of the blood, the lymph, pus, and mucous globules, as isolated cells. Vogel and Henle, on the other hand, consider the pus globule as a nucleus; and Valentin holds the same opinion with regard to the blood globule. Dr Martin Barry has even car ried this doctrine so far as to affirm, that the cells from which all the animal tissues are derived, are formed directly from blood globules.

We have thought it necessary to give this short condensed account of the formation and development of cells, which will, perhaps, enable those who may not have studied the subject to follow us more readily. Let us now return to our author. Dr Gerber informs us, that

"The dimensions of the cell germ are different in different mammals, and under different circumstances in the same mammal (from theth to the

th of a line in diameter); and it bears a general relation to the size of the blood globules of the individual. Its specific gravity is always greater, the older it is, and this only declines when it is again dissolved." Pp. 41, 42.

Mr Gulliver, however, remarks on this statement:

"In a series of observations which I made on the pus of various mammiferous animals, there did not appear to be any general relation between the size of the pus and that of the blood corpuscle of the same animal; and in the vicugna and paco which have oval red particles, the pus globules presented no peculiarity, being in form and size like those of many other animals." P. 41.

The consideration of granules, nuclei, and cells, naturally leads to a description of those constituents of the body which contain them in their normal state. Hence the author proceeds to treat of chyle, lymph, and blood, which, under the microscope, present different corpuscles, referrible to one or the other of these groups of bodies. We regret that our limits oblige us to pass over this part of the work, which, however, is replete with interest, but at the same time contains numerous statements which are far from having been confirmed, and ought, in our opinion, to be received with extreme caution.

We regard much that has been written on extravasation and exudation as very interesting; and this portion of the work receives additional value from the numerous notes of Mr Gulliver. We shall endeavour to condense the view held concerning inflammation by several eminent German pathologists; and in doing so, are guided not so much from what is stated by the author, as from the private sources of information which we possess on this subject.

They consider that the effusion of serum, coagulable lymph, ("plastic matter,") and blood, merely depend upon different degrees of distension which the capillary or intermediary vessels may undergo; in other words, that as the walls of these vessels become more thin, they allow denser matters to pass through

VOL. FOR 1842, NO. III.

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them. Thus the thin or serous portion of the blood will traverse the vessels under circumstances which will not admit of an effusion of coagulable lymph; and this again may be exuded when the blood globules, from their size, are retained in the vessels. In short, according to this view, the vessels act as filters, which permit some matters to pass through them, whilst others are retained according as their coats are more or less thick. That other causes, however, come into operation, appears evident to us, on taking into consideration that numerous vessels may be greatly distended by simple congestion, and no effusion of lymph or blood occur; whilst in other cases, where the distension does not appear by any means so great, false membrane is thrown out in great quantities. The general doctrine which prevails on this subject amongst British pathologists-and we consider it the true one-is, that this distension of the capillaries is invariably preceded by some change of a vital nature, either in the blood itself, or in the minute vessels, and sometimes probably in both.1 The result is, a transudation of the fluid or more solid constituents of the blood.

When fibrine becomes effused, as the result of inflammation, into the living textures, it appears to possess a tendency to assume a finely-granular structure. Globules are formed, which have received the name of globules of inflammation or exudation corpuscles; and as these become more and more aggregated together and developed, the effused matter becomes more dense. In the exudations thrown out in closed cavities, vessels now appear, and form a capillary net-work, similar to those found in the intestinal villi, which are indispensable to the repair of the injury and absorption of matters effused.

"When, for instance, inflammation of the shut sacs of the body (the serous and synovial membranes) has exceeded the limits at which resolution is possible, or when it has destroyed all capacity in the part to perform its function, then is this termination, by an exudation of coagulable lymph, the most favourable that can occur, nay, it is the only one that renders a recovery (which, however, is only relative) possible. An organizable deposit has become necessary to the restoration of the part,--and such a deposit is coagulable lymph, projecting into the affected cavity, increase the extent of absorbing surface, become vicarious of the functions of the now incompetent membrane, and remove immediately the serum which has become free, in consequence of the coagulation of the exudation." Pp. 88, 89.

