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DISEASES OF MAN: 
 
 DATA OF THEIR 
 
 NOMENCLA TURK, CLASSIFICA TION &^ GENESIS. 
 
To DESCRIBE IS TO PARTICULARISE. 
 
 " Words are the fortresses of thought." 
 " In words are contained the sciences possessed by the 
 nations of the earth. ..." 
 
 To DEFINE IS TO GENERALISE. 
 
 Definition is the summary of description. 
 " Perfect definition is the summit of human knowledge in 
 every part of science " 
 
 "To NAME IS TO KNOW." 
 
 " The true progress of science must always be realised in 
 names." 
 
 "Things are known when understood and are understood 
 when interpreted." 
 
 "The perfection of a science depends, in no inconsiderable 
 degree, upon the perfection of its language; and the perfec- 
 tion of every language upon its simplicity and precision." 
 
 "To THINK IS TO CLASSIFY," 
 
 and to classify is to think. 
 
 " System is the Ariadnean thread without which all is con- 
 fusion." 
 
 " Classification is not attainable by art only, it requires a 
 mind that is capable of distinguishing things by their specific 
 differences ; not separating things that are alike nor blending 
 things that are different." 
 
DISEASES OF MAN: 
 
 DATA OF THEIR 
 
 NOMENCLATURE, CLASSIFICATION &<» GENESIS. 
 
 BY 
 
 JOHJST ^Sr. S. G^OUILi:E Y, M. D., 
 
 Surgeon to Bellevue Hospital. 
 
 NEW YORK : 
 J. H. Vail & Co., 2 1 Astor Place. 
 
 LONDON: 
 
 H. K. Lewis, 136 Gower Street. 
 
 1888. 
 
Copyright, 1888. 
 By J. W. S. Gouley. 
 
PREFACE. 
 
 The objects of this book are ; first, to urge the 
 official adoption of a stable basis for the nomen. 
 clature and classification of the diseases of man ; 
 second, to place before the medical profession 
 certain propositions directed to an improved 
 classification of diseases ; and third, to awaken 
 the attention of teachers to the necessity of 
 ameliorating the nomenclature of medicine, 
 pointing out some of the many misused and im- 
 properly formed words that are now current, 
 and proposing new terms for their considera- 
 tion. 
 
6 PREFACE. 
 
 In attempting to classify the affections of the 
 male urogenital apparatus, it was found diffi- 
 cult to do so satisfactorily, owing to the defects 
 of the existing nomenclature. This led to an 
 inquiry into the former and actual state of nos- 
 onomy and nosotaxy, and into the methods em- 
 ployed by nosographers from the time of 
 Sauvages to the present. The conclusion ar- 
 rived at, is that a nomenclature and classification 
 to be useful and stable should not only rest 
 upon a proper foundation, but should be duly 
 authorised by the whole profession of medicine. 
 The principles deduced from an analysis of the 
 methods of nomenclators and classifiers are now 
 submitted to the profession ; and certain ques- 
 tions are suggested for discussion in, and for 
 settlement by, the International Medical Congress 
 which properly represents the medical profes- 
 sion. 
 
 The presentation of this subject to the profes- 
 sion is designed as a plea for the more systematic 
 
PREFACE. 7 
 
 study of diseases, and as an individual protest 
 against their existing nomenclature and classfica- 
 tion, with the hope that this protest will become 
 general among teachers and others who realise 
 the necessity of bettering the condition of 
 medicine, without undertaking to destroy its 
 fabric in order to reconstruct it ; but rather to 
 modify, simplify, and improve it by gradually 
 substituting exact terms for those that have 
 never conveyed correct ideas. 
 
 During the preparation of this book, more 
 or less frequent consultations were held with 
 Doctors Clymer, Carroll, Flint, Biggs, Cronyn, 
 Taylor, Clark, Leale, Grauer, John Shrady, 
 Edmund Arnold, and others. The valuable sug- 
 gestions of these kind friends are gratefully 
 acknowledged. 
 
 Botanists, Mineralogists, Biochemists and Phi- 
 lologists have been consulted with much advant- 
 age and their hints have been thankfully received 
 and carried out. 
 
8 PREFACE. 
 
 Works on Botany, Zoology, General Chemis" 
 try, Biochemistry, Physiology, Descriptive Anat- 
 omy, General and Special Pathology, and Sur- 
 gery, and many of the treatises on nomenclature 
 and classification have been freely used. A 
 general acknowledgment is made to the authors 
 of these works which have been of the greatest 
 service in this endeavor to elucidate the princi- 
 ples of nosonomy and nosotaxy. 
 
 324 Madison Avenue, 
 New-York, January 1888. 
 
CONTENTS. 
 
 PREFACE, page 5-8 
 
 CORRIGENDA, " I2 
 
 INTRODUCTION "13-24 
 
 SECTION I. 
 
 Preliminary Considerations. 
 
 Outline of the anatomical view of man. Definition of med- 
 icine. A classification of the science and art of medicine. 
 Medicine and Surgery. Arrangement of medicine into certain 
 departments in accordance with the apparatuses of the humaa 
 body. The physician. Definition of disease. A synopsis of 
 the morbid states and morbific processes of the body. The 
 value and significance of proper anatomical terms in classi- 
 fication. Definition of system, organ, apparatus, and function. 
 Systems and organs perform no function, but yield service to 
 apparatuses. Each apparatus performs only one function, 
 and there is no function without an apparatus, . page 25-72 
 
lO CONTENTS. 
 
 SECTION II. 
 
 Human Nosography. 
 
 A summary of the progress of nosography since its founda- 
 tion. The scope of nosography. Notice of Sauvages. A 
 consense of views necessary in methodical arrangement. 
 Synopses of Sauvages'. Cullen's, Parr's, Good's, and Delorme's 
 arrangements of diseases. Comments on these several sys- 
 tems. Cullen's rules for distinguishing genera, species, and 
 varieties of diseases. Parr's rules. Some of the aphorisms, 
 relating to classification, extracted principally from the phil- 
 osophia botanica of Lmnaeus, by Dr. Thomas Young, 
 
 page 73-199 
 
 SECTION III. 
 
 NOSOGRAPHICAL BIBLIOGRAPHY. 
 
 A chronological list of the works on nosography that have 
 appeared from the time of Felix Platerus to the present, 
 
 page 200-2 1 1 
 
 SECTION IV. 
 
 Basis and Method of the Classification and 
 
 Character of the Nomenclature of 
 
 THE Diseases of Man. 
 
 Many high authorities opposed to classification. To think 
 is to classify. Characteristics of good classifiers. Modem 
 classifiers use terms of classification arbitrarily without taking 
 the pains to define these terms. Nosography on the basis of 
 symptoms misleading and retrogressive. Anatomy the only 
 stable basis for nosography. Description and definition of dis- 
 
CONTENTS. II 
 
 eases. Methods of the nosographer. The use of the dead 
 languages in nomenclature. The names of men should not 
 be applied to diseases. Suggestions for an improved classifi- 
 cation of diseases. A consense of views necessary in the use 
 of terms of classification. Questions suggested for discussion 
 at the Tenth International Medical Congress. Definitions of 
 the terms of classification page 212-252 
 
 SECTION V. 
 
 Review of the Morbid States and Morbific 
 
 Processes. The Bacteria. Ptomaines, 
 
 Leucomaines, and Extractives. 
 
 Analysis of some of the terms used in general pathology 
 and of those contained in the synopsis of morbid states and 
 morbific processes, together with remarks on these states and 
 processes. Summary of the present state of knowledge of 
 the bacteria, ptomaines, leucomaines, and " extractives." 
 The relations borne, to medicine and surgery, by these micro- 
 organisms and alkaloids of putridity. Classifications of the 
 bacteria, ptomaines, and leucomaines. Uniformity in their 
 nomenclature and classification much needed. Remarks on 
 the neoplasams and on their classification, - page 253-379 
 
 CONCLUSIONS " 380 
 
CORRIGENDA 
 
 Page 36, second line, for propylactic, read prophylactic. 
 
 40, foot note, for celibary, read celibacy. 
 
 48, V. 8, for (obsteoma), read (osteoma). 
 
 56, foot note, for eyyEvrjiy read EyyEviji. 
 
 63, " " for opyavov, read opyavov. 
 
 67, tenth line, for antonomous, read autonomous. 
 
 69, fifth line from bottom, for corect, read correct. 
 102, IX. L, for sangninfluxus, read sanguifiuxus. 
 150, fourth line, for cornea, read cornea. 
 212, first line, for authorites, read authorities. 
 255, foot note, for t'ltoy read V7t6. 
 
 365, third line from bottom, for oDoii, read aodii. 
 For Laenec read Laennec. 
 
13 
 INTRODUCTION. 
 
 I. This book is divided into five sections. The 
 first section comprises : some anatomical consid- 
 erations of the normal human body; a statement 
 of the objects and scope of medicine ; a classifica- 
 tion of medicine ; the mutual relations of medi- 
 cine and surgery ; an arrangement of medicine 
 into departments in accordance with the appara- 
 tuses of the human body ; the definition and 
 genesis of disease ; a synopsis of the morbid 
 states and morbific processes of the body, de- 
 signed as a suggestion of a ground-work for the 
 classification of diseases; and an analysis of some 
 of the anatomical terms used in classification. 
 The synopsis of morbid states and morbific pro- 
 cesses stops at genera, but a few species are given 
 in foot-notes. 
 
 The second section relates to the history, de- 
 velopment, scope and significance of human 
 nosography, and contains synopses of a considera- 
 ble number of systematic arrangements of dis- 
 eases, illustrative of the principles of nomencla- 
 ture and classification, and also rules for the 
 guidance of nosographers by Cullen, Parr, Young 
 and Linnaeus. 
 
14 INTRODUCTION. 
 
 The third section consists of a nosographical 
 bibliography, chronologically arranged, from the 
 time of Felix Platerus. 
 
 The fourth section is devoted to the elucida- 
 tion of what is conceived to be a proper basis, 
 character, and method of the nomenclature and 
 classification of the diseases of man : and to the 
 definitions of the terms of classification. 
 
 The fifth section is intended as further explana- 
 tions of the morbid states and morbific processes, 
 and as an analysis of some of the terms used in 
 general pathology, besides which it embodies a 
 summary of the present state of knowledge of 
 the bacteria, ptomaines, ieucomaines, and " ex- 
 tractives," and indicates the relations borne, to 
 medicine and surgery, by these microorganisms 
 and toxic alkaloids of putridity, and finally re- 
 marks on the neoplasms and on their classifica- 
 tion. 
 
 2. This work is undertaken with the hope that 
 it will induce all those devoted laborers in the 
 field of medical science who are struggling so 
 diligently to solve great problems in physiology, 
 histology, pathoanatomy, and therapy, to con- 
 sider how much assistance methodical arrange- 
 ment will afford them in their investigations and 
 how much of their time will thereby be saved J 
 
INTRODUCTION. 1 5- 
 
 also how important it will be for them to adopt a 
 correct and uniform nomenclature. They will 
 then probably reject all inexact terms and coin 
 words, — ** verba-fidelia " — in accordance with the 
 conditions they wish to designate with precision. 
 
 In medicine, the coinage of a new word is at» 
 tended with some difficulty and requires much 
 deliberation, besides the censorship of men of ex- 
 perience and sound judgment. The word should 
 then be submitted to the profession, whose ver- 
 dict on the question of its general adoption 
 should be respected. On this subject of the coin- 
 age of words, Ben Jonson says : " A man coins 
 not a new word without some peril, and less 
 fruit ; for if it happen to be received, the praise 
 is but moderate ; if refused the scorn is assured." 
 
 At present, a very considerable part of the 
 nomenclature of medicine consists of such a great 
 number of inappropriate, incorrectly formed and 
 misleading terms, that often it is not easy, for 
 investigators, even of the same nation, writing in 
 the same tongue, to understand each other. 
 
 " It is a waste of time," says Mill, in his Exam- 
 ifzation of Sir William Hamilton s Philosophy, " for 
 a mere student of philosophy to have to learn 
 the familiar use of fifty philosophic phrase- 
 ologies." This applies with much force to the 
 many anatomists and medical investigators who 
 
l6 INTRODUCTION. 
 
 use words of their own invention which others 
 are at great pains to understand. 
 
 3. While the progress made in medical art 
 during the last quarter of a century is marvelous, 
 the improvement in the nomenclature has by no 
 means kept pace with this great advance in the 
 art of medicine. Accuracy is often attained in the 
 latter while it seldom obtains in the former. If 
 more attention were given to the formation of 
 scientific language, much confusion and misap- 
 prehension, which have the effect to impede the 
 progress of medical science, would be avoided. 
 
 The technical terms of medicine derived from 
 the Latin and Greek tongues are used partly for 
 the sake of brevity and partly that they may be 
 understood by the medical profession of the dif- 
 ferent nations that cultivate the dead languages. 
 Unfortunately hovvever the cultivation of these 
 languages is too limited among physicians. As a 
 consequence, many meaningless expressions and 
 as many hybrid words, compounded of Latin and 
 Greek and sometimes of Hebrew roots, very dis- 
 tasteful to the experienced scholar and serving to 
 puzzle rather than to instruct the junior student, 
 are constantly used in text-books and other 
 works. The few modern writers who have un- 
 dertaken the task of improving the nomenclature 
 
INTRODUCTION. 1 7 
 
 of medicine are little heeded, and professors in 
 the great schools are still thoughtlessly dissem- 
 inating false notions by the careless use of inac- 
 curate expressions in their daily lectures. Many 
 ancient words, however inexact and absurd, are 
 adhered to with great tenacity, and innovations 
 the most appropriate are resisted with an ob- 
 stinacy too little in keeping with the forward 
 movement of the time. Conservatism is praise- 
 worthy Avhen applied to words that have stood 
 the test of years and are still adjudged good and 
 proper, Those time-honored terms v/hich convey 
 ideas with precision should be jealously pre- 
 served ; but that multitude of misleading expres- 
 sions, to be found in the literature of medicine, 
 should be speedily blotted out of coming medical 
 treatises and dictionaries, and their places filled 
 with well chosen and philologically correct 
 words. 
 
 If teachers in the several departments of medi- 
 cine will earnestly consider this subject, and if 
 each will contribute his share to the reformation, 
 in another quarter of a century there will surely 
 be a more uniform and exact medical language. 
 
 The needed reformation in medical nomencla- 
 ture should however be rightly directed, and 
 those who undertake it should be mindful of 
 Lord Bacon's precept that " It is good also, not 
 
I8 INTRODUCTION. 
 
 to try experiments ; except the necessity 
 
 be urgent, or the utility evident : and well to 
 beware that it be the reformation that draweth 
 on the change ; and not the desire of change 
 that pretendeth the reformation." 
 
 4. It is improbable that the often repeated 
 statement, " it is not profitable to attempt to 
 change the present methods of writing and of 
 teaching medicine owing to its great mutability,*^ 
 will deter nomenclators and classifiers from the 
 pursuance of their investigations, but it is a fact 
 that they are too little encouraged, even by those 
 who realise the necessity of a radical change in 
 these methods. Exact nosonomy and nosotaxy 
 will surely cause greater changes and advances 
 than have ever been made in medicine. To give 
 correct names to diseases involves the closest in- 
 quiry into their nature. It is therefore fair to 
 assume that the time will come when the name 
 given to each disease shall indicate its nature. 
 When this good time does come, medicine will 
 be taught as other sciences are taught. The con- 
 sideration of the advances destined to be made 
 by a methodical nosography, leads to the conclu- 
 sion that it must keep pace with the advancement 
 to which it has given rise, and must of necessity 
 be provisional. 
 
INTRODUCTION. 1 9 
 
 5. The inexact nomenclature of diseases, and 
 the defective arrangement and inconsistencies in 
 existing S3'stems are such that it is almost im^ 
 possible for the student to learn medicine as he 
 should ; and, in view of its continued advances, 
 this will be quite impossible in a quarter of a 
 century, unless a radical change be made first in 
 the nomenclature of anatomy and next in the 
 nomenclature and classification of diseases. 
 
 Without an accurate nomenclature and classi- 
 fication, the one hundred and tvv^enty thousand 
 flowering plants could not have been known, nor 
 could the immense number of species of animals 
 be studied, and it would not have been possible 
 to obtain an accurate knowledge of minerals. 
 Thus Botany, Zoology, and Mineralogy, have for 
 many years, taken each a high rank among the 
 sciences owing to proper nomenclature and to 
 methodical arrangement. 
 
 The science of medicine will never progress as 
 it should and will never be learned as it should 
 be learned until it is placed upon the same foot- 
 ing as that of the natural sciences. 
 
 Without an accurate nomenclature and classi- 
 fication it is very difficult for the practising phy- 
 sician to have the clear understandmg of diseases 
 so necessary to their rational treatment. All 
 morbid states of the human body should be 
 
20 INTRODUCTION. 
 
 known by names that indicate their nature, and 
 it is only a right conception of this nature which 
 can lead to the use of appropriate remedies. 
 
 6. The terras nomenclature and classiiication of 
 diseases do not by themselves express with suf- 
 ficient precision the scope and objects of syste- 
 matic arrangement. Therefore the word nosog- 
 raphy should, in its broadest sense, be employed 
 to signify the whole, or some part of the science 
 of medicine as, for example, human nosography, 
 nosography of the uro-genital apparatus, or of 
 any other apparatus of the human body. 
 
