cosmopolitan value, namely, that every factory or industrial establishment which employs more than ten artisans of different ages and sexes should have a physician attached to it, and that this physician should yearly furnish an accurate report as to the children and women employed in the factory, and as to the general state of health prevailing therein. It is to be hoped that a clause to this effect is embodied in the new Danish "Factories Act."-June 16th, 1873.

REPORT ON PATHOLOGY AND PRINCIPLES AND PRACTICE OF MEDICINE.

BY FRANCIS C. WEBB, M.D., F.L.S.,

Member of the Royal College of Physicians, Physician to the Great Northern Hospital.

On Microscopic Appearances in Inflammation, and the Origin of PusCells.-The controversy between Stricker and Cohnheim, and their followers, on the question whether, as Cohnheim maintains, pus-cells are emigrated white blood-corpuscles, or whether all living cells of tissues can change by division into pus-cells, has occupied much attention, and produced a number of observations both in Europe and America. Cohnheim's view is founded upon his observation that in the mesentery of the living frog, when drawn out of the abdominal cavity and prepared for microscopical examination, large numbers of white corpuscles are to be seen emigrating from the vessels and wandering through the tissues. Virchow maintained that connectivetissue-corpuscles undergo division during the inflammatory process, in order to be transformed into pus-cells. This is denied by Cohnheim, who maintains that the cornea-corpuscles do not change during inflammation of the cornea. He injected anilin into the vessels, and afterwards exciting the cornea, found pus-cells in the inflamed cornea bearing anilin. From his observations he maintains (1) that pus-cells and white blood-cells are not to be distinguished from each other; (2) that the formation of pus-cells from cornea-corpuscles has never been observed; (3) that pus-cells emigrate; (4) they wander into irritated tissue. Stricker, on the other hand, maintains that it is not true that the cornea-corpuscles do not change during the inflammatory process. He states that the stellate cornea-corpuscles, after the cornea has been excited to inflammation, draw back their processes, multiply their nuclei by division, and become amoeboid. Stricker observed the division of such larger cells into smaller ones. Pus-cells and white blood-corpuscles are young cells, and young cells are not to be distinguished from each other, whether they are born of a cornea-cell by division or whether they wander from a vessel. Anilin injected into the blood-vessels has been seen by Stricker and Norris of Philadelphia in the cornea (stellate) cells, therefore the pigment-bearing pus-cells may as well be daughters of the stellate cells as emigrated white blood-corpuscles. Dr. S. Talma (Archiv für Ophthalmogie, xviii vol., 2nd part, Berlin, 1872) has made some

experiments in this difficult subject. He finds that on irritating the
centre of the cornea the opacity which supervenes shows itself at
first at the circumference, and afterwards extends towards the centre.
The cornea so irritated is detached and placed in a concentrated
solution of sugar.
After treatment by this reagent two forms of
cells, differing clearly from each other, may be seen by the microscope.
One is the pus-globule, become spherical, and strongly refracting
light; the other is the fixed cornea-cell, flattened, pale, stellate.
Between these two elements he does not find any having an inter-
mediate character, or which may be considered as a transition from
the one to the other. Talma acknowledges that in an inflamed cornea
treated by chloride of gold transitory forms between the fixed cor-
puscle of the cornea and the pus-globule are found, but he does not
consider that this invalidates the former experiment. On the other
hand, R. v. Pfungen ('Stricker's Medizin Jahrbucher,' 1873, pp. 80—
95), in some experiments carried on under Stricker's direction, arrives
at different results. He produced inflammation of the cornea by passing
a thread of silk through it. Preparations of the inflamed cornea
treated with chloride of gold constantly exhibit an active prolifera-
tion of the fixed cells of the cornea. Six hours after the injury the
fixed cells of the cornea exhibit club-shaped prolongations, which
anastomose with like prolongations from neighbouring cells. Many
of these prolongations are only connected with the cell by a very fine
pedicle--by a sort of filament of protoplasm. The body of the cell
exhibits the characteristic nucleus of the cell of the cornea. At the
end of about twelve hours the body of the cell becomes constricted
and divided into segments, as well as the nucleus, which is replaced
by several elements answering completely to the form of pus-globules,
except in size, which is variable. They are not, therefore, white
globules which have penetrated into the fixed cells of the cornea.
Von Pfungen concludes, therefore, that in inflammation of the cornea
the fixed cells of that tissue proliferate and give birth to nuclear cor-
puscles identical with pus. Similar phenomena occur in corneas
inflamed after section of the fifth pair, with or without destruction of
the Gasserian ganglion. Similar observations were recorded by Straus
and Duval in the Gaz. Méd. de Strasburg,' 1870. Dr. S. H. Chap-
man, of New York, has published some researches on artificially
produced pericarditis which are strongly confirmatory of Stricker's
views. His observations were made in the frog and toad. Pericar-
ditis was induced by opening the pericardium and applying nitrate
of silver to the pericardial sac. On microscopical examination it
was found that at first all cell elements of the tissue became hyper-
trophied; the endothelia and their nuclei, retaining their contours,
grew in area and in thickness, the connective-tissue-cells enlarged, the
vessels and nerves were more readily found than in normal tissue, and
the cilia upon the outer endothelia increased in length and calibre.
On the second day the changes were more marked; the endothelia of
either surface had begun to develope towards the formation of a new
membrane; nuclei of outer endothelia split up; cells show a ten-
dency to divide; nuclei of internal endothelia proliferate by a more

