DISEASE GERMS
THEIR
REAL NATURE.
i
i
DISEASE GERMS
THEIR
REAL NATURE.
AN ORIGINAL INVESTIGATION.
BY
LIONEL S. BEALE, M.B., F.R.S.,
Fellow of the Royal College of Physicians; Physician to King's College Hospital; and lately Profefsor of Physiology and of General and Morbid Anatomy in King's College , London.
TWENTY-FOUR PLATES CONTAINING MANY COLOURED ILLUSTRATIONS.
LONDON:
J. CHURCHILL & SONS, NEW BURLINGTON STREET.
1870.
[All Rights Reserved.]
SI SOTS
1
HARRISON AND SONS,
PRINTERS IN ORDINARY TO HER MAJESTY, ST. martin’s LANE.
6z f*
24 t, SX
TO
THE RADCLIFFE TRUSTEES,
WILLIAM STRATFORD DUGDALE, Esq.,
THE RIGHT HON. T. H. S. B. E. SOTHERON-ESTCOURT, THE RIGHT HON. W. E. GLADSTONE, M.P.,
HIS GRACE THE DUKE OF MARLBOROUGH, K.G.,
AND TO THEIR LIBRARIAN,
HENRY W. ACLAND, M.D., LL.D., F.R.S.,
THIS WORK
IS RESPECTFULLY DEDICATED.
PREFACE.
The conclusions concerning the nature of disease germs, now published for the first time in a connected form, were briefly sketched in the lectures I delivered at Oxford in 1868-9, by direction of the Radcliffe Trustees, ^nd have been taught by me for many years past. Some of the facts will be found recorded in my Report on the Cattle Plague in 1866, and in several memoirs and works published as early as 1863.
The illustrations in the present volume are in advance of any yet published by me. By printing in three colours, very accurate copies of the specimens, prepared by the process of investigation I have long adopted, have been obtained. Although less clear and elaborate, and far less beautiful than the originals, the figures in the last few plates of this book really give with great accuracy the appearances of the speci- mens themselves. Although the result obtained may perhaps be scarcely considered commensurate with the time and labour expended I feel sufficiently en- couraged to make further efforts in the same direction.
The time has now arrived when, I think, without impropriety, I may ask scientific observers, and the
PREFACE.
viii
public interested in those branches of scientific inves- tigation which I have now for many years prosecuted, to calmly examine for themselves the actual work which has been done, and not to allow their judgment to be unduly influenced against the conclusions arrived at, either by the circumstance that my researches have not been acknowledged by some scientific writers, or because my views have been very cursorily, and per- haps disparagingly noticed.
It sometimes happens that a leader of opinion, though professing to give the public in a manner the most disinterested and ingenuous, an impartial view of the general state of knowledge in a particular de- partment of research, is led away by his enthusiasm, and perhaps almost unconsciously proclaims and ad- vocates the tenets of his own particular belief ; or, without intending it, constitutes himself the mouth- piece of a faction.
However damaging it may be td the interests of science, and however fatal to every other view, there is some excuse for such a course, for the main objects of a party, which has already agreed upon its principles, must necessarily be to force into notoriety, and make the utmost of those arguments which support the particular dogma to which its members have committed themselves, to the exclu- sion of every other idea. Observations which happen to be opposed to the prevailing propaganda must be ignored or disparaged, or put down by the force of
PREFACE.
IX
authority. The individual opinion of a member must yield to the interests or necessities of the party to which he belongs, but he who desires to serve the interests of science and hopes to extend the bounds of natural knowledge, should endeavour to preserve his individuality, defend liberty of opinion, and strive to retain complete independence of thought and action.
November , 1870.
L. S. B.
TABLE OF CONTENTS.
BIOPLASM AND ITS DEGRADATION.
Bioplasm...
Degradation in power ...
Bioplasm of man and animals in health Bioplasm of amoebae Bioplasm of bacteria, ...
Vital movements of bioplasm ...
Bioplasm of mucus ...
Embryonic bioplasm ... ...
Blood-bioplasts or white blood-corpuscles ...
Bioplasm of the tissues of the adult ...
From health to disease... ...
The pus bioplast derived from the germinal matter of all the
tissues ... ... ... 3°
Of retrogression in formative power ... ... 31
Bioplasm of epithelium... ... ... ... ... ... ... 34
Multiplication of blood-bioplasts in disease ... ... ... ... 37
New observations on the growth and multiplication of pus ... 42
On the movements occurring in ordinary living pus ... ... 44
Death and decomposition of pus ... ... ... ... ... 46
DISEASE GERMS IN ANIMAL FLUIDS AND
SECRETIONS.
Germs in fluids and secretions 48
Simple exudation ... ... ... ... ... ... ... 50
Lymph capable of producing a poisoned wound ... ... ... 55
Pus of purulent ophthalmia and gonorrhoeal pus ... ... ... 59
Germs in vaccine lymph ... ... ... ... ... ... 60
Germs of small-pox ... .. ... ... ... ... ... 64
Disease germs of fever ... ... ... ... ... 64
Syphilitic disease germs ... 65
Living disease germs in secretions ... ... ... ... ... 67
PAGE
• 7
. 12 . 12
• 14 . 14
• 17 . 18
• 19 . 26 . 27
TABLE OF CONTENTS.
xii
PAGE
Living tubercle germs ... '■ 68
Cancer germs 69
INTRODUCTION OF DISEASE GERMS INTO THE BODY AND OF THEIR ESCAPE.
Disease germs in air, water, and food ... ... 72
On detecting disease germs in the air... .. ... ... ... 77
Mode of Entrance of Germs.
Of the passage of disease germs into the blood ... ... ... 80
State of vessels favouring the entrance of disease germs ... ... 84
Of the presence of disease germs in the capillaries ... ... ... 89
State of blood favourable to the multiplication of disease germs^ ... 92
Obstruction of the capillary circulation ... ... ... ... 94
Destruction of the vessels and tissues... ... ... ... ... 97
Multiplication of the disease germs in the infected organism ... 103 Concerning the possibility of disease germs passing into the sub- stance of normal living bioplasm ... ... ... ... 107
Escape of Disease Germs from the Infected Organism.
On elimination ... ... ... ... ... ... ... ... 115
The passage of disease germs through the vessels * ... ... ... 129
The constant phenomena of fever and inflammation ... ... 130
The manner in which disease germs may occasion death ... ... 138
Of the manner in which an organism may be “protected” from
other attacks of the same contagious disease ... ... ... 141
OF THE NATURE OF THE CONTAGIOUS DISEASE GERM.
Contagious disease germs not parasites ... ... ... ... 148
Nature of contagious disease germs ... ... ... ... ..-IS1
No difference to be detected in the appearance of different kinds of
living matter ... ... ... ... ... ... ••• 162
Disease germs may long remain dormant though alive 164
On the origin of disease germs 167
TABLE OF CONTENTS
PLATES.
PAGE
Plate I. — Fig. I. Bioplasm of bacterium. Figs. 2 and 3. Bio- plasm of amoebae. Figs. 4 and 5. Bioplasm of mucus ... 16
Plate II. — Fig. 6. ^Growing extremities of placental tuft. Fig. 7.
Capillary vessels opening into small vein ; Pia mater ... .... 20
Plate III. — Fig. 8. Capillary vessels and small vein from tbe
turtle’s ovum, at an early period of development ... ... 22
Plate IV, - — Fig. 9. Capillary vessels ; Frog’s mesentery. Fig. 10,
Vessels, muscular fibres and nerves ; Bladder frog ... ... 24
Plate V. — Fig. 11. Deep layer of the cuticle; Newt Fig. 12. Superficial layer ; Cuticle newt. Fig. 13. Cartilage rib ;
Kitten at birth. Fig. 14. Cartilage rib cat 26
Plate VL — Fig. 15. — Epithelium from pharynx ; Sore throat Fig. 16. Mucus cells from bronchial tubes of a cow, cattle plague. Fig. 17, Cancer cells ... ... ... ... ... 36
Plate VII. — Fig. 18. Epithelium of the tongue in a state of in- flammation. Fig. 19. Formation of pus in epithelial cells of the mouth. Fig. 2Q. Division of bioplasm in cells of bladder
epithelium ... * ... .... .... ... ... 38
Plate VIII. — Fig. 21, Portion of the pectoral muscle frog, 48
hours after being perforated by a thread ... . ., . 40
Plate IX. — Fig. 22, Portion of pectoral muscle frog, 96 hours
after being perforated by a thread ... ... ... ... 42
Plate X. — Fig. 23. Portion of pectoral muscle frog, 168 hours after being perforated. Fig. 24. Vein and capillary branches ;
Web of frog after inflammation has been set up by mustard ... 44
Plate XI.- — Fig. 25. Pus bioplasts from a case of chronic inflam- mation of bladder. Fig. 26. Portion of a living pus corpuscle from the bladder, very highly magnified. Fig. 27. Portion of a dead pus bioplast from the bladder. Fig. 27'“. Different forms assumed by a minute mass of bioplasm from the bladder during five seconds ... .... ... ... ... ... 46
XIV
TABLE OF CONTENTS.
PAGE
Plate XII. — Fig. 28. Red and white blood-corpuscles in a drop of blood from the finger. Fig. 29. Minute particles of bioplasm from exudation. Fig. 30. White blood corpuscles and fibrin from a pale clot, human subject. Fig. 31. Capillary vessel with numerous masses of bioplasm in its walls .. . ... ... 52
Plate XIII. — Fig. 32. Vallisneria spiralis, showing large and small cells. Fig. 33. Altered blood bioplast from the finger.
Fig. 34. Lymph corpuscles from a vaccine vesicle. Fig. 35.
Part of a cell in vallisneria showing minute bioplasts which move round the cell, with other contents ... ... ... 54
Plate XIV. — Fig. 36. Bioplasts and bacteria in vaginal mucus, cow, cattle plague. Fig. 37. Bioplasts from small-pox vesicle.
Fig. 38. Blood from intestinal capillaries, cattle plague. Fig.
39. Particles from vaccine lymph. Fig. 40. Bioplasts from a small vein. Fig. 41. White and red blood-corpuscles, cattle plague ... ... ... ... ... ... ... ... 64
Plate XV. — Fig. 42. Bioplasts in milk, cattle plague. Fig. 43. Bioplasts and fungi in mucus, frgm vagina, cattle plague.
Fig. 44. Smallest masses of bioplasm in milk, cattle plague.
Fig. 45. Cancer cells from a case of cancer of bladder. Fig.
46. Tubercle in coats of a small artery ; Pia mater ... ... 68
Plate XVI. — Figs. 47 — 51. Dr. Maddox’s apparatus for collecting
germ and solid particles suspended in the atmosphere 78
Plate XVII. — Figs. 52 — 54. Vertical sections through mucous membrane of small intestines in cases of cholera. Fig. 55. Vessel with bulgings, consequent upon obstruction from a villus, cholera. Fig. 56. Cell-like mass, villus, cholera. Figs.
57 — 59. Villi and Lieberkuhn’s follicles, in cases of cholera ... 100 Plate XVIII. — Fig. 60. Summit of a villus, Jejunam, cholera.
Fig. 61. Part of summit#of villus, cholera ; Impervious capil- laries. Fig. 62. Altered capillaries of villus, cholera... ... 102 Plate XIX. — Fig. 63. Summit of a villus, Jejunam cholera ; Shrunken and wasted vessels. Fig. 64. Summit of villus, nearly healthy. Fig. 65. Capillary vessels containing pigment, granules and oil globules. Fig. 66. Capillaries and bodies external to the vessel, cholera. Fig. 67. Vessel from villus,
cholera 102
Plate XX. — Fig. 68. Mucous membrane of fourth stomach, cattle plague ; Vessels injected with Prussian blue. Fig. 69. Portion
PL A TES.
xv
PAGE
of a vessel from fig. 68, more highly magnified. Fig. 70. Capillary vessels from surface of a villus, containing bioplasts.
Fig. 71. Capillary loop from malpighian body (injected with Prussian blue) containing bioplasts ... ... ... ... 104
Plate XXI. — Fig. 72. Fat vesicles invaded by bioplasts. Fig.
73. Loops of vessels from eruption of cattle plague. Fig. 74. Capillary from surface of a villus, cattle plague ... ... 104
Plate XXII. — Fig. 75. Section of pustule from eruption, cattle plague. Fig. 76. Fibrous tissue of the corium from the pustule (fig- 75)- Fig. 77. .The fibrous tissue (fig. 76) more highly magnified. Fig. 78. Particles of contagious bioplasm. Fig.
79. Capillary retina, calf, cattle plague. Fig. 80. Bioplasts from villus, cattle plague ... ... ... ... ... ... 104
Plate XXIII. — Fig. 81. Vertical section of skin, cattle plague ; Vessels blue, showing papillae covered with their epithelium.
Fig. 82. Papillae beneath eruption, cattle plague. Fig. 83. Plan to show how contagious bioplasm may pass from the blood and reach the parallel layers of cuticular cells. Fig. 84. Young cuticular cells and masses of bioplasm. Fig. 85. Minute sporules of fungi, from superficial cells of cuticle ; Near erup- tion, cattle plague. Fig. 86. Cuticular cells under scab, cattle
plague 130
Plate XXIV. — Fig. 87. Connective tissue corpuscles healthy.
Fig. 88. Enlarged connective tissue corpuscles, cattle plague.
Fig. 89. Capillary from mucous membrane, fourth stomach, cattle plague, injected with Prussian blue. Fig. 90. Small artery, with large mass of bioplasm obstructing its cavity, in- jected with Prussian blue... ... ... ... ... ... 134
Dr. Lewis’s Observations on Haulier’s Cholera Fungus.
Since the remarks on pp, 152 — 156 were printed, I have received from Calcutta, through the kindness of the author, a copy of the “ Report on the Microscopic Objects found in Cholera Evacuations, &c.,’* by Assistant-Surgeon Lewis, M.B., attached to the Sanitary Commissioner with the Government of India. By a series of most care- ful microscopic investigations it is proved for once and for all, that Hallier’s views on cholera are erroneous. His cholera fungus is not peculiar to cholera stools. Dr. Lewis’s Report is illustrated by nearly a hundred very careful drawings, exhibiting points of great interest and importance. Everyone studying the subject of disease germs should see this Report. Some of the questions referred to in the first part of my work are considered with great care, and several of the conclusions at which I have arrived receive support from Dr. Lewis’s observations. To the correctness of his drawings, and remarks upon Bennett’s and Pouchet’s statements (p. 48 of Dr. Lewis’s Report), I can bear testi- mony. See also p. 56 of “Disease Germs, their Supposed Nature.” [Nov. 8th, 1870.3
Concerning Magnifying Powers.
In order that some idea may be formed of «the degree of magnifying power of the one-fiftieth, of an inch object glass, lately made for me by Messrs. Powell and Lealand, it may be stated, that if it were possible to see a human hair in its entire width under this power, it would appear to be nearly one foot in diameter, and an object an inch in height would be made to appear 250 feet high.
CORRECTION.
P. 55, insert at the beginning of the fifth line from bottom the words “in which.”
DISEASE GERMS:
THEIR
REAL NATURE.
MONG the most fatal diseases from which man and the higher animals suffer are those which are called contagious or infectious. These depend upon a poison, which, having entered the body, grows and multiplies there in a marvellous manner peculiar to matter which is alive. The living poison may be introduced into our bodies in the air we breathe, in the water we drink, or in the food we eat, and may possibly also gain access to us by the pores of the skin, or even by penetrating through the cuticle itself. No care on our part will insure us against invasion ; but, though surrounded by infection, and living among contagious disease germs, it is by no means certain that we shall be attacked, indeed the probabilities of escape are very great. We might wear water-proof coats and water-tight boots, cover the head with mackintosh, protect the nostrils and mouth with a cotton wool respirator, and grease or varnish every particle of skin exposed, and, in spite of II. B
2
Z YMO TIC DISEASES.
all these precautions, the living germs might enter our bodies, grow and multiply there to our detriment, and perhaps destroy us ; while a friend who took no such pains to protect himself, and may have been for hours exposed to the infected air, might escape altogether, and enjoy perfect health though surrounded by con- tagion on every side !
We shall have to consider in another part of this work what circumstances probably increase our lia- bility to attack, and by what means we may improve our chance of escape.
The diseases in question are known a.sZymotic(Zvfirj9 a ferment, leaven), but under this head have been also included affections due to malaria, maladies resulting from changes in the food, and diseases depending upon the introduction into the body of living parasitic animal or vegetable organisms. This classification is not altogether satisfactory, because diseases induced by the introduction into the organism of bodies so essentially distinct from one another, as for instance the poison of small-pox, and the tape worm, should scarcely be included in one class. At the same time, when the subject comes to be carefully considered, it must be admitted that there are many difficulties, while the classification in question possesses many practical advantages, and upon the whole has been found to work well. If the conclusions arrived at in this work are accepted, it will not be difficult to separate the fevers and allied diseases from others which are at present
CONTAGIOUS DISEASES.
3
grouped together in the zymotic class, without intro- ducing changes in nomenclature or classification, which might cause inconvenience in practice.
Some of the contagious fevers are among the most terribly fatal maladies which we are called upon to treat, but many of us feel convinced that these of all diseases are the most preventible, for this has been clearly proved by the great success which has already attended measures as yet but imperfectly carried out. Y et year after year, in consequence probably of those who make our laws being ignorant of the facts, and seldom brought face to face with actual cases of disease, little is done to reduce the virulence, or to arrest the spread of these frightful scourges, some of which, as scarlet fever, are almost as fatal to the children of persons in easy circumstances as they are to the children of the classes whose day’s work seldom produces much more than is sufficient for the day’s sustenance, and sometimes less than enough to pre- serve the body in a state fit for work.
The ignorance even of many very intelligent persons concerning the simplest practical requirements for limiting the spread of contagious diseases is deplorable, so that in epidemics the scourge is sometimes fostered and spread by the very persons in charge of the sick, sometimes by the patients being allowed to mix with the healthy and distribute far and wide the germs of disease. Heads of families are not always aware that a child who has .completely recovered from scarlet
B 3
4
MORTALITY FROM
fever and is in fact well, may communicate it to half the children with whom he comes in contact, unless he is placed in quarantine for two months, by which time there is reason to think all the active contagious particles will have died, or will have been removed.
From a return moved for by Mr. W. H. Smith, and printed by order of the House of Commons, we learn that the deaths from zymotic diseases in England and Wales amount to upwards of 111,000 annually, out of a population of under 22,000,000, the total deaths from all causes being under 500,000. Continued fever destroys upwards of 20,000 lives per annum ; scarlet fever alone averages about 18,000 victims, and sometimes destroys 30,000 persons in a single year. The actual numbers are given in the accompanying
|
table, which has been |
calculated from |
the Registrar |
|
General’s return above |
referred to. |
|
|
Fve years, |
Average |
|
|
1864 to 1868, |
for |
|
|
inclusive. |
one year. |
|
|
Estimated population |
21,210,431 |
|
|
Total deaths |
487,765 |
|
|
Diarrhoea and Cholera |
125,828 |
25,165 |
|
Fever |
100,807 |
20,161 |
|
.Scarlet fever |
18,659 |
|
|
Hooping cough |
54,077 |
10,815 |
|
Measles |
9,208 |
|
|
Small-pox |
4,337 |
|
|
Diphtheria |
3,644 |
|
|
Other zymotic diseases |
97,127 |
19,425 |
|
Total Zymotic diseases |
557,090 |
111,418 |
Being 22 '84 per cent, of the total deaths.
Z YMO TIC DISEASE.
5
It would be too much to say that this frightful mortality represents the deaths from preventible diseases, but there can be little doubt that good sani- tary regulations, combined with cleanliness and tem- perance upon the part of the people, would save at least 100,000 lives annually in England and Wales alone. But this eminently practical part of the sub- ject has been well considered by others far better qualified for the task than myself. I therefore pass on to discuss the nature of the material concerned in the spread of contagious diseases. It was shown in the first part of this work that the active substance was not a lowly vegetable organism developed independently of man or the animals subject to disease. We have, therefore, now to enquire what is the material substance which passes from the diseased to the healthy organism in small-pox, in measles, in scarlet fever, and other allied contagious diseases from which man and domestic animals suffer so severely. The material in question grows and multi- plies and produces its kind as all living things do, and as nothing that does not live has been proved to be capable of doing. We may therefore conclude that it is living matter. But it has been already shown that it is not a vegetable organism. What then is its nature ? The arguments advanced against a vegetable germ theory of disease do not perhaps apply to some Other forms of a germ theory, one of which will be considered.