 7. It is often said that language fails to express 
 with accuracy the ideas which man conceives of 
 things. Sweepmg as this statement may seem, it 
 is defensible, particularly in the case of medical 
 language which so much needs reconstruction. 
 That however which causes the greatest per- 
 plexity in the expression of ideas, is the misap- 
 plication of words, and also their employment in 
 different senses, so as to give to each several 
 meanings. Since it is not probable — at least not 
 for a very long time — , that human language will 
 consist of words having each a single meaning, 
 the most judicious use should be made of existing 
 terms and the greatest care taken in the forma- 
 tion of new words ; and all writers should strive 
 
INTRODUCTION. 21 
 
 to give a clear exposition of their ideas by some- 
 times explaining the words of many meanings 
 which they are obliged to employ. Some of the 
 great faults in medical language are : (i,) the 
 misapplication of words; (2,) the use of improp- 
 erly constructed words; (3,) the use of words 
 which do not convey an exact idea of the object 
 designated ; and (4,) the use of men's names to 
 designate diseases. These faults are all remedia- 
 ble, but to repair them most effectually and to 
 prevent their recurrence, a consense of views in 
 the medical profession is absolutely necessary ; 
 then the changes in terms will be uniform, will 
 come authoritatively, and will therefore be ac- 
 cepted. 
 
 It appears that medicine is not the only science 
 whose progress has been hindered by abuses in 
 terms. 
 
 In his Elements of the Philosophy of the Human 
 Mind, Dugald Stewart says : " When I consult 
 Johnson's Dictionary, I find many words of which 
 he has enumerated forty, fifty, or even sixty dif- 
 ferent significations ; and, after all the pains he 
 has taken to distinguish these from each other, I 
 am frequently at a loss how to avail myself of his 
 definitions." 
 
 A great thinker and metaphysician comments^ 
 
22 INTRODUCTION. 
 
 -as follows, upon words and deplores their wrong 
 usage. 
 
 " In words are contained the knowledge 
 
 and sciences possessed by the nations of the 
 
 earth A strict adherence to propriety in 
 
 the use of words, is the only means for maintain- 
 ing clearness of ideas, for preserving and har- 
 monising them Many ancient and modern 
 
 sophists, and many profane philosophers, sought 
 artfully to alter the true value and force of 
 words. The world could scarcely be deceived 
 except by such alteration. Abuse has been made 
 of almost all philosophical and political terms, as 
 has been frequently shown by various writers. 
 Whoever takes note of the errors that have arisen 
 from the abuse of the word Nature, in the 
 sciences of Right and Politics — of the words 
 Sensation, Pleasure, Pain, in Metaphysics ; of the 
 words Equality and Liberty in Politics; of the 
 word Wealth in Political Economy — and of the 
 many others to which, generally, there has been 
 added only a more extensive signification than 
 that given them by common usage, will discover 
 the sources of incredible deceptions to the mind, 
 and of incredible evils to humanity." (Rosmini^ 
 Introduzione alia Filosojia.) 
 
 Max Miiller in his Science of Thought ^ 1887, (p. 
 18) says :,.....*' That every one of these words 
 
INTRODUCTION. 23 
 
 is used in different senses by different philoso- 
 phers, might be tolerated, if each philosopher 
 would tell us clearly, and once for all, in what 
 sense he himself means to use them. This is 
 what few attempt to do ; and if they do it, they 
 often seem to imagine that because there are so 
 many words, there must be also so many distmc- 
 tions. They overburden us with definitions and 
 make confusion worse confounded." 
 
 The following, which is much to the purpose 
 is also quoted from the recent work of Max 
 Miiller. 
 
 " All I maintain is that, not only to a considera- 
 ble extent, but always and altogether, we think 
 by means of names, and that things are no more 
 to us than what we mean by their names. What 
 we really mean by names must be settled by defi- 
 nition, and according as our knowledge changes, 
 the definition and therefore the meaning of names 
 will change. Every new addition to our ex- 
 perience may be said to change, to correct, or to 
 complete the intension and the extension of our 
 names, but before we can use our new knowledge, 
 it must always have been embodied either in an 
 
 old or a new name There may be little or 
 
 much, there may be false or true knowledge in 
 our names, but without some sort of name we 
 cannot reason," (p. 35, Science of Thought,) 
 
24 INTRODUCTION. 
 
 8. As a means to the desired end, students of 
 medicine should be thoroughly drilled in the use 
 of words of precision, whose employment is 
 coupled with exact knowledge, — not forgetting 
 the fact that to name is to know^ for these two 
 words have been traced to the same root whose 
 antiquity is almost as great as that of man — , and 
 exact medical knowledge, methodically arranged, 
 will inevitably lead to its practical application in 
 the cure of disease or the alleviation of human 
 suffering. High as is the achievement of curing 
 disease or of alleviating suffering, the physician 
 should aspire to the still higher object of preserv- 
 ing the health of the people. This should be the 
 end of medicine. 
 
 •^ 
 
PRINCIPLES 
 
 OF 
 
 NOMEiXCLATURE AND CLASSIFICATION. 
 
 SECTION I. 
 
 Preliminary Considerations. 
 
 Outline of the anatomical view of man. Definition of medi- 
 cine. A classification of the science and art of medicine. 
 Medicine and Surgery. Arrangement of medicine into certain 
 departments in accordance with the apparatuses of the human 
 body. The physician. Definition of disease. A synopsis of 
 the morbid states and morbific processes of the body. The 
 value and significance of proper anatomical terms in classifi- 
 cation. Definition of system, organ, apparatus, and function. 
 Systems and organs perform no function, but yield service to 
 apparatuses. Each apparatus performs only one function, 
 and there is no function without an apparatus. 
 
 THE HUMAN BODY. 
 
 Anatomically considered man's body is a 
 grand complex apparatus destined to perform 
 the one function of reproduction of its species. 
 To that end the male and female must couple. 
 The sperm of the male then fecundates the ovum 
 
26 THE HUMAN BODY. 
 
 which is within the female, and she completes 
 the function of reproduction of the species. 
 
 This primary human apparatus is an assem- 
 blage of secondary apparatuses that are intended 
 to perform certain special functions, some of 
 which are designed to conserve the individual, 
 and others to keep the body in a healthy condi- 
 tion and fit it for the performance of its one great 
 function. 
 
 The senses of man, each of which being the 
 function of a special apparatus, are all subservi- 
 ent to the genetic sense, to the one paramount 
 function, requiring the union of the sexes for its 
 accomplishment. 
 
 Such are the facts that may be gleaned from 
 anatomy, but archaeology too teaches its lesson. 
 It appears that many of the ancient nations made 
 the external genital organs of both sexes objects 
 of worship, so much importance did they attach 
 to generation, and that traces of phallic worship 
 have been discovered within a comparatively re- 
 cent period, even among the savage tribes of the 
 South Sea Islands, and of North, Central, and 
 South America. 
 
 Anatomy and archaeology having spoken their 
 word, if a glance be now cast at chapter i, verse 
 28, of the Book of Genesis, it will be seen that, 
 for a long series of centuries, civilized man has 
 
THE HUMAN BODY. 2/ 
 
 entertained the belief that the object of his exist- 
 ence is to multiply his species. The first com- 
 mand to man was " Increase and multiply and 
 fill the earth." That was to be the one function 
 of man. The other commands, to subdue the 
 earth and rule over all living creatures, are sub- 
 ordinate to the first command, to the one func- 
 tion. Man was to subdue the earth to the end 
 of fulfilling that first command, and he was to 
 rule over all living creatures and make such use 
 of them as might be subservient to that first 
 command. The general disobedience of that 
 command w^ould entail disease, death and the 
 speedy extinction of the species. 
 
 All organic nature is busy with the multiplica- 
 tion of species. In the lowest forms of animal 
 and vegetable life this multiplication continues 
 until by some accident the process is interrupted. 
 Such an interruption is one of the checks to the 
 inordinate increase of the species ; but when the 
 process ceases, extinction is the inevitable out- 
 come. 
 
 Man alone is prone to violate the great law of 
 creation which impels organized beings to repro- 
 duce their kind. In these days there are too 
 many unfortunates who, desirous to sin without 
 conceiving, adopt the most injurious means to 
 effect their purpose. Among these may be men- 
 
28 DEFINITION AND OBJECTS OF MEDICINE. 
 
 tioned the iniquity of Onan, so common among 
 the hig-her classes, so demoralising and so hurt- 
 ful to both the male and female. 
 
 Most persons are conscious that many of their 
 diseases are caused by their own vices and ex- 
 cesses, the consequences of which are certain to 
 assail and perhaps to destroy them. Often 
 blinded however by their passions, or heedless of 
 nature's inexorable laws they fail to perceive the 
 cause of a particular malady until it is almost if 
 not altogether too late for its removal. Then 
 perhaps they have reluctant recourse to the 
 physician. 
 
 DEFINITION AND OBJECTS OF MEDICINE. 
 
 It often happens that certain patients long 
 hesitate to consult the true physician, who pre- 
 scribes for disease and not for symptoms, be- 
 cause of their vague notions of the character and 
 scope of rational medicine — so much derided by 
 cynics and charlatans — and of their idea that the 
 practiser of medicine gropes in the dark in his 
 search for the nature of diseases and for the 
 means of their cure, and that his diagnosis is con- 
 jectural while his treatment is empirical. To a 
 man of this class the title of Doctor in medicine 
 is a misnomer, because the " Doctors " whom he 
 
DEFINITION AND OBJECTS OF MEDICINE. 29 
 
 knows are neither learned nor wise. He had 
 never been able to make the distinction between 
 the ignorant pretender and the conscientious and 
 well qualified physician. He is at length brought 
 face to face with a Doctor whose mental quali- 
 ties give him a right to the title. After a short 
 conference he propounds the old question so 
 often asked by the laity, '' what is meant by 
 medicine, and can it be ranked as a science " ? 
 The answer to this question involves a definition 
 of a science and of an art. If knowledge, 
 acquired by study, experiment, and observation, 
 methodically arranged to serve as a basis upon 
 which are established general and particular 
 principles for guidance in the practice of an art, 
 be accepted as one of the definitions of a science, 
 and if an art can be defined as skill acquired in 
 the use of means for the accomplishment of an 
 end, then medicine is entitled to be ranked as a 
 science and an art. These definitions mav be 
 thus condensed ; science is to know, and art is to 
 do. This is the answer to the second part of the 
 question. The first part will be answered by a 
 definition of medicine and by a concise statement 
 of its aims and of the methods employed in its 
 study. 
 
 Medicine,* as related to man, may be defined 
 
 * Medicine, from mederi, to heal. 
 
30 DEFINITION AND OBJECTS OF MEDICINE. 
 
 as the science of man in his abnormal states, and 
 the art of curing or ol alleviating disease. 
 
 Medicine presupposes the science of man in 
 his normal state, and implies the arts of preserv- 
 ing health, of preventing disease, and of prolong- 
 ing life. 
 
 Medicine and its fundamental science and 
 associated arts lay under contribution botany, 
 zoology, mineralogy, chemistry, pharmacology, 
 physics, mathematics, and mechanics ; assist in 
 the execution of the law of the land, particularly 
 in the special department known as Medical 
 Jurisprudence ; aid the State in the prevention 
 of disease, through the department of State 
 Medicine ; and have their influence upon the 
 morals of the people. The system of medical 
 morals written by the Father of scientific medi- 
 cine more than two thousand years ago, is so 
 sound in its broad principles as to have required 
 no changes except in a few details, and the addi- 
 tions that have been made thereto only serve to 
 enforce these principles. The best modern ethical 
 essays are founded upon the Hippocratic oath 
 which was itself erected upon the imperishable 
 foundation of reason, truth, justice, and bene- 
 ficence. There can be only one medicine, the 
 medicine which, together with its fundamental 
 science and associated arts, is ever seeking the 
 
CLASSIFICATION OF MEDICINE. 3 1 
 
 truth, and whose objects are to prevent, heal, or 
 alleviate disease, to preserve health, and to pro- 
 long life. 
 
 True medicine, founded as it is upon biology, 
 is not fettered by dogmata and is therefore al- 
 ways advancing. The student of medicine must 
 understand the laws of life, and be acquainted 
 with the science of man in his normal condition, 
 and very particularly with the functions of the 
 apparatuses of his body. Until then he is unfit 
 to study, and still more unfit to cope with dis- 
 ease. This leads to what is believed to be a 
 proper classification of medicine. 
 
 CLASSIFICATION OF MEDICINE. 
 
 Medicine comprises : (A,) the science ; and 
 (B,) the art of medicine. 
 
 A. THE SCIENCE of medicine and its funda- 
 mental science of man in a normal state consist : 
 (I,) of anthropophysiography, or the description 
 of man in a state of health ; and (II,) of anthro- 
 ponosography, or the description of man in a 
 state of disease. 
 
 I. Anthropophysiography comprises all the 
 branches of anatomy and is the same as human 
 biology. 
 
 Anatomy is divided into: (i,) transcendental 
 
32 CLASSIFICATION OF MEDICINE. 
 
 anatomy ; (2,) homological anatomy ; (3,) phys- 
 iognomical anatomy; (4,) embryology; (5,) de- 
 scriptive anatomy ; (6,) comparative anatomy ; 
 (7,) topographical anatomy ; (8,) histology ; (9,) 
 stoechiology ; (10,) human ph^^siology ; and (11,) 
 comparative physiology.* 
 
 1. Transcendental anatomy is the study: (i,) of 
 the general design of the body ; and (2,) of the 
 particular design of the organs. 
 
 2. Homological anatomy is the study of the cor- 
 relations of the several parts of the body — (i,) of 
 the organs and their parts ; (2,) of the tissues ; 
 and (3,) of the apparatuses of the body. 
 
 J. Physiogjtomical anatomy is the study of ex- 
 pressions depicted upon the exterior of the body, 
 more particularly upon the face, such as expres- 
 sions of joy, despondency, mental anxiety, pain, 
 fear, anger, etc. ; and is also the study of those 
 expressions induced by disease. -f 
 
 * These branches of anatomy are not ordinarily studied in 
 the order in which they appear above, but the arrangement 
 adopted is in correspondence with the general plan of this 
 work. 
 
 t The facies of disease were very long ago carefully studied. 
 Hippocrates described so graphically the expression often in- 
 duced by the exhaustion incidental to certain chronic and 
 acute diseases, and by long fasting, that this expression bears 
 
CLASSIFICATION OF MEDICINE. 33 
 
 ^. Embryology is the study : (i,) o^ the fecund- 
 ation of the ovum ; (2,) of the growth of the 
 embryo ; and (3,) of the development of the 
 organs. 
 
 5. Descriptive anatomy is the study : (i,) of the 
 general configuration of the body and of the 
 particular configuration of its several parts ; (2,) 
 of the gross appearances of the organs ; (3.) of 
 the construction of the organs ; (4,) of the form, 
 size, color, consistency and weight of the organs ; 
 and (5,) of the composition of the apparatuses. 
 
 6. Comparative anatomy is the study and com- 
 parison of the body and organs of man with 
 those of the lower animals. Its object is to ascer- 
 tain the nature of the modifications of structure 
 adapted to the needs of different animals. 
 
 7. Topographical anatomy is the study of the 
 situations and relations of the several parts and 
 organs of the body. 
 
 8. Histology is the study: (i,) of the minute 
 structure of the tissues ; and (2,) of the minute 
 structure of the organs. 
 
 the name of fades Hippocratica, There are too the facies of 
 cancer, of tuberculosis, of cholera, of hysteria, of epilepsy, etc. 
 The facial expressions varying also according to the seat of 
 particular diseases. 
 
34 CLASSIFICATION OF MEDICINE. 
 
 9. Stoechiology * is the study of the chemical 
 elements of the gases, fluids, and solids of the 
 body. 
 
 10. Htwian physiology is> t\iQ studiy '. (i,) of the 
 uses of the organs ; and (2,) of the functions of 
 the apparatuses of the body of man. 
 
 //. Comparative physiology is the study and 
 comparison of the uses of the organs and of the 
 functions of the apparatuses of all organized 
 beings. 
 
 11. Antroponosography, which should be 
 based upon all the branches of anatomy, consists 
 of the two divisions: (i,) teratology; and (2,) 
 pathology. 
 
 1. Teratology is the study of the congenital 
 anomalies of the whole or of parts of the body. 
 
 2. Pathology is the study: (i,) of general 
 diseases ; (2,) of diseases of particular organs ; 
 {3,) of diseases consequent upon parasitic inva- 
 sion of the human organism ; (4,) of the conse- 
 quences of the introduction of foreign substances 
 into the body ; (5,) of the effects of injuries ; (6,) 
 of the consequences of the ingestion of poisons ; 
 and (7,) of functional disorders of the appara- 
 tuses. 
 
 * Stoechiology — from 6roix^iov, an element — is ordinarily 
 taught under the names of physiological chemistry and organic 
 chemistry. 
 
CLASSIFICATION OF MEDICINE. 35 
 
 The means employed in the study of disease 
 consist in making proper use ; (i,) of aetiology ; 
 (2,) of symptomatology ; (3,) of semeiology ; (4,) 
 of pathoanatomy ; (5,) of pathohistology ; (6,) of 
 nosonomy ; (7,) of nosotaxy ; (8,) of diagnosis ; 
 and (9,) of prognosis. 
 
 B. THE ART of medicine and its associated 
 arts consist: (i,) of h3^giene, or the art of pre- 
 serving health ; (2,) of prophylaxy, or the art of 
 preventing disease ; (3,) of therapy, or the art of 
 curing or of alleviating disease ; and (4,) of 
 biothalmy, or the art of prolonging life. 
 