connec

uniform division, enlarge and separate from one another, at the same time the cells have been changing their forms by amoeboid movements. The connective-tissue-cells elongate and their nuclei divide. The vessels and nerves are at least increased in size, if not in number. On the sixth day, in the ground substance, which was multiplied to many times its normal thickness, were scattered free cells of different shapes, resembling pus, the transformed nuclei of tive-tissue-cells and stellate and elongate cells. The appearances of the nerves supported the belief that a new growth was taking place. The endothelia of the outer surface no longer possessed their normal outlines, but were transformed into elongate or spindle-shaped cells. Upon the inner surface the change was even more marked. The amoeboid-like endothelia had divided into innumerable cells of various forms and sizes, varying from that of the pus-cell to several times the size of normal internal endothelia. In a more advanced stage the spindle-shaped cells of the external surface unite with one another, arrange themselves in rows, and form a compact membrane. The cells of the inner surface throw out delicate filaments, which unite with like filaments from neighbouring cells to form a new network of fibres and a new connective tissue. The author thus sums up his investigations:-1. All cell elements of a tissue during inflammation multiply. 2. New formations take place-first, of cells; second, of connective tissue (false membrane); and third, most probably of nerves.-G. Hayem's Revue des Sciences Méd., Avril, 1873.-The American Journ. Med. Sciences, Oct., 1872.

Septicemia.-In December, 1872, M. Davaine brought before the Académie de Médecine the results of some new experiments:-1. One drop of sanious fluid from gangrenous lung, taken from a man who died from pulmonary gangrene in the Hôpital Saint Antoine, was inoculated on a rabbit; there was no result. The blood taken from the heart was inoculated on three rabbits in the dose of one drop, one thousandth of a drop, and one millionth of a drop. The three rabbits died in from one to two days. 2. To a sheep, aged three years, 100 grammes of pork brine were administered daily. It died on the tenth day, having taken one litre. Three rabbits were inoculated with blood from the heart in doses of one tenth of a drop for one, and one millionth for the two others; they died ten and thirteen days after inoculation. 3. On the 28th October blood of a patient suffering from typhoid fever was obtained from the median basilic vein by means of a Pravaz syringe. One thousandth of a drop was inoculated in a rabbit. The rabbit died on November 28th; the patient recovered. Another patient, suffering from typhoid fever in its decline, furnished blood from a pricked finger. Two rabbits inoculated with a thousandth and a millionth of a drop of the blood respectively died in thirteen days. A third patient, suffering from severe typhoid, likewise furnished blood from the finger. Inoculations with a thousandth of a drop of the blood thus obtained, performed after several days' interval, killed several rabbits. Similar experiments with the blood of a fourth patient with typhoid were followed by similar results. A fifth patient, in

the fifteenth day of very grave typhoid, furnished some drops of blood obtained from a small vein. A rabbit, inoculated with a millionth of a drop of this blood, died in about fourteen hours.— Arch. Gén. de Méd., Feb., 1873.

M.

M. Onimus in March, 1873, reported the following experiment to the Société de Biologie:-Having made a sort of filter with dialysis paper, he filled it with putrid blood, or blood taken from a septicæmic rabbit; he then placed it in water. In a very short time the water contained considerable quantities of bacteria-of vibrios; this water injected in different doses into rabbits did not kill them. Onimus, therefore, concludes that in septicemia bacteria are not the cause of the propagation of the putrefaction or of the septic poison. The septicæmic poison is not a dialysable substance. The bacteria formed in the water were not derived from the putrefied blood; they did not traverse the dialysing paper. This, however, does not prove that bacteria have nothing to do with septicemia. It only establishes the fact that bacteria formed in the neighbourhood of a putrid liquid do not convey the septicemic virus.-Gaz. Hebdom. de Médecine et de Chirurgie, March 7th and 14th, 1873.