6
Z YMO TIC DISEASE.
In order to make the conclusions at which I have arrived intelligible, it will be necessary for me in the first place to direct the readers attention to some of the most important changes which occur in the living matter or bioplasm of the healthy tissues.
BIOPLASM AND ITS DEGRADATION.
Those marvellous progressive changes which occur during the development of the embryo, while the structures which characterise the organism are being evolved, are still but very imperfectly understood. We know, indeed, that all the complex tissues and organs of man and the higher animals are dependent for their production upon changes occurring in a minute mass of perfectly colourless living matter, in which no indications of form or structure can be dis^ cerned, but how these changes are brought about we have not yet been able to ascertain ; nor is it con- veying much information to the student if the teacher informs him that the perfect organism, with all its marvellous apparatus, existed “ potentially ” in the little colourless living embryonic particle, since it would be impossible to distinguish the particle which was»rto develop a highly elaborate mechanism from that which was to produce a simple amoeba, as its highest developmental product. Hence, while it can- not be said that the structures evolved “ existed ” in the original mass of living matter it will not make the assertion more correct if it be qualified by the term " potentially,’’ All we know is that such and such structures result, but we know this from seeing them, not from a priori reasoning. For the characters and
8
BIOPLASM.
composition of the living matter do not enable us to premise anything whatever as to its formative pro- perties.
In the formation of man and the higher vertebrata the primary mass of bioplasm or living matter absorbs nutriment, and grows, and then divides and subdivides into numerous masses, which are arranged in a defi- nite manner, but what determines this is not known. From each of these in pre-ordained order, and with perfect regularity, more are produced, no doubt, ac- cording to “ laws,” but laws about which we know nothing, except that if physical, they are very different from any physical laws yet discovered. As this pro- cess of division goes on, the resulting masses produce various substances, some having wonderful structure and properties. But the power of each series to pro- duce these peculiar materials, which did not exist before, and which cannot be extracted from the food supplied, differs from that of the series which pre- ceded it, and so on until the complex structural basis of the organism is as it were laid down.
There are developed masses of bioplasm to form nerve, others to produce muscle, others glands, and so on, all of which have been derived from one common mass, but the bioplasm destined to take part in the development of a gland will, under no circumstances, produce muscle or nerve.
And yet with all this marvellous difference in power, which if not acquired is at any rate manifested
FORMA TION OF OR CAMS.
9
as development advances, there is, as far as is known, no difference in matter which will account for the result. The nerve or muscle producing bioplasm is, as far as can be ascertained, the exact counterpart of the gland or bone forming bioplasm, and why one produces one tissue and the other a very different tissue cannot be explained ; all these different forms of bioplasm have descended from one, which may be regarded as the parental mass, but in regular, definite, and pre-arranged order ; so that if from any circum- stance the bioplasm which is to form a gland or other organ, or a member, is not produced, and does not occupy its proper place at the right period of develop- mental progress, that gland, organ , or member will be wanting in the particular organism.
The manifestation of power or property to form special parts with special functions proceeds in regular order, progressively in one direction only as the germ advances towards the particular perfect form it is to attain. The power once lost can never be regained, although life may continue to be manifested never- theless, and perhaps more actively than before. If the particles of bioplasm which were to take part in the development, say of the brain, do not receive at the proper period a supply of the right kind, or the proper proportion of nourishment ; a well-developed healthy brain cannot in that case be formed. The particles may waste and die, or they may grow for a time and then cease to progress further; or they may
IO
BIOPLASM.
grow, and live, and multiply, and form a great mass of matter, which however will never produce a brain or an organ capable of performing the functions which the brain was designed to discharge. They may multiply fast, and take up more nourishment than the brain cells would have appropriated, had they been formed, but the organ with its marvellously complex intricate structure, which for its formation requires gradually progressive changes, steadily pro- ceeding during a length of time, will never be pro- duced ; and under no circumstances conceivable could any of these masses, or any of their descendants, develop one perfect brain cell. If progress towards the mature state be stopped at any point the perfect state of development can never be reached, and the organism if developed must be imperfect. The de- velopment of other complex organs may have pro- ceeded with perfect regularity, but the organism must ever remain incomplete in structure, and incapable of performing all the functions it might have dis- charged.
But although developmental power may be lost for ever, power of a different kind may be acquired pari passu during the rapid multiplication of bioplasm. Progressive advance in the capacity to form lasting structures and elaborate organs is characterised by the comparatively slow but regular and orderly growth and multiplication of bioplasm. Rapid mub tiplication, gn the other hand, involves degradation
DEGRAD A TION IN PO WER.
II
in formative power, which is at length entirely lost, never to be reacquired.
Degradation in power is commonly associated with increased rate of growth, increased faculty of resisting adverse conditions, and, in some cases, with such remarkable vitality of the living matter that it takes up more than the nourishment which should be appro- priated by healthy parts. Consequently these last are at length starved and deteriorated or are completely destroyed. Nay, the actively living degraded bioplasm may retain its vitality although removed altogether and for some time from the living body, and it may grow and at length destroy other living organisms to which it gains access.
It is the main object of this work to show that a disease germ is probably a particle of living matter derived by direct descent from the living matter of man’s organism, and I propose to give a sketch of some of the most important facts which have led me to adopt this view. The inquiry is of great interest, and affects the question of the nature of the material concerned in the propagation of contagious diseases. I shall also indicate how our views of treatment and more particularly how our efforts to extirpate the poison of contagious diseases and to prevent its pro- duction, will be influenced by the conclusions arrived at. In the first place I shall refer to the mode of multiplication of the bioplasm of man in health, and then endeavour to trace its degradation until a form
12
BIOPLASM
of bioplasm destructive of healthy life and capable of infinite multiplication results.
Bioplasm of Animals and Man in Health.
Bioplasm of Amoeba. — Among the lower, simplest living forms known are some very simple organisms consisting apparently of transparent structureless semifluid material. Seldom indeed as much as the toV o °f an inch ’m diameter, they vary much in size down to particles of extreme minuteness and tenuity only just visible under the highest power yet made, equalling about 5,000 diameters. These masses, apparently composed almost entirely of living matter, can move in any part, and in any direction (Figs. 2, 3, plate I.). Portions of the seemingly viscid or semi- fluid material may protrude in advance of the rest of the mass, and coming in contact with protrusions from other parts, join these, and thus may result a ring or a series of rings. The protrusion may be withdrawn and the whole assume the appearance of a perfectly smooth globular mass.
Such naked masses of living bioplasm or germinal matter may apply themselves to foreign bodies, and if these are small, completely invest them, so that the latter are at length seen in the interior of the mass embedded in its very substance. It is in this way that these simple forms of life are capable of effecting the solution of certain substances, and afterwards ap-
IN HEALTH.
13
propriating them as nutrient materials. They increase in number in a very simple manner. If one of the protrusions above referred to be detached, artificially or by accident, a new and independent organism results. So long as a pedicle remains between the two, though it be so thin as to be only just visible, the diverticulum may be withdrawn, and the whole form one single spherical mass of living, growing, moving matter. But if the communication be once completely severed two separate beings result, and these can never again be incorporated so as to form but one.
Any one can study for himself the most im- portant of the highly interesting phenomena which have been observed in these wonderful and simple organisms. Amoebae can be readily obtained from water which has been left for a few days in a warm light room. Their growth can be watched from day to day, and their movements can be seen without difficulty. With the aid of high powers it will be found that the moving material is clear, transparent, and as far as we are able to discover, destitute of structure , exhibiting no appearance which could be reasonably supposed to be due to the presence of “ molecular” or any kind of “ machinery.” It ap- pears like homogeneous matter of syrupy consistence which moves in all directions. No one has been able to offer anything like an explanation of these move- ments although every one can see and study them without difficulty. Authorities have expressed them-
I4
BIOPLASM OF BACTERIA.
selves as if they had been able to give a full and sufficient explanation of the phenomenon, but there is nothing in their statements to justify the confidence which they seem to repose in the correctness of their views. The cause of these movements is unknown, if it is not unknowable. An attempt has been made to delineate the appearance of the moving matter in question in Plate I., fig. 3, which was examined under a power of 5,000 diameters. The difference in the shading indicates changes in thickness resulting from the movement.
Bioplasm of Bacteria. — If a large bacterium be • crushed, the very simply living matter may sometimes be expressed from the envelope without injury, and may be seen to exhibit vital move7nents , while in the field of the microscope, Fig. 1. The progressional movements of many of the simplest organisms are effected by the bioplasm of their bodies protruding through the pores in their investing membrane or shell, by currents in the fluid caused by the movement of the living matter, and by the action of this same self-moving living material upon processes of the envelope or other passive organs composed of formed material project- ing from different parts of the surface.
Vital Movements of Bioplasm. — These movements, which take place in every kind of bioplasm, or living matter, and which are to be observed so easily in the amoeba, were formerly supposed to be peculiar to this organism. When it was discovered that the same
MOVEMENTS OF BIOPLASM.
15
sort of motion was to be observed in the case of many of the lower forms of life and in the white blood cor- puscle, it was spoken of as amcebiform or amoeboid ’ as if the movements in question were connected with some mechanism or action peculiar to the amoeba and the lowest forms of life. And even now the formation of “ amoeboid corpuscles ” is spoken of as if it were some very special and exceptional phenomenon. The movement is, however, characteristic of the whole living world ; but it is strictly confined to living beings, and nothing like it has been shown to occur in non-living matter. In man and the higher animals it is not always possible to see the movements of the bioplasm, for a very slight change in the circumstances under which life is carried on may cause its death ; but in some cases, and these not a few, they may be seen in the living matter taken from man’s organism, and from animals, both in health and also in the diseased state. See Plates XI., XIII., figs. 25, 26, fig. 33, pp. 46, 54.
As I have endeavoured to show, these movements are invariably limited to living matter (bioplasm). I have called this movement vital and have endeavoured to show that it is distinct from muscular contractility , and from every other kind of movement known. The vital movements of bioplasm vary remarkably in activity, and the same kind of living matter may move quickly or slowly according as the surrounding conditions change. Living particles transport -them-
i6
BIOPLASM OF LIVING
selves from place to place ; they may insinuate them- selves through the narrowest apertures, or creep through very minute fissures and channels. They may climb through water, and there is even reason to think they may move upwards through perfectly still air by virtue of their capacity for vital movement. The division and subdivision of living matter, and hence the multiplication of living beings, are among the results of vital movements. These vital move- ments too are the cause of many phenomena which are characteristic of man and the higher animals. That is, a chain of changes, each being a consequence of an antecedent change, may be traced backwards until at last we arrive at the movements occurring in the living matter, beyond which we can- not go ; for we cannot ascertain the cause of these movements, although we know it must be closely related to life itself, for life cannot be conceived of without movement. The growth and multiplication of disease germs, their introduction into the body, their passage into the blood, and their subsequent wanderings, are intimately connected with their capacity for vital movement. Their formation I shall endeavour to prove is associated with greatly increased activity of vital movements, and the undue nutrition of certain forms of the bioplasm of the organism. In order to render intelligible to the reader the grounds of my views, it will be necessary in the first place to offer some general remarks concerning the nature and
PLATE I.
BIOPLASM OF BACTERIUM, AMCEBA, AND MUCUS.
Fig.' 1.
Bioplasm or living matter from a crushedbacterium showing the changes in form which occurred during a few seconds, x 1900. p. 14.
Fig. 2.
Mucus from the trachea during life, magnified 700 diameters, p. 17.
One of the living mucus corpuscles represented in Fig. 4, magnified by the = 2800 diameters, showing alterations in form during one minute, p. 17.
io.uoo^ of an inch. —
x '/OO linear, x 2800, x 5000.
1370:
[To face page 16.
L. S. B.]
MATTER OF MUCUS.
17
growth of the bioplasm of the higher animals and man.
The Living Matter or Bioplasm of Mucus. — If a little mucus which collects commonly enough upon the soft mucous membrane of the air passages be examined upon a warm glass slide, with the aid of a power magnifying 700 diameters, or upwards, little oval masses of germinal matter not unlike amoebae will be seen in great numbers embedded in the viscid transparent material which gives to the mucus its properties, and which has been formed by the par- ticles of the bioplasm, Fig. 4, plate I.
By attentive examination movements will be ob- served in many of these masses, not unlike those above described in the case of the amoeba. Fig. 5 represents the changes in form in a living mucus corpuscle under a power of 2,800. If the distribution of nutriment to the mucus be increased, the bioplasts enlarge, and divide and subdivide until vast numbers result. In some cases of inflammation of the mucous membrane all the viscid matter secreted upon the surface appears to consist of bioplasts ordinarily termed pus corpuscles , while on the other hand the proportion of formed material which was abundant in ordinary mucus is exceedingly small. The bioplasm has multiplied so fast that there has not been time for the production even of the soft mucus.
Vital movements resembling those which have been described in the amoeba, in the bioplasm of mucus, n. „ C
i8
EMBRYONIC BIOPLASM.
and in white or colourless corpuscles may be seen, but not so easily, in the bioplasm of young epithelial cells, in that of cartilage, the cornea, connective tissue, and other textures, and there can be no doubt whatever that all bioplasm possesses the power of movement, and that by virtue of this power of movement the several masses are able to take up the positions they respectively occupy in all the different tissues which they form, and in the preservation and main- tenance of which, in a state of integrity, they play so highly important a part as long as life lasts.
Embryonic Bioplasm . — The growth and multipli- cation of bioplasm at an early period of development may be studied in an embryo, and many highly import- ant observations may be made if the growing tissues of the chrysalis of the common blow-fly be submitted to examination, especially when they have been suc- cessfully stained by the carmine fluid. A mass of formless bioplasm invariably represents the earliest stage of development of every tissue and organ. The bioplasm, which is concerned in the formation of the special tissues, emanates from this, and in many cases a sort of temporary structure is formed in the first instance in which the development of the higher tissue afterwards takes place. Some suppose that the particles of bioplasm are formed anew , but this is certainly not the case. They have been invariably derived from pre-existing bioplasm. In the forma- tion of the tissues of the imago or perfect insect
WHITE BLOOD CORPUSCLES.
19
during the chrysalis state, each texture is developed anew from bioplasm, but this was derived from the bioplasm of the larva. If one of the growing extre- mities of a foetal tuft of the placenta be examined, it will be found that the material which advances first, which grows away as it were from the tissue which is already formed, is a mass of bioplasm, which is di- vided and subdivided into smaller portions, as repre- sented in Fig. 6, plate II. The loop of vessels gradually increases in the wake of this little collection of living matter which continues to move onwards as long as the placenta continues to grow. These little collections of bioplasm bifurcate, and thus form branches into which vascular loops afterwards pro- ceed. As in every other instance, the first changes are produced by bioplasm ; and by this living matter every kind of growth and development is effected.
White Blood Corpuscles or Blood Bliop lasts. — If a drop of blood be obtained from the finger by pricking it with a needle, and allowed to fall upon a glass slide slightly warmed, covered with thin glass, and carefully pressed, and then examined under a power of 700 dia- meters or upwards, here and there, colourless slightly granular, apparently spherical bodies will be seen amongst multitudes of the well-known red blood- corpuscles. These are the so-called white or colour- less blood-corpuscles (Plate XII, fig. 28). They con- sist of living bioplasm or germinal matter, and exhibit movements like those referred to in the amoeba and
* C 2
20
BLOOD BIOPLASM.
in the mucus corpuscle. The movements continue for many hours after the blood has been withdrawn from the body. The colourless as well as the red blood-corpuscles vary much in size, although they are often represented as if they were of uniform diameter. These bioplasts multiply by giving off little diverti- cula, which become detached, and then grow into complete corpuscles-. In the blood there are, besides the white blood-corpusles, multitudes of minute masses of living matter, probably composed of the same material as the white blood-corpuscles. These were described and figured by me in 1863, and I showed that when the capillary walls became stretched by distension they would escape through little longitudinal rents or fissures into the spaces external to the vessels, where, being freely supplied with nutrient matter, they grew and multiplied, giving rise to the numerous corpuscles seen in this situation in inflammation. These minute particles are indeed the most important constituents of inflammatory exuda- tion, and are the agents by which the important changes occurring in the exudation are effected. They vary much in number in the blood and are very abundant in inflammation.
Whenever the circulation is carried on slowly in any part of the body the colourless or white blood- corpuscles grow and multiply , and at an early period of development, before the heart and lungs are fully formed, the only corpuscles are these white or colourless
PLATE II.
INCREASE OF BIOPLASM.— DEVELOPMENT OF VESSELS AND OTHER
TISSUES.
Eig. 6.
Growing extremities of festal tufts from human placenta, 7th month., x 215 At every extremity is seen a collection of small masses of bioplasm which are. undergoing division. Each collection advances, and the vessels and other structures grow in its wake as it were. The masses of bioplasm of the capillaries and other structures entering into the foimation of the tuft are al*o well seen. 1864. p. 19
Fig. 7.
Capillary vessels opening into a small vein. Pia mater. Human foetus, fifth month of intra- uterine life. The capillaries contain numerous, white blood corpuscles (bioplasm) which are coloured by carmine, and the vein is completely filled with them. Very few red blood corpuscles were present. X 216. p 21.
•jo’iio of an inch x 215*’linear.
L. S. B.] . 1870.
[_To face page 20.
ACCUMULATION IN VESSELS .
21
blood-corpuscles. This important fact may be easily demonstrated if the blood in any of the small vessels of the embryo of a vertebrate animal be examined. A very striking and beautiful example is represented in Fig. 8, plate III, from the ovum of the turtle. The capillaries are seen to be filled with living growing blood bioplasts (white blood-corpuscles) every one of which has been well coloured by carmine fluid, and can therefore be very distinctly seen in the specimen. Only here and there could a red blood- corpuscle be discovered.
In Fig. 7, plate II, I have given a drawing of part of a small vein, with a few capillaries opening into it, from a beautiful specimen of the pia mater> covering the hemispheres of the brain of a human embryo at the fifth month of intra-uterine life. This illustrates the same fact. The little veins were quite filled with blood bioplasts, very few of which had as yet become developed into red blood-corpuscles. In the capillaries represented in this drawing will be seen many very minute bioplasts which have been detached from larger ones and are growing. The bioplasts seen in the capillary interspaces are those which take part in the development of the other textures of which the pia mater is constituted.
In animals which hybernate, or which have been kept inactive in confinement for some time, and in man, under certain circumstances, many of the red blood-corpuscles in the blood-vessels are absorbed,
22
BLOOD BIOPLASTS,
just as they are from a clot formed in any of the smaller vessels, and in some instances from a clot situated external to the vessels, and the living- bio- plasts (white blood-corpuscles) grow and multiply at their expense. After a time, such is the increase of the latter that the capillaries in many tissues are almost entirely occupied by them. This fact is illustrated by Fig. 9, plate IV, which represents very small capillary vessels of the mesentery of the com- mon frog in winter. The vessel is almost choked up with white blood-corpuscles, only one or two red ones remaining in the specimen from which the drawing was taken. Another illustration of this fact is given in Fig. 10, plate IV, which represents some of the capillaries from the bladder of a half-starved frog. The capillaries have much wasted, and contain no red blood-corpuscles whatever, their cavity being entirely occupied by fluid liquor sanguinis and masses of bioplasm, differing much in size, the largest particles having the ordinary dimensions of the white blood- corpuscles, while the smallest are so minute that they cannot be demonstrated under a power magnifying much less than 1,000 diameters. It is remarkable that in this case the white blood-corpuscles are still growing and multiplying, and are, indeed, probably the active agents in the absorption of the tissues. In this specimen taken from the most beautiful and delicate of all the tissues of the frog may also be seen the very fine pale nerve-fibres which I demonstrated
PLATE III.
BLOOD BIOPLASTS, OR, WHITE BLOOD CORPUSCLES IN VESSELS OF EMBRYO.
Fig. 8.
Capillary vessels and small vein from the ovum of the turtle at an early period of development. The vessels were entirely filled with white blood corpuscles, and in some places they were completely distended with them. Developing connective tissue with connective tissue corpuscles, fat cells, and perhaps nerve fibres are also seen. To the right of Lhe drawing at a will be observed a very young capillary, the tube of which is not yet wide enough to allow a blood corpuscle to pass through it. x 215 1864. p. 21
yijj of an inch. x 215 linear.