 I. Hygiene,* or the art of preserving health — 
 The preservation of health is generally effected 
 by the strict observance of the rules which relate 
 to the maintenance, in their normal state, of the 
 functions of the body and which are directed 
 principally: (i,) to alimentation; (2,) to exer- 
 cise; (3,) to clothing; (4,) to sleep ; (5,) to ablu- 
 tion ; (6,) to residence ; (7,) to ventilation ; (8,) 
 to light ; (9,) to temperature ; etc. 
 
 II. PROPHYLAXY,t or the art of preventing dis- 
 ease. — Disease may be prevented : (i,) by avoid- 
 ance of contagion ; (2,) by abstention from ex- 
 cesses ; (3,) by the strict observance of the rules 
 
 * Hygiene, from vyi'sid, health. 
 
 t Prophylaxy, from itpo, beforehand, and (pvXdzr eiv y to 
 guard. 
 
36 CLASSIFICATION OF MEDICINE. 
 
 of hygiene ; (4,) by the use of medicinal sub- 
 stances having propy lactic properties ; (5,) by 
 the selection of a suitable climate ; (6,) by disin- 
 fection ; (7,) by proper house drainage ; (8,) by 
 the isolation of cases of contagions disease. 
 
 III. Therapy, * or the art of curing or of al- 
 leviating disease. — It should be borne in mind 
 that many diseases are cured by unassisted na- 
 ture, nevertheless they require the closest ob- 
 servation of the medical attendant. Meddle- 
 some physic in such circumstances is often pro- 
 ductive of much evil. Here then is a field for 
 the exercise of good judgment on the part of the 
 wise physician who knows when to apply and 
 when to abstain from applying remedies. Here 
 too is the opportunity for the charlatan to make 
 the most of his spurious wares, and to boast of 
 *' great cures " which he never effected. How- 
 ever, in ordinary circumstances of disease, na- 
 ture needs assistance and this assistance should 
 be intelligent, prompt, and efhcient. Such assist- 
 ance may be directed : (i,) to a general disease ; 
 (2,) to a special disease of a particular organ ; 
 (3,) to an injury ; etc. The internal use of med- 
 icaments, external applications, mechanical ap- 
 pliances, or the surgeon's ministrations, may be 
 
 * Therapy, from OspaTCevsiVy to cure. 
 
CLASSIFICATION OF MEDICINE. 3/ 
 
 needed. From these resources, for the cure or 
 alleviation of disease, it is the office of the 
 physician to select that which is suited to in- 
 dividual cases. 
 
 IV. BiOTHALMY,* or the art of prolonging life. 
 — Man's life may be prolonged beyond its ordi- 
 nary duration, if he be free from disease, (i,) by 
 great sobriety and moderation in all his acts ; (2,) 
 by the close observance of the rules of hygiene ; 
 (3,) by avoidance of exposure during inclement 
 weather ; and (4,) by his leading a serene exist- 
 ence, free from the cares of ordinary life, but 
 with pleasant pursuits. f When man is affected 
 with incurable disease, his life may be prolonged : 
 
 * Biothalmy, from Bio^aXjuioi, long-lived. Macrobiosis 
 is also used to express the idea of longevity. 
 
 t On this important subject of the prolongation of man's 
 life, the reader may, u'ith advantage, consult " The Code of 
 Health and Longevity," by Sir John Sinclair, Edinburgh, 1807. 
 This very interesting and valuable compilation, in four octavo 
 volumes, contains : rules for preserving health and promoting 
 longevity ; regulations for the health of the community ; an 
 account of the doctrines of Hippocrates concerning health and 
 longevity ; also accounts of Galen ; of the minor Greek 
 authors ; and of the Arabian and Jewish authors who have 
 written on the subject of health ; and of Cicero and Seneca 
 on old age and the shortness of life. It also contains the 
 "Regimen Sanitatis Salerni," with Doctor Holland's transla- 
 tion thereof ; an account of Lewis Cornaro, a Venitian gentle- 
 
38 CLASSIFICATION OF MEDICINE. 
 
 (i,) by a proper dietary ; (2,) by suitable medica- 
 ments ; (3,) by the maintenance of certain func- 
 tions, as far as practicable, in their normal state ; 
 (4,) by rest or exercise as needed, and attention ta 
 the conditions of the physical surroundings ; (5,} 
 by mechanical appliances ; and (6,) by a surgical 
 operation, if such be required. 
 
 man who livecl a " sober life " and died aged upward of one 
 hundred years , of the weighing chair of Sanctorius and of his 
 Medicina Statica ; and an account of British authors wha 
 have written upon health and longevity, from Friar Bacon, 
 vrho died in the year 1292, to Doctor Waterhouse in 1805. 
 Among the many accounts of centenarians given in this work,, 
 are those of John Rovin in his one hundred and seventy- 
 second (172) year, and of his wife Sarah in her one hundred 
 and sixty-fourth (164) year, and of Petratsch Zortan in the 
 one hundred and eighty-fifth (185) year of his age, with en- 
 gravings of their portraits which had belonged to the Percys^ 
 Earl of Northumberland. 
 
 An essay by J. P. M. Flourens, bearing the following title, 
 may also be profitably consulted : " De la longevite humaine 
 et de la quantite de vie sur le globe," Paris, 1856. 
 
 A very interesting paper on " the habits and family history 
 of centenarians" by Professor Humphry appeared in the 
 " Popular Science Monthly " for March 1887. This paper had 
 formed a part of a report on the subject by Professor Hum- 
 phry to the British Medical Association. It contains an 
 analysis of the table of centenarians, by A. Francis, M. R, 
 C. S., of Kings College, Cambridge, which is well worthy of 
 careful perusal. 
 
39 
 
 MEDICINE AND SURGERY. 
 
 Medicine has been separated into two depart- 
 ments : ( I,) Medicine proper, or, as the French 
 still call it, internal pathology ; and (2,) Surgery,, 
 or external pathology."^ Neither designation is 
 
 * For many centuries medicine was in the hands of the 
 priesthood. In Eg>'pt, for instance, none but the priests were 
 permitted to minister to the sick; among the early Israelites, 
 the Prophets, Priests and Levites were the only physicians ; 
 and the Priests of Apollo and of Esculapius were, for a long 
 time, the only medical advisers of the Greek people. This 
 most ancient custom, of combining the offices of physician 
 and priest, was adopted by the Christian clergy and prevailed^ 
 with few interruptions, until the middle of the eighteenth 
 century. 
 
 The school of Salernum owed its celebrity, from the eighth 
 to the twelveth century, to the many learned members of the 
 clergy who there taught or were taught medicine. Among 
 these illustrious men may be mentioned ; Theodore, Arch- 
 bishop of Canterbury ; Wigart, Bishop of Hildesheim ; 
 Cuthbert, the English monk ; the monk Campo ; Hughes, 
 Abbot of Saint Denis ; John of Ravenna ; and Gerbert, after- 
 wards Pope Sylvester 11. They had all learned the medicine 
 of the Arabs. 
 
 During the eleventh century the Benedictine monks of 
 Monte Cassino greatly distinguished themselves at the Saler- 
 num school, and Didier, the Abbot of Monte Cassino, who be- 
 came Pope Victor III, was one of the teachers in that 
 renowned school. 
 
 In the twelveth century priests were forbidden to practise 
 
40 MEDICINE AND SURGERY. 
 
 rational, for '' medicine proper " has to deal as 
 much with external as with internal diseases, and 
 surgery has as much to do with internal as with 
 external diseases. The physician uses his hands 
 in diagnosis and in mmistering to the sufferings 
 of his patients as much as does the surgeon. The 
 word "surgery," meaning simply the art of 
 healing by the use of the hands, does not neces- 
 sarily imply how the hands shall be used. It 
 does not mean that the hand must needs contain 
 a cautery or a knife any more than a blister or a 
 poultice, or that the hands shall reduce a hernia 
 
 surgery, that is to say to use the knife and shed human blood 
 or to use the actual cautery, and even to study medicine. But 
 during the crusades, and when leprosy was imported into 
 Western Europe, the lepers' hospitals were attended entirely 
 by monks. 
 
 There came another prohibition, in the latter part of the 
 thirteenth century, under the pontificate of Boniface VIII. 
 
 The law of celibary imposed, in France, upon physicians, 
 was abrogated, m 1452, through the influence of Cardinal 
 d'Etouteville. This should have placed medicine entirely 
 in the hands of the laity. It did not however ; for the 
 clergy continued to practise medicine. 
 
 The final decree prohibiting priests from practising medicine 
 or surgery was promulgated in the middle of the eighteenth 
 century during the pontificate of Benedict XIV. (Diocesan 
 decrees. Book XIII, chapter X.) 
 
 Medicine and surgery were not made absolutely distinct 
 branches until the fourteenth century. 
 
MEDICINE AND SURGERY. 4I 
 
 rather than percuss a chest or administer a po- 
 tion. The term ''medicine" was applied to the 
 healing of wounds long before internal diseases 
 were understood. 
 
 The term chirurgery, relating to manual opera- 
 tions, was, according to Celsus, not used until 
 the time of Herophilus (307 B. C). A few cen- 
 turies ago the word surgeon was employed to 
 designate the " barber-surgeon " in contradistinc- 
 tion from the educated healer who was styled 
 "*' Master in chirurgery." 
 
 In France, as early as the beginning of the 
 fourteenth century, no barber-surgeon was per- 
 mitted to exercise his calling until he had been 
 examined by certain Masters in chirurgery.* 
 
 It would seem preferable to use the word med- 
 icine as a generic term and to arrange the science 
 and art of medicine into certain departments in 
 accordance with the several apparatuses of the 
 body such, for instance, as relate ; (I,) to affec- 
 tions of the cephalo-rhachidian apparatus and of 
 its subsidiary apparatuses ; (II,) to affections of 
 
 * " Rule in favor of the Masters in chirurgery of the month 
 of August 1301," contained in Girodat's presentation of the 
 case of the surgeons of Paris under the title of '• Recherches 
 Critiques et Historiques sur VOrigine, sur les Divers Etats, 
 €t sur les Pr ogres de la Ckzrurgie en France," Paris 1744, 
 p. 435. 
 
42 THE PHYSICIAN. 
 
 the nutritive apparatus and of its subsidiary ap- 
 paratuses ; (III,) to affections of the motory 
 apparatus ; (IV,) to affections of the cutaneous 
 apparatus ; and (V,) to affections of the generative 
 apparatus which united to the urinary apparatus 
 constitutes the uro-genital apparatus. 
 
 General affections, involving several appara- 
 tuses, should also be arranged into proper 
 groups. 
 
 THE PHYSICIAN. 
 
 The ancient Greeks called the physicians 
 idrpoiy the healer. The ideal physician should 
 however be more than a mere healer of wounds 
 or a prescriber of pills and potions. — Handicraft 
 and shrewdness are his lowest attributes. — He 
 should, in a broad sense ol the word, be a philan- 
 thropist (implying not only a lover but a knower 
 of man), and a close, thoughtful, observer of the 
 nature of the human apparatuses, the disorders 
 of whose functions he has to interpret. He- 
 should investigate questions relating to the 
 structural and other characters of diseases. He 
 should devise means for the cure of diseases, and* 
 formulate rules for their prevention. He should 
 be both iatrosophisia and iatrotecJina,, learned in. 
 the science and skilled in the art of medicine. 
 
43 
 
 DEFINITION AND GENESIS OF DISEASE. 
 
 In this connection it will be proper to answer 
 the commonly asked question ; " What is meant 
 
 by disease?" 
 
 Disease is a deviation from the normal state 
 of the whole or of any part of the body. 
 
 The term disease* was long ago introduced 
 into medical language to express the idea of 
 bodily uneasiness or distress such as may be 
 caused by an injury ; by an interruption, or a 
 disturbance of vital functions ; or by an alteration 
 in the structure of an organ or of several organs 
 of an apparatus or of all the apparatuses of the 
 body. Hence it is that diseases have been classed 
 into functional and organic diseases.f But dis- 
 ease of an organ always disorders, in a greater 
 
 * The etymology of the word disease though having little 
 scientific value, is not without interest. This word is derived 
 from dis, without, and ease, through the old French desaise, 
 lack of ease, uneasiness, distress. 
 
 t In a v/ritten communication on this subject, Professor 
 Meredith Clymer of New York uses the following language : 
 " There can be no change in the accustomed expression of an 
 activity — either by increase, diminution or perversion — with- 
 out coincident change in the plasmode. Hence strictly there 
 can be no such thmg as a functional as distinguished from a 
 structural disease. Disease is always material, whether 
 recognisable as such or not." 
 
44 DEFINITION AND GENESIS OF DISEASE. 
 
 or less degree, the function of the apparatus to 
 which it belongs, and sometimes disorders the 
 functions of several apparatuses. Therefore such 
 a classification is faulty and misleading. 
 
 The affections of the human body may be : 
 (i.) Congenital, resulting from vices of the pri- 
 mary conformation ; 
 (2.) Hereditary, transmitted by progenitors ; 
 (3.) Primary, arising from more or less well 
 
 known causes ; 
 (4.) Secondary, consequent upon preexisting dis- 
 ease — in this case the word pathengenetic * 
 expresses briefly the idea of a disease spring- 
 ing from another disease ; 
 (5.) Traumatic, resulting from injuries ; or 
 (6.) May be the outcome of errors of diet, of the 
 effects of climate, of parasitic invasion, and 
 of gaseous, mineral, vegetable, or animal 
 poisons, including ptomaines and leucomaines. 
 Although these affections number many spe- 
 cies, the morbid states and morbific processes 
 from which these species originate are compara- 
 tively few and are comprised under the follow- 
 ing captions : ( I,) alterations in the composition 
 of the blood ; (2,) disturbances in the circulatory 
 
 * The word pathengenetic was lately coined by Dr. Alfred 
 L. Carroll. 
 
MORBID STATES & MORBIFIC PROCESSES. '45 
 
 apparatus ; (3,) pathengenetic alterations of struc- 
 ture ; (4,) retrograde metamorphoses; (5,) new 
 growths; (6,) granulation-growths; (7,) cysts; 
 (8,) stones; (9,) injuries; (10,) monsters; (11,) 
 extraneous bodies; (12,) parasites ; (13,) poisons ; 
 (14,) functional disorders. 
 
 SYNOPSIS OF THE MORBID STATES AND MORBIFIC 
 
 PROCESSES OF THE BODY, BEING 
 
 A SUGGESTION OF A GROUND WORK FOR THE 
 
 CLASSIFICATION OF DISEASES. 
 
 I. Alterationes in quantitate, in qualitate, et in 
 compositione sanguinis, (Alterations in the 
 
 quantity, quality, and composition of 
 the blood). 
 
 1. Hyperaemia, (Superabundance of blood). 
 
 2. Hypoaemia, (Insufficiency of blood). 
 
 3. Hyperhydraemia, (Increase of blood- water). 
 
 4. Hypohydraemia, (Decrease of blood-water). 
 
 5. Hyperinosaemia, (Increase of blood-fibrin). 
 
 6. Hypoinosaemia, (Decrease of blood-fibrin). 
 
 7. Hyperleucontaemia,* (Increase of blood-albumen). 
 
 8. Hypoleucontaemia, (Decrease of blood-albumen). 
 
 9. Hyperalonaemia, (Increase of blood-salts). 
 10. Hypoalonaemia, (Decrease of blood-salts.) 
 
 II. Hyperchromataemia, (Increase of blood-color). 
 
 * XsvHoVf the white of an egg — albumen. 
 
46 MORBID STATES & MORBIFIC PROCESSES. 
 
 12. Hypochromataemia, (Decrease of blood-color). 
 
 13. Hyperleucoc3'thaemia, (Increase of white blood- 
 
 cells). 
 
 14. Hypoleucocythaemia, (Decrease of white blood- 
 
 cells). 
 
 15. Hypererythrocythaemia, (Increase of red blood- 
 
 cells). 
 
 16. Hypoerythrocythaemia, (Decrease of red blood- 
 
 cells). 
 
 17. Hyperlipaemia, (Increase of blood-fat). 
 
 18. Hypolipaemia, (Decrease of blood-fat). 
 
 19. Hyperphysaemia, (Increase of blood-gas). 
 
 20. Hypophysaemia, (Decrease of blood-gas). 
 
 21. Hyperglycaemia, (Increase of blood-sugar). 
 
 22. Hypoglycaemia, (Decrease of blood-sugar). 
 
 23. Acetonaemia, (Acetone in the blood). 
 
 24. Ammoniaemia, (Ammonia in the blood). 
 
 25. Hyperuraemia, (Increase of blood-urea). 
 
 26. Hypouraemia, (Decrease of blood-urea). 
 
 27. Hyperuricaemia, (Increase of blood-uric acid). 
 
 28. Hypouricaemia, (Decrease of blood-uric acid). 
 
 29. Cholaemia, (Bile in the blood). 
 
 30. Hypercholesteraemia, (Increase of blood-choles- 
 
 terin). 
 
 31. Hypocholesteraemia, (Decrease of blood-choles- 
 
 terin). 
 
 32. Melanaemia, (Black pigment in the blood). 
 
 33. Septicaemia, (Putrid infection of the blood). 
 
 34. Pyosapraemia, (Putrid-pus infection of the blood). 
 
MORBID STATES & MORBIFIC PROCESSES. 4/ 
 
 II. Turbationes in apparatus circulationis, 
 (Disturbances in the circulatory apparatus). 
 
 1. Ischaemia,* (Arrest of the blood). 
 
 2. Athroisaemia,f (Blood accumulation, congestion). 
 
 3. Phlegmasia,^ (Inflammation). 
 
 4. Lymphexomosis, (Transudation of lymph). 
 
 5. Lymphorrhagia, (Flow from a rent lymph-vessel). 
 
 6. Haemorrhagia, (Flow from a rent blood-vessel). 
 
 7. Haemodiapedisis, (Oozing through blood-vessel 
 
 walls). 
 
