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Julii Vogel Icones Histologia Pathologica Tabulæ Histologiam Pathologicam illustrantes viginti sex tabulæ, continentes ccxci figuras, quarum cclxx ad naturam delineatæ sunt. Lipsiæ, 1843.
Erlauterungstafeln zur Pathologischen Histologie mit vorzüglicher Rucksicht auf sein Handbuch der pathologischen Anatomie herausgegeben von Dr. JULIUS VOGEL, ausserordentl. Professor der Medizin in Göttingen. Sechs und zwanzig Tafeln, mit 291 Figuren, wovon 270 nach der Natur gezeichnet sind. 4to. pp. 128. Leipzig, 1843.
The Pathological Anatomy of the Human Body. By JULIUS VOGEL, M. D. Professor of Clinical Medicine at the University of Giessen. Translated from the German, with additions By GEORGE E. DAY, M. A. and L. M. Cantab. Member of the Royal College of Physicians: Physician to the Western General Dispensary; Lecturer on Histology and Animal Chemistry at the Middlesex Hospital Medical School; Member of the Pathological Society of London, and formerly Senior President of the Royal Medical Society of Edinburgh. Illustrated by upwards of one hundred plain and coloured Engravings. 8vo. pp. 587. London, 1847.
In the last volume of the Examiner, (p. 239,) we heralded the advent of the "Icones" of Vogel-the first work on histological pathology that had been issued. The "Pathological Anatomy of the Human Body" by the same author, of which we have before us the translation by Dr. Day, is illustrated by plates taken from the "Icones ;" and is, as the translator remarks—or rather implies the only work in the language that embraces the recent discoveries effected by chemistry and the microscope. It is a treatise on general pathological anatomy; and, we are told, will very shortly be followed by another, devoted to the consideration of pathological changes affecting special organs.
The work consists of an Introduction treating of the relations
of pathological anatomy to the other departments of medical science; and of ten chapters, which consider-I. The abnormal development of gaseous matters-Pneumatoses. II. Abnormal collections of aqueous fluids-Dropsies. III. Pathological relations of the blood. IV. The general relations of pathological epigeneses, [new formations.] V. Special relations of pathological epigeneses. VI. Pathological changes in the physical properties of the tissues and organs of the body. VII. Combinations of morbid elementary changes. VIII. Independent organisms in the human body-Parasites. IX. Congenital modifications of the human body-Malformations. And X. Changes occurring in the body after death-Post-mortem changes.
It is obviously impossible for us, in the space we can assign to this notice, to examine into the views of the author on all these important subjects; but we may refer to a few. Under Pneumatoses he properly remarks, that gas may be developed in the human body partly from food in the act of decomposition in the intestinal canal, and partly from the decomposition of the constituents of the body itself. He has no doubt, too,-nor have we,—that it may be actually secreted by different parts of the frame.
"Thus, Magendie and Girardin assert, that on confining a portion of the intestine of a live dog between two ligatures, in the course of some hours the included portion was found full of air, which escaped with a hissing sound on making an incision.* In the intestinal canal of swine we sometimes meet with considerable accumulations of gas between the layers forming the walls of the bowels. Sir Francis Smitht has described an interesting case of the development of gas in man, which deserves a full notice. He states-"On the 12th of May, 1840, I was consulted by a gentleman, who told me that he often suffered from an enormous development of gas in the stomach, which he discharged by eructation: that he likewise, occasionally, experienced a development of gas from the bladder, and that his skin acted in a similar manner, as he had observed in the bath. On the morning of the 15th, I found my patient in a bath at 79° F.
*Magendie et Girardin; Recherches physiolog. sur les gaz intestin. Paris, 1824. p. 24; Lobstein, Path. Anat. Vol. 1, p. 138. †Dublin Med. Journal, January, 1841. p. 454.
His breast, shoulders, abdomen, and hands, were literally covered with minute bubbles of gas: On being questioned, the attendant at the bath stated that he had never previously witnessed anything of the kind. On removing the hands and arms from the water, the air bubbles disappeared, but gradually returned on again immersing those organs. The bubbles were of the size of a pin's head. On wiping them off, they disappeared, but gradually formed again.
"In opposition to the above observations of Magendie and Girardin, it may be urged that the gas which was developed might probably have arisen from the decomposition of remnants of food in the inclosed portion of intestine, or that the portion of gut becoming distended by peristaltic motion had imbibed air from the peritoneal cavity, or from the adjacent portions of the intestinal canal; and similarly the escape of air from the stomach and urinary bladder, in Smith's case, admits of the same mechanical explanation as has been given in a previous page. Not so, however, the escape of air from the skin: the fact that all bodies, when immersed in water, give off a little entangled air, affords no explanation of the continuous evolution of gas from the skin: neither does the accumulation of air occasionally noticed in the intestinal canal of swine seem to admit either of a mechanical or chemical solution. If we are asked for the particular causes of these developments of gas, I confess I can give no satisfactory reply. No secretion of gases occurs in the human body in a normal condition; for the development of gas in respiration is a purely physico-chemical proceeding, and is in exact accordance with the laws of displacement and diffusion of gases, as has been recently proved by Valentin and Brunner;* and, probably, the same law holds good for the development of gas through the skin. We can only refer to the analogical proceeding in fishes, where we find an actual secretion of gas in the swimming-bladder, and must, for the present, defer all further questions respecting their causes or pathological indications." p. 32.