L. S. B.l
1870.
[To face page 22
THEIR INCREASE HV NUMBER.
23
some years- ago. A fine bundle is seen at a , from which point it may be readily followed, as it divides into finer branches, ramifications of which are seen in every part of the drawing. The bundles of unstriped muscular fibres are marked b, while the bioplasm masses of the connective tissue corpuscles are repre- sented here and there in the intervals.
So far I have endeavoured to show that the masses of germinal matter or bioplasm which are to be found in all parts of the tissues of man and the higher animals at every period of life, and suspended in the nutrient fluids, notwithstanding very remark- able differences in power, exhibit the same general characters as those manifested by the living matter of the lowest animals and plants. In all cases it is the bioplasm only which lives and grows and multi- plies. Moreover, attention has been especially directed to the fact that the rate of growth of the bioplasm varies according to the scarcity or abundance of the nutrient material, and to the rapidity of its access. The bioplasts (white blood- corpuscles) of the blood increase in number, when the fluid in which they are suspended moves slowly as at an early period of life before the propelling apparatus is fully de- veloped, or at any period of life when the circulation is retarded from any cause whatever.
This remarkable growth and multiplication of the blood bioplasts seems to be determined by the altered conditions under which life is carried on without any
24
GROWTH AND MULTIPLICATION
derangement of the health necessarily accompanying the change. The fact of the increase of the white blood-corpuscles in apparently opposite conditions of the system receives a simple explanation. A hyber- nating animal cannot be said to be suffering from disease, but nevertheless the blood in his capillary vessels contains a vastly increased number of bioplasts, and could hardly be distinguished from blood which was stagnating in consequence of something im- peding the circulation — a state of things which would be rightly regarded as disease. In this part of the inquiry we seem indeed to be on the very confines of disease ; in a sort of border-land where the healthy process may so gradually and imperceptibly pass into the morbid process that it would not be possible to draw a distinction in words, nor would the appearances which may be demonstrated by the eye enable us to define with greater exactness the special condition. In fact, up to this point there is no real difference. The state of things I have described, if it continues, and if it leads to other changes, would be considered evidence of disease. If, on the other hand, the circu- lation soon returned to its normal rate, the increased number of white blood-corpuscles in the capillaries would soon pass into the circulation and become lost in the mass of the blood, where they would undergo further changes. There would be no stronger evidence of even a temporary disturbance of the healthy con- dition than was afforded perhaps by some triv.'al
BIO PI AS VI IN BLOOD VESSELS.
PLATE IV.
Fig. 9-
Capillary vessels and connective tissue, and connective tissue corpuscles Mesentery. Frog in winter. The capillaries are filled with numerous white blood corpuscles (bioplasm). Only one or two red blood corpuscles were present. X 215. p. 22.
Fig. 10.
Bladder of a frog which was half starved. The capiVaries are wasting, and contain bioplasm only. No red blood corpuscles could be detected. Bundles of unstnped muscle are seen ramifying over the field Some have fibres radiating in three directions, and the bioplasm of these is triangular b. At a, a bundle of very fine nerve fibres is represented. Its ramifications may be followed over every part of the specimen. The bioplasm of the- connective tissue is also represented. Thus, all the tissues of the thin bladder are demonstrated. X 215. The drawing was taken from a specimen mounted in 1862. X 215, p. 22
1870.
[To face page 21.
L. S. B.]
Tooo
of an inch x 215 linear.
OF BLOOD BIOPLASTS .
25
nervous derangement possibly, giving rise, in the case of man and the higher animals to slight pain, which might soon pass off, or perhaps escape notice altogether.
These blood bioplasts possess formative power of a very remarkable kind even in the adult. Not only are they capable of producing fibrin, but they or bioplasts directly descended from them, are capable of forming fibrous tissue which resembles the ordinary fibrous tissue developed in connection with several textures of the body. But, more than this, these bioplasts, poured out from the vessels suspended in fluid exudation, or their descendants growing and multiplying upon a surface wound of the skin or a mucous membrane may produce cuticular cells or the epithlial particles of a mucous membrane, not perhaps quite so perfect and well formed as those developed in situ , but nevertheless efficient as a protecting covering. The varied power of forming tissue pos- sessed by these bioplasts is perhaps due to the circumstance that they have inherited formative powers from1 the bioplasts of the germinal area at an early period of development, for it must be remembered that the ancestral white blood-corpuscles from which all have directly descended, were developed at a time anterior to that when the various bioplasts taking part in the formation of the tissues diverged from their common progenitor. So that formative power of a more general character than is possessed by the
26
BIOPLASM OF TISSUES.
bioplasts of the tissues might be expected to belong to the blood bioplasts. And in the case of some of the lower animals which exhibit the power of reproduction of lost parts and organs, it appears very probable that the agents directly concerned in the development of these are bodies resembling the blood bioplasts ; and that from them result masses of bioplasm which take part in the formation of the several tissues of which the new member is constituted.
Bioplasm of the Tissues of the A dult. — As the tissues are formed by the conversion of the outer part of each bioplasm mass into the formed material or tissue, the distance by which the several masses of bioplasm are separated from one another becomes greater. This important fact may be demonstrated in almost any tissue of a young or adult animal. In Figs. 1 1 and 12, plate V, are represented young and fully formed cuticle of the newt from the very same spot of skin. The formed material of the cuticular tissue accumulates around each mass of bioplasm until the well known adult “ cuticular cell” results, Fig. 12.
Again, in Figs. 13 and 14, the appearance of sec- tions of permanent cartilage from the same part of the body is given under a power of 700 diameters. At an early period of development “tissue ” scarcely exists, and all that can be discovered is bioplasm. In young tissue, at all periods of life, the same fact is observed, but as the textures advance towards ma- turity the proportion of bioplasm in a given bulk of
PLATE V.
BIOPLASM OF FULLY FORMED TISSUES.
Fig. 11.
Cuticle. Newt. Deep layer, consist- ing of "bioplasm with, very little foimed material. X 215. p. 26.
Fig. 12.'
Cuticle. Newt. Superficial layer, showing each mass of bioplasm surrounded by its formed material. X 2i5. p. 26
Cartilage rib of kitten at birth, showing large masses o'f bioplasm with very little formed material between them, x 700. p. 26.
Cartilage rib of young cat, showing diminished size of masses of bioplasm and great increase of matrix or formed material of cartilage, x 700.
Fig. 13.
.Fig. 14.
of an inch- x 215 linear.
1870.
[To face page 26.
L. S. B.]
FROM HEALTH TO DISEASE.
27
texture becomes less. Now in disease we shall find that in adult tissues the bioplasm increases, and that the general appearance assumed is that which em- bryonic tissue presents, indeed some “ inflamed ” textures might be mistaken for embryonic tissue.
From Health to Disease.
I have endeavoured to show that the only material in the organisms of living beings capable of growth and multiplication is that which I have recently named bioplasm, hitherto known as germinal or living matter. In fully formed tissues the proportion of this is v.ery small. Still, all active change which takes place in the tissue depends upon this living matter, however little there may be. If there be none, the tissue is as incapable of undergoing active changes as if it did not form a part of the body. The smallest particle of bioplasm possesses active powers, and if supplied with proper pabulum, soon grows. Each little bioplast grows, that is, increases, by taking up material differ- ing entirely from it in composition, properties, and powers, and converts certain elements of this into matter identical with that of which it consists. After the bioplasm-particle has reached a certain size, division occurs. Instead of growing larger and larger, and forming a continuous mass of enormous size, as some have fancifully supposed exists at the bottom of the ocean, portions are from time to time detached.
28
FROM HEALTH TO DISEASE.
These separate themselves and move away from the parent mass. Each of these little germs has pro- perties in many respects like those of the parent mass, though it may possess the capacity for forming matters which the parent mass could not have pro- duced. Each bioplasm particle lives and grows, attains a certain size, and may produce its kind in the same way.
Now, the whole human organism at a very early early period of its development consisted entirely of little masses of living bioplasm like those above referred to. Each of these grew and divided and sub- divided, so that multitudes at length resulted from the division of a few. All were descendants of the first primitive germinal mass, which was itself derived from pre-existing germinal matter. After a time some of the bioplasm particles cease to multiply, though they still live and take up food. The living matter of which they are composed undergoes change. It dies under certain conditions, and “tissue” results. In this way muscle, and nerve, and fibrous tissue, and bone, and hair, and horn, and nail, and all other textures, are formed. In the adult, however, there remain some masses of germinal matter which go on growing and dividing just as all grew and multiplied in the embryo. Among these are the white or colourless blood-corpuscles, which possess formative power even in old age in greater degree than any other form of bioplasm in the adult, as has
CHARACTERS OF BIOPLASTS.
29
been already shown. At the deep aspect of the cuticle and below the fully formed epithelium of mucous membranes and some glandular organs, are masses of germinal matter, which continue to divide and subdivide in the same way throughout life. These, in the ordinary course, move towards the surface, and as they move, each gradually forms upon its surface the hard cuticular matter (cell-wall) to which the properties of the epidermis are due, see Plate V, % 12.
It has been already said that the bioplastic masses of different organisms, and those in different parts of the same organism, possess different endowments. For from one kind of bioplasm is formed muscle, from another nerve, from another fat, and so forth, but yet all these kinds have directly descended from one. They could not be distinguished from one another, nor from the primary mass from which they came, by any microscopical or chemical characters. Neither could one of these kinds of bioplasm in the adult develop a mass capable of producing the rest. Al- though no one could distinguish one particle from the other, each will produce its kind, and that alone. It would be as unreasonable to expect an amoeba to result from a pus-corpuscle, or from a yeast particle, or to suppose that by any alteration in food or man- agement a cabbage would spring from a mustard seed, or the modern white mouse from the descendant of an ancestral white rabbit, as it would be to maintain
3°
THE PUS-BIOPLAST.
that muscle, nerve, brain, gland, or other special tissue might be produced indiscriminately by any mass of bioplasm of the adult, supposing that the conditions under which it lived were changed to any possible extent. Its vital powers, which are within, and upon which the capacity to develop depends, cannot be thus changed by any mere alteration in external circumstances.
The Pus-Bioplast derived from the Germinal Matter of all the Tissues. — But it is certainly very remarkable that the many kinds of germinal matter of the organism of man and the higher animals, though differing so much in power or property that one pro- duces nerve, another muscle, a third bone, a fourth fat, and so on, will each under certain conditions give rise to a common form of germinal matter or bioplasm differing in properties and powers from them all. This is the form of bioplasm known as pus , which may go on multiplying for any length of time, producing successive generations of pus-bioplasts, which exhibit remarkable vital properties, although they cannot form tissue, nor produce tissue-forming bioplasts of any kind whatever.
It is evident from this that the power is manifested in one direction only — onwards. Embryonic living matter or bioplasm gives rise to several different kinds, not one of which can produce matter having precisely the same endowments as that which existed immediately before it, and from which it sprang. And
RETROGRESSION IN ROWER.
31
yet every kind of germinal matter exhibits powers of infinite growth:*
When bioplasm or germinal matter lives faster than in health, in consequence of being supplied with an undue proportion of nutrient material, a morbid bioplasm results ; and if the process continues for a short time, changes familiar to those conversant with pathological alterations occur upon a large scale.
Of Retrogression in Formative Power. — In discuss- ing questions of this kind, involving such minute details, we must be most careful to avoid too hasty generalization, and must proceed by very slow steps. This is more particularly necessary if it so happens that our inferences in some measure accord with the views of speculative and enthusiastic persons, who are always fancying that we are on the eve of some grand dis- covery which is to revolutionize thought. Many, from a consideration of the arguments I have advanced, would perhaps be led to look with favour upon the doctrine that the lowest living forms are capable of being produced by the retrograde development of higher forms, and that bioplasm even very high in the
* While, however, the process of division is proceeding, as has been described, in some cases a small portion of the germinal matter does not undergo division into masses of the next series, but retains its primi- tive powers. This remains in an embryonic condition after the tissue has been formed, and thus the development of new tissue, even in advanced life, is, in some cases, not only possible, but actually occurs. Many cancers and other morbid growths probably originate in these masses of embryo bioplasm which remain for a long time in a quiescent state embedded in some of the fully-formed textures of the adult.
32
PRODUCTION OF
scale of organization, may give rise to forms of bio- plasm approximating more and more closely to the lowest constant forms of life with which we are acquainted. A doctrine asserting that by continual retrogression through ages, the descendants of the highest forms would gradually deteriorate until their only remaining representatives were monads, would not be very easily disproved, and might be supported by many ingenious arguments. It is a view that doubtless would recommend itself to many minds in the present day.
But on the other hand it is obvious that cells and organisms might retrograde and produce various modified forms, without giving rise to any of those particular forms characteristic of the lower organisms which we are acquainted with. Nay, cells of different organisms might give rise to many different retrograde forms, and every one of these be very different from one another, and yet totally unlike any known or- ganism. It is obviously possible that there should be infinite advance and infinite retrogression in multi- tudes of parallel lines, as it were, without the resulting forms of any one line becoming identical with those of another. Just as it is possible to conceive infinite advance in the features of the dog, without any resemblance whatever to the human face resulting, and retrogression and deterioration of the latter pro- ceeding to any degree, and continuing for any length of time, without the production of the simian type of countenance.
RETROGRADE FORMS.
33
Sufficient allowance is not made by many thinkers for the infinity of difference even in structure, and variety of change, possible in living forms, without the production of two things alike, or any indication of the merging of one set of forms into another. It must not be forgotten for an instant that from such a marvellous storehouse of facts as is placed at our disposal in nature, we may with very little ingenuity select certain series of facts in favour of several very different general hypotheses ; and however conflicting these may be with one another, it may not be possible to disprove any one of them in the present state of knowledge. The fact that masses of germinal matter, derived by direct descent from cells of one of the lower animals, may grow and multiply in man’s organism, and vice versa , might be adduced as an argument in favour of the original common parentage, countless ages back, of the predecessors of both ; but there are, it need scarcely be said, facts and arguments tending to a different conclusion, and these must not be lost sight of in our attempts to ascertain the truth.
It is not improbable that the germinal matter of some of the lower, simpler plants and animals, when exposed to altered conditions, may give rise to morbid forms bearing a relation to their normal healthy living germinal matter, similar to that which pus bears to the germinal matter of healthy tissues, and it is possible that in our observations upon the lower forms of life we may be sometimes examining II. D
34
BIOPLASM OF EPITHELIUM
morbid instead of normal healthy organisms. It may be that the matter of the malarial poison may thus result, in which case it must be regarded as a morbid bioplasm of some low organism, — not as a species of any kind whatever, — but as a deteriorated form of living matter freely multiplying but incapable of pro- ducing healthy matter or of returning to its primitive healthy state.
I propose now to draw attention to the facts I have been able to observe in connection with the deteriora- tion in power of bioplasm during that increased multiplication which results from the very free supply of pabulum, and which may at last lead to the production of diseased germs.
Bioplasm of Epithelium. — When the germinal matter of the epithelial cells of certain mucous membranes, or that of other tissues of the body, or the germinal matter of the white blood-corpuscles, lives faster than in health, in consequence of being supplied with an undue proportion of nutrient material, it grows and multiplies to an enormous extent ; so that one mass may perhaps be the parent of five hundred, in the time which, in a perfectly healthy state, would be occupied in the production of two or three cells. And in some ordinarily very slowly-growing tissues, the germinal matter may in disease divide and subdivide very quickly, although in the healthy state it would undergo scarcely any appreciable change in the course, perhaps, of several weeks or months. The
AND ITS MULTIPLICATION.
35
increased rate of access of nutrient material to the living matter is the necessary condition of its increase. The living matter always tends to increase, but in the normal state of things it is only permitted to do so at a certain regular rate, which is determined by the even distribution and somewhat limited access of the nutrient material.
In certain cases in which an increased proportion of nutrient material is distributed to the epithelium of the mucous membrane, — as, for example, to that of the fauces, — the young epithelial cells grow and multiply so rapidly that the superficial layers of older and hardened structure become detached, and upon the free surface is produced a thick layer of soft, spongy, epithelial elements, with, in many instances, but faint indications of division into individual epithe- lial particles, Fig. 15, plate VI. In fact, under the circumstances alluded to, growth takes place too rapidly for the formation of the characteristic hardened epithelial texture, though the changes are not so rapid as to lead to the formation of actual pus. The spongy texture produced may be regarded as occupy- ing a position midway between healthy epithelial tissue and the pathological bioplasm, pus. I have examined the young rapidly-growing, but as yet im- perfectly-formed epithelial particles, in specimens taken from the surface of the pharynx in a case of slight sore-throat coming on in a person enjoying ordinarily good health ; some of these are represented
D 2
36
INC RE A SED MUL TI PLICA TION
in Fig. 15 under a power magnifying 700. The mode in which the masses divide and subdivide could be well seen, and the thick plastic character of the matter of which they are composed has been carefully given in drawings. The greater part of the material consists of living matter or bioplasm, some of which has pro- bably undergone conversion into soft-formed material, which, however, still remains mingled with it. From any part of one of these masses diverticula might have been formed, and thus new bioplasts, each capable of undergoing conversion into an epithelial cell, would result. Many epithelial formations exhibit much the same changes in disease, and the transition from the healthy to the morbid state is beautifully indicated (Fig. 16). Nay, we may almost conceive that it is by unremitting continuance of this very process, combined with irregularity in the rate of multiplica- tion of contiguous particles, that the remarkable pathological formation of epithelial cancer results (Fig. 17, pi. VI.).
If, then, the bioplasts of a tissue receive an un- usually abundant supply of nutrient matter, they grow and multiply just like the amoeba, the white blood-corpuscle, the mucus-corpuscle, and the pus- corpuscle, and they may give origin to pus. Masses of bioplasm which under ordinary circumstances would form cuticle, grow and live so very fast, that there is not time for their cuticle-forming property to manifest itself. The changes are well shown in Fig. 18, pi. VII.,
PLATE VI.
FROM HEALTH TO DISEASE. F-ig. 15.
a
Epithelium from the surface of the pharynx of a healthy person suffering from very slight sore throat, a day after ‘ catching cold.’ a a normal full grown epithelial cell for contrasting with the other specimens in which the proportions of germinal matter is very great and the formed material still plastic and containing very much bioplasm in some instances dependentupon very rapid growth. X TOO. p 35.
Fig. 16.
Some of the smallest cells in white mucus from the smallest bronchial tubes of a cow which died from cattle .'plague. The bioplasm has increased in quantity. The animal was warm when examined. X 1800. p, 35.
Fig. 17.
Cancer cells from a case of epithelial cancer of the bladder, showing growth and multiplication of the bioplasm which exists in large quantity X 215. p. 36,
L. S. B.]
noth of an inch — x 700 linear. ,, ,, x 1800.
1870.
[To face page 36
OF BLOOD BIOPLASTS IN DISEASE.
37
to the left of which, at abed, are represented separate cells, the bioplasm of which is growing and dividing and subdividing. The cells multiply faster than any cuti- cle cells, and the numerous descendants they produce are pus-corpuscles, Figs. 19, 20. From these pus-bio- plasts, diverticula, proceed, and particles are from time to time detached which are extremely minute, and by their movements may pass through very narrow chinks in tissues, and thus spread from the point where they were first produced : not only so, but some of these are so minute, that, like the little germs detached from the yeast cells and other microscopic fungi, the amoeba germ, and many others, air will support them ; they may thus be carried long distances from the spot where they were developed. If exposed to great heat or cold, or to the action of certain gases and vapours, they will be killed, but in warm, moist air they will live ; and if they fall in a favourable place, that is, where there is proper food for them, they will grow and multiply a thousandfold like yeast. But the yeast germ is essentially different from these, and will not produce amoeba, or the latter pus. The pabulum suitable for the first would kill the last.
Multiplication of Blood-bioplasts in Disease. — Next, then, let us consider whether the multiplication of the bioplasts (masses of germinal matter) of the blood which occurs in the capillary vessels in disease , differs from the process which we have seen going on in the vessels of all animals at an early period of develop-
38
INFLAMMA TION.
ment, and throughout life at a certain time of the year in the case of hybernating animals, and in man under physiological conditions which cause the blood to circulate very slowly, or to stagnate for a time in the smaller vessels of the body. As will be inferred from the remarks made in pp. 24, 35, it is not possible to draw any distinct line of demarcation between physiological and pathological changes. In inflamma- tion, the phenomena above referred to proceed a stage further, and then are unquestionably pathological. But even if this stage be reached, it by no means follows that the texture involved should not regain its normal condition and the previous healthy state be perfectly restored.