 8. Thrombosis, § (Coagulation). 
 
 9. Embolismus,! (Plugging.) 
 
 III. Alterationes structurae pathengeneticae, 
 (Pathengenetic alterations of structure). 
 
 1. Hypertrophia, (Hypertrophy). 
 
 2. Hypotrophia, (Hypotrophy). 
 
 3. Atrophia, (Atrophy). 
 
 4. Auxesis, (Enlargement, increase). 
 
 * Anaemia localis, (Local capillary anaemia). 
 
 t Athroisaemia, from dBpoi6}xa, accumulation, and axiioLy 
 blood. Athroisaemia activa et passiva. Eff usio serosa. 
 
 \ Exudationes. 
 
 § Angiohaemothrombus (blood-vessel clot), cardiohaemo- 
 thrombus (heart clot). 
 
 I Angioembolus, (Vessel plug). 
 
48 MORBID STATES & MORBIFIC PROCESSES. 
 
 5. Ectasis, (Dilatation, expansion). 
 
 6. Stenosis, (Contraction, stricture). 
 
 7. Echmasis, (Obstacle, obstruction). 
 
 IV. Metamorphoses retrogrades, 
 (Retrograde metamorphoses). 
 
 1. Necrosis,* (Necrosis, death). 
 
 2. Meiosis, (Meiosis, decrease). 
 
 3. Degeneratio,t (Degeneration). 
 
 4. Infiltratio,); (Infiltration). 
 
 V. Neoplasmata, (New-growths). 
 
 (i.) Desmoneoplasmata, [Connective tissue neoplasms), 
 
 1. Endothelioma, (Endothelioma). 
 
 2. Sarcoma, (Sarcoma). 
 
 3. Inoma, (Fibroma). 
 
 4. Myxoma, (Myxoma). 
 
 5. Neuroglioma, (Neuroglioma). 
 
 6. Lipoma, (Lipoma). 
 
 7. Chondroma, (Chondroma). 
 
 8. Osteoma, (Obsteoma). 
 
 * Necrosis, — coagulationis, colliquativa, et caseosa. Gan- 
 graena humida et sicca. Ulceratio. 
 
 t Degeneratio, — granulosa, adiposa, amyloides, colloides, 
 mucoides, hyalina, inoides, et sclerosa. 
 
 X Infiltratio, — adiposa, pigmentaria, calcarea, et urica. 
 
MORBID STATES & MORBIFIC PROCESSES. 49 
 
 (2.) Myoneoplasmata, (Muscular tissue neoplasms\ 
 I. Myoma,* (Myoma). 
 
 (3.) Neuroneoplasmata, {Nerve tissue neoplasms). 
 I. Neuroma, (Neuroma). 
 
 (4.) Angioneoplasmata^ {Vascular tissue neoplasms). 
 I. Angioma,! (Angioma). 
 
 (5.) Epithelioneoplasmata^ {Epithelial neoplasms.) 
 
 1. Epithelioma, (Epithelioma). 
 
 2. Carcinoma, (Cancer). 
 
 3. Adenoma, (Glandular growth). 
 
 VI. Blastomata, (Granulation growths), 
 
 1. Syphilis, (Syphilis). 
 
 2. Ulcus chancroides, (Chancroid ulcer). 
 
 3. Lepra, (Leprosy). 
 
 4. Tuberculosis, (Tuberculosis). 
 
 5. Lupus, (Lupus). 
 
 6. Equinia, (Glanders). 
 
 7. Actinomycosis, (Actinomycosis). 
 
 8. Rhinoscleroma, (Rhinoscleroma). 
 
 * Rhabdomyoma, leiomyoma, 
 t Haemangioma, lymphangioma. 
 
 (St. 
 
50 MORBID STATES & MORBIFIC PROCESSES. 
 
 VII. Cystides, (Cysts.) 
 
 VIII. Lithi, (Stones). 
 
 1. Sialolithus, (Salivary stone). 
 
 2. Chololithus, (Gall stone). 
 
 3. Enterolithus, (Intestinal stone). 
 
 4. Urolithus, (Urinary stone). 
 
 5. Prostatolithus (Prostatic stone). 
 
 6. Piilebolithus, (Vein stone). 
 
 IX. Traumata, (Injuries,) including all kinds of 
 
 injuries to the body. 
 
 X. Terata, (Monsters,) including all kinds of 
 
 congenital anomalies of the body. 
 
 XI. Corpora extranea, (Extraneous bodies,) in- 
 cluding the lodgment, in the body, of all 
 
 kinds of foreign substances. 
 
 XII. Parasiti, (Parasites). 
 
 1. Entozoa, (Entozoa). 
 
 2. Ectozoa, (Ectozoa). 
 
 3. Entophyta, (Entophyta). 
 
 4. Epiphyta, (Epiphyta). 
 
MORBID STATES & MORBIFIC PROCESSES. 5 1 
 
 XIII. Venena, (Poisons,) including all kinds of 
 
 gaseous, mineral, vegetable, and animal 
 
 poisons. 
 
 XIV. Vitia functionum, (Disorders of the 
 functions. 
 
 1. Perversio, (Perversion). 
 
 2. Deficiens, (Deficiency). 
 
 3. Immoderatio, (Excess). 
 
 4. Diminutio, (Diminution). 
 
 5. Suspensio, (Suspension). 
 
 6. Abolitio, (Abolition). 
 
 COMMENTS ON SOME OF THE TERMS USED 
 
 IN THE SYNOPSIS OF MORBID STATES 
 
 AND MORBIFIC PROCESSES. 
 
 The names given to the morbid states and 
 morbific processes of the body should be changed 
 whenever the true nature of these states and pro- 
 cesses is discovered. Many of the names only 
 convey an erroneous idea of the condition which 
 they are intended to express. 
 
 The term inflam7nation^ for instance, is used 
 under protest until a better term shall be agreed 
 
52 TERMS USED IN THE SYNOPSIS OF 
 
 upon by the profession. The coinage of this 
 word is based upon symptoms and not upon 
 morbid properties. When the exact pathic con- 
 dition of this so called inflammatory process is 
 clearly defined, the proper name will be found, 
 and when this is found, words will probably be 
 coined in place of those ending in itis to denote 
 inflammation of particular parts of the body. 
 
 Auxesis'^ is placed under the caption alterations 
 of structure because increase in bulk of an organ 
 may and does occur independently of what is 
 called inflammation. This word is substituted 
 for hypertrophy which ordinarily is improperly 
 used in the sense of augmentation. Hypertrophy 
 neither means nor does it even imply enlarge- 
 ment. It signifies over-nourishment, the opposite 
 of no nourishment or atrophy. When the body 
 is over-fed, the organs do not of necessity en- 
 large, but much of the surplus nourishment is de- 
 posited, in the form of fat, under the skin, in the 
 mesentery, and around the kidneys; this is an 
 example of true hypertrophy. The organs of 
 the human body receive nourishment to the ex- 
 
 * Auxesis, from av^7^6ii, increase, augmentation enlarge- 
 ment. 
 
MORBID STATES & MORBIFIC PROCESSES. 53 
 
 tent of their requirements, neither more nor less 
 whatever may be their condition. When, from 
 disease, an organ slowly increases in size and 
 afterwards does not tend to decrease, the calibre 
 and length of its nutrient arteries are often 
 found to be increased and the thickness of the 
 walls of these vessels is also proportinately aug- 
 mented. This condition of the blood vessels is 
 not ordinarily called hypertrophy. It is assuredly 
 a great inconsistency to apply the term hyper- 
 trophy to an enlarged organ and not to its en- 
 larged arteries. The careful study of the morbid 
 anatomy of enlarged organs shows that the 
 auxesis has a cause entirely foreign to over- 
 nourishment. The disturbing element may or 
 may not be carried to it by the blood, and when 
 it is so carried, the enlargement is due to this dis- 
 turbing element and not to the quantity of blood 
 which is only proportionate to the demand of the 
 organ for its adequate nutrition. A liver enor- 
 mously enlarged from cancerous disease is not 
 generally called hypertrophied, and yet it may 
 receive one third more blood than when it was in 
 a normal condition. A large fatty liver is called 
 a fatty and not a hypertrophied liver. The well 
 developed muscles of the athlete are not over- 
 nourished. If they were, he would probably be 
 unfit to perform his feats of strength and agility. 
 
54 TERMS USED IN THE SYNOPSIS OF 
 
 The enlarged heart is not over-nourished ; it is 
 as likely to be inadequately fed. 
 
 The only other instance of hypertrophy is that 
 which occurs in the beginning- of certain varieties 
 of local inflammation when, for a short period, 
 the parts are over-fed owing to an undue activity 
 in the circulation. This may soon be followed by 
 stasis of blood in the capillaries. During the 
 static period there is hypotrophy — diminished 
 nutrition, under-feeding — , and if the stasis per- 
 sist, nutrition ceases. Here then is true atrophy. 
 The part that is no longer nourished dies. This 
 is what is commonly called mortification which 
 is regarded as an unfavorable termination of the 
 inflammatory process. Marasmus, and the ema- 
 ciation which occurs in phthisis pulmonalis or in 
 the course of febrile disorders, such as typhus 
 and typhoid fevers ; in the course of cancerous 
 affections ; in chronic pyelo-nephritis ; and in 
 saccharine diabetes, exemplify hypotrophy. An 
 organ which has decreased in size may be called 
 meiomous.^ 
 
 Hypertrophy and atrophy are correctly coined, 
 and good words in their proper places. It is 
 only their misuse that is here criticised. 
 
 The words hypertrophy and atrophy of the 
 
 * Meiomous, from nEiGoj.ia, a decrease. 
 
MORBID STATES & MORBIFIC PROCESSES. 55 
 
 kidneys which are employed in the Enghsh no- 
 menclature of diseases in the year 1869 are re- 
 jected in the revision of 1885. The hypertrophy 
 referred to was presumably applied in 1869 to 
 the form of disease now called in the revised 
 edition of 1885 "large white kidney of nephri- 
 tis " which is a condition of auxesis or enlarge- 
 ment. In like manner atrophy was employed in 
 1869, but to express the opposite condition now 
 known, and classified in the revised edition, as 
 contracted kidney, which is a decreased or mei- 
 omous kidney, a retrograde metamorphosis. It 
 seems clear in both these instances that the word 
 hypertrophy and atrophy, used in 1869 in the case 
 of the kidney, failed to convey an adequate idea, 
 in the minds of the revisers, of the pathic condi- 
 tions in question, or else, in the revision of 1885, 
 they would not have been abandoned. 
 
 If therefore this interpretation of the omission 
 be correct, why should it not be applied to all 
 cases where the word hyphertrophy is used in 
 the sense of increase in bulk, and atrophy in the 
 sense of diminution ? 
 
 Auxetic affections may be echmatic as in cer- 
 tain types of enlargement of the prostrate, or 
 may not be echmatic as in uniform enlargement 
 of the prostate which does not impede the flow 
 
$6 TERMS USED IN THE SYNOPSIS OF 
 
 of urine. Some auxetic affections are neoplastic, 
 others are pathengenetic. 
 
 The words hypertrophy and atrophy will not 
 be employed in this work except when in their 
 true meaning, they are absolutely required. 
 
 Stenosis* is generally the outcome of inflamma- 
 tory action. Stenotic affections are pathic con- 
 ditions of the excretory ducts and of hollow 
 viscera by which these ducts are narrowed and 
 the viscera lessened in capacity, as in the case of 
 stenosis or stricture of the urethra or in the case 
 of a permanently contracted bladder with mark- 
 edly diminished capacity. A stenotic affection 
 may or may not be echmatic. It is often echmatic 
 in stricture of the urethra, but not in stenosis of 
 the bladder. Stenotic affections are sometimes 
 congenital, sometimes traumatic, but most fre- 
 quently they are pathengenetic,t that is to say 
 are the sequelae, the offspring" of, or are engen- 
 dered by a preexisting morbid condition, as for 
 instance, the strictures which result from ureth- 
 ritis, or the stenosis of the bladder springing 
 from inflammation of that viscus. 
 
 * Stenosis, from drsruco, to make narrow, to contract. 
 t Pathengenetic, from TtaQo?, a disease, and eyyevrfi, 
 sprung from. (Carroll.) 
 
MORBID STATES & MORBIFIC PROCESSES. 5/ 
 
 Ectasis * is a condition of expansion or dilata- 
 tion of certain serous cavities, hollow viscera, 
 excretory ducts, and lymphatic and blood vessels. 
 Stenotic affections are pathengenetic, and due to 
 inflammatory action, or to obstruction from dis- 
 ease or from the lodgment of a foreign body. 
 Morbid dilation of the bladder, general or local, 
 is an ectatic affection. A so called hydrocele of 
 the tunica vaginalis gives rise to ectasis of the 
 tunica vaginalis. 
 
 Echmasis f may result from inflammation, from 
 a neoplasm, or from the lodgment of a foreign 
 body. Echmasis is here used in preference to 
 epischesis of which Vogcl makes a class and 
 Cullen an order. Epischesis, from snexsiv, to hold 
 up, to check, to restrain, is defined as a suppres- 
 sion of excretions. Echmasis defines more 
 exactly the character and the cause of the sup- 
 pression of the excretion, as in the case of reten- 
 tion of urine in the bladder, which generally has 
 for its cause a material obstruction in the urinary 
 passage, such as stricture of the urethra or en- 
 largement of the prostrate. Echmatic affections 
 may therefore be also stenotic or auxetic, and 
 
 * Ectasis, from sk, out, and vEiveiv, to stretch, expand, 
 or extend. 
 t Echmasis, from '^XJJ'0(-i obstruction, obstacle, hinderance. 
 
S8 TERMS USED IN THE SYNOPSIS. 
 
 they may be pathengenetic, that is to say may 
 spring from or be engendered by a preexisting 
 pathic condition. 
 
 Blastoina "^ should be substituted for granuloma 
 which is a h3^brid word meaning, according to 
 Dunglison, '' a morbid product formed by parti- 
 tion and multiplication of the connective tissue 
 cells into groups of others resembling lymph 
 cells, lying in an intercellular substance, with a 
 tendency to fatty degeneration ; as elephantiasis 
 ifiraecoruni), lupus, etc." The same author de- 
 fines a granule as '' a small grain, a compact par- 
 ticle, a cytoblast." The French name for granu- 
 lation is bourgeon charnu, fleshy bud. Blastoma 
 seems to express the meaning intended to be con- 
 veyed by granuloma, and something more, for 
 the blastomata are now regarded, by many his- 
 tologists, as affections caused by the presence of 
 microorganisms, and on this account also the 
 word blastoma is preferable to granuloma which, 
 besides being an ill-formed word, fails to convey 
 the idea of a germ disease. 
 
 The term disorder \ is applied to functional af- 
 fections, e. g., disorder of a function, or func- 
 tional disorder. An organ is said to be diseased, 
 
 * Blastoma, from ftXadroi, shoot, bud, germ, and ca/za. 
 t Disorder, from dis without, and order. 
 
PROPER ANATOMICAL TERMS. 59 
 
 but a function disordered. Functional disorders 
 are caused by disease of one or of more than one 
 organ of an apparatus. It is often difficult and 
 sometimes impossible to ascertain which of the 
 organs of an apparatus is so diseased as to dis- 
 order the function of that apparatus. 
 
 Of the six genera of functional disorders enu- 
 merated in the synopsis of morbid states and 
 morbific processes, only four were formerly 
 recognised. It has seemed proper to add de- 
 ficiency (2), which is exemplified by the lessening" 
 of urea in the urine, and suspension (5), which is 
 exemplified by anuria, and also by retention of 
 urine. 
 
 THE VALUE AND SIGNIFICANCE OF PROPER 
 ANATOMICAL TERMS IN CLASSIFICATION. 
 
 Certain explanatory comments are now due re- 
 specting this proposal for the establishment of a 
 stable basis for the nomenclature and classifica- 
 tion of diseases in general and of affections of the 
 uro-genital apparatus of the male in particular. 
 
 In accordance with the definition given of the 
 word disease, parasitic affections ; congenital ab- 
 normities ; the lodgment, in the body, of extrane- 
 ous substances or of poisons ; and injuries ; may, 
 with propriety, be classed among the diseases of 
 
6o PROPER ANATOMICAL TERMS 
 
 man, for they, also, interrupt or they disturb 
 vital functions. At the same time the word 
 affection may be used as an equivalent term 
 to disease whenever it is found convenient ; 
 for, although an affection does not always imply 
 the existence of an organic morbid condition with 
 structural change, all diseases are affections. For 
 instance man may be affected with a congenital 
 malformation, or an injur}^, as well as with a 
 disease in which there is alteration of structure 
 or impairment of function. 
 
 Apparatus is used instead of system for the 
 reasons herein given. 
 
 English speaking authors of high reputation 
 have, for a long time past, made use of the 
 phrase genito-urinary system, although the word 
 system, in this sense, is so obviously inappropri- 
 ate. A critical examination of the subject will 
 not fail to convince the inquirer that system, in 
 this particular sense has been misapplied if he 
 take the pains to consult the standard medical 
 dictionaries. 
 
 The word system,^ when used in the anatomical 
 sense, signifies an assemblage of organs composed 
 of the same tissues and intended for similar uses, 
 as for instance the nervous system (system of 
 
 * System, from iv'iTrjfxa, from 'ivviir-qf.n to place together. 
 
