement especial pains with the statistical part, pass into the state of pus-corpuscles which very pertinently remarks that if consumpdissolve and distroy the clogged textures, tion were really contagious in the proper but at the same time clear them away, acceptance of that term, the fact would and relieve the oppressed part of the em- have been abundantly proved in the case barrassment. But when inflammation oc- of the Hospital for Consumption at Brompcurs in the consumptive condition of blood, ton, by the extension of the disease there tubercle-deposit is formed out of the de- to attendants; whereas, as an actual fact, ranged plasina, instead of purulent matter, it is found that the occurrence of consump and the deposit continues to clog instead of tending to clear away, and so carries with it the habit of further and progressive destruction, filling and choking up the affected parts with decaying material, and involving them in prolonged, and frequently in fatal disorder. tion in persons connected with the hospital and its administration since its foundation in 1816, has been remarkably rare, and the deaths very few, in proportion vastly below the number of cases of infectious fever found in the staff of any of our fever hospitals, or indeed of any of the |