On the other hand, it is quite certain that if the state of things now to be described continues for a time, and proceeds to any great extent, destruction of tissue is inevitable and return to the original con- dition is rendered impossible. Repair may follow the injury, but this repair involves serious alteration in structure, with corresponding deterioration in action, without capacity for improvement and without the possibility, under any circumstances, of return to the former state.
When the circulation through the capillary vessels is impeded in many cases of fever, inflammation, and other diseases, the blood bioplasts (white blood-corpuscles) multiply, and the capillaries often appear to be filled with them. The vessels and their
PLATE VII.
FROM HEALTH TO DISEASE.
Fig. 18.
A portion of the epithelial covering of the tODgue in a state of inflammation The bioplasm at the lower part is growing and multiplying very rapidly. The changes taking place in individual cells or elementary parts are represented on the right, at a, b, c, d, X 700. This drawing- has not been copied from a single preparation, but has been completed from tne appearances observed in several different specimens, p 3>,i.
Fig. 19.
Increase of bioplasm and formation of pus in individual epithelial cells of mucous membrane. Mouth, x '210. p, 37.
Fig. 20.
Division of bioplasm in cells of blad- der epithelium. From a case of inflammation of the bladder. X 215.
1870.
[To face page 33.
L. S. B.]
:o\jo of an inch
x 215 linear.
INCREASE OF BLOOD BIOPLASTS.
39
contents then very closely resemble those of an animal during the early period of its development. This state of things always exists in inflammation, and the multiplication of the bioplasts often proceeds to a wonderful extent. The appearances seen are cer- tainly not due simply to the accumulation of white blood-corpuscles, as some have held, but only in part to this, and mainly, as I pointed out many years ago, to their actual growth and increase. “ If in any capil- laries of the body the circulation is retarded from any cause, an increase in the white blood-corpuscles in- variably takes place. In congestion and inflammation of the vessels of the frog’s foot, the number of the white blood-corpuscles soon becomes so great as to impede and ultimately to stop the circulation through the vessel. Although the great majority are merely corpuscles that have been retarded in their passage, there can be little doubt that the corpuscles actually multiply in number in the clot that is formed.”* In Fig. 24, plate X, p. 44, a very small vein with two capil- laries from the frog’s foot a few hours after inflamma- tion had commenced, is represented under a magni- fying power of 215 diameters. The white blood- corpuscles form a thick layer all round the vessel, the circulation had quite ceased, and the entire tube would soon have been entirely occupied by white blood-corpuscles. The little capillaries are quite
* “On the Germinal Matter of the Blood, with Remarks upon the Formation of Fibrin,” December 9th, 1863, ‘Trans, of the Mic. Soc.’
40
DISTENSION- OF CAPILLARIES
occluded. The liquor sanguinis is transuding through their walls, and in a very short time the minute vessels would have appeared quite filled with bioplasm, and the growth of the living matter from the minute particles of bioplasm which escaped when they were distended, would soon have commenced as in Figs. 21, 22, 23, plates VIII, IX, X. The fact of the increase of the white blood-corpuscles appears to have been overlooked in consequence of the prepara- tion of the specimens not having been conducted with sufficient care to permit of examination being made with powers of high magnifying power.
Whenever a capillary vessel is distended, its walls necessarily become much reduced in thickness, and in extreme distension which occurs in inflammation, little longitudinal rents or fissures are here and there produced. Through these, serum, holding in suspen- sion very minute bioplasts probably detached from the larger ones growing and multiplying in the vessel, pass. Having thus extravasated, these particles, resulting directly from the subdivision of the white blood-corpuscles, make their way by vital movements into the interstices of the surrounding tissues, and being nearly stationary, and abundantly supplied with nutrient pabulum, grow and multiply in the new locality, and at an increasing rate. The phenomena here described will be understood if the figures given in Plates VIII., IX. and X. be carefully studied. These have been copied from preparations which were pre-
PLATE VIII.
INCREASE O? BIOPLASM IN INFLAMMATION.
Portion of pectoral muscle, frog, forty-eight hours after being perforated, x 50. Showing increased growth of bioplasm in all the tissues. The vessels contain an increased number of white blood corpuscles (bibplasm), and the bioplasm masses of the muscles are already dividing and sub- dividing. The elementary muscular dbres have in several instances ruptured and contracted within the tube of the sarcolemma. From a specimen mounted in ldt>3. p. 40.
L. S.'B.J
10*00 °f an inch — x 50 linear.
1570.
[To face page 40.
BY BLOOD BIOPLASTS.
41
pared in the year 1863. But the facts demonstrated were well known to me, had been described in my lec- tures before 1863, and were particularly referred to in a paper presented to the Royal Microscopical Society in that year. I did not come to the conclusion which has since been adopted by Cohnheim, that an individual white blood-corpuscle passed through the wall of the vessel, and then changed its characters and became a pus-corpuscle, an idea which had been previously advanced by W. Addison and also by Waller ; but my observations led me to believe — and of the correctness of the conclusion I am fully satisfied — that the particles of germinal or living matter seen in such great numbers outside the vessels in cases of inflammation, result for the most part from the growth, division, and subdivision of minute particles of ger- minal matter which have passed through the vascular wall suspended in the fluid exudation. Many of the masses of germinal matter represented in Fig. 23, pi. X., are the descendants of white blood-corpuscles, but they are not the white blood-corpuscles which were previously in the blood, and which were circu- lating in that fluid. They may continue to grow and multiply like other kinds of germinal matter, until at last that rapidly-growing form of bioplasm, the com- mon result of the greatly-increased growth and multiplication of every form of bioplasm in the living body, may be produced. In inflammation of a texture going on to pus-formation, — of the pus-corpuscles in
42
ON THE GROWTH AND
the abscess, some are descendants of white blood-cor- puscles, others of the bioplasm of the tissue, vessels, and nerves. The pus-corpuscle may therefore be a descendant of the white blood-corpuscle, as well as of the germinal matter of epithelium, and of other tissues. We may, indeed, trace back its parentage to the original embryonic bioplasmic mass, which must be regarded as the primitive ancestor of all.
New Observations on the Growth and Multiplication of Pus. — The researches upon which the conclusions here briefly expressed, are based, have proved, I think, as I showed in the first course of lectures which I gave at the Royal College of Physicians, 1 86 1, that the pus corpuscle is not formed by the breaking up of the tissue, and the aggregation of lifeless particles resulting therefrom. Nor is pus produced by the precipitation of particles from a clear exudation and their subsequent aggregation to form masses, as Dr. Bennett of Edinburgh supposes. Pus, as I have endeavoured to show, is a form of living germinal matter, and has descended uninterruptedly from the normal germinal matter of the body. Virchow concluded that pus was formed in connective tissue corpuscles and in epithelial cells only. But there is little doubt that pus may be derived by very rapid growth from any germinal matter in the body.
The pus corpuscles usually figured and described are dead ’ not living. These spherical granular cor- puscles have no longer the power of growth or multipli-
PLATE IX.
CHANGES IN INFLAMMATION— INCREASE AND MULTIPLICATION OF
BIOPLASM.
Fig. 22.
Muscular fibres and connective tissue of the pectoral muscle of the frog in a state of inflammation from the immediate neighbourhood of the seat of iuiury FOUR days after the muscle had been transfixed by a fine thread. The vessels are seen to he filled with white blood corpuscles. Some of the bioplasm particles, probably derived from the white bloo-t < orpuscles (page 40) havS escaped from the vessel at two points. The bioplasm of the connective tissue and also that of the muscular fibres is much increased. X 21S. From a specimen mounted iu 1863. p. 40.
[To face page 4 J.
of an inch. x 215 line c.
MULTIPLICATION OP PUS.
43
cation. In many coagulation has taken place on the surface, and thus a sort of “ cell wall” has been formed. Within this are granules and minute oil globules, resulting from the disintegration of the living matter, of which the corpuscle originally consisted, and germs of bacteria. Such pus corpuscles do not alter their form of their own accord. After a time they undergo further disintegration. If the pus remains in a cavity in the tissues, the fluid products may be absorbed, while a small quantity of cheesy matter, rich in oil and cholesterine is all that represents what was once pus.
But how different is the living corpuscle. This may be seen to change its form under the microscope. Diverticula, which are from time to time detached, are seen to be formed at every part of the circumference, and thus give rise to new pus-corpuscles. The living pus-corpuscle is a mass of living, growing germinal matter, derived from matter like itself, or from the normal bioplasm matter of the organism. Plate XI.
As I stated in 1863, the white blood corpuscle, the minute masses of germinal matter which I have described as existing in the blood, lymph corpuscles, chyle corpuscles, the masses of germinal matter in the spleen and other ductless glands, those found in con- nection with the walls of capillaries, germinal matter of nerve, muscle, and other tissues of the body, may give rise to pus if placed under conditions in which they are too freely supplied with pabulum.
44
ON THE MOVEMENTS
On the Movements occurring in ordinary living Pus. — I propose now to bring forward evidence which seems to me conclusive as to the mode of growth and multi- plication of pus corpuscles, and which, I think, goes far to show how living particles, so minute that they may be transferred considerable distances without loss of vitality, may be produced.
There is certainly no true cell-wall in the case of living pus, for protrusions of the matter of which pus corpuscles consist may occur upon every part of the surface, and not only so, but some of these protruded portions, after moving a considerable distance away from the mass, become disconnected from it, and thus new pus corpuscles are produced. It is in this way that the very rapid multiplication of pus corpuscles is effected.
In pus from the bladder, movements even more active than those in the mucus corpuscle are very easily observed, and when fresh, not a single spherical corpuscle can be found. See Fig. 25, plate XI, repre- senting some of the many different forms of pus corpuscles present in a very small quantity of pus. Every corpuscle exhibits a great number of these protrusions, and every protrusion might be detached and form a free pus corpuscle, Figs. 25, 26. Little particles are sometimes detached, and these are often so minute (less than -nroVo o' °f an inch *n diameter) that they might be supported by the atmosphere and thus transported to a distance while yet alive.
PLAT 3- X
CHANGES IN INFLAMMATION— GREAT INCREASE AND MULTIPLICATION
O? BIOPLASM.
Fig. 23.
This drawing was taken from a preparation resembling that represented in Fig. 22, but the period allowed to eiap'se after the inflammation had been excited was longer, The Frog was killed SEVEN days after the pectoral was perforated by a thread, x 215. p. 40.
Fig. 24.
\ ein in the web of a young frog during life, a few minutes alter inflammation had been excited by the application of mustard, x 215. p,’39
yifjth of an inch x 40.
T5l(T„th ,, x 2 J 5 .
[To face page 44.
OCCURRING IN LIVING PUS.
45
(Fig. 27.*) In warm weather, I have known the movements continue in pus corpuscles in urine con- taining little of the ordinary urinary constituents, for forty-eight hours or more after the urine had left the bladder.* The very phenomena which take place upon the surface of the mucous membrane of the bladder may in fact be watched for hours under the microscope, and there are few things more beautiful or more instructive.
The conditions required for the maintenance of life being more complex in the case of some forms of germinal matter than in others, we should conclude that such movements would continue for a consider- able period of time in particles after their removal from their natural habitat, only in the lowest and most degraded forms. This is actually the case, just as some simple creatures are capable of supporting life under a great variety of conditions, while comparatively
* It is probable that careful observations upon this transparent living moving material will teach us much concerning the nature of life. I think that this subject merits far more attention than it has hitherto received, not only from physicists, chemists, and physiologists, but from philosophers. I do not think that what will be learned from the study will favour the notions now most popular, but that is no reason why it should any longer be wholly neglected, especially by those who profess to desire to carry their enquiries to the utmost possible limits, but who really carry them a very little way, who, if successful in destroying, are certainly obstructive. Some of those who profess to be most liberal in science strongly object to enquiry being carried beyond the limits they have arbitrarily and without sufficient reason laid down.
46
DEATH AND DECOMPOSITION
slight alterations would be fatal to others higher in the scale.
It is not possible to distinguish many pus corpuscles from lymph corpuscles, white blood corpuscles, and many other masses of germinal matter ; indeed, if the developing brain of an embryo be examined at an early period, it will be found that this important structure consists of nothing more than a number of spherical cells, which could not, by any means we are yet acquainted with, be distinguished from many forms of pus corpuscles. See “ The Microscope in Medicine,” Plate XX, figs. 155, 156. If we carefully reflect upon many observed facts, we shall be com- pelled to admit that masses of germinal matter which resemble one another in every character we can ascertain, differ nevertheless remarkably in power , as is proved by the results of their living. Few recent writers seem to have fully recognized the remarkable truth that living things may agree in physical and chemical characters, but nevertheless differ widely in pozver ; that transcendent difference in vital power may be associated even with similarity of composition, so that we are quite prepared for the discovery that the powers of certain forms of morbid bioplasm are very different from those of the normal living matter from which they have descended, although no differ- ence whatever can be detected in their chemical composition.
Death and Decomposition of Pns. — When pus bio-
PLATE XI.
PUS BIOPLASTS— THEIR VITAL MOVEMENTS.
Fig. 25.
Puq bioplasts or corpuscles in active movement, from the urine of a case of chronic inflammation of the bladder. X 700. p. 44..
Fig. 26. Fig. 27.
... Portion of a living pus bioplast or corpuscle from the bladder The portion marked b moved out in four seconds, and was then retracted. The other portion was extended in about the same time. X 2,600. p 45.
Different forms assumed by the same minute mass of bioplasm of pus from the bladder, during five seconds. X 2,800. p 45.
A portion of a pus corpuscle from the bladder of man, the third day after the urine contain- ing it had been passed Th evital movements had long ceased, and it was very transparent At a little particles (Bacteria) weie oscillating in all directions. One of these was seen to take the course indicated by the dotted line during the fraction of a second, x 2,800, p. 47.
■jThjj of an inch
To ooo »i
X 700.
x 2S00.
To face x-<age 46.
OF PUS BIOPLASTS.
47
plasts die, and their death occurs when they are placed in any fluid which is not adapted for their nutrition, the vital movements cease and the cor- puscles invariably assume the spherical form. Not unfrequently a change occurs in the outer part, and a sort of membrane like a cell wall is produced ; the contents become more granular, and they assume the appearance usually given in published drawings. After a short time the matter of which they are com- posed undergoes change, and is invaded by bacteria germs, which grow and multiply as represented in Plate XI, fig. 27. These bacteria are not formed directly from the matter of the pus which once lived, but it is quite possible that bacteria germs existed in a living but perfectly quiescent state amongst the oldest particles of the living matter on the surface of the pus corpuscle when it was yet alive.
DISEASE GERMS IN ANIMAL FLUIDS AND SECRETIONS.
BEFORE I proceed to describe the characters of the particles suspended in animal fluids, having virulent contagious properties, it is very desirable to draw attention to the minute particles of bioplasm, which may be demonstrated in many specimens of simple exudation. From this subject we shall pass on to the consideration of other forms of “ exudation ” which possess specific disease-producing properties. We shall find that by a careful microscopical examination of fluids which experience has proved to us have con- tagious properties, facts of great interest are disclosed which have an important bearing on the question of the nature of the poison of contagious diseases. Many such fluids are clear like water, and quite as tran- sparent when examined by the unaided eye only. When we come to subject them to examination with the aid even of the highest powers yet made, although solid particles are detected, and sometimes in great number, we observe nothing peculiar to these fluids alone — nothing which would enable us to form any conception of the wonderful properties they possess — nothing that would attract the attention of the chance observer, or excite the interest of any one who had not long and carefully studied the matter. Nevertheless,
GERMS IN FLUIDS AND SECRETIONS.
49
what we are able to demonstrate is of vast importance, and with the aid of other observations and experi- ments, we may form, I think, clear notions of the nature and origin of these morbid poisons, and of the manner in which they produce their marvellous and oftentimes disastrous effects. Much yet remains to be disclosed, but we shall soon learn more if we will but work and think independently, and accept the teaching of facts of observation and experiment, while careful to avoid being misled by the dog- matism of those who obstinately persist in assert- ing that all vital phenomena are to be explained by physics and chemistry, and try to make people believe that living organisms are mere machines con- structed by force. For all truly vital phenomena must necessarily be altogether out of the range of mere physical investigation ; nevertheless, to such ex- travagant lengths has the opposite view been carried of late, that it has even been seriously stated that he who refuses to look upon life as mere inorganic force opposes investigation, 'and looks upon the structure of man’s organism as a subject unsuitable for scientific exploration. It would be as reasonable to assert that a man who is to be a scientific investigator must com- mence by confessing his belief in the truth of a con- clusion which has long been proved to be false by reason and observation.
The evidence that the wonderful properties of the
fluids about to be considered are due to the II.
5°
SIMPLE EXUDATION
of extremely minute particles of living matter will, I think, be admitted to be conclusive, while the effects produced by these in a living organism cannot be explained by physics or chemistry, or imitated artifi- cially. Few persons will in these days be so deluded as to accept as an explanation the assertion that vital phenomena are “ molecular,” or admit that it conveys any more information than the announcement that the phenomena of living beings are due to the molecular changes in the basis of physical life. Such “ expla- nations ” explain nothing, and are but impertinent fictions of the imagination.
Simple Exudation. — The transparent colourless fluid which moistens the surface of a superficial wound after it has ceased to bleed, is poured out from the capillaries, or from the lymphatic vessels, or from both sets of vessels. This fluid, besides containing albumen in solution, contains multitudes of minute particles of bioplasm, which grow and multiply upon the surface. These form fibrin and matters more or less allied to it, and perform an essential part in the healing process, or in the formation of pus, as the case may be. These minute particles of living matter are present in the blood and lymph in countless numbers. They are concerned in the production of fibrous tissue outside the capillaries, which takes place in many pathological processes, and also in the pro- duction of pus-corpuscles, and other “ corpuscles ” in the same situation, in disease. All “ exudations ”
FROM THE BLOOD.
51
contain these particles of living matter. The follow- ing paragraphs are taken from a paper written by me in 1863* : —
“ When the capillary vessels are distended, as in that extreme congestion which soon passes into in- flammation, a fluid which possesses coagulable pro- perties transudes through the stretched capillary walls. It is probable that in such cases minute and narrow fissures result, which, however, are too narrow to allow an ordinary white or red blood-cor- puscle to escape, but, nevertheless, wide enough to permit many of the minute particles of the living or germinal matter (the existence of which in the blood has been already referred to) to pass through. The small protrusions upon the surface of the white blood- corpuscle might grow through the capillary walls, become detached, and pass into the tissue external to the vessels. Such minute particles of living matter external to the vessels being surrounded with nutrient pabulum, and stationary, would grow and multiply rapidly, while a similar change would of course go on in the now stagnant fluid in the interior of the capil- lary. The result would be exactly that which is observed, viz., the presence of a vast number of cells like white blood-corpuscles in the interior of the capillary vessel ’ and immediately around its external
* “ On the Germinal Matter of the Blood, with remarks upon the Formation of Fibrin.” Microscopical Society, December, 9th, 1863. — See Trans. Mic. Soc., April, 1864.
E 2
52
VERY MINUTE PARTICLES
surface , and sometimes these extend for some distance in the substance of the surrounding tissue, and they increase in number.
“ I venture, then, to conclude that many of the clear fluids which have been considered as ‘ exudations' from the blood, really contain a multitude of extremely minute particles of living matter, which are intimately related to the white blood-corpuscles, and that these grow and become one source of the small granular cells or corpuscles which are so familiar to all who have studied morbid changes in the tissues as they occur in man and the higher animals.
“ Some of these active living particles may be so small as to be invisible by a power magnifying 5,000 diameters. I have seen such particles, less than the 50,000 of an inch in diameter, and have no reason whatever for assuming that these are really the smallest that exist.”
These minute particles of bioplasm multiply freely, but they may also be derived from the white blood- corpuscles, and from other forms of bioplasm. The general appearance of such minute particles is repre- sented in a minute portion of recently drawn blood in Fig. 28, plate XII. As the blood coagulates they undergo change, die, and help to form the non-living fibrin. In every clot numerous white blood-corpuscles, also composed of living matter, can be detected, Fig. 30. In coagulation it is probable that the most minute particles of bioplasm change first, and become
PLATE XII.
