other. In these latter, the formative power is not sufficiently controlled by the laws of the general system, nor directed, as in ordinary inflammation, to a reparative function, but the new formed product takes on itself an independent vitality. In scrofulous and tubercular formations the formative power is deficient, and the cells which are formed, either remain abortive, or instead of cells, we find the granular corpuscles already described. The cells which many have found, belong most frequently, in our opinion, to original structures mixed up with the tuberclemasses: thus in fig. 4 there is a microscopic representation of lung tubercle, showing the remains of vascular and cellular tissue, mixed with the usual tubercular granules; the cells in fig. 7, from tubercle of the heart, are probably of the same character, and similar to those figured by Scherer, as already stated. We have not been able to discover any essential difference between the microscropic structure of infiltrated tubercle and that of the ordinary tubercle already described. The structure of infiltrated tubercle consists of irregular corpuscles and granules, some epithelial scales mixed with a few exudation corpuscles, and a great number of minute molecules."-P. 53.

If the Microscopic History of Tubercle has been hitherto so barren of available information, much more so, in this respect, is the Chemical, notwithstanding the labours of many eminent analysts. Those, who are interested in tracing the results obtained by successive experimenters, may be gratified with the details in our author's work. We shall content ourselves with giving one extract.

"The results of the chemical analysis of tubercle, and its after-products, of scrofulous bones, &c., although they may not as yet warrant very decisive conclusions, yet furnish some useful information, which will be found to bear upon the patholo gical propositions advanced concerning the essential nature of scrofulous and tubercular affections.

"Thus the large quantity of fat and extractive matters in tubercle, has a direct bearing upon the theory supported by many of the advocates of the use of codliver oil in the treatment of these diseases. The existence of pyin is important, and could we be sure of that of casein in quantity, we might to a certain extent explain the unorganisability of tubercle. But we have never been able to satisfy ourselves that the protein constituent of tubercle, as examined by us, approaches much nearer to casein, than to albumen. Nevertheless, the researches of Preuss, Boudet, Scherer, and others, must be held decisive of the existence, at least, in some cases of casein; although the last-named observer is far from confirming former writers in the statement of a large proportion of tubercle matter being composed of this substance. We have made other examinations for casein than those recorded, and have never been able to detect its presence. Whoever considers the very doubtful power of the tests which we possess, for distinguishing these different substances in the animal body, will be very doubtful of the precise nature of the protein basis of tubercle. Nevertheless, we may perhaps conclude that there is great probability of this protein compound having a certain approach to casein, or at least of a portion of it, exhibiting a tendency to take on the characters of this latter substance."-P. 88.

Chap. II. is entitled, "Humoral Pathology of Scrofula," and is occupied with the examination of the state of the Blood, Bile, Lymph, Chyle, and the Gastric and Urinary Secretions, in this disease. Dr. Glover seems to have bestowed considerable attention upon the hæmatological phenomena of Scrofula; but the results of his experiments have not added much-and indeed we could not expect it-to our information. All that we gather from them is, that there is "an increase in the solids of the serum, and a

1847]

Essential Nature of the Disease.

135

diminution of the blood-globules, which is very nearly the alteration that has been long suspected to exist."*

There is sound truth in the following passage:

Changes in the blood, more subtile than any which can be detected by our analyses, may play a most important part in the phenomena of disease: and as Bredow well remarks, if a peculiar condition of the scrofulous blood could not be proved by chemical or microscopical researches, still it would not necessarily follow that such a state does not exist, but only that the necessary re-agents were not known, and the microscopes employed not sufficiently powerful.""†—P. 97.

Perhaps this will be the most suitable place to notice the opinion of our author as to the Essential Nature, or proximate cause, of Scrofula. The definition of the disease, which he proposes, is to this effect ::--we should premise that the pathognomonic character of Inflammation is declared to be "the occurrence of effusion of blood-plasma with preceding congestion;" whether these phenomena be accompanied with pain, heat, redness and swelling, or not.

"Scrofula is (speaking of the actual diseased process, not of the diathesis, which has been elsewhere described) a peculiar modification of inflammation, whereby the usual, or, as they may be termed, the normal products of this process are not evolved, but instead of them other materials, incapable of passing into the regular cell forms, and which constitute the substance already described under the name of scrofulous or tuberculous matter. The peculiarity of this formation, and the continuance of the scrofulous diathesis are the causes of the characters assumed by the various after-processes which result from the existence of tubercle."-P. 181.

He expands the same idea in the following passage:

"It is probable, that if the effusions in scrofulous and in ordinary inflammation were examined in their primitive state, no difference in anatomical character would be detected. The opinion maintained by Mr Addison, regarding the actual passage of corpuscles from the blood in the process of inflammatory exudation, seems not in accordance with analogy. The probability is in favour of such exudations being composed, in the beginning, of a plastic fluid, in which the different corpuscles characteristic of ordinary inflammatory organisation are afterwards developed. A scrofulous effusion, then, from some deficiency of organic power, of innate susceptibility, does not pass into the higher organised forms. We have, as a result, either a granular mass, destitute altogether of cell forms, or only abortive attempts at cell formation.”—P. 185.

