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tion that from superabundance keeps up diarrhea ? It is only of late that we have noticed the importance of this subject and have commenced to supply artificially a substitute for the deficient ptyalin of this important secretion.
Dr. Roberts, of Manchester, in a series of thoughtful articles in the British Medical Journal, and Mr. Dukehart, of Baltimore, have both lately investigated the subject of the digestive ferments, the first as a scientific physician, the second as a practical observer, on a large scale, in a brewery. The work of the former gentleman was, probably, a labor of love; the second, due to a providence, or combination of circumstances, called an accident, that compelled the thought and action that follows. Nearly four years ago, on brewing day, the boilers gave out, so as to compel a postponement, and, in consequence, many dairy men could not obtain their usual supply of grains, the residue of the process. Among these was a wealthy farmer, who seemed greatly chagrined; and when asked why he did not turn the cattle into his beautiful meadows, replied, that if he did, he would lose from the want of the grain fifteen per cent in the yield of milk. It happened shortly afterward that the wife of a friend was confined, and it was mentioned that the mother had not sufficient milk to nourish the infant. Reflection upon what the farmer had said induced a trial of the effect of some pure malt extract, which was prepared for the purpose, and gave the most complete satisfaction. Since that time, the extract of malt and hops, or glucose and dextrine, as he calls it, has been improved and prepared upon a large scale in the following
Malted barley is ground and placed on a perforated diaphragm in a mash tub, and water of 158° F., or less, run on, thoroughly mixed, and allowed to remain in contact with it for one and a half hours. At first the temperature slightly rises, but afterwards falls to 154° F., or less, when the liquor is withdrawn and concentrated in vacuo, until the saccharometer registers 26. Hops are now added, and after their virtues are extracted, the liquid is strained, and again concentrated in vacuo. The final step is the addition of sufficient glycerine to prevent fermentation, a formidable obstacle when the manufacture was first commenced. Medical men who have largely used it, speak very favorably of its action, and as it is among the few remedies of the kind that are presented in the fluid or soluble condition, and as it contains no alcohol, it seems every way worthy
of extensive trial. Its power to convert starch, when properly prepared, into maltose, is very great, as I have proved by frequent experiments. In the market, it is offered in various combinations, such as citrate of iron and quinine, glucose and dextrine, with bypophosphates, malt wine and iron, cod-liver oil, extract of malt with hypophosphates of lime, etc. It would be useless to attempt to mention all the names of the various restoratives, but I cannot leave the subject without drawing attention to some of the defects of the ferments, especially pepsin, and saying a few words concerning our old friends, digitalis and iron. Many who have used pepsin in various forms, have been frequently disappointed at the negative results, and have become skeptical about it, as usually obtained. Some also have observed irritating effects and unpleasant odors that produced nausea and vomiting. To settle these questions, I have tested various preparations, both fresh and stale, in the following manner. A weighed quantity has been dissolved in half a drachm of very dilute muriatic or lactic acid, and this fluid, with a known quantity of coagulated white of egg, cut into uniform pieces of small size, has been placed in a drachm homeopathic vial, and tightly corked. A strong cord is now attached to its neck, and the vial thrust into the rectum, with the string protruding. It is thus placed, as nearly as possible, under natural conditions of temperature and peristaltic shaking that occurs as we walk. At the end of one, two, three, and four hours, it is withdrawn to watch the effect, and if none is observable at the termination of the longest period, the specimen is considered practically useless. Microscopic examination reveals the fact that numerous specimens in the market are of very different characters, and a thorough investigation of them, under many different circumstances, is very urgently needed.
A multitude of experiments, conducted in both ways, has convinced me that fresh material is the only kind to be relied upon, and I have obtained better effects from the watery or dilute wine extract of the stomach, than in any other manner. Dr. Roberts, who has investigated this subject very extensively, prefers dilute alcohol, to prevent spoiling, but mentions solutions of boracic acid and chloroform water as also effective. Lately, I have thought of a plan of preparation for both the stomach and pancreas, that promises to be of assistance, to reduce it from the semi-liquid to the solid or powdery condition, and thus
contribute to its preservation. It depends upon a principle before announced, when speaking of urea, by means of which we are enabled to evaporate to dryness, or dehydrate without production of elevated temperature. The substance employed is fine plaster of Paris, which is added to the chopped-up lining membrane of the stomach or to the pancreas, allowed to stiffen, and afterward powdered. When it is desired to be used, the active part can be extracted by water, which dissolves but little of the lime. A small quantity of sand may be of assistance to help the disintegration, but as promptness is the chief object, a plenty of powdered plaster ought to be used to solidify it immediately. How long it will thus keep during hot weather, I am not able to say, but am now testing the question. The action of iron is so generally admitted as a restorer of blood-globules that, if it were not for an occasional failure, I should not mention it; but when we reflect upon the cause of this failure, or what seems to be the cause, a very important subject at once comes before us.