LIVING BIOPLASM FROM THE BLOOD.
Fig. 28.
Fig. 29.
Red and white blood corpuscles in a drop of blood which had just been removed from the finger x 2,800 The large smooth circular bodies are the red corpuscles. Three very small red corpuscles are less than the _JL_th of an inch in diameter. The smallest particles are composed of matter like that of which the white blood corpusole or blood bioplast (6) consists. Threads of fibrine are being formed by the coagulation of the minute particles of bioplasm of the blood These are seen between the corpuscles in the upper and lower part of the field a red corpuscle exhibiting angular projections Above it and to the left is another with still more pointed processes.
September, 1863. p, 62.
•-L s. ( .-. t3
0
<m &
Very minute particles of bioplasm from exuda- tion. x 5,000. p. 52.
Fig. 30.
From a pale clot in the heart of a patient who died of exhaustion, show- ing white corpuscles, or blood bioplasts, . and fibres of fibrine x 100.
P.S2.
Fig. 31.
Capillary vessel, from the mucous membrane of the epiglottis. Show- ing numerous masses of bioplasm situated very close together and projecting into the cavity of the vessel, x 100. p. 53.
is iiooth. of an inch x 2,800.
[To face page 52.
OF BIOPLASM IN BLOOD.
53
fibrin. After a time the white blood-corpuscles also die, and thus the coagulum of fibrin continues to in- crease for a short time after coagulation has com- menced. The diverticula from a white blood-cor- puscle undergoing conversion into fibrin are repre- sented in Plate XIII, fig. 33. The lines round the red blood-corpuscles seen stretching from one to the other in Fig. 28, represent the earliest stage in the formation of fibrin, and the minute particles of bio- plasm are seen actually undergoing change. The bioplasm of the blood is derived from the bioplasm originally found in the vessels of the germinal area at a very early period of development, from the bio- plasm of the capillary walls, which is very abundant in some capillaries, and projects into the cavity, Plate XII, fig. 31, and from the lymph and chyle bioplasm which is being continually poured into the vascular system and mixed with the blood.
If the clear transparent material which moves round the cells of Vallisneria (Fig. 32, pi. XIII.) and other plants be carefully examined under very high powers magnifying upwards of 2,000 diameters, it will be discovered that this is not a simple fluid like water containing the nucleus and chlorophyl (Fig. 35). But the apparent fluid has suspended in it an infinite number of particles of living matter like those of which the amoeba, white blood-corpuscle, and other forms of living matter consist. With high powers the slightly opalescent appearance may be detected, and
54
BIOPLASM OF VALLISNERIA.
by careful foccussing minute particles of living matter will be brought into view. The movements of the fluid may therefore be compared with the movements of the living bioplasm of an amoeba. In the circu- lating juice of many plants similar appearances may be observed, and in the blood and circulating fluid of all animals, and in man himself, minute particles of living matter are to be demonstrated in immense multitudes. These are diffused through the fluid, and to them is probably due the movement of the contents of the finer vessels and spaces. This con- stituent of the blood, seen with such difficulty that its presence is not yet admitted by observers, is pro- bably the most important, for its increase or diminu- tion may occasion serious disease or death. This almost impalpable living moving matter is the seat of many very important changes, and is perhaps in- fluenced before any other constituents of the body when certain poisons and disease germs find their way into the blood. “ Protection,” after successful vaccination, and the escape from a second attack, which is the rule in the case of many contagious fevers, is most likely brought about by changes induced in the living matter under consideration.
In health it is upon this material that the coagulable property of the blood is mainly dependent, and it is this which in great part undergoes conversion into what we call fibrin, when the blood is removed from the living vessels or “ dies.” If destroyed it may,
PLATE XIII.
BIOPLASM, BLOOD; VACCINE LYMPH; VEGETABLE CELLS.
Fig. .32. FU. 33.
Vallisneria spiralis, showing large and. small cells wich living contents which. • rotate. X 130. p. 03.
Altered blood bioplast or corpuscle. Bodies of this form were common in the blood an hour after it had been drawn from the finger. The projecting processes consist of germinal matter which is gradually undergoing change into fibrin.
X 1,800. p 53.
Fig. 34.
4 ' 9 gg|>
=-L.ii -.iii-n < r~ .
Corpuscles consisting of germinal matter or living bioplasm in the * lymph,' from a vaccine vesicle, showing changes in form which occured a few minutes after the lymph had been transferred to a warm slide. X 1,800. pp. 60, 62.
Fig. 35.
c b
c
Part of a cell in vallisneria, showing circulation. The large mass, a, with nucleus, is colourless, and consists of bioplasm. The smaller particles (under 6) are also composed of living matter or bioplasm. The movements of the entire conlents round the cell are probably due to these. After death they are transformed into fibrin. The round bodies, c, are masses of chlorophyl, which are in process of formation, x 2,800. pp 53,55.
Toooo °f an inch x 1800.
Tri£,-lS ,, „ — x 2S00.
[To face page C-
LIVING PARTICLES POISONOUS.
55
under favourable circumstances, be renewed by the appropriation of nutrient matter by the white blood- corpuscles which are intimately related to this living bioplasm and take part in its formation. I believe they bear to it the same relation as the “ nucleus ” in the cell of Vallisneria bears to the living particles sus- pended in the fluid, Fig. 35, pi. XIII., while the red blood-corpuscles of the blood correspond to the chlo- rophyl particles in the rotating fluid contents of the vegetable cell. In this work attention will be drawn to the vast importance of this living fibrin-forming matter in various exudations, and it will be found that a simple explanation of many most important morbid phenomena may be given. Now in the fluid exuda- tion or virus which produces a “ poisoned wound ” when inoculated we also find minute particles of living bioplasm.
Many arguments will be advanced in this treatise in favour of the view that the virulence of the poison is due entirely to the living particles, and not to the fluid in which these are suspended. In the case of some of these poisonous fluids we are able to study the production of the contagious virus, and we may even in some cases succeed in tracing out the manner the material with the wonderful poisonous property originates.
In some forms of inflammation of serous membranes the process may be made out, and a conception formed of the several changes which occur, and at
56
CHANGES IN BIOPLASM
last end in the development of the poison. The morbid change is sometimes limited to the effusion of serum and the production of “ inflammatory lymph,” but in other instances the inflammation proceeds to a further stage, and actual pus is generated. Peritonitis is an example of an inflammation which much more frequently proceeds to the formation of pus than inflammation of other serous membranes. The greater vascularity of the peritoneum as compared with allied textures may perhaps account for this fact. It is inter- esting to discuss briefly the characters of the different “ inflammatory products,” as they are called, resulting from peritoneal inflammation, varying in intensity.
In slight inflammation there is great vascular dis- tension, accompanied, as in other cases, by the escape of exudation in which are suspended particles of bio- plasm. The exudation coagulates upon the surfaces of the serous membrane, perhaps glueing them together. The fluid portion is gradually absorbed, and if the case progresses to recovery, much of the coagulated matter is also taken up, a little being transformed into fibrous tissue, resulting in a few “ adhesions,” or mere thickening of the serous membrane, as the case may be.
When, however, the intensity of the inflammation is more marked, the little particles of bioplasm ori- ginally derived from the white blood-corpuscles, grow and multiply, and with the fibrinous matter in which they are entangled, form transparent flocculi, which
DURING INFLAMMATION.
57
are suspended in the serous part of the exudation, or adhere here and there loosely to the peritoneal sur- face. Many of these flocculi are found to contain multitudes of bioplasm particles, and oftentimes a vast number of these are suspended in the fluid, and congregated here and there, forming little collections, upon the surface of the delicate serous membrane, to which they adhere, and where they grow.
If the inflammatory process still continues, and in- creases in severity, the vascular congestion becomes more marked, and the exudation is poured out from the blood more abundantly ; the masses of bioplasm increase in number yet faster, and the exudation in consequence appears nearly opaque. The flocculi are of a yellowish colour, and look very like pieces of clotted cream which stick here and there to the peri- toneum covering the intestines and the inner surface of the abdominal parietes. Not unfrequently the surface is smeared over in places with whitish pasty masses of soft cream-like matter, in the intervals between which the highly-injected vessels stand out with great distinctness. The masses of bioplasm would now be called pus-corpuscles. Here then is an interesting example of the production of pus-corpuscles by the rapid growth and multiplication of particles of bioplasm which were once in the blood, and intimately related to the white blood-corpuscles.
But further : if, as is well known, a little of this material were to be introduced into the body, as may
58
NATURE OF POISON
unfortunately happen from a dissection-wound in the course of making a post-mortem examination, terrible inflammation may be excited in the person inoculated. The most tiny morsel of this virulent, rapidly-multi- plying morbid bioplasm may give rise to a dreadful form of “ blood-poisoning,” which may end fatally and in a very short time.
In some cases similar poisonous particles which have been derived from a diseased organism are so very light that they are supported by the air, and may find their way into the blood of a healthy (?) person through his respiratory organs, or may gain access to his circulating fluid by traversing the narrow chinks between the epithelial cells of the cuticle.
Now, what is the nature of the matter inoculated, which produces these dreadful results ? The virulent poison which sometimes destroys life in cases of dis- section-wounds cannot, as was remarked in Part I, be attributed to the presence of vegetable germs, for the period of its most virulent activity is very soon after death, but before the occurrence of putrefaction, when the vegetable fungus germs multiply. A punc- tured wound is not dangerous if putrefactive decom- position has taken place, because, although bacteria are developed in immense numbers, the real contagious virus is dead. The vegetable germs in fact grow and flourish upon the products resulting from the death of the dangerous animal living poison. In short this material is living and very actively growing germinal
INTRODUCED BY INOCULATION.
59
matter ; living matter which retains its life after the death of the organism in which it was produced has occurred ; living matter which has descended directly from the living matter of health, but which has ac- quired the property of retaining its life under new conditions ; living matter destroyed with difficulty, and possessing such wonderful energy that it will grow and multiply when removed from the seat of its develop- ment and transferred to another situation, provided only it be supplied with suitable nutrient pabulum, — and it is to be feared the ordinary nutrient fluids of a perfectly healthy organism are eminently adapted for the nutrition of this destructive virus.
The Germs of Purulent Ophthalmia — Gonorrhoeal Pus. — Such is the vitality of these forms of bioplasm that they will grow and multiply upon certain mucous surfaces if placed there ; not only so, but the living particles will retain their vitality for some time after their removal from the surface upon which they grew. They may even be transported long distances by the air, or they may remain for some time in moist cloths without being destroyed. When once a room has been infected with such particles, some weeks may elapse before the death of all the specific disease- carrying germs has taken place.
The characters and vital movements of pus and minute pus germs, have been already described in p. 44-
The pus possessing specific contagious properties
6o
VA CCIJVE L YMPH.
cannot be distinguished from ordinary pus. It differs indeed from this last, but not in appearance, chemical composition, or physical properties. It differs in vital power.
Vaccine Lymph. — Vaccine lymph which has been just removed from the growing vesicle will be found to contain a great number of extremely minute par- ticles of bioplasm, which may be well seen under a power magnifying from 1,000 to 2,000 diameters. In 1863 I made a drawing of the appearances I observed in the bioplasts from a drop of perfectly fresh lymph which had been transferred to a warm glass slide, and carefully covered with very thin glass, under the -J-g object glass, which magnifies about 1,800 diameters. The results are represented in Fig. 34, plate XIII, which was published in the “Quarterly Journal of Microscopical Science” for April, 1864.
In vaccine lymph which has been kept for some time in glass tubes, multitudes of very minute par- ticles are observed, and these exhibit the most active molecular movements. These particles have often been termed debris , and have been regarded as quite unimportant elements of the lymph. To them, how- ever, the active properties of the lymph are entirely and solely due. And I should be no more inclined, in the absence of the most positive evidence to the contrary, to regard the fluid portion of the vaccine lymph as the active material, than I should be to assume that the fluid in which the spermatozoa were
PARTICLES OF BIOPLASM.
6l
suspended was the fertilizing agent, and that the spermatozoa themselves were merely epithelial debris , and quite unimportant ; or to infer that the fluid in which the yeast fungi or bacteria were growing, was the active agent in exciting fermentation while the actually growing, moving and multiplying particles were perfectly passive. The germinal particles in all cases are, without doubt, the active agents, and it seems to me as much opposed to the facts of the case to maintain that the materies morbi of cattle plague and other contagious fevers is a material that can be dissolved in fluid, and precipitated and reformed, or ’sublimed as a volatile substance, as it would be to look upon any living organism as the result of the con- centration of an albuminous solution, and capable of resolution and precipitation.
The little particles represented in Plate XIV, fig. 39, could not be distinguished from the minute particles of pus, Plate XI, fig. 27*, or other germs of living germinal matter, and I think they consist of a peculiar kind of living matter, the smallest particle of which, when supplied with its proper pabulum, will grow and multiply, giving rise to millions of little particles like itself, each having similar properties and powers.
I consider it to be almost certain that the material of which these particles are composed has the power of forming matter like itself from pabulum around it, which differs from it in properties and composition.
62
VACCINE BIOPLASTS ,
Such living germs may pass from the organism on which they grew to another, and will grow and multiply there if they meet with the proper pabulum. The only condition in which matter is known to ex- hibit these powers of self-multiplication is the living state.
M. Chaveau (Comptes rendus, February, 1868) de- scribed these same bodies in 1868. It is evident he had not seen my observations, published in the Cattle Plague Report, or my previous researches published in the Microscopical Transactions for 1863.* Fig. 34, plate XIII, was appended to this paper, which was read December 9th, 1863. Chaveau showed that the active particles subsided after forty-eight hours, and that no effects were produced by inoculating the albuminous supernatant fluid, while the full effects were produced by vaccinating with the deposit. As would be supposed from the excessive minuteness of these bodies, they are not to be separated by ordinary filtration, but if the fluid containing them also con- tains a trace of coagulable fibrin diffused through it, this by contraction after coagulation would filter off the little bioplasts, and leave a serum perfectly free. Dr. Farr calls the living particles biads (fiia, force, fiios, life), and speaks of the vaccine particles as
* “Beale had, before Chaveau, declared that the ‘active properties of vaccine lymph are entirely and solely due 1 to these corpuscles. He has figured them.” — Dr. Farr, “ Report on the Cholera Epidemic of 1866,” p. lxviii.
THEIR NATURE.
63
vaccinads. — “ Report on the Cholera Epidemic of 1866,” p. lxx.
The circumstance that vaccine lymph retains its activity if kept in a tube for several weeks, seems conclusive as to the possibility of the particles re- taining their vitality for a considerable time after they have been removed from the place where they grew ; the arguments advanced as proving that the active power resides in the particles and not in the fluid, being admitted. It is not more difficult to explain the fact that such living particles may be dried with- out losing their power, than that an amoeba or rotifer should exhibit the same peculiarity. As this property is observed in connection with many of the lower forms of life, we might almost anticipate that the living matter from the highest organisms, if reduced to a degraded condition, would retain its vitality under circumstances which would cause its death in its nor- mal condition. Yet it must not be supposed that these particles any more than the “ dried animalcules ” are really dried. Some moisture is retained by the particles within the imperfectly dried mass. Com- plete desiccation will destroy life in both cases. Since it has been shown that the active powers of vaccine lymph reside in the minute particles of living germinal matter, and it has been proved that these may be dried (imperfectly) without loss of power, it is surely not too much to conclude that the materies morbi of other and allied contagious diseases is probably com-
64
VARIOLA— FE VER.
posed of living particles which have the same property of living for some time in a state of partial desicca- tion.
Living Germs of Variola. — 1 have examined the contents of the little vesicle which rises in small-pox at different stages of its development, and find, as in allied pathological changes, vast multitudes of minute particles of living matter or bioplasm, but, as will have been anticipated from wdiat has been already said, these present nothing peculiar or characteristic, nothing that would enable us to say if we saw these particles under the microscope that they had been ob- tained from a small-pox vesicle, and would certainly give rise to that disease. I have made a drawing of some of the varioloid bioplasts from a well-developed vesicle on the fifth day of the disease, and also from a vesicle which was just making its appearance. Plate XIV., fig. 37-
Living Germs of Fever. — As was shown experi- mentally of Dr. Sanderson, a mere trace of blood serum was sufficient to progagate cattle plague. A very small portion of blood or of the tissues of an infected animal had the same effect. Nay, the contagium is so subtle that in this as well as in many other contagious diseases, the breath of the diseased organism contains numbers of the potent par- ticles of poison, and in this manner the very air of a considerable space or even district may become infected.
BIOPLASM OF Fig. 36.
PLATE XIV.
SMALL POX VESICLE, AND BLOOD IN FEVER.
Fig. 37.
Bioplasts from the vagin al mucus of a- cow. Cattle Plague, a. bacterium amongst these, b, a mass of germinal matter con- taining minute particles like bacteria. These are also seen in the white blood and pus cor- puscle. &c. X 2,800. p.64.
■ Bioplasts from small pox vesicles on the fifth day of the diseasfe The two bodies under a from one of the youngest vesicles, which was just beginning to be white at the summit. The six bodies under b from a fully formed vesicle. X 1,800. p. 61.
Fig. 38. b
Blood from intestinal capillaries and small mesenteric vein Cattle Plague. The serum was reddish a, part of white blood corpuscle in outline ; b. minute particles of bioplasm (disease germs) in immense number in all parts ofthe field. The smooth round bodies are young red corpuscles. The angular corpuscles are old and altered red blood corpuscles, x 2,800. p 65,
Fig. 39. Fig. 40. Fig. 41.
Particles from vaccine lymph which h ad been kept in a tube, exhibiting very active move- ments. X 6,000. pp. 60, 61.
Very small masses of ger- minal matter and white blood corpuscle (a) from small vein as in Fig. 38. X 2,800. p. 65.
White and red blood corpuscles from abranch of the pulmonary vein. Cattle Plague. A quantity of germinal matter or bioplasm in a very minute state of divi- sion is seen around the lower part of the white corpuscle. X 1,800, p. 65.
To.ooo of an inch x 1800.
- x 2800.
[To face page 64.
SYPHILITIC BIOPLASTS.
65
In the blood removed from the smaller vessels, in the mucus secretions of the mouth, intes- tinal canal, and in the milk of animals suffering from this disorder, I have found multitudes of minute particles of bioplasm, which, as long as they remain alive, are, without doubt, disease-carrying particles. Disease germs are figured in Plates XIV and XV, and in Plates XX to XXIII. Their characters will be further discussed in the Section on the “Nature of Disease Germs,” p. 161.
The disease germs of many contagious fevers will , retain their vitality in water and other fluids for a length of time, and there is reason for concluding that some of these poisons not only grow and multiply in fluids different from any in the organism, but that in the course of such growth and multiplica- tion, they acquire still more virulent properties. Dr. C. Macnamara has discovered that cholera poison in water after exposure to the sun for a few hours, becomes extremely virulent, and that this period corresponds with the development of multitudes of vibrios ; but that after the lapse of a day or two, when the vibrios will have disappeared and given place to ciliated animalcules, the fluid may be taken with impunity.
Syphilitic Disease Germs. — The syphilitic germ is another of those remarkably special living poisons which may be suspended in serum and other fluids, and retain its vitality for a length of time.
II.
F
66
SYPHILITIC BIOPLASTS.
There is reason for thinking that a single epithelial cell may carry multitudes of active particles of syphilitic poison, one of which introduced into the blood or lymph of a healthy person would probably grow and multiply, and give rise to pathological changes characteristic of, and quite peculiar to this particular poison.
We know that the syphilitic poison may retain its specific characters in the organism for years, from time to time giving rise to local pathological phenomena, which are characteristic of this kind of morbid bioplasm. It is impossible from the facts of the case to arrive at any other conclusion than this : that a certain portion of the living matter remains in the organism, and that under certain favourable circum- stances this grows and multiplies, producing disease. Particles of this virulent poison may be transferred from the infected organism to a healthy one, and contaminate it, even many years after its introduction into the first had taken place. Of syphilitic bioplasm there are different kinds, giving rise to different pathological affections belonging to the syphilitic class. Indeed, some facts render it probable that there are several different species or varieties of syphilitic poison, instead of only one or two.