IN CLASSIFICATION. 6l 
 
 nerves), the arterial system, the venous system, 
 the lymphatic system, the muscular system, the 
 osseous system, the ligamentous or desmic sys- 
 tem, etc. Systems have general uses, but per- 
 form no functions. They are all contained in 
 apparatuses, to which they yield service. 
 
 In the nomenclature of diseases prepared by 
 the joint committee appointed by the Royal Col- 
 lege of Physicians of London (1869), system is 
 throughout used instead of apparatus with the 
 exception of the phrase " lacrymal apparatus." 
 The use of the word apparatus in this isolated 
 case would seem to be an inconsistency. The 
 term apparatus being however accepted as the 
 designation of the group of organs by which the 
 tears are secreted and conveyed into the nasal 
 cavity, it is evident that the groups of organs 
 which perform the functions of sight, hearing, 
 smell, taste, respiration, digestion, urination, 
 generation, etc., should be regarded as so many 
 apparatuses. 
 
 In the first decennial revision (1885) of this 
 same nomenclature, the word system continues 
 to be used for apparatus, except as before, in the 
 case of the lacrymal apparatus. But in the cap- 
 tion which preceeds, the revisers m.ake use of the 
 term apparatus in a singularly inappropriate 
 sense, i. e. " Disorders of the muscular appara- 
 
62 PROPER ANATOMICAL TERMS 
 
 tus " of the eye. The visual, like the other ap- 
 paratuses of the body, contains parts of several 
 systems ; therefore muscular system of the eye 
 should have been used instead of muscular ap- 
 paratus^ since there is not, in anatomy, any rec- 
 ognition of a muscular apparatus. Again, in this 
 same edition of the London nomenclature, ap- 
 paratus is used where system should have been 
 applied, e. g., " Nervorum apparatus morbid The 
 nervous system yields service to the cephalo- 
 rhachidian and other apparatuses, but there is no 
 nervous apparatus. Another example is in the case 
 of " Diseases of circulatory j^j/^w," latinised into 
 ^^ Sa7iguinis apparatus morbid The circulatory 
 apparatus comprises a system of arterial, of 
 venous, and of lymphatic vessels, with certain 
 reservoirs, and a pump to carry on the circula- 
 tion. Therefore there exists neither a blood ap- 
 paratus nor a circulatory system, but properly a 
 circulatory apparatus. Still another inconsis- 
 tency may be noticed in the case of " Diseases of 
 the respiratory system, '' latinised into " Spiritus 
 organorum morbi,'' and why not here apparatus 
 instead of organs, since the next Latin caption is 
 *' concoctionis apparatus 7?zorbi,'' which is translated 
 into '' Diseases of the digestive system " ? 
 
 These may perhaps be regarded as fair ex- 
 
IN CLASSIFICATION. 6^ 
 
 amples of the many defects which seriously mar 
 the modern English system of nomenclature. 
 
 An organ,"^ in anatomical parlance, is a part of 
 the body designed to contribute its share to 
 whatever may be necessary for the completion of 
 a function. An organ may aid in the performance 
 of two or more than two entirely different func- 
 tions. For instance the urethra, while it trans- 
 mits the urine is a urinary organ, and while it 
 transmits the semen it is a genital organ ; and 
 there is no lack of other equally good examples in 
 human anatomy. Therefore an organ performs 
 no function, being simply one of an assemblage 
 of instruments constituting an apparatus, which 
 alone can perform a function, that is to say bring 
 it to its completion. f "■ In the organs of a system 
 of organs there is analogy of structure, while in 
 the organs of an apparatus there is analogy only 
 of function." :|: 
 
 * Organ, from opyavov, an instrument. 
 
 t An organ, like a system, yields service to an apparatus ia 
 the performance of its function, or to two or more than two 
 apparatuses. Hence it is rightly said that an organ has its 
 uses, while an apparatus performs its one function. 
 
 X Dunglison, Littre and Robin, and Dechambre, Duval and 
 LerebouUet. 
 
64 PROPER ANATOMICAL TERMS 
 
 All apparahis^ of the human body is an as- 
 semblage of organs which work toward the same 
 end or, in other words, v/hich concur in a common 
 function, though they be of different nature. An 
 apparatus then comprises organs of differing 
 anatomical constitution. An apparatus may be 
 composed of, or may contain, several other ap- 
 paratuses. For instance, the primary human ap- 
 paratus consists of five secondary apparatuses 
 which contain sixteen subsidiary apparatuses. 
 
 The secondary apparatuses of the body are : 
 (I,) the cephalo-rhachidian apparatus, containing 
 the subsidiary apparatuses,(i ,) of vision — including 
 (2,) the lacrymal apparatus — , (3,) of audition, (4,) 
 of olfaction, and (5,) of gustation ; (II,) the nutri- 
 tive apparatus containing the subsidiary appara- 
 tuses, (6,) of mastication, (7,) of deglutition, (8,) 
 of digestion, (9,) of absorption, (10,) of circula- 
 tion, (11,) of respiration,'!' — containing (12,) the 
 apparatus of phonation — , (13,) of urination, and 
 (14,) of defecation; (III,) the motory apparatus ; 
 (IV,) the cutaneous apparatus, containing (15,) 
 
 * Apparatus, from the prefix ad, and parare, paratutn, to 
 prepare. 
 
 t The respiratory apparatus contains, but is subsidiary to, 
 the phonetic apparatus which is subsidiary to the cephalo- 
 rhachidian apparatus. 
 
IN CLASSIFICATION. 65 
 
 the apparatus of touch,* and (16,) the apparatus 
 of transpiration ; f and (V,) the apparatus of 
 generation. 
 
 The secondar}^ apparatus of generation and the 
 subsidiary apparatus of urination bear such close 
 anatomical relations to each other that, for clin- 
 ical purposes, they should be united under the 
 name of the uro-genital apparatus. 
 
 Parts of several systems are included in an ap- 
 paratus as, for instance, nerves, vessels, glands, 
 muscles, bones, cartilages, ligaments, connective 
 tissue, mucous membranes, etc. Each apparatus 
 accomplishes only one function, while each organ 
 of that apparatus may have several uses. There 
 is no apparatus but performs a function, and 
 there is no function without an apparatus (Robin), 
 man himself being a grand primary apparatus 
 destined to perform only one function.:]: 
 
 * The tactile apparatus is subsidiary to the cephalo-rhachi- 
 dian apparatus. 
 
 t The transpiratory apparatus is subsidiary to the nutritive 
 apparatus. 
 
 I Inasmuch as the views above expressed have been charac- 
 terized as allied to positivism, it is proper that some notice be 
 here taken of this assertion. The subject under consideration 
 js man's body, not his soul ; his anatomy, not his psychology. 
 Anatomy, in all its branches, teaches nothing contrary to be- 
 lief in an Almighty God Creator of all things. A firm believer 
 
66 PROPER ANATOMICAL TERMS 
 
 The primary apparatus man then, consists of 
 an assemblage of secondary apparatuses ; a sec- 
 ondary apparatus consists of an assemblage of 
 subsidiary apparatuses ; and a subsidiary appara- 
 tus consists of an assemblage of organs and ot 
 parts of systems. 
 
 A function "^ is the act accomplished, not by an 
 organ or a system of organs, but by an appara- 
 tus which, as already stated, consists of an as- 
 semblage of differing organs. Therefore the use 
 of the word function should be restricted to the 
 act of an apparatus. 
 
 If the following comparison be allowable, the 
 human apparatus may be likened to a grand 
 orchestra consisting of many differing musical in- 
 struments and of men to perform thereon. The 
 function of each performer and his instrument 
 being music. In this case each instrument is 
 passive until it is played upon, when it becomes 
 
 in God, who masters anatomy discovers therein nothing to 
 disturb his creed. Anatomy can deal with only what is finite 
 in man ; but with the infinite part of man, that which is God- 
 like, it can have nothing to do, and on this immortal part of 
 man, it can have nothing to say worth hearing, nor is it ever 
 likely to shake the faith that is once well implanted in any 
 mind. 
 
 * Function, ftmctio from fimgt, fuftctus, to act, to per- 
 form. 
 
IN CLASSIFICATION. 6/ 
 
 a secondary apparatus, and a collection of such 
 secondary apparatuses constitutes the grand 
 orchestra or primary apparatus whose function 
 is JLarvio7iioiis music. 
 
 Doctor Meredith Clymer defines " a function 
 as the sum of the automatic activities of the or- 
 gans which go to make up an apparatus, and 
 says ; an organ * yields service to an apparatus, 
 but it can only do this by being put into act, and 
 that act must be the result of an autonomous, in- 
 hering property, a potentiality, set free by a lib- 
 crating force. The product is an activity or func- 
 tion. An organ can yield no service in a passive 
 state. It must be in an active state, and it cannot 
 do or be active without a transformation of po- 
 tential mto kinetic energy by the liberation of 
 energy.* " 
 
 Doctor Clymer is known to be a close reasoner 
 and to be convincing by his sound arguments, 
 therefore it is not easy to venture upon anything 
 like opposition to the views he so lucidly puts 
 forth ; nevertheless an attempt will be made to 
 find therein a possible flaw. 
 
 The "activities" of organs are unquestioned,, 
 but if each of these organs be isolated, its activ- 
 ity is insufficient to constitute a function in a 
 
 * From a written communication. 
 
68 PROPER ANATOMICAL TERMS 
 
 physiological point of view. The organ must 
 have the concurrence of other organs, or the 
 function cannot be completed, in other words, 
 the function can be performed only by an as- 
 semblage of organs of differing anatomical prop- 
 erties. Each organ contributing its share of 
 activity toward the elaboration and completion 
 of the function. To this assemblage of differing 
 organs, the name of apparatus has been given, 
 and the apparatus performs the function which 
 is the terminal act. 
 
 The Doctor's definition of function is excellent 
 and is in harmony with the views contained in 
 this work, but does not precisely agree with 
 what follows, for if the '' automatic activities " 
 of certain organs go to make up the function of 
 an apparatus, which is it that performs the func- 
 tion ? Is it each organ or every organ ? Is it 
 not all the organs together, of the apparatus, 
 rather than each organ separately? If each organ 
 separately, then an assemblage of organs, consti- 
 tuting an apparatus, would perform as many 
 functions as there are in it organs. But the con- 
 trary is known to be the case in physiology. For 
 instance, the function digestion is " the sum of 
 the automatic activities " of the organs which 
 constitute the digestive apparatus. The function 
 motion is " the sum of the automatic activities ' 
 
IN CLASSIFICATION. 69 
 
 of the organs which constitute the motory ap- 
 paratus, etc. 
 
 Littre and Robin define the fujiction of an ap- 
 paratus (in anatomy) as the special act whicli 
 each apparatus executes, and define the uses of 
 organs, as the acts executed by each organ. One 
 and the same organ having several uses, while 
 an apparatus performs only one function. '^ One 
 and the same muscle may aid in the flexion and 
 rotation of a limb. The jaw is used in mastica- 
 tion and in phonation, etc. The word use should 
 not be confounded with the word /miction which 
 has an entirely different signification.""^ 
 
 The difificulty arising from the employment of 
 these terms does not lie in the interpretation of 
 the acts themselves, but in language, in the 
 modes of denoting and of differentiating the 
 several acts. It is to be hoped that a suitable 
 word, other than use or function, will be found 
 to express a corect idea of the activity of an 
 organ. The word function however seems w^ell 
 adapted to denote the act of an apparatus. Its 
 use should be so restricted. Therefore, until a 
 better word is suggested, the term function \vill 
 
 * Dictionnaire de Medicine, de Chirurgie, etc. D'apres le 
 plan suivi par Nysten. Douzieme edition. Par E. Littre et 
 Ch. Robin, Paris, 1865. 
 
70 PROPER ANATOMICAL TERMS 
 
 be used, in this work, in connection with the act 
 of an apparatus. 
 
 May not the word faculty be applied to the 
 activity of an organ, as for example, the gly- 
 cogenic faculty of the liver ? 
 
 Crabb defines " a faculty as a specific power 
 which is directed to one single object ; it is the 
 power of acting according to a given form." 
 
 Lewes, in commenting upon faculty and func- 
 tion, says : " ... By faculty is commonly under- 
 stood the power or aptitude of an agent to per- 
 form a certain action or class of actions. It is 
 thus synonymous with function, which means the 
 activity of an organ, the uses of the instrument. 
 I propose to detatch faculty from this general 
 signification, limiting it to the action or class of 
 actions into which a function may be diversified 
 by the education of experience. That is to say, 
 let function stand for the native endowment of 
 an organ, and faculty for its acquired variation of 
 activity." * 
 
 If the word faculty be used to denote the act, 
 the use, the aptitude, of an organ, it should not 
 be detatched from its general signification and 
 should " stand for the native endowment of an 
 
 * Problems of Life and Mind. By George Henry Lewes. 
 American edition. Boston, 1879, p. 27. 
 
IN CLASSIFICATION. 7I 
 
 organ," and function should be restricted to the 
 act of an apparatus. 
 
 One of the conclusions drawn from the forego- 
 ing considerations is that there is no urinary 
 systein. The kidneys are the uropoietic organs 
 of the urinary apparatus ; they secrete the ma- 
 terials which enter into the composition of the 
 urine ; in them the urine is concocted and is then 
 transmitted by their excretory ducts to its proper 
 reservoir. The urinary organs are the kidneys ; 
 their excretory ducts, the ureters ; and the grand 
 reservoir of the urine, the bladder. These organs, 
 together with the urethra and the prostate, con- 
 stitute the urinary apparatus. It is by means of 
 this apparatus that the function of elimination, 
 from the body, of certain effete substances, is 
 brought to its completion. 
 
 Another conclusion is that there is no geni- 
 tal system. The testicles are simply the spermo- 
 poietic organs of the genital apparatus. The 
 genital organs are the testicles ; the deferential 
 canals ; and the seminal vesicles ; these organs 
 together with the urethra, the prostate, and the 
 penis, constitute the genital apparatus by which 
 the function of generation is accomplished under 
 proper conditions. 
 
 The uro-gemtal apparatus comprises the urin- 
 ary apparatus and the genital apparatus. 
 
72 PROPER ANATOMICAL TERMS. 
 
 The organs of the urinary apparatus and those 
 of the genital apparatus are so intimately asso- 
 ciated and so interdependent that they must act 
 in perfect harmony or the double apparatus is 
 affected in a greater or less degree. Diseases of 
 any of the urinary organs cause some derange- 
 ment of the others and disturb the genital organs 
 and often the whole organism. 
 
SECTION II. 
 
 Human Nosography. 
 
 A summary of the progress of nosography since its founda- 
 tion. The scope of nosography. Notice of Sauvages. A 
 consense of views necessary in methodical arrangement. 
 Synopses of Sauvages', CuUen's, Parr's, Good's and Delorme's 
 arrangements of diseases. Comments on these several systems. 
 Cullen's rules for distinguishing genera, species, and varieties 
 of diseases. Parr's rules. Some of the aphorisms relating to 
 classification, extracted principally from the philosophia 
 botanica of Linnaeus, by Doctor Thomas Young. 
 
 ORIGIN AND PROGRESS OF NOSOGRAPHY. 
 
 An outline of the development of nosography 
 may, with advantage, be traced from its founda- 
 tion to the present time, and be followed by a 
 brief commentary upon the methods employed 
 by some of the nosographers of the last and of 
 this century. 
 
 Nosography is in reality the science of medi- 
 cine and therapy is its art. Nosography in- 
 cludes the description, the definition, the nomen- 
 clature, and the classification of diseases. A 
 knowledge of the several branches of anatomy 
 is the essential preliminary to the study of noso- 
 
74 ORIGIN AND PROGRESS OF NOSOGRAPHY. 
 
 graphy. The physician who is thoroughly 
 acquainted with this science is a master of the 
 natural history of diseases. The training neces- 
 sary to its acquirement gives him a precision in 
 diagnosis, and a degree of wisdom in prognosis 
 and of skill in therapy, to which otherwise he 
 could never attain. 
 
 The word nosography* is of comparatively 
 modern application. It was not in use among the 
 ancient physicians. f Although the study of the 
 history of diseases began Avith the founder of 
 medical art and was faithfully continued by his 
 successors, no attempt at their classihcation 
 seems to have been made until about the close of 
 the sixteenth century. Andreo Cesalpino, J the 
 Italian physician and naturalist, was probably the 
 first to suggest the methodical arrangement of 
 
 * Nosography, from vodo's, disease, and ypdgjeiv, to de- 
 scribe. 
 
 t The works of the ancient authors, such as Hippocrates, 
 Galen, Celsus, and others, contain no synopses of classifica- 
 tion, but their description of diseases is often very accurate 
 and- much of their nomenclature is still in use. Although the 
 Arabian physicians were close followers of the doctrines of 
 Aristotle, nothing that can be called a methodical classifica- 
 tion of diseases has been found in their treatises. 
 
 \ Cesalpino was born at Arezzo in the year 15 19 and 
 died in 1603. 
 