The following is the author's account of union by the first intention and formation of pus :

"Simple incised wounds, made with a clean sharp instrument, heal, by what is called the first intention, in the course of a few days, almost of a few hours, when the wounded surfaces can be brought into apposition without dragging, and the reparative process is suffered to go on undisturbed. In

The best article on this subject that we are acquainted with, is by Dr Alison, in the first volume of Dr Tweedie's Library of Medicine.

this case, the fibrine of the extravasated blood fills up all the smaller accidental hollows in the depth of the wound; cytoblasts are then produced. These are transformed into cells, which acquire a final organization in consonance with that of the parts injured; and the superficies of the wound is repaired. The adjacent edges are united by means of a secondarily produced, firm tissue, universally known by the name of cicatrix.”

"Wounds with a loss of substance, gaping sabre wounds, gun-shot, and other wounds, where a certain degree of bruising attends the solution of continuity, wounds, too, that have been filled with foreign substances, dirt, &c., which must be got rid of before they will cicatrize,-all heal by suppuration. The process in these cases is as follows:—

"After having bled to a greater or less extent, the wound becomes stiff, and painful, and dry; an exudation of the liquor sanguinis is then established from the entire extent of surface, and this goes on incessantly till the injury is repaired. The fibrine, as it coagulates on the raw surface, forms exudation globules, or cytoblasts, many of which cohere in layers, and compose the false membrane that finally invests the entire superficies of the sore. The layers of globules in most immediate contact with the living tissues, become cells, which then undergo further transformation, in accordance with the nature of the structure to be reproduced. Those layers of globules, again, which are most remote from the living parts, become pus globules, and these, mingled with a small quantity of serum, compose true or laudable pus, which, on the one hand, indues and protects the focus of organization, separating the granulating surface, as the surface of a wound in process of repair by suppuration is called, from external agencies, and on the other, forms the soft, mild medium, in which reproduction goes on from the more remote parts towards the centre, and by which foreign substances are detached and removed from the sore."

"Pus.-The exudation globules, which lie beyond the vivifying influence of the surface of the wound, and exposed to the action of external agencies, cannot be expected long to retain their vitality; these globules, therefore, forsaken, as it were, by the organizing principle, begin to degenerate in their organization, and to suffer changes in their chemical constitution; whilst those that continue in immediate contact with the living structures of the body advance in their organization; those globules that are cast loose then die,- -mors vitæ origo.

"On the exudation globules that are free a number of delicate lines, radiating from a centre, are first perceived, which divide their peripheries into from six to eight (seldom more) segments; these lines become more and more distinct, and the capsule appears as if it were torn or cleft, but without separation of parts; in many globules, too, the nucleus now appears to incline to fall into from two to four pieces; the originally reddish-yellow colour of the globules fades, the segments of the envelope and the divisions of the nucleus, which had been linear and sharp in appearance, become rounded off, till they appear like aggregated granules, whilst the pus, now completely formed, acquires a greenish-yellow hue." Pp. 89-91.

It will be observed, that the author ascribes the origin of the pus globule to degenerated exudation corpuscles. In this we think him to be correct, as our own observations have led us to a similar conclusion. But the changes he describes as occurring in the exudation globule itself, preparatory to the transformation into pus, have escaped our notice.

The author now enters into a consideration of the chemical analysis of healthy or laudable pus. This he sometimes calls reproductive pus, and as the corpuscles which compose it generally consist of seven granules, it might be designated the seven

granular pus." He then speaks of the different kinds of false or unhealthy pus. The following are his observations on the fluid of ulcers. (Ichor.)

"In the discharge of sores, true pus corpuscles are only discovered when there are parts of the ulcerated surface upon which healthy exudation and the formation of cytoblasts are proceeding, as means of repairing the breach of continuity. If this be not the case,-if the entire ulcerous surface be in an unhealthy state, then the secreted serum contains ichor corpuscles, with granules in variable quantity; and when the sore is of the phagedenic kind, larger or smaller detached shreds of the structures implicated, in the shape of filaments and fibres, cartilage corpuscles, and the like; occasionally also, oil globules and crystals. This fluid is of very different colours in different cases, and is generally much thinner than good pus. An ill-conditioned or unhealing sore is a wound with a surface incapable of throwing out or organizing plastic lymph, bedewed with an altered serous fluid-ichor, in technical languagedestructive of any exudation that may be produced. This ichor seems even to irritate and cut farther into the tender surface of the wound, and to cause the destruction of the more superficial vessels, which leads to the discharge of small quantities of blood, which is immediately discoloured, and so much changed, that the liquor sanguinis rarely coagulates save in granules, and the blood globules appear variously puffed up or crumpled together, superficially corroded or broken down into irregular pieces. The blood globules, thus altered, are denominated ichor corpuscles; they are very commonly covered with granules loosely or more intimately attached to them; they are probably better studied in the discharge of glanders than in any other, this consisting in great part of them. When the unhealthy surface of a sore is turned into a fresh wound, either by the removal of the surface with the knife, or the destruction of this, together with the discharge, by means of the actual or potential cautery, under otherwise favourable circumstances, reproductive suppuration is established." Pp. 105-107.

