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organization is produced in the gemmation of the polypes, which we know to result from some of the causes which give rise to inflammation in the higher animals. Does not inflammatory new production answer to an abortive gemmation ? Especially does this appear when we extend our consideration to the case of repair, for between the gemmation of a hydra when wounded, and the granulation of a wound in man, is there not an obvious parallel ?
Nor can I pass from this subject without again adverting to the phenomena of embryonic development. When we see one portion of the germ deliquescing and other portions developing, as if at their expense, can we avoid recognising in it a similarity to that which is the essential part in inflammation? Is it not as if
, in inflammation, the system, under the pressure of adverse circumstances, threw itself back, as it were, upon the mode of existence proper to the embryo? As if, to retain as much as possible of perfectness under conditions threatening to destroy it, the law of its first formation came again into operation? The process which develops the life of the germ comes in to remedy defect of life in the completed animal. Not, indeed, by any special alteration of the laws of its being, but by the operation of the universal conditions of organic exist
For the processes of life in gerin and adult are the same; different to our imperfect view they may appear, but the essential identity is made manifest in disease. The generation of life from death, organization from decay, striking to sense in germ-life and in inflammation-life, is patent to the reason equally in the life of maturity and health. It is the law of life. No new thing is presented to us in inflammation. The embry onic powers come forth in disease to meet the hostile agencies, only because they are at work unseen in all the operations of the vital force.*
And if inflammation be thus parallel to the processes of health, no less may its relation be seen to other morbid conditions. Of these it may suffice to select for the comparison the class of tumours. Differing in all other respects, these two diseases appear to possess in common but the one element of increased formation, yet, if what has been advanced respecting inflammation be well grounded, it affords a sufficient basis for the establishment of an intimate connexion between them. For if the increased formation in inflammation has its origin in increased decomposition, the same, it would appear, must be the case with tumours. Let it only be granted that such an origin is possible, and the evidence in favour of it is abundant. If all the known causes of adventitious growths be analysed, they will be found to correspond very closely to those of inflammation. They are causes of irritation, things that operate antagonistically to the vital power. Whether local or general, they have this character in common. How often the development of a tumour follows a blow, for example. It has indeed been frequently remarked that it appears almost a matter of accident whether a given injury shall produce an inflammation or a tumour. All the evidence, therefore, which assigns an antivital starting point for inflammation, applies with equal force to tumours. Nor does the increased formation in the one case furnish any opposing evidence that would not bear equally upon the other. The distinction, then, between tumours and inflammation is not that the one disease is primarily of the formative process, the other of the decomposition. In this respect they do but appear to differ. They are both increased formation, due to increased decomposition; that is, to a diminution of the control maintained in the living state over the chemical affinities existing in the body. But they differ in the extent and intensity of this decomposing process ; in inflammation it amounts to a true destruction, in part, of the vital condition, with a giving off of force to the inorganic world; in tumours it produces only an increased local activity of the organizing process. So far these affections resemble each other; they have this dynamical correspondence.
But into other questions relating to tumours, of course I do not enter. A condition that appears like a gradation between inflammation properly so called, and the growth of a tumour, may be seen in the increased formation of bone from chronic inflammation.*
* Dr. W. Aldison bas observed the resemblance of the morphological conditions in inflammation to those of the embryonic state. (On Healthy and Diseased Structure, &c.) 'If it should occur to any one as an objection to this view, that by inflammation the vital integrity is lowered and not elevated, it will be sufficient to remind him that an injury to, and loss of, the vital integrity, is the sole occasion of inflammation. The inflammatory action seldom or never wholly repairs this loss, but its tendency is in that direction. Such repair is its object, its final canse or use in respect to the organic body. 'A man is not ill because he has an intlammation, but he has an inflammation because he is ill or injured. In reference to this view of the subject I have been greatly benefited by the perusal of an unpublished paper, entitled The Philosophy of Disease.'