ORIGIN AND PROGRESS OF NOSOGRAPHY. 75 
 
 diseases. This however was not attempted until 
 the beginning of the seventeenth century when, 
 in 1602, Felix Platerus, of Basle, published, in his 
 ^^ Praxeos Medicae,'' the plan of a nosographical 
 method, but went no farther. Among other con- 
 tributions were, the '' Nosologia'' of Warenius of 
 Leipsic, 1605; the ^^ Nosologia Harmonica, Dog- 
 fnatiga, et Hermetica'' of Petraeus of Marburg, 
 1614; the ^^ Idea Universalis Medicinae, of John- 
 stonus of Amsterdam, published in 1644, with a 
 section devoted to classification, wherein are 
 arranged all diseases into three classes, divided 
 into internal and external diseases ; and finally, in 
 1675, the '' Nosologia'' of Schoenfeld. All these 
 essays were incomplete and of little use except 
 that they were the forerunners of the good work 
 which was subsequentl}^ performed. Such was 
 the extent of the progress of nosography, which 
 then stood still for half a century. Sydenham 
 and Baglivius,* who wrote toward the end of 
 the seventeenth century, were of opinion that 
 diseases should be classified, like systems of 
 botany, by genera and species with characteristic 
 definitions. Other physicians of their time were 
 of the same opinion (CuUen). It appears, how- 
 
 * Georgii Baglivi, De Praxi Medica, etc., Lugduni Batavo- 
 rum, 1700. 
 
^6 ORIGIN AND PROGRESS OF NOSOGRAPHY. 
 
 ever, that this was not attempted until the year 
 1732, when Frangois Boissier de Sauvages of 
 Montpellier published an essay with the title of 
 ** Nouvelles Classes de Maladies Disposees dans un 
 Ordre semblable a celui des Botanistes.'' From this 
 preliminary essay he built up his " Nosologia 
 Methodica' which he did not publish until 1760, 
 after nearly thirty years of diligent labor. Men- 
 tion should also be made of the nosographical 
 contribution of Hebenstreit of Leipsic, 1754. 
 But Sauvages was really the founder of method- 
 ical nosography to which he gave the greatest 
 impulse. He was followed by Linnaeus, Vogel, 
 CuUen, Sagar, Macbride, Vitet, Darwin, Selle, 
 Pinel, Baumes, Tourdes, Tourtelle, Recamier, 
 Crichton, Parr, Swediaur, Young, Richerand, 
 Good, Alibert, Hosack, and others who, in some 
 instances, subtracted from, or added to, without 
 materially changing, his great plan the frame- 
 work of which they all retained while they made 
 very little change in his nomenclature, much of 
 which is still in use. 
 
 Sauvages was a man of brilliant mind and ex- 
 traordinary industry. He had been prepared for 
 his task of founding the science of nosography by 
 a broad and liberal education. He had studied 
 and taught botany, and his tastes brought him 
 into close relations with the renowned Linnaeus. 
 
ORIGIN AND PROGRESS OF NOSOGRAPHY. ^J 
 
 He had for counselor the illustrious Boerhaave, 
 from whom he received much encouragement in 
 the prosecution of his difficult and arduous la- 
 bors. He cheerfully accepted, and profited by, 
 the criticisms of his contemporaries, and lived to 
 complete, but not to see in print, the last revision 
 of his gigantic work which was not published 
 until a year after his death. Sauvages had en- 
 tered the medical profession at an early age, and 
 had passed a little over one year in Paris where 
 he gathered the material for an essay upon 
 fevers. His first nosographical essay was pub- 
 lished in 1732. He then wrote upon inflamma- 
 tion, upon capillary vessels, upon hemiplegia, 
 and upon rabies. He wrote also a physiological 
 conspectus which was published at Lyons in 
 1751 ; upon a theory of the circulation of the 
 blood ; upon the effects of medicaments ; upon 
 embryology ; upon tumors ; muscular move- 
 ments ; elements of physiology ; difficult respira- 
 tion ; vision ; a theory of convulsions ; method- 
 ical pathology ; and finally came his Nosologia 
 Methodica. This was the crowning work, for after- 
 wards only a few dissertations appeared from his 
 fertile pen, and he died, full of honors, on Febru- 
 ary 19th, 1767, at the age of sixty-one, after an 
 illness of two years duration. 
 
 To exemplify the estimation in which this 
 
78 ORIGIN AND PROGRESS OF NOSOGRAPHY. 
 
 truly great physician was held, the following is 
 quoted from Good's Physiological system of 
 Nosology 1823. 
 
 " The Nosologia Methodica, for such is the 
 title of Mr. de Sauvages' work, is indeed, an 
 Herculean labour. It consists, in its latest and 
 most perfect form, of three distinct arrangements 
 — a symptomatical, an aetiological, and an ana- 
 tomical ; so as to accommodate itself to the taste 
 of the old school as well as of the new. The 
 symptomatical, to which the others are pro- 
 fessedly subordinate, is by far the most extens- 
 ively elucidated ; and comprises ten classes, (each 
 introduced by an elaborate pathological synop- 
 sis), upwards of forty orders, more than three 
 hundred genera, and an almost innumerable host 
 
 of species We have yet, however, to add the 
 
 varieties, which under several species are not 
 few ; and to bear in mind that to every variety, 
 species and genus, as far as their relative charac- 
 ters will allow, are allotted a definition, list of 
 synonyms, history, diagnosis, prognosis, and 
 mode of cure ; with, frequently, an exemplifica- 
 tion of cases, and a brief statement of the peculiar 
 opinions of other writers, before we can fairly 
 appreciate the entire mass of matter with which 
 the volumes of Mr. de Sauvages abound. He 
 seems, indeed, to have been desirous of collecting 
 
ORIGIN AND PROGRESS OF NOSOGRAPHY. 79 
 
 materials of every kind and quality from every 
 quarter to which a market was open ; and of fol- 
 lowing up every deviation from health into all 
 its possible as well as its actual shades and rami- 
 fications " 
 
 The followers of Sauvages, from Linnaeus to 
 Hosack were all men of much general and scien- 
 tific culture. None of these eminent men was 
 better endowed with those requisite qualities 
 than the celebrated Cullen, who in the edition of 
 his works prepared in 1827 by Doctor John 
 Thomson, paraphrases an aphorism of the illus- 
 trious Aristotle as follows : 
 
 " Perfect division and definition is the summit 
 of human knowledge in every part of science, 
 and requires not only the clearest but the most 
 comprehensive views, such as, with respect to 
 diseases, we can arrive at only by often-repeated 
 exercises and much study." 
 
 Cullen further says, " The attempt may at first 
 appear uncouth and difficult, but by repetition it 
 will become more familiar and easy, and 3"ou 
 must be content to make such a progress. When 
 a little more than thirty years ago, I first got a 
 sight of the botanical system of Linnaeus, it ap- 
 peared to me to be a piece of the most uncouth 
 jargon and minute pedantry ; but, by length of 
 time, it is now as familiar to me as my mother 
 
8o A CONSENSE OF VIEWS NECESSARY 
 
 tongue ; and with whatever difficulty it was first 
 received in most parts of Europe, it has now sur- 
 mounted these, and its utility has reconciled 
 every person to the study of it." 
 
 A CONSENSE OF VIEWS NECESSARY IN 
 METHODICAL ARRANGEMENT. 
 
 The earliest medical authors realised the im- 
 portance of arrangement* in the elucidation of 
 their teachings, but formed no concerted plan. 
 The effect of this lack of common agreement was 
 the adoption of many differing methods. Most 
 of these early writers divided their works into 
 parts, books, chapters, and sections. Some of 
 them adopted the synoptic, and others the sys- 
 tematic method. Later the method of the bota- 
 nists was adopted ; and the arrangement of dis- 
 eases into classes, orders, genera and species, has, 
 ever since, been used by the systematic writers. 
 The systematic method has been variously modi- 
 fied : (i,) by the adoption of an alphabetical ar- 
 rangement of diseases ; (2,) by the arrangement 
 
 * " Without arrangement, no art or science can be acquired, 
 for in its absence none can be treated of or communicated." 
 (J. M. Good.) 
 
IN METHODICAL ARRANGEMENT. 8 1 
 
 of diseases, in accordance with their duration, 
 into acute and chronic diseases ; (3,) by the 
 arrangement of diseases in accordance with the 
 anatomical regions of the body, such as the 
 head, the trunk, and the extremities ; (4,) by the 
 arrangement of diseases in accordance with their 
 aetiology ; (5,) by the arrangement of dis- 
 eases in accordance w^ith the sex and age of the 
 patients ; and (6,) by the arrangement of dis- 
 eases in accordance with their symptoms. The 
 last named arrangement having been suggested 
 by Platerus and first effected by Sauvages. 
 In order to convey to the mind a correct idea 
 of the arrangement adopted by the nosographers 
 of the past, a synopsis of the classes of the most 
 prominent among them is introduced. But the 
 synopses of Sauvages, CuUen, Parr, Good, and 
 Delorme, are given entire to enable the student 
 to conveniently examine and compare these 
 several systems. Sauvages' system (i 732-1 767), 
 representing the beginning of the science ; Cul- 
 len's system (i 769-1 790), showing the progress 
 made up to his time ; Parr's system (1809), ex- 
 hibiting a marked change, not however for the 
 better, in classification, while the nomenclature is 
 little changed ; Good's system (1822), showing a 
 very great improvement in classification though 
 not in nomenclature ; and Raige-Delorme's sys- 
 
82 NOMENCLATURE OF HIPPOCRATES. 
 
 sytem (1841), being a fair specimen of the de- 
 cline of nosographj in France. 
 
 As it may be useful to students of nosography 
 to have before them some ol the most ancient 
 terms used in medicine, a part of the nomen- 
 clature of Hippocrates is here inserted in order 
 that they may see at a glance those ancient words 
 which are retained in the existing medical nomen- 
 clature. 
 
 ALPHABETICAL LIST OF DISEASES UPON WHICH 
 
 HIPPOCRATES HAS WRITTEN, BEING A FAIR 
 
 EXEMPLIFICATION OF HIS 
 
 NOMENCLATURE.* 
 
 1 Abscesses 
 
 2 Achores 
 
 3 Alopecia 
 
 4 Anasarca 
 
 5 Anchylosis 
 
 6 Anus, inflamed 
 
 7 " hard tubercles of or near the 
 
 8 Appetite, canine 
 
 9 " , loss of 
 
 * From Motherby's Medical Dictionary. Third edition, 
 London. 1791. 
 
NOMENCLATURE OF HIPPOCRATES. 83 
 
 10 Aphthae 
 
 11 Apolepsis 
 
 12 Apoplexy 
 
 13 Arms, shortness of the 
 
 14 Ascarides 
 
 15 Asthma 
 
 16 Auante 
 
 17 Baldness 
 
 18 Barrenness 
 
 19 Biles 
 
 20 Bladder, tubercles in the 
 
 21 Blood, spitting of 
 
 22 " , vomiting 
 
 23 Blotches, red on the legs, from sitting by 
 
 the fire 
 
 24 Brain, concussion of the 
 
 25 '' , ruptured vessels in the 
 
 26 Breath, foetid 
 
 27 '* , straightness of the 
 
 28 Buboes 
 
 29 Carbuncle 
 
 30 Catamenia : disordered, natural 
 
 31 Catoche 
 
 32 Cancers 
 
 33 Carus 
 
 34 Cataphora 
 
 35 Cachexy 
 
 36 Catarrh 
 
84 NOMENCLATURE OF HIPPOCRATES. 
 
 37 Caries 
 
 38 Cheek, a sphacelous of the 
 
 39 Chilblains 
 
 40 Cholera morbus 
 
 41 Chalk stones in the joints 
 
 42 Cough 
 
 43 Coryza 
 
 44 Coma 
 
 45 *' vigil 
 
 46 Contractions of the fibres 
 
 47 Consumption, of the whole body 
 
 48 '* , ischiadic 
 
 49 *' , nephritic 
 
 50 Colour, bad 
 
 51 Crookedness 
 
 52 Deafness 
 
 53 Delirium 
 
 54 Defluxion or rheum 
 
 55 Diarrhoea 
 
 56 Dreams, frightful 
 
 57 Dumbness 
 
 58 Dysentery 
 
 59 Dyspnoea 
 
 60 Dysury 
 
 61 Ears, pains in the 
 
 62 " , redundant moisture in the 
 
 63 " , ringing in the 
 
 64 " , tubercles about the 
 
NOMENCLATURE OF HIPPOCRATES. 8$ 
 
 65 Ecchymosis from contusion 
 
 66 Empyema 
 
 6y Emprosthotonos 
 
 68 Epilepsy 
 
 69 " , in children 
 
 70 Epinyctides 
 
 71 Erysipelas 
 
 72 Eruption on the skin 
 
 73 Evil 
 
 74 Eye, distortion of the 
 
 75 " , bleared 
 
 y6 '' , dry-bleared 
 
 yy " , clouds in the 
 
 78 " , cicatrices in the 
 
 79 "■ , pearls in the 
 
 80 '* , white spots in the 
 
 81 *' , ruptured 
 S2 " , exulcerated 
 
 83 " , inflamed 
 
 84 '' , dry inflammation of the 
 
 85 Eye-lids, excressences on the 
 
 86 " , tumid outward 
 -87 " , coalesence of the 
 B8 '' , scabby 
 
 Sg " J tumors on the 
 
 90 Face, hard tubercles on the 
 
 91 Favi 
 
 92 Fainting 
 
86 NOMENCLATURE OF HIPPOCRATES. 
 
 93 Fevers 
 
 94 Fistulas 
 
 95 Fractures 
 
 96 Freckles 
 
 97 Gangrene 
 
 98 Glaucoma 
 
 99 Green sickness 
 
 00 Griping of the intestines 
 
 01 Gout 
 
 02 Gonorrhoea benigna 
 
 03 Gums, black 
 
 04 '' , pains in the, from teething 
 
 05 " , tubercles on the 
 
 06 Haemorrhages 
 
 07 Haemorrhoids 
 
 08 Hearing, dull 
 
 09 Heartburn 
 
 10 Head, heaviness of the 
 
 11 " , ache 
 
 12 '^ , scurvy 
 
 13 Herpes 
 
 14 Hesitation 
 
 15 Hiccough 
 
 16 Horror 
 
 17 Hoarseness 
 
 18 Humors, discharge of morbid 
 
 19 Hysterics 
 
 20 Hypersarcosis 
 
NOMENCLATURE OF HIPPOCRATES. 8/ 
 
 121 Jaundice 
 
 122 Illiac passion 
 
 123 Impotence 
 
 124 Inflammation: external, internal 
 
 125 Itch 
 
 126 Itching 
 
 127 '' , a pungent, in the mouth 
 
 128 Kidnies, disorders of the 
 
 129 Labour, difficult 
 
 130 Leprosy 
 
 131 " , the white 
 
 132 Lethargy 
 
 133 Leucophlegmatia 
 
 134 Lientery 
 
 135 Lips, fissures in the 
 
 136 Limping 
 
 137 Liver, inflamed 
 
 138 Lochia, disordered 
 
 139 Lungs, spasmodically contracted 
 
 140 '' , varix in the 
 
 141 " , suppurated 
 
 142 " , crude tubercles in the 
 
 143 Luxations 
 
 144 Madness 
 
 145 Melancholy 
 
 146 Mind, alienation of the 
 
 147 " , alienation through melancholy 
 
 148 Miscarriage 
 
88 NOMENCLATURE OF HIPPOCRATES. 
 
 149 Mole 
 
 150 Mouth, distorted 
 
 151 Nauseating food 
 
 152 Navel, inflamed 
 
 153 Neck, a hard tumor in the 
 
 154 Nose, a discharge of pus in the 
 
 155 Nocturnal pollutions 
 
 156 Nyctalops 
 
 157 Opisthotonos 
 
 158 Orthopnea 
 
 159 Pain, in the loins 
 
 160 Palpitation 
 
 161 Peripneumony 
 
 162 Phlj'ctaenae 
 
 163 Phrenitis 
 
 164 Phrontis 
 
 165 Placenta, adhering 
 
 166 Plague 
 
 167 Pleurisy 
 
 168 " , a dry 
 
 169 " , a moist 
 
 170 Polypus, in the nose 
 
 171 Pterygion 
 
 172 Pustules, from acrid sweat 
 
 173 Pudenda, excressences of the 
 
 174 " , putrefaction of the 
 
 175 Pupil of the eye, too small or angular 
 
 176 '' " " " , exulcerated 
 
NOMENCLATURE OF HIPPOCRATES. 89 
 
 177 Pupil of the eye, cicatrix of the 
 
 178 " *' " '' , spoiled 
 
 179 '* " '* " , removed from its natural 
 
 situation 
 i8o *' " ** " , prominent 
 
 181 Quinsey, affecting the lungs 
 
 182 Restlessness 
 
 183 Rheum, a defluxion of 
 
 184 Ruptures 
 
 185 Salivation, a spontaneous 
 
 186 Sciatica 
 
 187 Scurvy 
 
 188 Sensation, suddenly lost 
 
 189 Shivering 
 
 190 Sight, a privation of 
 
 191 Skin, desquamations of the 
 
 192 Speech, too volatile 
 
 193 Spleen, swelled 
 
 194 ** , inflamed 
 
 195 Spine, distorted forwards 
 
 196 Sprains 
 
 197 Sphacelus 
 
 198 Stertor 
 
 199 Strangury 
 :2oo Stone 
 
 201 Stupidity 
 
 202 Stammering 
 
 203 Superfetation 
 
90 NOMENCLATURE OF HIPPOCRATES. 
 
 204 Tabes dorsalis 
 
 205 Teeth, stupor of the 
 
 206 " , gnashing and grinding of the 
 
 207 " , ache 
 
 208 " , of both jaws fixed together 
 
 209 Tetanus 
 
 210 Tetters 
 
 211 Testicles, swelled 
 
 212 Tenesmus 
 
 213 Terminthi 
 
 214 Tonsils, disorders of the 
 
 215 " , swelled 
 
 216 Torpidness of the body 
 
 217 Tongue, fissured 
 
 218 " , tumor under the 
 
 219 Trichosis 
 
 220 Tubercles of various sorts 
 
 221 Tumors 
 
 222 Uvula, relaxed 
 
 223 " , retracted 
 
 224 " , putrefied 
 
 225 Uterus, disorders of the 
 
 226 " , fallmg down of the 
 
 227 Ulcers 
 
 228 Urine, retained 
 
 229 Urethra, caruncles or tubercles in the 
 
 230 Voice, loss of the 
 
 231 Varices 
 
SAUVAGES' SYSTEM. 9I 
 
 232 Vertigo 
 
 233 Warts 
 
 234 Worms 
 
 235 Whitlow 
 
 236 Wry neck 
 
 237 Wounds 
 
 238 White flux 
 339 Yawning 
 
 SYNOPSIS OF THE CLASSES, ORDERS, AND 
 GENERA OF SAUVAGES' SYSTEM. 
 