One very remarkable property of the poison of syphilis is, that it may be re-inoculated into the same organism over and over again, until inoculation ceases to produce any specific effect. As soon as this is the
DISEASE GERMS IN SECRETIONS..
67
case, the organism is said to be “ protected.” But such protection sometimes cannot be procured until successive inoculations have been practised during several months, and, as has been remarked, the remedy is in many respects worse than the disease, besides being, and on many grounds, quite unjustifiable.
Living Disease Germs in Secretions . — The living germs of many fevers pass from the blood into the secretions. The urine, the secretions from the mucous membrane of.the nose, mouth, stomach, and intestinal canal, contain them in large niunbers. There is reason to think they may also escape in the secretion of the sweat and sebaceous glands. In the excre- ments there can be no doubt disease germs exist in vast numbers in typhoid fever, in cholera, and in some other diseases. Even in the milk, in the tears, in the saliva, they are present. Some of the living particles in the milk from a cow suffering from Cattle Plague are represented in Figs. 42 and 44, plate XV, and in Fig. 43, particles of bioplasm as well as fungi are seen in vaginal mucus from another animal suffer- ing from the same disease. The particles of bioplasm in which I believe the contagious properties reside, are situated immediately under the letter d in Fig. 43. Below and to the left of these particles are sporules of fungi, which cannot be mistaken. Their spherical form, sharp, well-defined outline, and the high retrac- tive power of the envelope, positively distinguish them from disease germs.
F 2
68
TUBERCLE BIOPLASTS.
Living tubercle germs will not be considered as very closely related to the contagious particles which are the active agents in the propagation of contagious fevers. There is, however, reason to think that particles of living growing tubercle exist sufficiently minute to be supported by the atmosphere and carried long distances ; while there are many facts which are considered by some sufficiently conclusive to justify the opinion that tubercular disease of the lungs is at least in some instances contagious. And it is certain that the most recent observations in connection with the question of the nature and mode of propagation of tubercle, so far from militating against this view, tend rather to support it. That tubercle is not eminently contagious is certain, while the probabilities of minute particles of living growing tubercle escaping into the air while it remains in the air-cells of the lungs, or rising in a living state into the atmosphere from the sputum after its expectora- tion, are not great. At the same time neither circum- stance can be regarded as impossible, neither view can be held to be untenable.
The manner in which the bioplasm of tubercle multiplies is represented in Fig. 46, pi. XV, where it is seen extending round a small artery in the areolar tissue of the external coat. The living particles obstructed in the vessel make their way through its lining membrane and between the fibres of the muscular coat, until they reach the areolar tissue
PLATE XV.
BIOPLASM, FEVER, Pig. 42.
Milk, a, Colostrum corpuscle with, bioplasm ; 0, oily matter forming cylindrical masses ; c, growing germinal matter or bioplasm, the so-called puslike corpuscles in the milk of a cow suffering from | cattle plague, x 700. p. 67.
Fig. 44.
CANCER, TUBERCLE. •
Fig. 43.
Mucus from -vagina. Cai tie plague. Bioplasm growing and multiplying rafidly. a, Sporules of fungi; 6, small s porules of fungi ; c, corpuscles and pus like cells The manner in which the rapid multiplication of imperfectly formed epithelial cells takes place is represented at e- Observe the concentric layers of the imperfectly hardened formed material X 700. p. 67.
Fig. 45.
dome of the smallest masses ofbioplasm (net coloured i in milk in cattle plague. X 2,800. p. 67.
Bioplasm {not coloured) in cancer cells from a case of cancer of the bladder, x 215. p. 67.
Fig. 46.
Tubercle bioplasm in the coats of a small artery ofthepia mater, from a cd mation. Death three weeks after the commencement of the attack.
gW of an inch.
x 215.
x 700.
)l iLfberciilcU1 mUM.m. 215. p 68.
x 2SC0.
[To face page 68.
CANCER BIOPLASTS.
69
outside, where they grow and multiply. By their accumulation, the pressure upon the vessel becomes greater, and at last its calibre will be completely obliterated. From such tubercle collections minute bioplasts may be readily detached, and after having found their way into a pervious lymphatic vessel, or blood capillary, might be carried to distant parts and grow there. In this way tubercles are developed in many different parts of the body and in the substance of many different tissues and organs. If a particle of fluid, holding living tubercle-germs in suspension, were introduced by inoculation into a weakly or- 1 ganism, the disease might be produced.
Cancer Germs. — Whilst it is almost certain cancer could be introduced by direct inoculation into the organism of a healthy person, many circumstances render it in the highest degree improbable that living germs detached from the growth, could, under any circumstances, gain access to another organism through the air breathed, or in any other manner pass into the blood or tissues, as long as the surface remained uninjured. Cancer germs would probably live for some time in animal fluids out of the body, and it is by no means impossible that we may succeed in growing them in glass vessels away from their natural seat of growth, and watch the changes which occur under our microscopes ; but it is exceedingly doubtful if these germs would long retain their vitality if removed from the fluid which nourished them. Some
7o
CANCER BIOPLASTS.
cancer germs are represented amongst the large cancer cells figured in Plate VI, fig. 17, and in Plate XV, fig. 45. Between the cancer germ, which cannot be conveyed by the air from the diseased organism to one not infected, — and the germ of scarlatina, which will retain its vitality for weeks after it has escaped from the organism in which it was produced, and may readily gain access to healthy organisms in the air they breathe, — we have examples of living disease germs manifesting powers of retaining their vitality when free in many different degrees. In other words, these poisons differ re- markably in the facility with which they are propa- gated, or spread from person to person. All exhibit the same appearances, though they differ remarkably in power. The capacity for resisting death, due to some inherent power and not to their chemical com- position, varies much, some being capable of living for weeks or months away from the fluids of the body, while others die within a very short time of their removal from the seat of growth.
In this section a number of remarkable forms of contagious matter or virus have been referred to. These resemble one another in general appearance. Neither by its form, chemical composition, or other demonstrable properties, could the vaccine germ be distinguished from the small-pox germ, or the pus- germ from either. All are like the minute particles
DISEASE GERMS.
71
of bioplasm of the blood from which they differ so remarkably in power. Of the conditions under which these germs are produced, and of the manner in which the rapidly-multiplying matter acquires its new and marvellous specific powers, we have very much yet to learn. Those who have committed themselves to physical views of life, undisturbed by the signal failure of all their attempts to demonstrate facts in favour of their hypothesis, must needs resort to the wretched expedient of suggesting that differences of form , structure , and composition , may be discovered at some future time. These, when discovered, they prophecy will fully account for the marvellous differences in power manifested by the different kinds of formless, structureless, living matter, healthy and morbid, which has hitherto defied chemical analysis. Yet it is imagined that the difference between the chemistry of the small-pox germ, and that of the ordinary pus germ, will be found sufficient to fully account for the different actions of the two. When chemical science shall have progressed sufficiently to enable chemistry to demonstrate the highly complex chemical pheno- mena of these germs, their marvellous collocations and combinations will, doubtless, be exhibited to the public. In the meantime chemists and physicists await with confidence the fulfilment of their pro- phecies, and decline to take notice of any facts that have been, or that may be advanced, against their untenable doctrines.
INTRODUCTION OF DISEASE GERMS INTO THE BODY AND OF THEIR ESCAPE.
Disease Gei'ms in Air , Water , and Food. — Such minute particles as those described in the last section are liable to be suspended in the air we breathe, or they may be disseminated through the water we drink, or hidden in the food we eat. Not only so, but there is reason to think that some kinds of these contagious disease germs even grow and multiply outside the body. Indeed, it appears probable that a few actually acquire their virulent properties after they have left the organism in which they have been developed, while they remain immersed in some extraneous medium containing the proper elements for their nutrition and further development.
That such particles as those represented are sufficiently light to be supported in the air and carried long distances by air currents, is proved by the fact that the scales of the wings of insects and starch corpuscles, each of which weighs more than a hundred times as much, are supported by the slight currents of air in our ordinary rooms, deposited upon shelves, and even transported long distances. The careful examination of the particles suspended in the air as seen in a sunbeam, renders all further remarks upon this part of the question superfluous.
DISEASE GERMS.
73
It is well known that many contagious diseases may be propagated by the breath. Of this we have direct proof as regards the poison of cattle plague, small-pox, scarlet fever, and some others. Kiichen- meister made a sheep breathe, during one hour, air which was made to traverse the shirt worn for twelve hours by a patient who was suffering from small-pox. Five days afterwards the disease commenced, and by the eighth day a well-marked eruption of variola was developed upon the sheep. Glanders is another contagious disease, and of a most fatal kind, which is propagated through the air, and, although direct inoculation is usually necessary for its communication to man, in one case which fell under my observation, the evidence that the fatal disease was communicated by the air was very strong indeed, if not perfectly conclusive.
I have endeavoured to ascertain if such particles as I have described could be actually demonstrated by microscopical investigation with the aid of the highest powers, in the air which was known to contain a form of contagious poison. Mr. Crookes made some investigations upon this part of the subject in connection with the Cattle Plague Inquiry, and he obtained some very interesting and important experimental results. He was good enough to give me a tube which contained a piece of cotton wool that had been exposed to the breath of a diseased animal, and was fully impregnated with contagious
74
DISEASE GERMS
matter, and another tube through which the breath of an animal, dying from the disease, had been passed. I carefully moistened the wool and the tube with perfectly pure glycerine, and subjected the fluid to examination with the -^th.
Although in each case I have seen particles resembling those already many times referred to, I do not attach much importance to these two isolated observations, or look upon them as con- clusive, for in the first place the number of minute particles of various kinds present makes it impossible to identify with any certainty the supposed particles of contagium ; secondly, as there are undoubted sporules of fungi, I could not prove that the very minute particles which I should be inclined to regard as the contagium had not been developed from these ; and, thirdly, in such an enquiry it would be wrong in principle to place much reliance upon only one or two observations.
At the same time it is only right to state that the piece of wool in one of the tubes, through which the breath had been passed, exhibited a much greater number of minute particles, resembling those which I regard as particles of contagium, than were obtained from the second piece of wool at the other end of the same tube, by which the air was subjected to a second filtration. It does, therefore, appear possible to de- termine the question from this experimental side. The microscopical part of the investigation presents
IN AIR, WATER, AND FOOD.
75
many practical difficulties, and any one entering upon it should perform, in the first instance, a great many preliminary experiments in order to determine the most convenient and most delicate methods of examination.
Many disease germs will retain their vitality in water, and there can be no doubt that many are introduced into the organism in this medium only. From the evidence that has been adduced, it is certain that both typhoid fever and cholera are disseminated by drinking water, and almost as certain that if pure wholesome water had been supplied to the victims ■ instead of the disease-carrying fluid, many lives would have been saved. That some disease germs will live for a considerable time in water, may be proved by experiment. Pus-corpuscles from the bladder may be kept alive in water, to which a very little albumen or serum has been added. The gonorrhoeal poison- germ, as well as the bioplast capable of producing purulent ophthalmia, will also retain their vitality in water, and probably even in water containing soap and other things dissolved in it. Much of the water containing disease-producing germs is very rich in organic matter, and the products of the decomposition of organic matter. Hence it is always desirable to discard such water for drinking or culinary purposes. Although there can be no doubt that many bad specimens of water are perfectly harmless, 'as we are unable to say whether disease germs are actually
76
OF DETECTING DISEASE
present or not in any given specimen, the only safe course is to condemn all water rich in dissolved and suspended organic matter, and to subject all doubtful specimens to the action of Condy’s fluid, boiling and filtration, before its use is permitted.
Various kinds of food afford a nidus for disease germs. Articles of diet should never be kept in the sick room longer than necessary, and the healthy should never be permitted to partake of food which had been left for some time exposed to the air of the sick room. In milk and weak soup it is probable some disease germs might retain their vitality for a length of time, and perhaps in warm weather grow and multiply to a great extent ; and although a number of persons might perhaps take these fluids with impunity, or be in other ways exposed to the influence of disease germs, the probability that but one here and there would be attacked, renders the slightest carelessness on the part of the attendants highly culpable, and deserving of severe punish- ment.
As is well known, the poison of scarlet fever, small- pox, and some other contagious diseases, may be retained for a length of time, in a living state, in the clothes of the sick, in the bedding, hangings, furniture, on the paper of the walls, and even in the floor, of the sick room. It is probable that in these cases the living germs are embedded in a portion of the poisonous matter itself or the secretion in which it
GERMS IN THE AIR.
77
was present, or in some other kind of organic matter which has dried up. Thus some of the germs become protected in the same manner as the living germs of vaccinia and of variola are preserved in the partially dried lymph. In this way, as is well known, they will retain their vitality even for many weeks upon the point of a lancet or upon a glass or ivory plate.
On Detecting Disease Germs in the A ir.— Various methods for detecting germs in the air have already been referred to when the subject of vegetable germs was under consideration. It remains now only to ' describe the apparatus recently devised by Dr. Mad- dox, for collecting from the atmosphere all foreign particles suspended in it. A full account of the instrument in question is given in the “ Monthly Microscopical Journal” for June 1st, 1870, p. 286. The arrangement will be understood, if the figures in Plate XVI, copied from those illustrating Dr. Mad- dox’s paper, be referred to.
In Fig. 47, the instrument is so placed as to be used like a vane outside the house. By slipping off the vane, and placing the rest of the apparatus in a vertical instead of horizontal position, and attaching to it another short tube (Fig. 51) with a metal pipe terminating in a small funnel, it can be used over a, cesspool, in any nook or corner, in an ordinary room, in a cow-shed or stable, or in a ward near apatient suffering from any infectious disease. A draught of
78
DR. MADDOX'S APPARA TUS
air is produced by placing a lighted lamp under the funnel, as shown in the drawing.
When the apparatus is to be used vertically, the extra brass tube (Fig. 5 1) is to be slipped over the end, and the whole is to be supported by one of the retort-holders of the laboratory, or in any convenient way, and beneath the open end of the little funnel is to be placed a lighted oil or spirit lamp, in order that a current of air may be generated. Its position above the surface of the ground may vary from a few to many inches or feet, according to choice. Dr. Maddox thinks about 3 feet the proper height. If it be desired to test the efficacy of various vapours or fluids as disinfectants for the purpose of destroying the living germs, an extra nozzle (Fig. 50) made as a flat box having a small nozzle projecting from the cover, looking towards the thin glass, can be screwed on the ordinary one. “If this narrow box, which should be platinized inside, be packed with fine cotton wool, damped at one part with any article, as creosote, tincture of the muriate of iron, or solution of quinine, or a particle of hypochlorite of lime placed at one part, the particles from the air may be supposed to be entrapped amongst the fibres ; but the cotton-wool should, before use, be soaked in absolute alcohol for half an hour, and squeezed dry between heated plates of glass ; or gun-cotton might be used if thought more free from error. The wool from opposite the nozzle might, in each case, be
DR. MADDOX’S GERM COLLECTING APPARATUS. Fig. 47.
PLATE XVI.
Dr. Maddox's apparatus for collecting germs and solid particles suspended in the atmosphere The air enters at a and through the smaller funnels above and below, it passes through the narrow nozzle in the central part of the figure and Fig- 48, strikes against the thin glass placed imme-
diately beneath This is smeared with glycerine or - purified treacle and to it all foreign particles adhere. The air then escapes through some holes at the circum- ference of the glass and then passes away, p. 77.
The spring for re- taining the thin glass in position, seen in section.
Fig. 49.
Fig. 50.
Screwed pipe with fine extra nozzle for experiments with disinfectants, p, 78.
The thin glass on its plate with holes around the circumference, through which the air escapes.
Tube and lamp for causing a draught through the apparatus when it is used in a room or confined space. The vane is removed and the apparatus arranged vertically, p. 78.
[To face page 78.
FOR DETECTING GERMS IN AIR.
79
removed with a pair of fine scissors and forceps, placed in a deep growing slide with some medium, and set aside for observation.”
The advantages claimed by Dr. Maddox for this apparatus are ready application at any spot, the col- lection of the atmospheric particles into a small space in such a manner that they may be at once micro- scopically examined with a Ath or ^th objective, placed in some form of cultivating apparatus for further observation, or mounted permanently.
Dr. Maddox has found besides particles of various organic and mineral matters, pollen grains, minute germs of various fungi or protophytes, and excessively minute bodies, “molecules,” “globules,” &c. These varied in number according to the force of the wind, dryness of the ground, and other circumstances.
At the close of his paper Dr. Maddox remarks : — “ The examination of the collections made over forty days has shown that in this immediate locality (Woolstone, near Southampton), at this period (May), the air cannot be considered as loaded with micro- scopic germs ; the largest number visible and counted as such on one cover being twenty-one (not including bacteroid bodies). A few only have germinated ; they are under observation.”
8o
ENTRANCE OF DISEASE
Mode of entrance of Disease Germs.
Of the Passage of the Disease Germs into the Blood. — In all cases in which disease germs produce their characteristic effects, they reach the blood. Until they have entered this fluid there is no possibility of their exerting any deleterious effects upon the system. Having entered the blood, they grow and multiply, and, as we shall see presently, become obstructed in the smaller capillary vessels, in and around which those changes occur, which give to each particular contagious fever the characteristics peculiar to it, and enable us to recognize and define it.
With regard to the manner in which the minute particles of contagious germinal matter gain access to the blood, there has been much difference of opinion, but many circumstances render it certain that they may reach it from many different surfaces.
Suspended in the air, they may pass towards or into the air-cells of the lung at every inspiration. Some of the lightest particles might reach the ultimate air- cells where an exceedingly delicate membrane easily penetrated by living particles alone separates them from the blood.
If living disease-germs fell upon the soft mucous lining of the air passages, they would there find a material if not adapted for their nutrition, at least favourable for preserving them in a living state. Through this they would gradually make their way
GERMS INTO THE BODY.
into the capillary vessels or lymphatics, ramifying in the tissues beneath. But besides gaining access to the blood of man’s organism through the breathing apparatus, the particles of contagious germinal matter may pass into the stomach with the food, and make their way into the blood after traversing the delicate mucous covering of that organ. They might get into some of the mucous follicles, and after growing and multiplying there, some of the particles might reach the vessels which lie just beneath.
As has been already mentioned, some disease- germs, like the lower vegetable and animal organisms, will live for a considerable time in water. But it must not be concluded that this fact tends in any way to favour the view that disease-germs are in fact animal or vegetable particles, for pus-corpuscles will not only live for a considerable period of time in water, holding in solution a very small quantity of animal matter, but they will grow and multiply. Of all media taking part in the wide diffusion of disease- germs, and facilitating, their introduction into man’s organism, water, there is reason to think, is the most general, and, perhaps with the exception of air, the most effective.
Lastly, the particles of contagious bioplasm or germinal matter may enter the body through the skin. In some states of the cutaneous surface, the epidermis is swollen, softened, and moist, and living particles would easily insinuate themselves in the II.
G
82
OF THE PASSAGE OF DISEASE
slight chinks which exist between the epithelial cells, and gradually make their way into the capillary vessels beneath.
I have heard that a well-known physicist has said, that if his mouth and nose were protected by a cotton-wool respirator, he would not hesitate to sleep in a bed which had been occupied by a patient suffering from scarlatina. Although we are much in want of information concerning the precise mode of ingress of poison-germs, I trust that so foolish and utterly useless an experiment will not be made. If the experimenter took the disease, the fact would add nothing whatever to our knowledge, while if he escaped scathless, the fact could be more satisfac- torily explained than by attributing it to the efficiency of the vaunted cotton-wool respirator. Germs so minute as those of contagious diseases will find their way into the blood by other channels than the air passages or alimentary canal. The mucous mem- brane of the conjunctiva, covering the front of the eye, is soft and moist, and they could easily worm their way between the soft epithelial-cells, and thus reach the blood. They might readily make their way into a hair-follicle, or pass down the tube of a sweat-gland. There are also many passages opening upon the external surface of the body by which such minute living, moving particles might gain access to the moist tissues, and make their way into the blood.
GERMS INTO THE BLOOD.
83
In some instances it seems that the disease-germs gain access to lymphatic vessels, and grow and multiply there, causing abscess in some of the lym- phatic glands. The blood is sometimes infected as well, while in some cases, in which there is serious inflammation of lymphatic glands, it appears to escape contamination.