It remains to consider the particular symptoms and terminations of inflammation, in 80 far as they bear upon the view suggested of its nature. But of these it is not necessary to speak at length. For, in the first place, the insufficiency of microscopic observations to furnish any clue to the essential character of the inflammatory process has been proved, and indeed admitted, long ago. Opposite theories dispose of them equally well, and the most minute investigations respecting them do plainly leave us entirely in the dark. In truth, these phenomena are to be interpreted by a sound theory derived from other and more appropriate facts, and not the theory to be framed on suppositions about the meaning of these phenomena. Very important and suggestive it is to know the particulars respecting contraction or dilatation of the arteries, the stasis of the blood, the aggregation of the corpuscles, and the nervous or other conditions associated with these, when we know to what essential changes, as respects the forces concerned in the life of the organism, they are to be referred. But we may gaze on such appearances for ever, and remain merely in blind wonder, or blinder theories of mechanical obstruction, paralysis, or mysteriously altered qualities. This is but a caricature of science.
And it is also undesirable to say much about these local phenomena, because we know so little. It is almost impossible to attempt to explain them without assumptions which go beyond our knowledge, and therefore, without creating hypotheses which are neither necessary nor useful. To me it seems sufficient to say at present that, under given circumstances, such conditions of the vessels and the blood have been observed. The facts must be valuable, but as yet they are not available for use. This, however, we know, that neither any state of the vessels
, nor of the nervous system, can be primary or even essential elements in the inflammatory process. For a condition identical with inflammation occurs in plants. What else is the “ increased formation” occasioned by the deposition in them of the larvæ of insects? The same cause which in the leaves of plants occasions swelling, hardness, and excessive formation of abnormal structure, produces in the animal textures heat, redness, swelling, pain, and the formation in excess of lowly organized tissue. Would it not be unreasonable to refuse to recognise identity of condition! In the plant, then, we see inflammation in its purest and simplest. form, and so understand at once the secondary part which must belong to any changes affecting the specifically animal structures.
But if the conditions of the circulation be of little moment in respect to the essential nature of inflammation, they are of the greatest importance in respect to its progress and terminations. Constriction or dilatation of the vessels, stagnation or altered qualities of the blood, merely consequences though they be of dynamical changes wholly independent of them, may nevertheless be the chief agents in determining
the course and results of the inflammatory process. The accumulation and stagnation of the blood in a part may be a cause of sloughing or of gangrene; its excess
, with or without co-existent alterations in its quality, may prevent the restoration of the normal vitality, or may give rise to effusions of various kinds. So it may become a matter practically of the utmost importance, to control or remove the accumulation of blood in an inflamed organ. The issue of life or death may depend on it. But these therapeutical questions are so far distinct from that which has been the subject of this paper, that they are better treated independently. I would remark only, that if inflammation be, as I have sought to show, a twofold process of increased decomposition and increased formation, having its source in a diminution of the vital control over the coerced chemical affinities in the living textures, a general conception of the appropriate treatment is easily dedu cible therefrom. If it be possible, let the vital power be restored, and the suspended control reinstated; all our efforts should be directed most strenuously to this end, to prevent or diminish that failure of the vital tension from which the active symptoms of inflammation spring. But if this be not possible, then let the resulting changes be so
• As indicative of the close connexion which has been felt to exist between inflammation and tumours, I may refer to Mr. Simon's representation of malignant disease as an excretory procesema "new secretion," we might say, the very conception which has suggested itself so strongly in respect to inflammation.
regulated as may be best adapted to conserve at once the sufferer's general strength and the integrity of the affected organ. If the action be threatening from its violence, let those means be adopted which check decomposition or divert the flow of blood. But ever and above all, let two things be remembered : first, that the process of inflammation, as it meets our view, is not wholly an evil; that the formative process in it is the witness of, and the remedy for, an injury to the system unseen and too often unthought of by us. If we could reinove all these symptoms, there would still remain that condition which has necessitated them; a worse evil, a more serious disease, in combating which we should have deprived ourselves of our only ally, in having set aside Nature's only remedy. There would still remain that diminution and loss of vital power which no art of ours could then supply; a death in life from which we might well shrink in impotent dismáy. Let it be remembered ever, that where the cause of intlammation in failing vitality exists, there inflammation will be. No power of ours can prevent it, nor could it be anything but most disastrons if it did. All her resources, all her life, will Nature pour into the gulf of a local inflammation rather than suffer the deteriorated organ to fail of its support. The quick sympathy compels all the living powers to that work, and sooner should the veins be drained of blood, and the most vital functions droop and fail, than the weakened member not receive its larger share.