 CLASSIS 1. VITIA. 
 Ordo I. Maculae. 
 
 Genus i. Leucoma. 
 
 2. Vitiligo. 
 
 3. Ephelis. 
 
 4. Gutta rosea. 
 
 5. Naevus. 
 
 6. Ecchymoma. 
 
 Ordo II. Efflorescentiae. 
 
 Genus 7. Herpes. 
 
 " 8. Epinyctis. 
 
 " 9. Psydracia. 
 
 '' 10. Hidroa. 
 
92 
 
 
 SYNOPSIS OF 
 
 
 
 Ordo III. Phymata. 
 
 Genus 
 
 II. 
 
 Erythema. 
 
 n 
 
 12. 
 
 Oedema. 
 
 ti 
 
 13. 
 
 Emphysema. 
 
 il 
 
 14. 
 
 Scirrhus. 
 
 <( 
 
 15. 
 
 Phlegmone. 
 
 « 
 
 16. 
 
 Bubo. 
 
 (< 
 
 17. 
 
 Parotis. 
 
 il 
 
 18. 
 
 Furunculus. 
 
 fi 
 
 19. 
 
 Anthrax. 
 
 it 
 
 20. 
 
 Cancer. 
 
 n 
 
 21. 
 
 Paronychia. 
 
 tl 
 
 22. 
 
 Phimosis. 
 Ordo IV. Excrescenti 
 
 Genus 
 
 23. 
 
 Sarcoma. 
 
 << 
 
 24. 
 
 Condyloma. 
 
 (( 
 
 25. 
 
 Verruca. 
 
 <( 
 
 26. 
 
 Pterygium. 
 
 11 
 
 27. 
 
 Hordeolum. 
 
 a 
 
 28. 
 
 Bronchocele. 
 
 << 
 
 29. 
 
 Exostosis. 
 
 (( 
 
 30. 
 
 Gibbositas. 
 
 (( 
 
 31- 
 
 Lordosis. 
 
 Ordo V. Cystides. 
 
 Genus 32. Aneurysma. 
 " 33. Varix. 
 
SAUVAGES* SYSTEM. 93 
 
 Genus 
 
 34. 
 
 Hydatis. 
 
 <( 
 
 35. 
 
 Marisca. 
 
 (( 
 
 36. 
 
 Staphyloma. 
 
 <( 
 
 37- 
 
 Lupia. 
 
 << 
 
 38. 
 
 Hydrarthrus. 
 
 it 
 
 39- 
 
 Apostema. 
 
 it 
 
 40. 
 
 Exomphalus. 
 
 (( 
 
 41. 
 
 Oscheocele. 
 
 OrDO VI. ECTOPIAE 
 
 Genus 
 
 42. 
 
 Exophthalmia. 
 
 << 
 
 43. 
 
 Blepharoptosis. 
 
 <i 
 
 44- 
 
 Hypostophyle. 
 
 (( 
 
 45. 
 
 Para^lossa. 
 
 <( 
 
 46. 
 
 Proptoma. 
 
 (( 
 
 47. 
 
 Exania. 
 
 <( 
 
 48. 
 
 Exocyste. 
 
 << 
 
 49. 
 
 Hysteroptosis. 
 
 << 
 
 50. 
 
 Enterocele. 
 
 <( 
 
 51- 
 
 Epiplocele. 
 
 (< 
 
 52. 
 
 Gasterocele. 
 
 (< 
 
 53. 
 
 Hepatocele. 
 
 <( 
 
 54. 
 
 Splenocele 
 
 (( 
 
 55. 
 
 Hysterocele. 
 
 (( 
 
 56. 
 
 Cystocele. 
 
 (( 
 
 57. 
 
 Encephalocele. 
 
 <( 
 
 58. 
 
 Hysteroloxia. 
 
 <( 
 
 59- 
 
 Parorchydium. 
 
94 
 
 SYNOPSIS OF 
 
 Genus 60. 
 
 Exarthrema. 
 
 " 61. 
 
 Diastasis. 
 
 " 62. 
 
 Laxarthrus. 
 
 
 Ordo VII 
 
 Genus 63. 
 
 Vulnus. 
 
 
 ' 64. 
 
 Punctura. 
 
 
 ' 65. 
 
 Excoriatio. 
 
 
 * 66. 
 
 Contusio. 
 
 
 ' 67. 
 
 Fractura. 
 
 
 * 68. 
 
 Fissura. 
 
 
 ' 69. 
 
 Ruptura. 
 
 
 ' 70. 
 
 Amputatura. 
 
 
 ' 71- 
 
 Ulcus. 
 
 
 * 72. 
 
 Exulceratio. 
 
 
 ' 73. 
 
 Sinus. 
 
 
 ' 74. 
 
 Fistula. 
 
 
 ' 75. 
 
 Rhagas. 
 
 
 ' 76. 
 
 Eschara. 
 
 
 ' 77- 
 
 Caries. 
 
 
 ' 78. 
 
 Arthrocace. 
 
 CLASSIS II. FEBRES. 
 
 Ordo I. Continuae. 
 
 Genus 79, Ephemera. 
 " 80. Synocha. 
 " 81. Synochus. 
 
SAUVAGES SYSTEM. 
 
 95 
 
 Genus 82. Typhus. 
 83. Hectica. 
 
 Ordo II. Remittentes. 
 
 Genus 84. Amphimerina. 
 " 85. Tritaeophya. 
 " 86. Tetartophya. 
 
 Ordo III. Intermittentes. 
 
 Genus 87. Quotidiana. 
 
 " 88. Tertiana. 
 
 " 89. Quartana. 
 
 " 90. Erratica. 
 
 CLASSIS III. PHLEGMASIAE. 
 Ordo I. Exanthematicae. 
 
 Geuus 
 
 91, 
 
 Pestis. 
 
 
 92. 
 
 Variola. 
 
 
 93- 
 
 Pemphigus 
 
 
 94. 
 
 Rubeola. 
 
 
 95. 
 
 Miliaris. 
 
 
 96. 
 
 Purpura. 
 
 
 97- 
 
 Erysipelas. 
 
 
 98. 
 
 Scarlatina. 
 
 
 99. 
 
 Effera. 
 
 
 100 
 
 Aphtha. 
 
96 
 
 
 SYNOPSIS 
 
 OF 
 
 
 ( 
 
 Ordo II. Membranaceae. 
 
 Genus 
 
 lOI. 
 
 Phrenitis. 
 
 
 it 
 
 I02. 
 
 Paraphrenesis. 
 
 
 It 
 
 103. 
 
 Pleuritis. 
 
 
 11 
 
 104. 
 
 Gastritis. 
 
 
 u 
 
 105. 
 
 Enteritis. 
 
 
 n 
 
 106. 
 
 Epiploitis. 
 
 
 u 
 
 107. 
 
 Metritis. 
 
 
 n 
 
 108. 
 
 Cystitis. 
 
 
 
 Ordo III. Parenchymatosae, 
 
 Genus 
 
 109. 
 
 Cephalitis. 
 
 
 it 
 
 no. 
 
 Cynanche. 
 
 
 it 
 
 III. 
 
 Carditis. 
 
 
 tt 
 
 112. 
 
 Peripneumonia, 
 
 
 tt 
 
 113. 
 
 Hepatitis. 
 
 
 tt 
 
 114. 
 
 Splenitis. 
 
 
 tt 
 
 115. 
 
 Nephritis. 
 
 
 
 
 CLASSIS IV. 
 
 SPASMI. 
 
 
 Ordo I. Tonici 
 
 Partiales. 
 
 Genus 
 
 116. 
 
 Strabismus. 
 
 
 i< 
 
 117. 
 
 Trismus. 
 
 
 tt 
 
 118. 
 
 Obstipitas. 
 
 
 tt 
 
 119. 
 
 Contractura. 
 
 
 tt 
 
 120. 
 
 Crampus. 
 
 
 tt 
 
 121. 
 
 Priapismus. 
 
 
SAUVAGES' SYSTEM. 97 
 
 
 0\ 
 
 RDO II. ToNci Generales. 
 
 Genus 
 
 122. 
 
 Tetanus. 
 
 it 
 
 123. 
 
 Catochus. 
 
 
 Ordo III. Clonici Partiales. 
 
 Genus 
 
 124. 
 
 N3^stagmus. 
 
 
 125. 
 
 Carphologia. 
 
 
 126. 
 
 Pandiculatio. 
 
 
 127. 
 
 Apomyttosis. 
 
 
 128. 
 
 Convulsio. 
 
 
 129. 
 
 Tremor. 
 
 
 130. 
 
 Palpitatio. 
 
 
 131. 
 
 Claudicatio. 
 
 
 Ordo IV. Clonici Generales 
 
 Genus 
 
 132. 
 
 Rigor. 
 
 
 133. 
 
 Eclampsia. 
 
 
 134. 
 
 Epilepsia. 
 
 
 135. 
 
 Hysteria. 
 
 
 136. 
 
 Scelotyrbe. 
 
 
 137. 
 
 Beriberia. 
 
 CLASSIS V. ANHELATIONES. 
 Ordo I. Spasmodicae. 
 
 Genus 138. 
 
 Ephialtes. 
 
 " 139. 
 
 Sternutatio. 
 
 140. 
 
 Oscedo. 
 
98 
 
 
 SYNOPSIS OF 
 
 Genus 
 
 141. 
 
 Singultus. 
 
 <( 
 
 142. 
 
 Tuffis. 
 
 Ordo II. Oppressivae 
 
 Genus 
 
 143. 
 
 Stertor. 
 
 <( 
 
 144. 
 
 Dyspnoea. 
 
 <( 
 
 145. 
 
 Asthma. 
 
 u 
 
 146. 
 
 Orthopnoea. 
 
 << 
 
 147. 
 
 Angina. 
 
 (< > 
 
 148. 
 
 Pleurodyne. 
 
 (( 
 
 149. 
 
 Rheuma. 
 
 a 
 
 150. 
 
 Hydrothorax. 
 
 151. Empyema. 
 
 CLASSIS VI. DEBILITATES. 
 
 Ordo I. Dysaesthesiae. 
 
 Genus 152. Cataracta. 
 
 " 153. Caligo. 
 
 " 154. Amblyopia 
 
 " 155. Amaurosis. 
 
 *' 156. Anosmia. 
 
 " 157. Agheustia. 
 
 " 158. Dysecoea. 
 
 « 159- Paracusis. 
 
 " 160. Cophosis. 
 
 " 161. Anaesthesia. 
 
SAUVAGES SYSTEM. 
 
 99 
 
 Ordo II. Anepithymiae. 
 
 Genus 162. Anorexia. 
 Adipsia. 
 Anaphrodisia. 
 
 Ordo III. Dyscinesiae. 
 
 Genus 16^. Mutitas. 
 Aphonia. 
 Psellismus. 
 Paraphonia. 
 Paralysis. 
 Hemiplegia. 
 Paraplegia. 
 
 Ordo IV. Leipopsychiae. 
 
 Genus 172. Asthenia. 
 
 Leipothemia. 
 
 Syncope. 
 
 Asphyxia. 
 
 Ordo V. Comata. 
 
 163. 
 164. 
 
 165 
 166 
 167 
 168 
 169 
 170 
 171 
 
 172. 
 
 173- 
 174. 
 
 175. 
 
 Genus 176. Catalepsis. 
 
 177. Ecstasis. 
 
 178. Typhomania. 
 
 179. Lethargus. 
 
 180. Cataphora. 
 
 181. Carus. 
 182.- Apoplexia. 
 
lOO 
 
 SYNOPSIS OF 
 
 CLASSIS VII. DOLORES. 
 
 
 
 Ordo I. Vagi 
 
 Geuus 
 
 183. 
 
 Arthritis. 
 
 u 
 
 184. 
 
 Ostocopus. 
 
 l( 
 
 185. 
 
 Rheumatismus. 
 
 << 
 
 186. 
 
 Catarrh us. 
 
 n 
 
 187. 
 
 Anxietas. 
 
 <( 
 
 188. 
 
 Lassitudo. 
 
 <( 
 
 189. 
 
 Stupor. 
 
 a 
 
 190. 
 
 Pruritus. 
 
 (( 
 
 191. 
 
 Algor. ' 
 
 (( 
 
 192. 
 
 Ardor. 
 Ordo II. Capit 
 
 Genus 
 
 193. 
 
 Cephalalgia. 
 
 <i 
 
 194. 
 
 Cephalaea. 
 
 n 
 
 195. 
 
 Hemicrania. 
 
 11 
 
 196. 
 
 Ophthalmia. 
 
 il 
 
 197. 
 
 Otalgia. 
 
 (( 
 
 198. 
 
 Odontalgia. 
 
 Ordo III. Pectoris. 
 
 Genus 199. Dysphagia. 
 " 200. Pyrosis. 
 " 201. Cardiogmus. 
 
SAUVAGES SYSTEM. lOI 
 
 Ordo IV. Abdominales internl 
 
 Genus 202. 
 
 Cardialgia. 
 
 " 203. 
 
 Gastrodynia. 
 
 " 204. 
 
 Collca. 
 
 ** 205. 
 
 Hepatalgia. 
 
 " 206. 
 
 Splenalgia. 
 
 " 207. 
 
 Nephralgia. 
 
 " 208. 
 
 Dystocia. 
 
 " 209. 
 
 Hysteralgia. 
 
 Ordo V. Externi et artuum. 
 
 Genus 210. 
 
 Mastodynia. 
 
 " 211. 
 
 Rhachialgia. 
 
 " 212. 
 
 Lumbago. 
 
 " 213. 
 
 Ischias. 
 
 " 214. 
 
 Proctalgia. 
 
 " 215. 
 
 Pudendagra. 
 
 CLASSIS VIII. VESANIAE. 
 
 Ordo I. Hallucinationes. 
 
 Genus 216. Vertigo. 
 
 " 217. Sujfifusio. 
 
 ** 218. Diplopia. 
 
 " 219. Syrogmos. 
 
 ** 220. Hypochondriasis. 
 
 " 221. Somnambulismus. 
 
102 
 
 SYNOPSIS OF 
 
 
 Ordo II. Morositates. 
 
 Genus 222. 
 
 Pica. 
 
 '' 223. 
 
 Bulimia. 
 
 " 224. 
 
 Polydipsia. 
 
 '' 225. 
 
 Antipathia. 
 
 " 226. 
 
 Nostalgia. 
 
 " 227. 
 
 Panophobia. 
 
 228. 
 
 Satyriasis. 
 
 " 229. 
 
 Nymphomania. 
 
 " 230. 
 
 Tarantismus. 
 
 '' 231. 
 
 Hydrophobia. 
 
 
 Ordo III. Deliria. 
 
 Genus 232. 
 
 Paraphrosyne. 
 
 " 233. 
 
 Amentia. 
 
 '' 234. 
 
 Melancholia. 
 
 " 235. 
 
 Mania. 
 
 236. 
 
 Demonomania. 
 
 Ordo IV. Vesaniae anomalae 
 
 Genus 237. 
 
 Amnesia. 
 
 " 238. 
 
 Agrypnia. 
 
 CLASSIS IX. FLUXUS. 
 Ordo I. Sangninfluxus. 
 
 Genus 239. Haemorrhagia. 
 " 240. Haemoptysis. 
 
SAUVAGES SYSTEM. IO3 
 
 Genus 241. Stomacace. 
 
 " 242. Haematemesis. 
 
 ** 243. Haematuria. 
 
 " 244. Menorrhagia. 
 
 ** 245. Abortus. 
 
 Ordo II. Alvifluxus. 
 
 Genus 246. Heptirrhoea. 
 
 " 247. Haemorrhois. 
 
 '* 248. Dysenteria. 
 
 " 249. Melaena. 
 
 " 250. Nausea. 
 
 " 251. Vomitus. 
 
 ** 252. Ileus. 
 
 " 253. Cholera. 
 
 " 254. Diarrhoea. 
 
 " 255. Caeliaca. 
 
 '' 256. Lienteria. 
 
 " 257. Tenesmus. 
 
 Ordo III. Serifluxus. 
 
 Genus 258. Ephidrosis. 
 
 259. Epiphora. 
 
 260. Coryza. 
 
 261. Ptyalismus. 
 
 262. Anacatharsis 
 
 263. Diabetes. 
 
 264. Enuresis. 
 
104 SYNOPSIS OF 
 
 Genus 265. Dysuria. 
 
 266. Pyuria. 
 
 267. Leucorrhoea. 
 
 268. Gonorrhoea. 
 
 269. Dyspermatismus. 
 
 270. Galactirrhoea. 
 
 271. Otorrhoea. 
 
 OrDO IV. ACRIFLUXUS. 
 