The most important deviations in the condition of the blood, are described to be as follows:
"1. Its physical and chemical characters may undergo alteration. It may be either thinner or thicker than usual, and its colour may be affected. The blood-corpuscles may appear changed. The proportion of its constituents to each other may be altered, and it may contain matter not normally existing in it, as sugar, free lactic acid, &c.
* Valentin, Lehrb. d. Physiol. d. Menschen, vol. 1, p. 559.
"2. Its quantity may be increased (hyperæmia or polyhæmia) or diminished (anæmia or hypæmia.) This increase or diminution may either be general, extending to the whole organism, or local, and restricted to particular parts of the body.
"3. It may be effused in consequence of laceration of the bloodvessels, into the interstices of the parenchyma of certain organs, or into some of the cavities of the body, constituting extravasation.
"4. The hæmatin may, by a process of decomposition, become dissolved, and then be imbibed by the tissues." p. 59.
The blood also becomes changed by the absorption of ferments and other extraneous matters, by which its character is at times essentially altered; and this, after all, is one of the most important considerations to be borne in mind in regard to the blood as a source of disease, and as suggesting methods of medication in various pathological states now properly esteemed of bloodorigin. The pathological relations of the blood are, however, not easy of appreciation; but, for that very reason, they should be more closely investigated.
From the chapter on Independent organisms in the human body-Parasites-we extract the following in relation to Epiphytes or parasites derived from the vegetable kingdom.
"All the parasitic plants which, up to the present time, have been observed in the human organism, belong to the lowest forms of vegetation-the algae and the fungi. They are all very minute, so that, to the unaided eye, the greater number are totally invisible, and others are only perceptible when accumulated in large masses. In order to recognize their peculiar structure, and thus to arrive at a more accurate diagnosis, the microscope is invariably necessary, and very high powers are often required. They are found either upon exposed surfaces, namely, upon the skin and mucous membranes, or floating in the fluids of the body. I am acquainted with no authentic case in which they have been observed during life in the parenchyma of human organs. Respecting the origin of vegetable parasites, there are the same two different views which have been noticed in relation to the origin of parasites generally. Whilst, for instance, Kützing, who has devoted much of his attention to the lower algæ, maintains, that their origin by repeated spontaneous generation is possible, others limit their origin to the mode by
Phycologia generalis, Leipz. 1843, p. 129, &c.; or his remarks in Erdmann's Journal f. prakt. Chemie, 1837, vol. xii. p. 391.
propagation. Although a positive decision of this disputed question may at present be impossible, it nevertheless appears to me that there are overwhelming reasons in support of the view that they invariably owe their origin to propagation alone. These reasons are chiefly founded upon the researches of Schwann on fermentation, upon similar investigations of Holmholtz, and upon others which Dr. Merklein has abundantly instituted upon this subject, all which show, that under conditions which otherwise prove favourable to the formation of fungi and algæ, these do not present themselves, when the possibility of the transference of uninjured germs is precluded. Moreover, all the parasites hitherto observed increase in enormous ratios by means of germules or spores: the latter are so infinitely numerous, so minute, and maintain their germinating power so tenaciously against the most common external agents, that by means of water and currents of air they certainly become universally diffused, and can, therefore, develop themselves wherever they meet with favourable conditions. That we have hitherto, in most instances, failed to demonstrate the origin of fungi by transference of germs, can be no argument against this mode of propagation; for, even in the most careful examination, certain fungus-spores, whose diameters are sometimes less than the 1000th of a line, may, and indeed always will escape the notice even of the most practised observer. In some cases the transference of parasitic fungi, or of their spores, from one subject to another, becomes facilitated by distinct relations, as immediate contact, &c., as may occur in porrigo, in some forms of impetigo, mentagra, &c. These are the cases which are especially regarded as contagious. In general, however, peculiar conditions appear requisite for the development and increase of the transferred germs-conditions which are in general only realized by pathological relations. It appears, for instance, that the surface upon which they are to develop themselves must in general, if not always, be in a certain state of chemical decomposition (putrefaction or fermentation;) as, indeed, we find that externally to the human and animal organisms, most fungi are developed only on putrefying substances. Experience shows us, that parasitic fungi are especially liable to occur on foul ulcers, and probably only exist on the skin or mucous membrane in the cases where these are furnished with a layer of decomposing exudation. Parasitic plants have so far a diagnostic value, that they indicate that a process of decomposition is going on, however locally circumscribed it may be. Hence it follows that they do not become developed at all spots on which the germs are deposited: their growth indicates a certain morbid disposition. This view
* Müller's Archiv. 1843, p. 453, &c.