And secondly : In cases of constitutional inflammation the morbid condition of the system is a cause continually operating to produce that lowered vitality on which the symptoms of inflammation depend, and the removal of that diseased state is the means whereby those symptoms must be averted.
In conclusion I remark that inflammation is rightly enough represented as an altered nutrition. I have endeavoured not to controvert this view, but only to add somewhat to its definiteness and value. As a formative or vital process, dependent on a decomposing or chemical one, it corresponds to the clearest conception of nutrition that we can gather from the phenomena of life in all its forms. Inflammation is the same process that constitutes all nutrition, but taking place under conditions other than those which are natural to, or best for, the individual organism in which it is excited. As an • abnormal nutrition, it not only is illustrated by the other phenomena of life, but serves also to illustrate them. The process of nutrition receives elucidation from the comparison as well as gives it. For that which is found to be the essential character of inflammation, must be not less essentially the character of nutrition. This is perhaps the chief advantage that results from the establishment of the parallel between them, that all the knowledge which is obtained by a study of the phenomena of intlammation, more definite and susceptible of rigorous investigation as they are, may receive a direct application to the more extensive and difficult problem of nutrition.
Chronicle of Medical Science.
HALF-YEARLY REPORT ON PHYSIOLOGY.
BY HERMANN WEBER, M.D.
I. GENERAL PHYSIOLOGY.
BROWN-SÉQUARD: Laros relative to the Dynamic Phenomena of the Animal Economy.
(Brown-Séquard's Journal de la Physiologie, tome i. p. 7. 1858. Browy-SÉQUARD places in front of his new Journal of Physiology a series of observations regarding various functions and phenomena of the animal economy, which he designates as physiological “laws." Some of these, as the author himself states, have been pointed out alrealy by other physiologists. The twelve observations published in the present number may be comprised in the following general law :-The energy of the faculty possessed by animal tissues to produce nervous action, muscular contraction, the discharge of the galvanic apparatus of fishes, the galvanic current of certain organs, and several other dynamic phenomena, appears to be in direct proportion to the normal reparative process, and in inverse proportion to the energy and duration of the existence of these phenomena.
II. FOOD AND DIGESTION. 1. HAMMOND: Experimental Researches relative to the Nutritive Value and Physiological
Effects of Albumen, Starch, and Gum, when exclusively used as Food. (Philadelphia,
1857.) 2. Cogvisart: On the Digestion of Azotized Substances by the Pancreatic Juice. (L'Union
Mélicale, vol. xii., No. 21, 1856.) 3. Bérard and Colin: On the Effects of the Extirpation of the Pancreas. (L'Union Médi.
cale, vol. xii., No. 8, 1858.) Hammond performed on himself, with great self-denial, a series of experiments on the nutritive value of albumen, starch, and gum. He commenced with ascertaining the usual condition of his system, and of the several excretions under the influence of mixed diet, and afterwards subjected himself
, retaining in other respects the same manner of living, exclusively to one of the articles of food above named. The researches on the effect of albumen were continued during ten days. The author's conclusions are: 1. That albumen may be assimilated into the system in such quantity as to furnish a sufficiency both of nitrogen and carbon to the organism; 2. That under the use of an exclusively albuminous diet, the nitrogenous constituents of the orine are increased over the ordinary average amount, though not in proportion to the quantity of albumen absorbed into the circulation ; 3. That either some other means than the urine exist for the elimination of nitrogen from the system, or the excess (over two-thirds) is retained in the organism, even when the body is rapidly decreasing in weight; 4. That the continued use of albumen increases the proportion of this substance (and of fibriu) in the blood, and in a short time causes it to appear in the urine; 6. That while pure albumen cannot be regarded as of itself adequate to supply the several wants of the system, there is no reason why, when associated with suitable inorganic matters, it should not sapport both life and health. With regard to starch, employed likewise during ten days, Hammond arrived at the following inferences: 1. It can be assimilated in more than suficient quantity to sustain the respiratory function; 2. Under its use the nitrogenous
constituents of the urine are much reduced in amount, even below what would probably occur during inanition, and although starch is not capable of nourishing the tissues, it is yet serviceable, apart from its heat-producing power, in retarding their destructive metamorphosis; 3. The continued use of highly amylaceous food causes the appearance of suga r in the urine; 4. Un ler such diet the nitrogenous constituents of the blood are diminished, and the carbonaceous increased. The experiments with gum were continued only during four days, as the feeling of hunger, debility, febrile excitement, and abdominal pain became at the end of that time so great, that a change of diet was imperative. The author concludes : 1. That gum is altogether incapable of assimilation, and therefore possesses no calorifacient or nutritive power whatever, but is, on the contrary, a source of irritation to the digestive organs; 2. That, therefore, the solids of the urine are entirely derived from the waste of the tissues of the body, and the carbon exhaled from the lungs from the consumption of its fat.