The living particles of contagious germinal matter readily find their way into the blood if there is an open wound upon any part of the body, and if, as is not unfrequently the case in patients suffering from wounds, the blood is not in a healthy state, the poison grows and multiplies rapidly. To introduce caLses of contagious fever into a ward where a number of persons who have undergone surgical operations are lying, would be a cruel and, though not so in law, a criminal act. To place a surgical case in a medical ward in which fever cases of any kind are admitted, is most dangerous. Even slight wounds like those made in operations upon the eye do not heal readily, and out of a number of such cases a large percentage will certainly go wrong. Accoucheurs are well aware of the horrible fatality of contagious poisons when intro- duced among lying-in women, and are but too often painfully familiar with the dread certainty with which these minute germs make their way into the blood, poison the living matter of the body, and destroy life in the puerperal state. For this reason lying-in wards can never be maintained in any general
G 2
84
ENTRANCE OF DISEASE
hospital, if cases of disease depending upon conta- gious poisons are also admitted. It is probable that if cases of surgical operations were placed in buildings apart from medical cases, the mortality from pyaemia and allied diseases, would be considerably reduced.
State of Vessels favouring the Entrance of Disease- germs. — Admitting, then, that it has been proved that contagious poisons generally consist of minute particles of living matter or bioplasm, and that this living matter, to produce its characteristic effects upon the system, must enter the blood, let us inquire how the living particles gain an entrance into the vascular system in cases in which no wound is made, in which there is no solution of continuity in any part of the vascular walls. The fact that, of a number of persons equally exposed to the influence of con- tagium, some will contract the disease, while the majority will escape, may be accounted for by sup- posing either that in the latter case the particles do not really penetrate the vascular wall at all, or that, they are in some way destroyed as soon as they traverse the wall of the capillary and come into contact with the blood.
We must therefore enquire what circumstances would favour or assist the passage of the livingparticles of the contagious material through the vascular mem- brane into the blood. Thin- walled capillary vessels, as is well known, come very near to the free surface in many parts of the body, and if these capillaries are
GERMS INTO VESSELS.
,85
distended with blood, their walls are rendered still thinner, and they come still nearer to the surface. The capillaries of parts of the mucous membrane of the nose, mouth, fauces, and conjunctiva, even in a state of perfect health, are covered with a very thin layer of protective epithelium, while those of the air- cells of the lung are practically bare. Through these, minute germs might readily pass. In many morbid states, the epithelial covering of the mucous mem- branes above enumerated, is very soft, and sometimes it is reduced to a thin layer of moist, pulpy mucous material in which any foreign particles would very readily become embedded. In such a material, con- tagious disease-germs would find a nidus suitable for their reception, and at the same time probably also soluble materials adapted for their nutrition. Having fallen into this, they would grow and multiply, and minute offsets from them might soon make their way to the external surface of the thin capillary walls.
When the capillaries are much stretched, as is always the case when they are fully distended with blood, the minute particles of living germinal matter or bioplasm of the blood, as well as diverticula from the white blood-corpuscles, readily make their way out of the capillaries through the walls with the blood serum, and grow and multiply in their new position. Even red blood-corpuscles, as is well known, often pass through the vascular walls under
86
DISEASE GERMS IN VESSEIS.
these circumstances. In many kinds of inflammation this commonly happens.
Every one who has been in the habit of making minute injections of the vessels of tissues must be acquainted with the fact that little longitudinal rents or fissures in the walls of the capillaries, quite wide enough for a red blood-corpuscle to pass through edgeways, are easily made. It is therefore quite certain that particles can pass from the interior of the capillary vessels outwards with the greatest readiness, and without the occurrence of any actual rupture of the vascular wall. There can, therefore, be no difficulty in explaining how the passage of disease-germs in the opposite direction in a similar state of the capillary wall takes place. These little particles, like other forms of bioplasm, possess inherent powers of movement, and would easily insinuate themselves through any slight fissure which existed in the capillary wall. Such particles of living matter are even capable of passing consider- able distances through the interstices of various tissues, like the living germs of some parasitic organisms, which, as is well known, often traverse a great extent of tissue before they arrive at the spot where they undergo development.
Again, it must be borne in mind that there are at very short intervals in the capillary walls masses of bioplasm (nuclei), which increase considerably in size when supplied very freely with nutriment. These
MODE OF ENTRANCE.
87
may divide and subdivide, and give rise to collections of little bioplasts “granular corpuscles,” as seen in cases of inflammation of the pia mater, and also in cases of tubercular disease of the same membrane. The walls of the vessel are weak and liable to altera- tions in the situation of these nuclei, as the latter increase or diminish in size. Hence there is no diffi- culty in accounting for the passage of minute par- ticles of the living contagious bioplasm in cases in which the capillary walls are diseased, and after they have been unduly stretched and have remained some- what flaccid.
Now, the state of things referred to above — a soft moist state of the mucous surfaces, a dilated con- dition of the capillaries, combined with a weak, flaccid state of their walls, which always follows long-continued congestion, and which is intimately connected with a weak heart’s action and feeble condition of the nervous system, are the very conditions which would facilitate the passage of living germs, — and is not this the state of things which exists in the organism about to be the victim of a contagious fever ?
No doubt in these cases the composition of the blood is altered and its fluid constituents manifest a tendency to permeate the vascular walls more readily than in a perfectly healthy state. Such a state of blood would doubtless affect the action of the nervous centres presiding over the contraction of the arterial walls, and regulating the flow of blood through them,
88
PRESENCE OF GERMS
thereby influencing the nutrition of the part. In this way a relaxed state of the arterial walls and a congested state of capillary vessels might be induced, or already existing, might be increased. It is this low and but too often ill-defined weak state of health, which often persists for some weeks before the attack of contagious disease occurs, that we should endea- vour to detect, and at once treat. Nay, it is almost certain that every serious acute disease dangerous to life to which we are subject is preceded by a condi- tion of system which in many particulars is a departure from health. If this can be altered, the liability to the supervention of the acute attack no longer exists. It is in the direction of anticipating the occurrence of actual serious well-marked disease that those most earnest in advancing medicine may reasonably hope to do useful work. And it seems certain that the more minutely we investigate, the more likely shall we be to learn how to discover and to appreciate that slight departure from the healthy state which precedes, and often by some considerable time, the development of many of the most serious and most fatal maladies. Were our knowledge greater we might perhaps in many instances succeed in warding off altogether the threatened invasion of disease.
Minute investigation in connexion with disease has been most unwisely discouraged, by purely scien- tific men on the one hand, and by those who confine themselves to their practical medical duties on the
IN THE CAPILLARY VESSELS.
89
other. By the first, because they think that medical practice affords occupation enough for one man ; by the last, on the ground that scientific work unfits a man for the practical duties. It has too often happened that the very few who have devoted themselves to real medical enquiry, have been unfairly treated, and by the very persons who ought to have afforded them support. The time has now arrived when the incen- tives to this course should be openly condemned, as resulting from narrow ancient prejudice, which has long survived its allotted term. Every intelli- gent person will do his utmost to further those ' branches of investigation which have already ex- erted so great an influence upon the discovery of the wonderful changes which occur in man’s body in health and disease, and therefore upon the pro- gress of medicine.
Of the Presence of the Germs in the Capillaries . — In every form of contagious disease, and during every period of its existence, the circulation through the capillaries is affected ; indeed, the essential phenomena of each special malady are due to changes in the quantity and quality of the contents of the capillary vessels. If recovery from the malady is rapid and complete, the capillary changes induced by the disease have been slight. If the disease terminates in death, the fatal result is occasioned by irreparable damage in and around the capillary vessels themselves, or it is occasioned by secondary changes in the tissues induced
90
PRESENCE OF GERMS
thereby. The character of the eruption is determined mainly, and in some cases entirely, by the abnormal state of the capillary circulation, and even in those instances in which local alterations in vascular tension are unquestionablyassociated with nervous disturbance, this is often induced indirectly by a primary change in the capillary circulation, by which the afferent nerve fibres passing to the ganglia, are influenced. Disturb- ance consequently occurs in the ganglion, and the central variation excited in the intensity of the current is conducted along the efferent vaso-motor arterial nerves. In consequence, many little arteries become dilated, and the vascularity of the area of tissue sup- plied by them is increased.
In all cases of contagious disease which I have examined, the same sort of living germinal or bioplas- tic matter has been discovered in the capillary vessels of many of the affected tissues of the body. In some parts the vessels appear to be quite filled with a “ granular,” more or less transparent material, which, when fresh, may be stained by the carmine fluid, and exhibits the characters of bioplasm, the particles of which are, however, exceedingly minute.
I cannot explain fully and satisfactorily why the contagious material collects principally in the capil- laries of the skin and mucous membranes, but I would remark that the masses of bioplasm in connexion with the surface capillaries are large, and project into their interior, Plate XII, fig. 31, p. 52. Thus there are
IN THE CAPILLARY VESSELS.
91
many little eminences by which the further passage of the germs might be interfered with. The vessels themselves change much in volume many times during every twenty-four hours ; the canal being some- times far too narrow to permit a red blood corpuscle to pass, Plate XXII, fig. 79, p. 104, while at others the tube is much dilated and filled with blood. Moreover, the capillaries often form loops, and sometimes little diverticula may be found here and there, in which particles might collect and accumulate to some ex- tent, without the tube of the vessel being in any way obstructed.
The little particles of contagious matter having gained entrance into the blood and arrived at the super- ficial capillary, probably absorb nutrient material ra- pidly. It is possible that fibrin may become coagulated around these little bodies, just as if they were par- ticles of pus, and the mass being too large to pass, may become impacted into some part of the capillary system. The large size of the white blood corpuscles in very many blood diseases is also a fact not gene- rally known, although of great importance, which must not be lost sight of in considering this part of the question ; but I cannot discuss it here. In those organs in which the circulation is slowest — as the spleen and liver — the conditions would be very favour- able to the multiplication of such particles of living matter, and it is probable that in some cases the capil- laries in these organs are principally affected in the
92
STATE OF BLOOD FAVOURING
early period of the disease. From the collections thus formed, particles may be carried to other parts.
State of Blood favourable to the Multiplication of Disease Germs. — No investigation is likely to be more fruitful in valuable results than a very care- ful inquiry into the microscopical and chemical cha- racters of the blood just before its invasion by con- tagious disease germs, and the alterations effected by them during the period of incubation. There is much reason to think that certain states of blood are favour- able to the multiplication of the poison, while others, perhaps, render its destruction almost certain.
It is at least doubtful if the growth and multipli- cation of every kind of disease germ will occur in perfectly healthy blood, even if introduced and mixed with it. Numerous facts, which will occur to every practitioner, render it far more probable that — at least in the case of the great majority of contagious fevers — a certain state of blood must be induced before the contagious poison can grow and multiply, and pro- duce new germs. No one has, however, yet suc- ceeded in ascertaining exactly in what particulars such altered blood differs from the perfectly healthy circu- lating fluid, but it is not a state of blood associated with a large number of red blood corpuscles, or with a highly active condition of the oxidizing processes ; nor is the condition under consideration brought about by living much in the open air, and by the plentiful supply of good wholesome food and water.
MULTIPLICATION OF DISEASE GERMS.
93
Although little has been discovered concerning the state of blood favourable to the growth and multipli- cation of disease germs, it has long been known that when fever, inflammation, and other blood diseases have become established, the composition of the blood is altered, and even in a slight feverish attack which constitutes an ordinary cold, the chemistry of the blood is temporarily deranged. The extractive matters soluble in boiling water are present in undue pro- portion, and it is probable that this increase arises from insufficient oxidation. Various matters which in perfect health are very highly oxidized, so as to be eliminated in the form of carbonic acid, urea, and other substances which are readily excreted, remain in the blood unoxidized, or are very slowly and with difficulty eliminated in a suboxidized state. Thus there remains in the blood an excess of soluble material, which per- meates the tissues much more readily than ordinary healthy serum. This transudes through the walls of the capillaries, and is appropriated by the bioplasm of the blood, of the vessels, and of the tissues. The bio- plasts or masses of germinal matter invariably increase in size under these circumstances. By this increased growth of germinal matter, which invariably takes place in all inflammations and fevers, the close analogy existing between these two classes of diseases is clearly indicated.
One important change in the composition of the blood when fever has become established, may be
94
OBSTRUCTION OF
demonstrated in a very simple manner. If the dried residue of the fever blood be extracted with boiling distilled water, it will be found that the proportion of matter dissolved out from the fever blood is much larger than that obtained from the healthy blood residue. Three specimens of blood taken from animals which died of the Cattle Plague, contained respec- tively, 2'9i, 2'22, and i *8 1 parts of soluble matter dissolved out by boiling water, or twice the quantity extracted from healthy ox blood. The exact amounts were as follows
Solid matter obtained by evaporating ioo parts of blood
Substances soluble in boiling water
|
Healthy ox blood. |
Blood from Cattle Plague. |
||
|
1. 2. |
1. |
2. |
3- |
|
19 ’87 20*63 |
23*1 |
22*78 |
24*88 |
|
1*33 rii |
2*91 |
2*22 |
1*81 |
The solid matter of the two healthy specimens con- tained respectively 6^69 and 5*38 per cent, of matters soluble in boiling water, while the diseased specimens contained respectively I2’62, 972, and 7*22 per cent. So that not only is the percentage of the solid matters generally greatly increased in this form of fever, but the extractives and other substances soluble in boiling water are present in increased proportion. These substances probably constitute a pabulum, which is very readily appropriated by degraded forms of bioplasm.
Obstruction of the Capillary Circulation. — In all
CAPILLAR V CIRCULA TION.
95
diseases depending upon the presence of disease germs in the blood there is at length unmistakeable evidence of obstruction to the flow of blood through the capillary vessels of different parts of the body. If this obstruction is incomplete, and only affects a limited area of tissue here and there, the case ter- minates in recovery, but if, on the other hand, the capillaries of a considerable portion of the body are obstructed, and more especially if the heart’s action in such a case should be weak, and the contractions of the left ventricle not sufficient to drive the blood forcibly towards those capillaries which may yet ■ remain more or less pervious, the disease must be fatal, and probably during its early stage. It is therefore of the utmost importance in critical cases to excite the heart’s action by giving remedies which are known to have this effect. See also page 140.
The contagious disease germs in some instances, as has been already suggested, are perhaps enveloped in a coagulum of fibrin, and thus are formed little masses which would be too large to traverse the capil- lary vessels. - Mr. Lee showed that if pus was injected into the blood of a living animal, coagulation of the fibrin of the blood immediately occurred. In the case of some contagious disease germs, it is possible that the coagulation of fibrin around the contagious par- ticles may only increase the size to that of a white blood-corpuscle, or little larger, but a body even of this size would, under some circumstances, fail to pass,
96
CAPILLARIES OBSTRUCTED.
and being obstructed in its passage, further coagulation is necessarily occasioned, p. 91. Thus many capillaries would be stopped up, and small patches of highly turgid •and obstructed vessels would result. Soon the germs enveloped by the coagulum increase and multiply, and thus after a while the cavity of the capillary vessel appears to be entirely occupied by them, and no blood whatever can pass through. This often leads to com- plete disorganization, which will be again referred to.
In some cases the obstruction depends rather upon the increase of the bioplasm of the capillary walls, which occurs in all inflammations and fevers, Plate XXIV, p. 134, and is not due to the increase and accumulation of the contagious disease germs them- selves.
But however the obstruction may be brought about, it is soon followed by most important changes, exter- nal to the vessels, in consequence of which the action of the tissues and organs involved becomes seriously deranged. It has been frequently proved that if, in certain states of the blood, particles of living matter allied to pus be introduced, phenomena which at length end in death, are occasioned. The blood cannot cease to circulate without the neighbour- ing tissues being deprived of nourishment, and if the obstruction remains complete for a few days, still more serious consequences ensue. Not only are the vessels themselves destroyed, but the adjacent textures are involved in the common ruin. Separation of the
DESTRUCTION OF VESSELS.
97
textures by the formation of sloughs not unfrequently occurs ; but where neighbouring vessels and lymphatics remain healthy, the removal of disintegrated tissue is sometimes effected by absorption, in which case por- tions of the tissue or organ afterwards appear as if they had wasted.
With regard to the particular capillaries obstructed, it has been already remarked, that those of the cuta- neous and mucous surfaces are most seriously involved in many contagious fevers, but these are by no means the only vessels affected. In some diseases the capil- laries of the liver and spleen are the seat of change, 'while in certain forms, those of the lungs, kidneys, and other glands, and even those of the muscular and nervous tissues suffer to such an extent, that part of the organ may undergo most serious pathological change, or be completely destroyed.
Destruction of Vessels and Tissues \ — Wasting of tissue, usually circumscribed, which not unfrequently follows a bad attack of contagious fever, is a direct consequence of the vascular changes which have been referred to. In such cases the organism is often seriously and permanently damaged, and the normal state can never be regained. There is not a tissue or organ in the body which is certain to escape the ter- rible consequences of a severe attack, but happily cases in which many organs in one individual are seriously damaged, are rare, for, as a general rule, when the disease is sufficiently severe to produce II H
98
DILATATION AND DESTRUCTION
such a result, it ends fatally. Still, we meet with many instances, where serious local damage has hap- pened, as, for example, where permanent local para- lysis follows continued fever, diphtheria, and scarlatina, or destruction of the delicate textures which form the nervous portion of the organs of sight and hearing, especially as a consequence of the last condition. Nor is prolonged or permanent derangement of the health and imperfect nutrition an uncommon consequence of the changes effected in and around the capillaries in many cases of different kinds of contagious fever, which are due to the entrance of disease germs into the blood. A very good notion of the sort of change which occurs may be formed if the great alterations which are induced in the villi as a consequence of cholera, be carefully studied.
If such changes have affected an extensive tract of small intestine, it will be seen that the proper functions of this important surface can never again be properly discharged. Although, no doubt, in the healthy state there is a much greater extent of absorb- ing surface than is really required, it must be obvious that if this be very much reduced, as is the case after a severe attack of cholera, the effective absorbing area will be too limited to take up the quantity of nutri- ment required to maintain the body in a state of health and vigour. Nor, after a careful consideration of the serious changes induced in the vessels and other tissues of the villi in cholera, shall we be surprised that serious
OF VESSELS OF VILLI.
99
attacks generally prove fatal. The obstructed vessels of the villi are represented in Plate XVII, figs. 52 to 59, under a low magnifying power. The villi them- selves are much smaller than in health, and some are completely disorganised (Fig. 57). Lieberkuhn’s fol- licles are also seen to be shrunken, short, and wasted, and some have completely degenerated (Fig. 59). In Fig. 58 the narrow openings of wasted follicles are represented. These are very much smaller, and are separated from one another by a much greater dis- tance than in health. Many of the vessels represented in these drawings are so changed and disorganised, that it is impossible they could ever again have trans- mitted blood. Had the patient recovered, many of the villi figured would have disappeared.
The capillaries in many of the villi have wasted in a manner and to an extent which is very remarkable. A specimen has been represented in PI. XVII, fig. 55, which shows the alterations very distinctly, although they have not yet proceeded to an extreme degree. In Pis. XVIII, XIX, a more advanced stage of disor- ganisation, is represented. At the summit of the villus in Figs. 60, 61, p. 102, many of the capillaries have become reduced to mere lines, and the texture a short distance from the surface has wasted ; indeed much of it had completely disappeared. In the intervals between the lines which mark the positions occupied by the capillaries is a little indeterminate tissue, in which several oil-globules are seen.
H 2
IOO
STATE OF CAPILLARIES
In Figs. 55, 62, the vessels have not wasted to the same degree, but their outline is irregular, and they are filled with an almost colourless material. A greater quantity of the tissue of the villus remains in the meshes of the capillaries in Fig. 60 than in Fig. 63. It is clear that the blood could not have circulated at all in these vessels for some time before death. Any blood that remained stagnant in the larger ones had become altered. Its colouring matter had dis- appeared, proving that many days had elapsed since the obstruction had first occurred. Those consti- tuents of the tissues which were incapable of absorp- tion have undergone great change. Among the resulting products is fatty matter in considerable quantity (Fig. 61).
In some cases there was demonstrative proof that some time before death blood had actually passed through the capillary walls into the surrounding tex- tures. Crystals of haematoidin, as well as oil-globules, were found in considerable number in this situation, as represented in Fig. 61. This circumstance proves that the villus had not been in a healthy condition, even for some time before the attack.
