RELATIONS OF MAN TO THE EXTERIOR UNIVERSE. Relations of astronomical, terrestrial, physical, chemical, and physiological phenomena The character and extent of physiological and pathological investigations established by Imperfect state of our knowledge of this fluid-Imperfections in the methods of analysis- Importance and difficulty of establishing a standard formula of the composition of the blood in health-The composition of the blood varies not only with the class, but with each species of animals, and corresponds with the development of the organs and appa- ratus; illustrated by the development of the blood and organs of invertebrate and vertebrate animals-Standard of Lehmann, and of Becquerel and Rodier-Importance of determining the changes of the blood during thirst and starvation-Importance and Difficulties of the investigation-Color of the blood and serum in malarial fever-Specific gravities and coagulation of the blood in malarial fever and other diseases-Fibrin decreases in malarial fever-Formation of heart-clots in congestive fever during life— Occurrence of heart-clots in other diseases-Conditions most favorable to the deposition of fibrinous concretions-Symptoms and diagnosis of fibrinous concretions in the heart and blood vessels-Perilous effects resulting from the detachment of fibrinous concretions Imperfect state of knowledge, with reference to the formation of fibrinous concretions in the living body-Cause of the coagulation of the blood unknown-Principles of treatment best adapted to prevent the formation of fibrinous concretions in malarial fever-Phy- sical and chemical changes of the constituents of the blood in malarial fever-Illustra- tive cases-Relations of the cerebro-spinal and sympathetic nervous systems to the changes of the blood and organs in malarial fever-Gangrenous erosion of cheek follow- ing malarial fever-Comparison of the changes of the blood in malarial fever with the changes in marsh cachexia-Mechanical dropsy-Acute dropsy-Cachectic dropsiesAlterations of the colored blood-corpuscles in malarial fever-Principles of treatment suggested by the changes of the blood in malarial fever-Effects of bloodletting-Of excessive purgation-Of nutritious diet and stimulants-Of phosphates-Of pepsinDetermination of the place of the destruction of the colored blood-corpuscles in malarial fever-Constitution of the blood in various diseases, in typhoid, typhus, and ephemeral fevers-In smallpox, scarlatina, measles, scurvy, erysipelas, cholera, phthisis, scrofula, carcinoma, Bright's disease, chlorosis, anemia, rheumatism, puerperal fever, pneumonia, peritonitis, angina tonsillaris, bronchitis, carditis, pericarditis, inflammation of brain, glanders, lead-poisoning-The colored blood-corpuscles are more uniformly and rapidly destroyed in severe cases of malarial fever than in any other acute disease-Diminution of fibrin in malarial fever corresponds to the severity of the disease-Discussion of the question, Do these changes of the blood precede, or succeed, or are they simultaneously with, the aberration of the physical, chemical, vital, and nervous phenomena, denominated fever? pp. 296-424 CHAPTER V. CHANGES OF THE ORGANS, AND TISSUES, AND APPARATUS OF THE BODIES OF THOSE WHO HAVE DIED WITH THE DIFFERENT TYPES OF MALARIAL FEVER, INTERMITTENT, REMITTENT, AND CONGESTIVE COMPARISON OF THESE CHANGES WITH THE PHENOMENA OF MALARIAL FEVER AND WITH SIMILAR CHANGES IN OTHER DISEASES, AND WITH THE ORGANS, TISSUES, AND APPARATUS OF MEN AND ANIMALS IN THE NORMAL CONDITION. Exterior-Muscular system-Cerebro-spinal nervous system-Dura mater, arachnoid membrane, pia mater, cerebrum, cerebellum, medulla oblongata, ventricles of brain -Cerebro-spinal fluid-Nervous phenomena of malarial fever compared with postmortem examinations-Causes of aberrated nervous phenomena in malarial feverTheory expressing the relations of the physical, chemical, and nervous phenomena of malarial fever-Malarial fever paroxysmal, not because the action of the cerebro-spinal or of the sympathetic nervous system is paroxysmal-Explanation of the paroxysmal character of malarial fever-Lungs-Heart-Alimentary canal-Tongue-Stomach-Intestinal canal-Liver-Weight of liver in malarial fever-Post-mortem examinations illustrating the changes of the color of the liver in malarial fever-Effects of previous pathological alterations upon the color-Changes of the color of the blood in the liver of malarial fever--Sources of the change of color in the liver during malarial feverCharacter of the bile in malarial fever--The liver of those cases which died in the active stages of malarial fever contained animal starch, whilst hepatic sugar was absent--Points of difference between the malarial fever and yellow fever liver-Spleen, pathological alterations of, in malarial fever-Pancreas-Kidneys CHAPTER VI. pp. 424-479 CIRCULATION, RESPIRATION, TEMPERATURE, STATE OF THE SKIN, TONGUE, AND CHANGES OF THE URINE IN INTERMITTENT, REMITTENT, AND CONGESTIVE FEVER-PRINCIPLES OF TREATMENT BASED UPON THESE OBSERVATIONS-ILLUSTRATED BY NUMEROUS CASES. Importance of determining the pulse, respiration, temperature, and changes of the urine in health and disease-Variations of the pulse, respiration, and temperature of different individuals and races-Intermittent fever--Cold stage-Illustrative cases-Phenomena of hot stage and period of intermission-Illustrative cases-Appearance of tongueCharacters of urine-Phenomena of remittent and congestive fever, with numerous illustrative cases-Comparative view of the phenomena of intermittent, remittent, and congestive fevers . pp. 479-615 OBSERVATIONS ON SOME OF THE PHYSICAL, CHEMICAL, PHYSIOLOGICAL, AND PATHOLOGICAL PHENOMENA OF MALARIAL FEVER. CHAPTER I. RELATIONS OF MAN TO THE EXTERIOR UNIVERSE-RELATIONS OF ASTRONOMICAL, TERRESTRIAL, PHYSICAL, CHEMICAL, AND PHYSIOLOGICAL PHENOMENA THE CHARACTER AND EXTENT OF PHYSIOLOGICAL AND PATHOLOGICAL INVESTIGATIONS ESTABLISHED BY THE RELATIONS OF MAN TO THE EXTERIOR UNIVERSE. THE object of this chapter is to sketch the mutual relations of celestial and terrestrial bodies and animated beings, and demonstrate that the existence of man is absolutely dependent upon the relations of the component members of the universe-that a single alteration in the chain of phenomena would destroy the conditions necessary for the existence and manifestation of the phenomena of man-that the forces of man are all resultants of the forces of the sun and fixed stars, which