Does all this throw any light upon the real history of Scrofula? Dr. Glover seems to think that it bears upon the question as to the influence of hereditary predisposition to the disease: "If scrofula be merely a

* Dr. Glover hazards a not very probable conjecture, in the following passage:

"We are strongly inclined to suppose that the original states of the blood in Scrofula, and in Gout, may present much similarity; perhaps there may be more fibrin in the blood of gouty patients; and that from a deficiency in assimilative power in the former disease, the excess of albuminous matter is excreted from the blood in the form of tubercle, as already described; whereas in gout, the assimilation is more complete, and the excess of nutriment is manifested in the form of uric acid in the destructive digestion of the tissues; but this is, in great part, hypothetical.”—P. 232.

"Ueber die Scrofelsucht, s. 30."

modification of the inflammatory process arising from a peculiar cachexia, and exhibiting every stage of deviation from the usual standard, we perceive at once how exaggerated are the notions of the excessive power of the hereditary influence, entertained by Lugol."

We regret to observe that Dr. Glover has, with the view of discovering more as to the nature of tuberculous formations, deemed it either necessary or right to repeat Cruvelheir's experiments of trying artificially to induce the disease in animals.

"Among the arguments usually advanced in favour of the production of tubercles by inflammation is the formation of them by artificial means. We have produced them in this way in the rabbit and dog, chiefly in order to examine them by the microscope. The mode of experimenting adopted was by incising the trachea, and injecting a quantity of mercury downward into the lungs. The appearance of the bodies which resulted, the animal being killed at a period of from one to two months after the operation, was not externally unlike that of tubercle; little round whitish masses, more or less agglomerated; and each nodule with a globule of mercury in its centre, around which the exuded matter was formed. Pus existed in some parts around the artificial tubercles; but on examining the broken up bodies by the microscope, although the structure of portions did not appear very different from that of the irregular granules and corpuscles of tubercle, yet the exudation corpuscles were tolerably numerous and those toward the edges of the exudation fully formed. Numerous nucleated cells also were found mixed with the mass; in short, the formation more nearly resembled an ordinary inflammatory product, such as we find in pulmonary hepatization."-P. 196.

So much for the instruction afforded from this (as it seems to us) unwarrantable source.

It is not necessary to do more than only allude to the opinions, or rather mere conjectures, that have been put forth by certain writers as to the changes of the Gastric Juice, Bile, and Chyle in Scrofula. Some have even gone so far as to hold that the immediate cause of the disease is a deficient secretion of the bile! We were a good deal surprised to find that so intelligent a man as our author should express even his qualified assent to such a fanciful doctrine:

"Although we cannot recognise a merely deficient secretion of the fatty principles of the bile as the cause of scrofula, it is not very improbable that these states of the liver and bile are closely connected with the pathology of the disease."-P. 120.

The only thing that calls for notice in the chapter On the Tuberculous Diathesis, is the very just remark of Dr. Glover on the controverted point whether fair or black-haired persons are most subject to scrofula:

"It might have been more satisfactory, if those who have made assertions on this head, as Dr. Alison in Edinburgh, Hufeland in Berlin, Lloyd in London, and Lugol in Paris, had informed us, first-what proportion persons of light complexion bear to those who are dark, in the inhabitants of these places, respectively; and second-whether the relation among people in general holds good in those affected with scrofula, or to what extent it is altered. This is clearly the only mode by which to arrive at a conclusion. If in Edinburgh and Berlin light hair and complexions are more common, and dark people predominate in Paris, it may well happen that the disease is more frequent in persons of one complexion in the two former places, and in those of a different complexion at the other, and yet the opinion of Mr. Lloyd may be correct."-P. 145.

1847]

Mode of Action of Cod-liver Oil and Iodine.

137

In his description of the Comparative Pathology of Scrofula, in the following chapter, Dr. G. quotes chiefly from the elaborate work of Heusinger, reviewed in a recent number (for April last) of this Journal. He might have also consulted with advantage many of the numbers of that clever periodical, the Veterinarian, which seems to have escaped his notice. So much for the Pathology of Scrofula, the consideration of which occupies the first part of the present volume; the second part is devoted to the subject of its Treatment. Unfortunately authors have but little, that is valuable, to tell us upon this head, save in the way of repetition of what their predecessors have already said. We may briefly notice one or two points, which may have the attraction of novelty at least for some of our readers.