The following is a summary of Davaine's experiments:-Putrefied blood injected in guinea-pigs and rabbits does not kill more than half of the animals operated on when the quantity injected is less than one drop. But by the injection of a minute portion of the blood of animals that have died of septicemia the toxic power increases, and this in such a degree that blood taken from animals of the twenty-fifth series of experiments is sufficient to kill in the injected dose of one trillionth of a drop. The septicemic poison acquires wonderful power by passing through living organisms. The septicemic virus is gradually destroyed during the putrefaction of the animal that it has killed. Hence the greater danger of a dissecting wound when putrefaction of the body has not set in. Davaine's experiments have been confirmed by Vulpian and Professor H. Bouley. Vulpian finds there is no infarctus in animals that have died of septicemia, and that septicemic blood shows an immense number of bacteria. Stricker has recently performed experiments which confirm, on the whole, Davaine's observations. He found that the malignity of the septic poison is increased with transmission; 0008 cubic centimètre of the blood of the twelfth animal injected was sufficient to kill the thirteenth. Stricker does not confirm the above observation of Onimus that septic matter is not diffusible through membrane. He found that fatally poisonous results were produced by fluid obtained from the blood by dialysis.Bullet. de l'Acad. de Méd., Sept., Dec., 1872, Jan., 1873; and Brown-Séquard's Arch. of Scientific and Practical Med., Feb., 1873; Wiener Allg. Mediz. Zeit., 1873, No. 20.

On the Presence of a very minute Filament, endowed with motion, in the Blood of Patients suffering from Relapsing Fever.-Dr. Otto Obermeier, in 1868, remarked the existence of a parasite in the blood of persons attacked with relapsing fever. The last epidemic, which lasted a year in Berlin, afforded him an opportunity of again

examining the subject. The parasite is in the form of an extremely firm filament, of the thickness of a filament of fibrine, and of the length of from one and a half to six red corpuscles. In the blood of a patient attacked with relapsing fever several were seen in the field of one preparation. As long as it remains fresh very lively movements of two kinds are observed in the filaments. There is first a movement of undulation of the filament itself, and, secondly, there is a movement of locomotion, which is tortuous. The latter movement was observed from one to two hours; the movements of undulation may go on for eight hours. They resemble those of spermatozoa. Hitherto the author has only discovered the filaments during the febrile state, during the crisis or a little time before, never during the remission. Their presence seems peculiar to relapsing fever, but Obermeier does not adventure an opinion as to their signification or their nature.-Centralblatt, No. 10, 1873, and G. Hayem's Revue des Sciences Méd. en France et à l'étranger.

On Fatty Heart.-Cases of fatty degeneration of the heart may be referred to two great classes; the first comprehends those in which the muscular structure is previously diseased, and becomes attacked with fatty degeneration, the cause being some obstacle to the circulation, and it remains localised. In the second class the fatty change is generalised, the muscular structure having been previously healthy and the valves intact. This class comprehends cases of infectious diseases; those from steatogenous poisons; and to this group must be referred those cases of so-called idiopathic fatty degeneration which have generally served as the type in classical descriptions. This latter is distinguished from the two preceding groups by its slower progress, and by the occurrence of portions of tissue in which the disease has advanced farther in the midst of a general uniform degeneration. The papillary muscles are the seat of these more advanced changes. Dr. Ponfick seeks to show that this last-named group itself is not a uniform one, and that under the designation "pure idiopathic fatty degeneration," are comprehended two completely distinct states, which have nothing in common except their final stage-they both terminate in adipose of the myocardium. The first is the senile and plethoric type (the type almost exclusively described), which, side by side with various alterations proper to old age, presents a complex lesion of the whole aortic system-a deforming endarteritis. Cerebral apoplexy by embolism, which is the proximate cause of death, is but a consequence of the disease of the arterial vessels. 2. The anæmic type, in which after death, beyond adipose change, we find no notable lesions except an extreme anæmia of all the organs. This decoloration of the viscera Ponfick believes to be diagnostic. It may be recognised during life by a pallor of the integuments which is only comparable to that produced by great hæmorrhages. This particular form of degeneration is met with principally in persons from twenty to forty years of age, and frequently at the autopsy it is impossible to attribute death to any particular lesion. The little blood contained in the cardiac cavities is liquid or recently coagulated; it is