PHYSICIAN TO THE WAKEFIELD DISPENSARY. THE conflicting statements published, and the indefinite result arrived at, by the many authors who have hitherto written on th subject of Tubercle, urged my especial attention to this subject more particularly as I had the opportunity of narrowly watchint .the progress of this disease, and witnessing the,post-mortem ex aminations of every man who died during the last five years ir the Wakefield Convict Prison, through the kindness of my frien< Mr. Milner,

more »

... the resident surgeon of the above establishment. From these observations, I believe I have arrived at conclusions as to the formation of tubercle, very different to those o any other inquirer. And, as a correct diagnosis is the first stel towards cure, so it cannot be doubted that a true knowledge o the pathology of tubercle may lead to better and more accuratl methods in the treatment of phthisis. From the experiments instituted by Simon, it appears thai during respiration the oxygen of the atmosphere combines witt ,the blood-corpuscles, and that the consumption of oxygen anc ,formation of carbonic acid stand in a direct ratio with the amount -of these blood-corpuscles, and with the number of respirations in a given period; hence it is obvious that the oxygen of th, atmosphere is consumed in the metamorphosis of the corpuscles And it would further appear that the amount of fibrine always s varies inversely with the mass of the blood-corpuscles, or, in other words, that the more corpuscles there are, the less in quan tity is the fibrine-and vice versâ. It appears most probable that as the blood-corpuscles principally consume oxygen during their change, it is by this process that the fibrine is produced; and that wherever an extraordinary consumption of corpuscles takes place, the quantity of fibrine in the plasma also increases. If by any means the circulation be quickened, or, in other words, the mutual action between the ,blood and oxygen be increased, more blood-corpuscles will be consumed in a given time. Although the temperature of the body is nearly the same in all parts, in consequence of the metamorphosis of the tissues constantly going on, yet the temperature of the lungs is slightly higher than that of the other parts of the system; which may be accounted for by the more energetic action of the oxygen on the mass of blood in these organs, than in other parts of the body. * Now Andral and Gavarret observe that, in all stages of phthisis, analysis of the blood shows that the fibrine is always on the increase, and the corpuscles on the decrease; but that this increase and decrease vary proportionately with the progress of the disease. Liebig states that it must be received as an undeniable truth, that all the organic nitrogenized constituents of the body are derived from protein, when we reflect on the development of the young animal in the egg of a fowl, where, out of the albumen, feathers, claws, globules of blood, fibrine, membranes and cellular tissue, arteries and veins, are produced. Now this albumen contains, for the quantity of nitrogen present, exactly the proportion of carbon required for the formation of these tissues! Let us, for one moment, look into the nature of tubercle. Chemistry has thrown little light on its mode of formation. Simon states that it might be regarded as protein from which a portion of carbon and oxygen have been removed; or, to speak precisely, it may be supposed to be derived from protein, which substance has lost, during the transformation, three atoms of carbon, and one .of oxygen. The formula is-From the observations previously made, viz., that the more corpuscles there are, the less in quantity is the fibrine; and from the experiments of Andral and Gavarret, that the blood in phthisis contains more fibrine and less corpuscles; and, moreover, recollecting that the temperature is somewhat greater in the chest than in other parts of the system, probably because a more energetic action of oxygen takes place in these organs,-it would appear fair to conclude from these facts, that in phthisis the combinatiou of oxygen and carbon, in the lungs especially, is more active than in the normal state. Now we will say one word concerning the remedies employed and found most beneficial in this