It is apparent to all who have given much attention to physics, that nature is full of circular motion; from the flow of the sap to the movements of fluid in the largest vertebrate they are all more or less circular. This seems to be a natural effect due to residence upon a planet, that is, a globe, and revolves in an ellipsoidal manner around a centre, which is also circular. Everything upon this planet, from the lowest to the highest, is subject to attraction, pulling in two or more directions, and the outcome of this is growth as a spiral wedge. A beautiful example of one of the forms produced by these motions is seen upon a large scale in the planet Saturn, with its rings; and in a small one, it seems to me, in some floating blood-corpuscles. That they were both produced by the same kind of motion seems evident from a study of the vortex motions enunciated by Sir Wm. Thompson, and made evident by the rings that occur when a drum-head is struck that is stretched over a box with a round aperture, said box containing muriate of ammonia in vapor.
The so-called centrifugal force apparatus also gives an example of the same in liquids, and the smoker's rings and those from the locomotive are familiar to all. Now, the heart in its action, as can be seen from its fibres (Fig. 4), pulsates or twirls round from left to right in a spiral, and this motion, once impressed upon its contents, continues until it is lost by friction on the sides of the small arteries or in the capillaries. The motions
that any particle sent forth from this organ has impressed upon it are, 1st, in a straightforward direction in the course of the artery; 2d, a spiral one not completely at right angles to it, so that the outcome of the forces will be the resultant of unequal energies, and produce a motion that can almost be called centri
fugal, a flattened discoidal one, but which really resembles the vortex motion of Sir Wm. Thompson. Observation of the rings produced in air and water shows a very close resemblance to our human blood-corpuscles, with this exception, that the centre of a corpuscle contains a thin continuity or film of structure, occupying all the space within the circle, giving it the discoidal shape it presents under the microscope. It is true, that this shape can also be impressed upon particles in the blood vessels in another manner than by sudden growth at the heart, but the same kind of motion is requisite, and it is quite probable that the red corpuscles, whose origin has so long been a mystery, are produced in both ways. At any rate, if you will but consider that each white corpuscle is nothing more than a small projectile, moving from the heart, as from a revolving mortar, and, besides this, a minature of the concussion shell that explodes from inertia (Fig. 5), the cell proper being the outer case, and the nucleus or granules the inner, I think you will be prepared to admit with me, that just such rupture of the cell wall does at times take place, setting free a nucleus with vortex motion impressed upon it, and, perhaps, bent in by contact that occurred at the time of impact. If Bennett's, Wharton Jones's and Huxley's views are correct, that the nucleus becomes a red corpuscle, and if this nucleus be of such a size when circular as to exactly acquire the dimensions of the red blood-corpuscle when flattened
out or compressed; if, moreover, the number of red blood-corpuscles to those of the white be in a certain proportion to the heart beats, which seems probable, and if anæmia be a common accompaniment of heart trouble, I think I have made a cumulative argument in favor of their being thus produced. At how many places this may happen I am not prepared at present to say, but everything looks as if the lungs and liver capillaries, and other small capillaries, might be the principal situations. In favor of this view is the fact that red corpuscles are more abundant in the capillaries and veins than the arteries. That white cells do rupture is certain, and that the force is sufficient to produce the effect is also plain, from the analogies of churning practised by some barbarous tribes who successfully use a leathern bottle that sways to and fro from a stake driven into the ground. I do not at present assert that all blood-corpuscles are thus produced, because some are found before any heart-beats to cause them, but this fact is certain, that whatever debilitates the heart will produce anæmia, and one of Bennett's cases of leucocythemia had an extremely feeble and very small heart. If these views are correct, tincture of digitalis is essential, besides iron, in all cases of anæmia to increase the energies of the heart, to make and circulate blood-corpuscles, and clinical experience seems to further confirm it. Horseback exercise (or that of the flying horse) ought also to be useful. The laws of fluid motion are so difficult, that we may well hesitate to express positive opinions, but unless some other force intervenes to change the motion, the physical laws of particles, that have briefly been stated, will here hold good. It is too soon to estimate the effect of discussion upon these remarks, since some factor may have been forgotten or undervalued that would make a difference, if discussion shall lead to more careful comparative study of the motions and shapes of hearts, their orifices and the materials that pass through them, this effort will not be in vain. In conclusion, let me state that Harvey, when he discovered what is termed the circulation of the blood, little dreamed of a wheel within a wheel, and that out of said circle would come another from the explosion he so beautifully describes denominated the red corpuscle.