Villi exhibiting the structural alterations de- scribed cannot be organs of absorption. Neither could secretion have taken place from the follicles. The passage of fluid out of the vessels must have ceased long before they became reduced to the state figured. They must now be regarded as mere processes of de-
PLATE XVII.
CAPILLARIES OP VILLI. ‘ CHOLERA. Fig. 52. Eig. 53.
Fig. 54.
a
■Vertical sections through mucous membrane of small intestines in cases of cholera showing enormously distended vessels of villi and wasted Lieberkuhn's follicles a small arteries in sub- mucous areolar tissue filled with, clots. X 40. p. 99.
Eig. 55.
Vessel with bulgings consequent upon obstruction. Prom the summit of a villus, (Cholera, case 4 ) x ‘215. Oil globules are seen in great number in the vessel itself and in the tissue external to it. pp 99,113.
Eig. 67. Eig. 58.
Eig. 56.
Cell-like mass represeented at b, Fig. 63. The dark bodies in tine lower ■ part may be bacteria X 1800.
59.
Villi of small intestine, cholera, show- ing distended vessels of villi with complete disorganisation of capil- laries and tissues at the summit X 40.
ri5 of an inch
Orifices of lieberkuhn’s follicles of small intes- tine—much wasted. X 40.
x 40.
x 215.
Irregular and much altered villi. Cholera a. Lieberkuhn’s follicles, much altered, wasted and degenerated. X 40. p 99.
X 13C0
[To face page 100.
OF VILLI IN CHOLERA.
IOI
generated tissue, useless to the economy, and destined to be removed, and their place occupied by new organs, if life had been preserved.
The changes affecting the capillary vessels as they appear under high powers, will be understood by refe- rence to Figs. 55, 60, to 67. Fig. 64 shows the capil- laries of the villus in an almost healthy condition.
It is quite certain that the morbid changes de- lineated in these drawings must have been progressing some time previous to the attack which destroyed life. It may be confidently affirmed that such changes as those described could not have taken place in a ‘few days. There is sometimes evidence of alterations which must have been going on, even for weeks before death. The kind of degeneration which has been observed obviously requires some time for its comple- tion, although I have not the data to enable me to fix the precise period. The time requisite for the changes which occur in blood-clots can be ascertained accu- rately in some cases, and we have no reason for infer- ring that the red blood-corpuscles could be much more quickly disintegrated in the tissue of the villi, or hsematoidin crystals formed in a shorter time, than in other situations.
In many of the specimens of small intestine from cholera cases I have found villi in every stage of wast- ing—the villus in which the change has only just commenced, and villi of which all that remained were little stunted elevations, projecting slightly from the
surface of the mucous m
Had the patient
102
EFFECTS OF CHOLERA.
recovered, I am of opinion that new villi would have been formed, and to some extent have replaced those which had been removed. As I have already remarked, in a given area of intestine in cholera cases there are fewer villi and fewer Lieberkuhn’s follicles than in health, and I believe that many victims of this disease had been suffering from degeneration of their villi for a long while before the occurrence of the attack of cholera, which proved fatal. The constant introduction of bad food and water, and in many instances terrible defi- ciency of food of all kinds, will sufficiently account for the marked changes which have been described. I think the evidence advanced in favour of the view that healthy persons die of cholera is defective and inconclusive, and believe, if this scourge is ever to be prevented, it will be by constant and unremitting atten- tion to the food and general habits of life of the poor, not merely while we are appalled by the actual pre- sence of the scourge, but at all times. There seems reason for thinking that it is possible by good manage- ment to prevent people from being attacked by cholera. Have we not reason to conclude that much may be done to prevent people from becoming subjects for the cholera poison f We know, alas ! that we can do little, sadly little, to cure those attacked — though, perhaps, very much to improve the health of those liable to attack. We might thus mitigate to some extent the severity of the disease, and improve the patients’ chances of recovery. I should waver in these views
PLATE XVIII.
SUMMIT OP VILLI— CHOLERA. Pig. 60.
Shrunken and altered vessels from the summit of a villus Jejunum. (Cholera, case 5.) Thickening of apparent ' basement membrane.' x 700. p. 100.
Pig. 61.
Part of the summit of a villus (Cholera, case 6.) a, crystals of hsematoidin. The vessel was pervious up to the point marked b. beyond which mere lines were discernible. The normal tissue, of the villus had completely disappeared, and numerous oil globules were disseminated through what lemained. x 700. pp. 100, 113.
Fig. 62. a c
b
Altered capillaries, from the summit of a villus. (Cholera, case 1.) a represents a large mass of germinal matter in the vessel, probably an altered white blood corpuscle b, some cells apparently in the tissue of the villus, perhaps in the lacteal ; one of these is represented more highly magnified in Tig. 56, Plate xvii. c, oil globules, x 700. p. 100.
T(m> o tL of an inch
x 700.
[To face page 100.
■
PLATE XIX.
VILLI IN CHOLERA. Fig. 63.
Fig. 64. a
i
Summit of a villus from the jejunum. (Case 4.) Nearly healthy, a, lacteal. X 700.
Fig. 66.
Capillaries and bodies external to the vessel. (Case 3.) X 700. p. 101.
Fig. .65.
Capillary vessels, from the summit of a villus. Containing a large mass with dark pigment granules and oil globules in its interior. In various piaces very minute bioplasts are seen. X 1,800. p. 101.
Fig. 67.
Vessels from the summit of a villus. Case 3.) Containing numerous oil globules, x 700. p. 101.
[To follow plate XVIII.
MULTIPLICATION OP PISE ASP GERMS.
103
if I should obtain but a single specimen of small in- testine in which I could not demonstrate diseased and altered villi. So far I have found them, without ex- ception, in every case I have examined, and hence I have been led to form the above opinion, which becomes stronger as I work on.*
Multiplication of the Disease Germs in the Infected Organism.— -From the observations already advanced concerning the size of the smallest living particles capable of growing and multiplying, it will be inferred that the actual quantity of contagious bioplasm suffi- cient to produce a contagious disease is wonderfully small, and that within the organism this minute par- ticle multiplies a million-fold.
The contagious disease germs, like particles of germinal matter in inflammation, multiply enor- mously, not only in the blood vessels (Plates XX and XXI), but after having passed through the capillary walls, and gained the interstices of the tissues, Plate XXII, they grow there, and not only
* I regret to have to notice here that a distinguished pathologist has stated that he has failed to confirm my observations upon the villi. It would have been but fair had he taken the trouble to look at my speci- mens before condemning my statements. It is probable he did not employ a method of examination which would afford a chance of success — certain that he did not proceed as recommended. Such hasty and confident assertions are calculated to excite distrust in the minds of many, but this cannot be helped. The observer simply records the facts, and if others, who have not taken the trouble to ascertain whether they are true or not, think proper to contradict him positively, he cannot prevent the practice. Speaking solely from what he has actually ob- served, and delineating carefully what he has seen, he may safely leave to those who contradict his observations the satisfaction of registering their contradiction.
104
DISEASE GERMS
appropriate the nutrient matter which is required by the bioplasm of the tissue, but they may even grow at the expense of the latter, Plates XXI and XXII.
The bioplasm of the tissue may be killed and the tissue completely destroyed. The latter very soon ceases to discharge its function, and gradually it dete- riorates in structure, and at length undergoes disinte- gration. Bacteria may be developed in it, and its decomposition may even occur in consequence of the rapid growth and multiplication of the germs of some contagious fever. In Plate XXII will be found draw- ings which illustrate some of the remarks just made, and in Plate XXI, fig. 72, is a drawing which shows very well the vast growth of bioplasm amongst the vesicles of adipose tissue in ordinary inflammation.
We have now to inquire more precisely into the circumstances under which the wonderful increase of the poison is brought about There are two views essentially different from one another, which may be supported by different arguments.
1. It might be maintained that the contagious ma- terial actually passing into certain portions of the living germinal matter of the organism excited in these new actions, and caused them to divide and sub-divide very actively, and communicated to them the same properties which the original particle possessed, somewhat in the manner in which the wonderful powers existing in connexion with the germinal matter of the spermatozoon are communicated to that of the ovum and affect to some extent every one
PLATE XX
DISEASE GERMS IN VESSELS— CATTLE PLAGUE.
Fig. 63.
Surface of mucous membrane, of fourth, stomach. Cattle Plague, corresponding to a thin depressed circular spot like antalcer ; a, superficial capillary vessels varying very much in diameter, filled with .( disease germs) minute particles of germinal matter or bioplasm. The orifices of several gastric glands are seen in the spaces bounded by the vessels, 'and the deeper vessels on a lower plane are also delineated.
X 350. p. 103.
Fig. 69.
Portion of one of the larger vessels on the surface of ' the mucous membrane represented, in Pig. 63, containing masses' of bioplasm, x 1,800. •
Fig. 70.
Capillary vessels from the surface of a villus con- taining large masses of bioplasm and minute bioplasts (disease germs). X 700. p. 101.
Fig. 71.
Capillary loop from Malpighian body of kidney. Cattle plague. Containing numerous white blood corpuscles and many minute bioplasts (disease germs). X 700. p, 104.
T?>g5 of an inch
x 700.
,[Tn face page 101.
BIOPLASM— CATTLE PLAGUE.
PLATE XXI.
Fig. 72.
Fat vesicles and areolar tissue from external coat of' vein of horse, three days alter it was opened by operation. Multitudes of bodies like white blood corpuscles (bioplasts), and probably direct descendants from them, are seerj in the intervals between the fat cells, which m some instances were dyed with the altered and dissolved colouring matter of the blood, the greater part of which had however been removed. The bioplasm represented in this figure is harmless, but could not bp-, distinguished from the contagious particles in other figures in this plate. X 215 p. 101.
Eig 73.
One of the loops of vessels in a papilla of the mamma, cattle plague. Just under the eruption, fig.- 75 The epithelium has been- removed’. The morbid bioplasm a. (disease germs) is seen just at the summit. The bioplasm of the epithelial cells, b, is much increased. X 7 00.
Eig- 74.
Portion of a capillary from the surface of a villus. Small intestine - from a very bad case of cattle plague The vessels were covered withlarge and small masses of bioplasm, and contained masses of the same character in their interior. Complete disorganization had occurred. X J.800.
__h_ of an inch x 215.
x 700.
x 2800.
[To follow Plate XX,
PLATE XXII.
DISEASE GERMS.— CATTLE. PLAGUE.
Fig. 75.
Vertical section through the centre of a well-marked papule (pustule ? ) from the udder of a cow, with cattle plague, sent by Mr Ceely, January 14th, 1866. The eruption and roaeoloid rash were well marked. There were also numerous scales ; a is the central softened portion of the papule. Natural size.
Fig. 76.'
Fig. 77-
Fibrous tissue of the eorium or true skin from the softened part of the papule, a, Fig. 75. The intervals between the fibres occupied with bioplasm (disease germs) growing and multiplying rapidly, x 215. p, 104.
A portion of Fig. 76, magnified 700. The masses of contagious bioplasm can be seen dividing and subdividing into new portions which are growing rapidly and invading the bundles of white fibrous tissue, p. 101.
Fig. 79.
Capillary; Retina of calf (cattle plague) showing enlarged nuclei, a, of the walls projecting into the interior of the vessel b, enlargsd white blood
corpuscle, c, c, c, red blood corpuscles. X 700.
Fig. 73.
Minute particles of contagious bioplasm Masses of bioplasm from the external
from the fibrous tissue of the skin, surface of a villus, cattle plague, x 7C0
beneath the eruption, (Fig. 77.) x 1,800.
t (Hio arL inch x 215 .
,, x 7oo:
[To follow plate XXI
IN INFECTED OEGANISM.
105
of the multitudes of living particles resulting from its division.
2. The contagious particle or particles having gained access to the fluids of the uninfected organ- ism may absorb nutrient matter, grow and multiply, and give rise to a progeny very closely resembling the originals.
In the first case the actual living matter of a healthy organism is supposed to take upon itself a new and peculiar action in consequence of the influence of another kind of germinal matter upon it. In the second the contagious material simply grows and multiplies at the expense of the pabulum.
It is open to discussion which of these two views is supported by the greatest number of and most preg- nant facts. I incline strongly to accept the latter as the more probable of the two.
It may, however, be fairly asked, when a pus cor- puscle from the surface of the conjunctiva of a person suffering from purulent ophthalmia, or when a particle of gonorrhoeal pus comes into contact with an uninfected conjunctiva and grows and multiplies, establishing a similar morbid condition to that in operation upon the surface where it grew, — whether the multitudes of resulting pus corpuscles are the direct descendants of the original specific pus cor- puscle, or are derived from the bioplasm of the blood or of the cells of the conjunctiva, which is modified in consequence of its action upon it.
It seems to me probable that the corpuscles capable
jo6
CAN DISEASE GERMS
of exciting a new action upon an unaffected surface are the direct descendants of the original corpuscles which excited that action. Not only so, but I believe they take the nutrient material which was destined for the nutrition of the normal bioplasm, and live at its expense. Just as in the case of cancer, the adventitious rapidly growing germinal matter takes the nutriment destined for the normal tissue, and even feeds upon the latter in consequence of its powers of growth being much more active.
At the same time in the case of the specific pus- corpuscles growing upon a mucous surface there is no doubt that the germinal matter of the normal cells increases and multiplies too. Indeed, in some in- stances I have proved that this is the case, so that there are two distinct processes goingon — I, the mul- tiplication of the specific bioplasm, and, 2, the multipli- cation of the germinal matter of the normal cells modified by the altered circumstances to which it is exposed. And it therefore follows that not every one of the pus-like bodies formed is capable of exciting the specific inflammation, but the morbid bioplasts outstrip to so great an extent, in the rate of their multiplication, the masses of normal germinal matter, that the number of descendants of the latter would be comparatively insignificant, and would soon be completely overwhelmed by the former.
Upon the whole, then, I venture to conclude that the millions of contagious particles produced in the
INVADE NORMAL BIOPLASM?
107
organism in an eminently contagious disease, are all the direct descendants of the very few, or perhaps even single particle first introduced ; just as the millions of bacteria and fungi developed in certain decomposing organic matters in the course of a few hours may have been produced from one or at most a very few par- ticles. And that although in the secretions upon the mucous surfaces, and in internal parts, there may be many masses of germinal matter resulting from the increased access of pabulum already many times referred to, these latter do not form the active elements of the contagious material or contagium.
Concerning the Possibility of Disease Germs passing into the substance of Normal Living Bioplasm. — It is true that in the substance of many masses of germinal matter found in the secretions and discharges of ani- mals dying from cattle plague, and of many other diseases, some minute particles which would ordi- narily be termed “granules,” which refract the light very highly, and probably have been often mistaken for minute oil globules, may be invariably observed in great number. The nature of these particles is not known. They are met with in almost all kinds of living matter with which I am acquainted, and different forms are observed. In PL XV, fig. 44, some are seen in masses of germinal matter from the milk. It seems to me probable that some of these particles have originated in the germinal matter itself, while others have passed into it from without.
io8 CAN DISEASE GERMS
Now it is certain that such particles are very numerous, and are commonly found in masses of bioplasm so situated as to render their entrance from without not only possible, but probable. The fact of the amoeba opening itself as it were, and then enclosing upon foreign particles, and embedding them in its very substance, is well known. Nor is this a phenomenon peculiar to the amoeba, but it is possessed by other kinds of germinal matter. And now that the supposed importance and even the actual existence in many cases of the cell-wall has been disproved, and the active spontaneous move- ment which used to be called amoebiform, because it was supposed to be peculiar to the amoeba, has been proved to be common to living matter in gene- ral, it is probable that this and other vital pro- perties, equally characteristic of all kinds of matter in a living state, will at last be admitted.
It must then be regarded as at least possible that particles of contagious living matter less than the to oVojj of an inch in diameter might pass into the substance of a white blood, lymph, or chyle corpuscle, and thus embedded, the particle might be carried to all parts of the system, The matter itself might increase and multiply in the corpuscle, destroying it and living at its expense until the new collection attained a size larger than that of the corpuscle ; or the foreign living particles in the white blood cor- puscle might interfere with its division and sub-
INVADE NORMAL BIOPLASM?
109
division, and the germinal matter of the corpuscle itself, attain a size larger than ordinary ; or the pre- sence of the bodies supposed might cause the death of some of the particles of germinal matter and the formation of oil globules and other substances which might go on accumulating until the white corpuscle became too large to traverse the smaller capillaries. The phenomena above referred to would not only seriously interfere with the growth and nutrition of the white blood corpuscles, but would prevent the material undergoing conversion into red blood cor- puscles ; and in consequence of the diminution in number of the red blood corpuscles, and the reduc- tion of the total quantity of blood in the system, various secondary phenomena would ensue.
But in whatever way the minute particles of germ- inal matter supposed to be included in the white blood corpuscle might cause their enlargement or interfere with their function, impediment to the free circulation of the blood in the capillaries must be induced. The minute particles now stationary would rapidly increase and multiply, and some might make their way through the vascular walls towards the surface, or into the surrounding textures.
The minute particles embedded in the germinal matter sometimes so closely resemble minute vege- table germs that in some cases it is difficult to believe they are not of this nature, and have gained access from without. In other cases these particles are of
no
ESCAPE OF DISEASE GERMS
the nature of nuclei, and have originated in the ger- minal matter itself, while I am quite certain that some of the minute highly refracting particles embedded in the white blood-corpuscles, pus-corpuscles, and some other masses of germinal matter, result from changes occurring in the germinal matter itself, and are closely allied to fibrin.*
Of the Escape of the Contagious Bioplasts from the Diseased Organism.
There are three ways in which such minute particles of living matter as contagious disease-germs have been proved to be, might escape from the system in which they have been developed. These may be stated as follows : —
1. The living disease-germs might make their own way through small chinks or fissures in the capil- lary wall when it is overstretched.
2. They might be removed from the blood sus- pended in the fluid which is made to exude through the vascular wall.
3. It is supposed by many that disease-germs may be, as it were, attracted through the walls from the blood by the action of epithelial and secreting cells situated outside the vessels.
The view which has long been entertained and is
* “Oil the Germinal Matter of the Blood; with remarks on the Formation of Fibrin.” Trans. Mic. Soc., Dec., 1863.
FROM THE INFECTED ORGANISM.
HI
most in favour at the present time, is the last. The opinion seems generally held, that disease-germs, like urea, uric acid, and other poisonous matters present in the blood may be selected and separated from the normal constituents of the circulating fluid by the agency of cells situated external to the vessels, and thus “ eliminated ” from the organism. But there is no analogy whatever between non-living urea and uric acid, and living disease-germs, while it is an error to suppose that if fluid is discharged from the blood the process is invariably due to the influence of epithelial or other cells. The result is often, I believe almost invariably, dependent upon other circum- stances altogether. So far from the epithelium taking an active part in the process, this structure is often damaged and sometimes destroyed and stripped off by the free escape of fluid from the blood, or before any discharge has commenced to take place.
The escape of the fluid is usually associated with a highly distended state of the capillary vessels. There have been stretching and consequent thinning of the capillary walls in these cases. Even after death fluid will transude through the capillary vessels which have been involved, with undue readiness. This I have frequently noticed in injecting the vessels of persons who have died of cholera. Although the fact has not been observed in every case, it has occurred too often to be regarded as a mere accident, and in many instances the phenomenon was so
112
ESCAPE OF DISEASE GERMS
striking that it could not fail to excite immediate and careful attention.
In order to make a good artificial injection of healthy capillary vessels, it is necessary, as is well known, to employ some force in pressing down the piston of the syringe, and the injection is seen to spread very slowly from the points where it first appears. It is only after several minutes that the injection becomes complete. In many cases of cholera, however, the injection seemed to run into the most minute capillaries almost instantly, and under very slight pressure indeed. The capillaries seemed to be filled at once, and extravasation occurred, without any force having been exerted, within half a minute after the injection had been commenced. While injecting the vessels, one was forcibly reminded of what takes place when fine injection is introduced by the aid of very slight pressure into one of the large vessels of a mollusk — the force required to inject the smallest vascular ramifications, which in this class are very large, being so slight that the injection will pass freely into the smaller vessels, although it runs out very fast through the opening made in the larger one, in which the pipe is placed without being tied.
I think there is little doubt that this increased facility of injection depends upon the extreme stretching to which the coats of the capillaries have been subjected during the course of the disease. The
FROM DISEASED ORGANISM.
n3
elasticity of the vascular walls had been much im- paired during the progress of the disease, and I think it