Corvisart has continued his researches on the action of the pancreatic jnice on azotized substances. In addition to the results previously related, * the author states that the quantity of albuminose (peptone) formed by the process of digestion, from a certain quantity of proteinaceous food, varies much according to the quality used; that, for instance, albumen yields only half of the amount which casein yields.
Bérard and Colin having extirpated the pancreas of a considerable number of animals of various families, draw from their experiments the inference that in herbivorous ruminants, in carnivorous animals, in the pig, which is omnivorous, and in birds, the pancreatic fluid is not necessary either for the digestion or for the absorption of fatty materials.
III. BLOOD, RESPIRATION, ANIMAL HEAT. 1. HEIDENHAIN: On the Physiology of the Blood. (Archiv f. Phys. Heilkunde; Jahrgang,
1857, p. 507. 2. Brown-SÉQUARD: Experimental Researches on the Physiological Properties of the Red
and Dark Blood. (Journ. de la Physiol., vol. i., p. 95 and 353. 1858.) 3. BERNARD: On the Varieties in the Colour of the Venous Blood of Glandular Organs,
according to their state of functional activity or rest. (Journ. de la Physiol., vol. i.,
p. 283. 1858.) 4. BROWN-SÉQUARD: On the Modification of the Blood-globules of Mammalia in the Blood
vessels of Birds, and of the Blood-globules of Birds in the Blood-vessels of Mammalia,
(Journ. de la Physiol., vol. i., p. 173. 1858.) 5. HAMMOND: On the Injection of Urea and other Substances into the Blood. (North Ame
rican Medico-Obir. Review, vol. ii. p. 287, 1858.) 6. AUBERT and Tschischwitz: Experiments on the Arrest of Action of the Diaphragm, &c.
(See sub. v.) 7. Ludwig and SPIESS : Comparison of the Warmth of the Saliva of the Submaxillary Gland
and Blood of the Carotid. (Sitzungsbericht der Wiener Akademie, Iuliheft, 1857.) 8. MARTINS : On the Temperature of the Palmipedes of the North of Europe. (Joum. de
la Physiol., vol. i., p. 10, 1858.) 9. Brown-SÉQUARD: Note on the Temperature of some Longipennate Palmipedes. (Jour. de
la Physiol., l. c., p. 42.) Heidenhain employed Welcker's methodt in calculating the total amount of blood in severa species of mammalia. After having exposed the fallacies of the other methods, he discuses the preference and also the disadvantages of Welcker's method, for which discussion we mus refer to the essay itself. According to the author's experiments, the quantity of blood bear to weight of body in rabbits, as the mean of six cases, the proportion of 1 : 18:13, the mini mum being 1: 20-78, the maximum 1: 14.92; in dogs, as the mean of five cases, the propoi tion of 1: 13.53, the minimum being 1: 15.09, the maximum 1: 12.33; in a fat guinea-pig weighing 676.5 grm., the proportion was 1: 25.01. If we compare these figures with thos given by Valentin-viz. 1: 4:50 for dogs and 1: 6.20 for rabbits, the difference is certainl very striking; they are, however, much more in accordance with those obtained by Welcke himselft-viz. 1: 12:5 for mice; 1: 11.8 for a young sparrow; and with that calculated b Bischoff for an adult man in health-viz. 1: 13. It may be further observed that the vari tions in the same species, with regard to the amount of blood, are, according to Weleker
# Cl. this Journal. vol. xxxix.
Conf. this Journal, No. xxxvii., and also Prag. Vierteljahrsschrift, vol. xliv., PP. 11-81, 1884.