keep up a never ending circulation and change of matter upon the surface of our globe-that man cannot create or annihilate force any more than he can create or annihilate matter that the great law of the Indestructibility of Force, of Action, and Reaction, applies to all the phenomena of man—that man is a type of the universe, and comprehends within himself all phenomena, astronomical, physical, chemical, physiological, and psychological-that the knowledge of the structure, phenomena, and relations of man includes a knowledge of all science, whether relating to matter or mind. The end of the whole investigation will be the establishment of the true character and extent of physiological and pathological investigations. In this inquiry we will examine first the general or simple phenomena, and lastly the particular or complex. There are certain phenomena, as gravity, which affect all bodies, and at the same time appear to be wholly independent, in their existence and manifestation, of all other phenomena. These phenomena have been called' general or simple, because they appear to be not only independent in their own existence of all other phenomena, but they form the foundation of the manifestation and conditions of the existence of all other phenomena. We have another class of phenomena which are confined to certain forms of matter, and whose existence and manifestation depend upon definite circumstances and the pre-existence of the general phenomena. These phenomena are called complex or particular. Thus the law of gravity, which (so far as our means of observation extend) affects every molecule of matter throughout the universe, is an instance of a general phenomenon; whilst physiological phenomena, which are manifested by only a comparatively small number of bodies, are instances of complex or particular phenomena. General phenomena are wholly independent of the particular or complicated; whilst the particular or complicated are dependent upon the general, and cannot exist without them. Thus, we cannot conceive of matter without weight, but we do conceive and know of the existence of matter in a state of perfect freedom from the manifestation of physiological phenomena. It is evident that if we wish to understand the complex phenomena, we must analyze the component phenomena, and examine first the most general, which form the foundations of the existence and manifestation of the restricted or complex. Man stands upon the summit of a pyramid, the foundation of which is the inorganic world, and the materials composing this pyramid consist: first, of plants in various stages of development, the simple extending downwards, the more complicated extending upwards, diminishing in numbers as they increase in complexity; and, secondly, of animals in various stages of development, increasing in complexity and diminishing in numbers as they extend upwards. To understand the physical and physiological constitution of man, we must commence at the base of the pyramid and examine successively all the elements, with their properties, forces, and constitution-we must examine the relations of the individual elements to each other and to the universe. That the true principles of the classification of the phenomena of the universe were recognized by the ancients, as well as by the moderns, is demonstrated by the fact that the historical development and classification of the sciences correspond with the logical classification. The principles of classification and the relations of the sciences have been discussed in a masterly manner by Auguste Comte in his Positive Philosophy. Upon the present occasion we can do nothing more than present a general outline of this immense subject, for the complete knowledge of the intellectual and moral constitution of man alone requires the knowledge of the relations of the moral and intellectual faculties of man to the material structures by which they are surrounded-requires the knowledge of the relations of the moral and intellectual faculties to the physical, chemical, vital, muscular, and nervous forces-requires the knowledge of the nature, origin, and development of all science-requires the knowledge of the constitution, and phenomena, and progress of the moral and intellectual faculties as revealed in all history, scientific, civil, and religious, past and present. If it be admitted that the art of medicine will attain to the rank of a science only when its relations with all the branches of knowledge are recognized and demonstrated, it must also be admitted that the present attempt to establish a standard for physiological and pathological investigations by the presentation of a general view of the relations of man to the exterior universe, incomplete and imperfect though it be, is an effort in the right direction. In the survey of the universe all natural phenomena have been divided into two great classes, celestial and terrestrial. Astronomical phenomena affect all bodies, whether they belong to this world or to the universe, and at the same time they may be said to be independent of all others. All bodies attract each other, in direct proportion to their masses, and in inverse proportion to the squares of their distances-this law, which is the sublimest of all generalizations, and the foundation of the science of astronomy, affects all bodies, inorganic and organic, inanimate and animate. The researches of astronomers are constantly enlarging our conceptions of the wide reign of the law of gravity. In every one of those wonderful binary systems of stars,' which have been suffi The number of double stars (those both optically and physically double) observed by Sir William Herschel (1776-1804); by Otto Struve in Pulkowa (from 1813 to 1842); by Sir John Herschel (from 1819 to 1838); by Bessel; by Argelander at Abo (1827—1835); by Encke and Galle at Berlin (1836 and 1839); by Preuss and Otto Struve in Pulkowa (since the catalogue of 1837); by Madler in Dopart; by Mitchell in Cincinnati, U. S.; and by several other astronomersmay be estimated, with some certainty, at 6,000. The number of the double stars, the elements of whose orbits it has been possible to determine, is stated at present to be 16. History of the Royal Society, vol. iii., 1757, p. 225. An Inquiry into the Probable Parallax and Magnitude of the Fixed Stars, from the Quantity of Light which they afford us, by the Rev. John Mitchell, Philos. Trans., vol. lvii. pp. 234 VOL. XII.-15 |