The following is his account of the process of granulation and cicatrization.

"With regard to the mode in which exudation takes place, the plastic lymph coagulates as fast as it is thrown out, and in a few minutes composes a layer of unorganized vitreous substance, investing the entire surface of the wound. Half an hour later, this is found transformed into an imperfect epithelium, the wound appears covered with a delicate membrane, made up of exudation corpuscles, arranged side by side, and under the microscope appearing tasselated, or like a piece of pavement formed of polygonal pieces; the nuclei of the several corpuscles are also now perceived, and the new membrane acquires a passing resemblance to the appearances seen in fig. 47. This most immediate layer now becomes transiently true epithelium, whilst the nucleus, at the same time, and under circumstances with the precise nature of which I am not yet fully acquainted, undergoes three different alterations, viz. 1st, it becomes granulated; or, 2d, a clear vesicle is formed on the cytoblast; or, 3d, a nucleolus appears in the nucleus, rounded cells are formed about the exudation corpuscles, and the exudation or cytoblast coverings become cell-coverings, which, were they permanent, would compose a true epithelium. The formation arrived at this stage is already an integral part of the body, where it is evolved, being included within the common boundary of the organism, and participating in its general states and operations. The cytoblasts which are remote from the surface of the wound, in the mean time retrograde; their enveloping membranes crack, and the masses into which they divide become granules, the nucleus farther splits into from two to four granules, and the cytoblast membrane is transformed to a pus membrane, which is now foreign, and felt to be foreign,

to the organism. The pus globules separate and become diffused through the serum; they fall at length into granules, and are gradually removed from the wound, whilst the general mass of pus included within it, from the granulating surface outwards, exhibits the various transition stages from the perfect exudation to the ripe pus globule."

"The cellular layer, which never covers the surface of the wound, as a living organized portion of the body, is competent to carry on the process of transudation and reparation; over and in contact with it a new layer of exudation globules is thrown out, which, undergoing the transformations just described, come in their turn to form a membraniform cellular layer, over which a layer of pus corpuscles is deposited as before, and so the process goes on."

"In the successive evolutions of these cellular laminæ, the newly-formed unite with the older cells to form a continuous cellular substance, which is by and bye converted into various kinds of cicatrix, cellular substance, bone, tendon, &c.; or, at all events, a matter which replaces cellular tissue, bone, tendon, skin, &c." Pp. 112-114.

Our own observations, which have not been few in connection. with the formation of pus, granulations, &c., induce us to place considerable confidence in the author's account of this interesting and important subject. They will probably be regarded as strange and fanciful by some of our readers; yet many of the facts alluded to, are susceptible of ready demonstration. The extracts we have made evince with what zeal the process of inflammation has been examined by German anatomists, and how our knowledge with respect to it has been advanced by means of the microscope. Indeed, these observations, if true, must greatly revolutionize the existing ideas on this subject, and we cannot too earnestly impress on all teachers of medicine and surgery in this country, the necessity of paying proper attention to them, and personally examining into their truth.

The analysis of this work will be continued in our next number.

The Fourth Fasciculus of Anatomical Drawings, selected from the Collection of Morbid Anatomy in the Army Medical Museum of Chatham. Drawn on Stone, by GEORGE H. FORD. Folio. London, 1841.

The Fourth Fasciculus of Anatomical Drawings, from the collection of the Army Medical Museum, is now before us; and we must say, that a more beautiful, and, as far as it extends, a more useful series of illustrations, we have never seen. If we are not much mistaken, these are the best specimens of anatomical drawings on stone which have ever appeared in this country, for boldness and accuracy of outline, management of light and shade, and successful imitation of texture. They exhibit none of that flatness of surface, and chalky appearance, which generally characterize lithographic prints. Colour, the usual remedy in such