As a curious specimen of very fanciful therapeutic speculation, we may point to Ascherson's and Klencke's theories of the action of Cod-liver Oil in scrofulous disease:

"He finds, that when albumen comes in contact with fluid fat, a coagulation takes place in the former, in consequence of which, a sacculated membrane or cell is formed, containing a molecule of the latter. He thus considers that the use of cod-liver oil in scrofula, may consist in its power of enabling, mechanically, the excess of albumen in the blood to be worked up into blood globules. The action of cod-liver oil is, in all probability, as a tonic, from the resinous principle which it contains; by stimulating animal heat; occasionally by acting as an aperient, and also, as a deobstruent, more particularly by increasing the quantity of urine. A more specific power is claimed for it by Klencke, who makes its usefulness to be owing to its supplying the deficiency of the fatty principles of the bile, which, according to him, are not excreted in sufficient quantity in scrofula, but remain in the organ, constituting the fatty liver so often found in this disease."*-P. 244.

The modus operandi of Iodine is thus attempted to be explained by Dr. Glover:

"When we consider the probable connexion of the secondary digestion of the tissues of which the principles of the urine are the chief results, with the state of the blood and the respiration, we may understand the important part which the use of a remedy like iodine may play in the treatment of such a disease as scrofula: 1st. In quickening the powers of absorption and getting rid of the effused albumen, (and tubercular is composed chiefly of albumen,) where this is not in such a form as to preclude all action of the kind; and 2nd, in removing the excess of albuminous substance in the blood. Again, we deem it by no means an improbable supposition that the chief seats of the formation of urea, may be in the lymphatic glands of the general system. This substance is not formed in the kidneys, as we know by the experiment of Prevost and Dumas. Now, is it not very probable that the lymphatic glands may play such a part on fluids absorbed from the digestion of the tissues, as there is reason to attribute to those of the mesentery and others in the course of the chyle, upon this fluid ?"-P. 257.

* We read of the following highly philosophic and most instructive (!) experiment by one of these German theorists:

"Klencke shaved two dogs, and subjected them to frictions of the oil; after three weeks of this treatment the animals were killed, and the bile contained as much fat, the chyle as many corpuscles with nuclei, the animal was in general in as good condition, as if he had taken the oil internally."-P. 274.

"Dr. Prout attributes the urea of the urine to the transformation of the

Medical chemists come in for a gentle rebuke in the following passage; premising that our author has, with much show of reasoning, pointed out that there is a marked analogy between Chlorine, Iodine, and Bromine, and their respective salts, in their action upon the system.

"Since the first discovery of iodine in the mineral waters of Piedmont, by M. Cantu, and the almost constant detection of this substance, or bromine, in every mineral water containing a large quantity of chlorides, in which the research has been undertaken; a ludicrous degree of importance has been attached to the existence of minute quantities of bromine and iodine in waters known to be highly charged with the alkaline and earthy muriates; as if such difference existed between the activity of chlorides, bromides, and iodides, as that a proportion of 11th of bromine, and th of iodine, to 189 grains of chloride of sodium, alleged to be found by Mr. West in the Woodhall, (or Iodine!) spa, the water containing at the same time the chlorides of lime and magnesium, could be of such great consequence. But the greatest absurdity is the making bromine and iodine figure in the analyses uncombined, at all; as if these powerful electronegative elements could remain for a single moment in such waters in a free state. According to Mr. West's analysis of this very water, there exists in it a quantity of bicarbonate of soda! Now we believe that bromide of sodium might be used as a condiment instead of the chloride."-P. 271.

In taking leave of Dr. Glover, we feel much pleasure in expressing our opinion that his work reflects credit alike upon him as the author, and upon the Medical Society of London, in having selected it for the Fothergillian prize. It displays excellent scholarship, and an ardent zeal in the pursuit of professional knowledge.

I.

ANIMAL CHEMISTRY, OR CHEMISTRY IN ITS

APPLICATIONS

TO PHYSIOLOGY AND PATHOLOGY. By Baron Liebig. Edited from the Author's Manuscript, by W. Gregory, M.D. F.R.S.E. Third Edition, revised and greatly enlarged. Part I. Octavo, pp. 256. Taylor & Walton, 1846.

II. EXPERIMENTAL RESEARCHES ON THE FOOD OF ANIMALS, AND THE FATTENING OF CATTLE : WITH REMARKS ON THE FOOD OF MAN. By Robert Dundas Thomson, M.D. 12mo. pp. 200. Longman, 1846.

THE publications of Baron Liebig have constituted an æra in chemical science. Long a laborious cultivator in this field of research, his investigations were little known, even to the professional public of this country,

gelatinous tissues, and the uric acid to the metamorphosis of the albuminous constituents of the body; but this is manifestly erroneous, on account of the small proportion which uric acid bears to urea in the urine, while the albuminous tissues far exceed the gelatinous. It is also opposed to the views of Liebig, who considers urea to be the ultimate stage of the transformation, and itself arising from a change produced upon the uric acid."-P. 7.