 Genus 272. Flatulenta. 
 " 273. Aedopsophia. 
 " 274. Dysodia. 
 
 CLASSIS X. CACHEXIAE. 
 Ordo I. Macies. 
 
 Genus 275. Tabes. 
 
 " 276. Phthisis. 
 
 " 277. Atrophia. 
 
 " 278. Aridura. 
 
 Ordo II. Intumescentiae. 
 
 Genus 279. Polysarcia. 
 
 " 280. Pneumatosis. 
 
 " 281. Anasarca. 
 
 " 282. Phlegmatia. 
 
 *' 283. Physconia. 
 
 " 284. Graviditas. 
 
SAUVAGES SYSTEM. 
 
 105 
 
 Ordo III. Hydropes Partiales. 
 
 Genus 285. 
 
 Hydrocephalus. 
 
 •' 286. 
 
 Physocephalus. 
 
 " 287. 
 
 Hydrorhachitis. 
 
 " 288. 
 
 Ascites. 
 
 " 289. 
 
 Hydrometra. 
 
 " 290. 
 
 Physometra. 
 
 " 291. 
 
 Tympanites. 
 
 " 292. 
 
 Meteorismus. 
 
 *• 293. 
 
 Ischuria. 
 
 
 Ordo IV. Tubera. 
 
 Genus 294. 
 
 Rhachitis. 
 
 " 295. 
 
 Scrophula. 
 
 ** 296. 
 
 Carcinoma. 
 
 " 297. 
 
 Leontiasis. 
 
 " 298. 
 
 Malis. 
 
 " 299. 
 
 Framboesia. 
 
 - 
 
 Ordo V. Impetigines 
 
 Genus 300. 
 
 SyphiHs. 
 
 " 301. 
 
 Scorbutus. 
 
 302. 
 
 Elephantiasis. 
 
 " 303. 
 
 Lepra. 
 
 " 304. 
 
 Scabies. 
 
 •* 305. 
 
 Tinea. 
 
io6 
 
 COMMENTS ON 
 
 
 Ordo VI. Icteritiae. 
 
 Genus 306. 
 
 Aurigo. 
 
 '' 307. 
 
 Melasicterus. 
 
 " 308. 
 
 Phaenigmus. 
 
 309. 
 
 Chlorosis. 
 
 Ordo 
 
 1 VII. Cachexiae ano 
 
 Genus 310. 
 
 Phthiriasis. 
 
 " 311. 
 
 Trichoma. 
 
 " 312. 
 
 Alopecia. 
 
 " 313- 
 
 Elcosis. 
 
 *' 314. 
 
 Gangraena. 
 
 " 315. 
 
 Necrosis. 
 
 In his nosologia methodica, Sauvages enumerates 
 ten classes, forty-four orders, three hundred and 
 fifteen genera and many species and varieties. 
 
 Many of the orders contain genera that bear 
 no relation with each other. For instance in the 
 third order, phyrnata, of the first class, vitia, are 
 included erythema, emphysema, scirrhus, bubo, 
 anthrax, cancer, paronychia and phimosis. In 
 the fourth order excrescentiae, are placed sarcoma, 
 condyloma, pterygium, bronchocele, and exos- 
 tosis. In the fifth order cystidcs are, aneurysm, 
 varix, marisca (piles), staphyloma, hydrarthrus, 
 and oscheocele. 
 
 In the second class are arranged the fevers, in 
 
SAUVAGES' SYSTEM. 10/ 
 
 three orders, continued, remittent, and intermit- 
 tent, and twelve genera. 
 
 In the first order exanthematicae^ of the third 
 c\2iS?,, phleginasiae, are placed the plague, small pox, 
 measles, purpura, erysipelas, and aphtha. In the 
 second order membranaceae, are phrenitis, pleuri- 
 tis, gastritis, metritis, and cystitis. In the third 
 order, parenchymatosae , are cephalitis, carditis, 
 nephritis, etc. 
 
 There are many other defects in this system 
 which now make it of little use, but it should be 
 borne in mind that medicine has greatly ad- 
 vanced since the time of Sauvages, and that his 
 classification is one of the great factors in this 
 advance. He used, to the best advantage, the 
 knowledge and the material which he possessed, 
 and his system made a profound impression on 
 the profession. 
 
 Sauvages had an enthusiastic admirer in Lin- 
 naeus who, after following the Sauvagian system, 
 for nearly twent}^ years, in his lectures at Upsala, 
 caused to be published (in 1759), a classification 
 of diseases prepared, under his direction, by one 
 of his disciples. Afterwards he, himself, pre- 
 pared and published (in 1763), a new classifica- 
 tion of diseases very similar to that of Sauvages 
 and consisting of eleven classes: i, Exanthema- 
 tici ; 2, Critici; 3, Phlogistici ; 4, Dolorosi ; 5, 
 
I08 LINNAEUS, VOGEL. 
 
 Mentales ; 6, Quietales ; 7, Motorii ; 8, Sup- 
 pressorii ; 9, Evacuatorii ; 10, Deformes ; 11, 
 Vitia: thirty-seven orders, and three hundred 
 and twenty-six genera. 
 
 In comparing this nosographical table with 
 that of Sauvages, says Pinel, it is easily seen 
 that descriptive medicine had not made great 
 progress under the fertile pen of Linnaeus. 
 
 Linnaeus was soon followed by Vogel of Got- 
 tingen who, (in 1764), published a classification of 
 diseases consisting of eleven classes : i, Febres ; 
 2, Profluvia ; 3, Epischeses ; 4, Dolores ; 5, 
 Spasmi ; 6, Adynamiae ; 7, Hyperaestheses ; 
 8, Cachaexiae ; 9, Paranoiac; 10, Vitia; 11, 
 Deformitates, and five hundred and sixty genera. 
 
 Vogel introduces three new classes : (3,) Epis- 
 cheses, (6,) Adynamiae, and (7,) Hyperaestheses ; 
 and places phlegmasiae among the vices. 
 
 The nosology of Cullen was first published in 
 1769, and was followed by several revisions. It 
 contains four classes, nineteen orders, one hun- 
 dred and fifty genera, nearly six hundred species, 
 and many varieties. A synopsis of the classes, 
 orders, and genera, is here introduced for com- 
 parison with the preceding systems. 
 
cullen's synopsis. 109 
 
 cullen's synopsis of classes, orders and 
 
 genera of diseases. partly from 
 
 the edition of 1 827. 
 
 CLASSIS 1. PYREXIAE. 
 
 Ordo I. Febres. 
 
 Sectio I. Interniittentes. 
 Genus i. Tertiana. 
 " 2. Ouartana. 
 " 3. Quotidiana. 
 
 Sectio 2. Continuae. 
 Gemis 4. Synocha. 
 '* 5. Typhus. 
 " 6. Synochus. — Hectica. 
 
 Ordo II. Phlegmasiae. 
 
 Genus 7. Phlogosis — Apostema. 
 Gangrena — Sphacelus. 
 
 8. Ophthalmia. 
 
 '* 9. Phrenitis. 
 
 " 10. Cynanche. 
 
 '^ II. Pneumonia. — Vomica. Empyema. 
 
 " 12. Carditis. 
 
 " 13. Peritonitis. 
 
 *' 14. Gastritis. 
 
 *' 15. Enteritis. 
 
 ** 16. Hepatitis. 
 
no CULLEN S SYNOPSIS. 
 
 Genus 17. Splenitis. 
 
 " 18. Nephritis. 
 
 " 19. Cystitis. 
 
 " 20. Hysteritis. 
 
 " 21. Rheumatismus — Arthrodynia. 
 
 " 22. Odontalgia. 
 
 " 23. Podagra. 
 
 " 24. Arthropuosis. 
 
 Ordo III. Exanthemata. 
 
 Genus 25. Variola. 
 
 *' 26. Varicella. 
 
 ** 27. Rubeola. 
 
 *' 28. Scarlatina. 
 
 " 29. Pestis. 
 
 " 30. Erysipelas. 
 
 " 31. Miliaria. 
 
 . " 32. Urticaria. 
 
 " 33. Pemphigus. 
 
 " 34. Aphtha. 
 
 Ordo IV. Haemorrhagiae. 
 
 Genus 35. Epistaxis. 
 
 " 36. Haemoptisis. Phthisis. 
 
 " 37. Haemorrhois. 
 
 " 38. Menorrhagia. 
 
 " 39. Catarrhus. 
 
 " 40. Dysenteria. 
 
cullen's synopsis. 
 
 Ill 
 
 CLASSIS II. NEUROSES. 
 
 
 
 OrDO I. COMATA. 
 
 Genus 
 
 41. 
 
 Apoplexia. 
 
 n 
 
 42. 
 
 Paralysis. — Tremor. 
 Ordo II. Adynamiae, 
 
 Genus 
 
 43. 
 
 Syncope. 
 
 <t 
 
 44. 
 
 Dyspepsia. 
 
 <( 
 
 45. 
 
 Hypochondriasis. 
 
 (< 
 
 46. 
 
 Chlorosis. 
 
 Ordo III. Spasmi. 
 
 Genus 
 
 47- 
 
 Tetanus. 
 
 n 
 
 48. 
 
 Trismus. 
 
 n 
 
 49. 
 
 Convulsio. 
 
 << 
 
 50. 
 
 Chorea. 
 
 <( 
 
 51. 
 
 Raphania. 
 
 << 
 
 52. 
 
 Epilepsia. 
 
 <( 
 
 53. 
 
 Palpitatio. 
 
 <( 
 
 54. 
 
 Asthma. 
 
 il 
 
 55. 
 
 Dyspnoea. 
 
 i< 
 
 56. 
 
 Pertussis. 
 
 <( 
 
 57. 
 
 Pyrosis. 
 
 << 
 
 58. 
 
 Colica. 
 
 <( 
 
 59- 
 
 Cholera. 
 
 it 
 
 60. 
 
 Diarrhoea. 
 
 li 
 
 61. 
 
 Diabetes. 
 
112 CULLEN S SYNOPSIS. 
 
 Genus 62. Hysteria. 
 " 63. Hydrophobia. 
 
 Ordo IV. Vesaniae. 
 
 Genus 64. Amentia. 
 
 65. Melancholia. 
 
 66. Mania. 
 
 " 67. Oneirodynia. 
 
 CLASSIS III. CACHEXIAE. 
 
 Ordo I. Marcores. 
 
 Genus 6%, Tabes. 
 " 69. Atrophia. 
 
 Ordo II. Intumescentiae. 
 
 Sect 10 /. Adiposae. 
 Genus 70. Polysarcia. 
 
 Sectio 2. Flatuosae, 
 
 Genus 71. Pneumatosis. 
 " 72. Tympanites. 
 " 73. Physometra. 
 
 Sectio J. Aquosae, 
 
 Genus 74. Anasarca. 
 " 75. Hydrocephalus. 
 " ^6, Hydrorachitis. 
 
cullen's synopsis. 
 
 113 
 
 Genus jy. 
 
 Hydrothorax. 
 
 78. 
 
 Ascites. 
 
 - 79. 
 
 Hvdrometra. 
 
 '' 80. 
 
 Hydrocele. 
 
 
 Seetio ^. Solidae. 
 
 Genus 81. 
 
 Physconia. 
 
 82. 
 
 Rachitis. 
 
 
 Ordo III. Impetigines 
 
 Genus 83. 
 
 Scrophula. 
 
 " 84. 
 
 Syphilis. 
 
 - 85. 
 
 Scorbutus. 
 
 - 86. 
 
 Elephantiasis. 
 
 " 87. 
 
 Lepra. 
 
 '' 88. 
 
 Frambesia. 
 
 " 89. 
 
 Trichoma. 
 
 - 90. 
 
 Icterus. 
 
 CLASSIS IV. LOCALES. 
 
 Ordo I. Dysaesthesiae. 
 
 mus 91. 
 
 Caligo. 
 
 " 92. 
 
 Amaurosis. 
 
 " 93- 
 
 Dysopia. 
 
 " 94. 
 
 Pseudoblepsis. 
 
 " 95. 
 
 Dysecoea. 
 
 - 96. 
 
 Paracusis. 
 
114 
 
 cullen's synopsis. 
 
 Genus 97. Anosmia. 
 " 98. Agheustia. 
 " 99. Anaesthesia. 
 
 Ordo II. Dysorexiae. 
 Sectio I. Appetitus Erronei. 
 Genus 100. Bulimia. 
 
 il 
 
 lOI. 
 
 Polydipsia. 
 
 l( 
 
 102. 
 
 Pica. 
 
 (( 
 
 103. 
 
 Satyriasis. 
 
 (< 
 
 104. 
 
 Nymphomania. 
 
 <( 
 
 105. 
 
 Nostalgia. 
 
 
 Sectio 2. Appetitus deficiens 
 
 Genus 
 
 106. 
 
 Anorexia. 
 
 <( 
 
 107. 
 
 Adipsia. 
 
 i( 
 
 108. 
 
 Anaphrodisia. 
 Ordo III. Dyscinesiae. 
 
 Genus 
 
 109. 
 
 Aphonia. 
 
 << 
 
 no. 
 
 Mutitas. 
 
 << 
 
 III. 
 
 Paraphonia. 
 
 << 
 
 112. 
 
 Psellismus. 
 
 << 
 
 113- 
 
 Strabismus. 
 
 <( 
 
 114. 
 
 Dysphagia. 
 
 (< 
 
 115. 
 
 Contractura. 
 
cullen's synopsis. 
 
 115 
 
 
 
 Ordo IV. Apocenoses 
 
 Genus 
 
 116. 
 
 Profusio. 
 
 
 117. 
 
 Ephidrosis. 
 
 
 118. 
 
 Epiphora. 
 
 
 119. 
 
 Ptyalismus. 
 
 
 120. 
 
 Enuresis. 
 
 
 121. 
 
 Gonorrhoea. 
 
 Ordo V. Epischeses. 
 
 Genus 
 
 122 
 
 Obstipatio. 
 
 n 
 
 123. 
 
 Ischuria. 
 
 n 
 
 124. 
 
 Dysuria. 
 
 tl 
 
 125. 
 
 Dyspermatismus. 
 
 It 
 
 126. 
 
 Amenorrhoea. 
 
 Ordo VI. Tumores. 
 
 Genus 
 
 127 
 
 Aneurysma. 
 
 
 128. 
 
 Varix. 
 
 
 129. 
 
 Ecchymoma. 
 
 " 
 
 130. 
 
 Scirrhus. 
 
 
 131- 
 
 Cancer. 
 
 
 132. 
 
 Bubo. 
 
 
 133- 
 
 Sarcoma. 
 
 
 134. 
 
 Verruca. 
 
 
 135. 
 
 Clavus. 
 
 
 136. 
 
 Lupia. 
 
 
 137- 
 
 Ganglion. 
 
Il6 
 
 
 SAG^ 
 
 lR. 
 
 Genus 
 
 138. 
 
 Hydatis. 
 
 
 << 
 
 139- 
 
 Hydrarthrus 
 
 
 (< 
 
 140. 
 
 Exostosis. 
 
 
 
 
 Ordo VII. 
 
 ECTOPIAE. 
 
 Genus 
 
 141. 
 
 Hernia. 
 
 
 li 
 
 142. 
 
 Prolapsus. 
 
 
 (< 
 
 143. 
 
 Luxatio. 
 
 
 
 
 Ordo VIII. 
 
 DiALYSES 
 
 Genus 
 
 144. 
 
 Vulnus. 
 
 
 
 145. 
 
 Ulcus. 
 
 
 
 146. 
 
 Herpes. 
 
 
 
 147- 
 
 Tinea. 
 
 
 
 148. 
 
 Psora. 
 
 
 
 149. 
 
 Fractura. 
 
 
 
 150. 
 
 Caries. 
 
 
 The simplicity and superiority of CuUen's sys- 
 tem over those of his predecessors are easily 
 valued, and show how much progress, in descrip- 
 tive medicine, was made from 1760 to 1769, but it 
 leaves much to be desired. Its defects are not 
 few, and many of the enumerated genera are, in 
 reality, species or only symptoms. 
 
 Sagar of Vienna published (i 771-1776) a sys- 
 tem of classification of diseases which is such as 
 to constitute a retrogressive step in nosology. It 
 
MACBRIDE, SELLE, VITET. 11/ 
 
 consists of thirteen classes : i, Vitia ; 2, Plagae ; 
 3, Cachexiae ; 4, Dolores ; 5, Fluxus ; 6, Sup- 
 pressiones ; 7, Spasmi ; 8, Anhelationes ; 9, De- 
 bilitates ; 10, Exanthemata; 11, Phlegmasiae ; 
 12, Febres ; 13, Vesaniae : fifty-four orders ; 
 three hundred and fifty-one genera ; and twenty- 
 five hundred species. • 
 
 Macbride (1772) counts four classes : i, Uni- 
 versal diseases; 2, Local diseases; 3, Sexual 
 diseases ; 4, Infantile diseases : twenty-three or- 
 ders ; and one hundred and eighty genera. 
 
 Selle's *' Iconographia syst emails inorborum 7iatu- 
 ralis'' {lyjZ) contains eighteen classes: i, In- 
 flammatory diseases ; 2, Putrid diseases ; 3, 
 Bilious diseases ; 4, Pituitous diseases ; 5, Verm- 
 inous diseases ; 6, Lacteous diseases ; 7, Nervous 
 diseases ; 8, Periodic diseases ; 9, Obstructions ; 
 10, Gouty diseases; 11, Rachitic diseases; 12, 
 Scrophulous diseases; 13, Cancerous diseases; 
 14, Venereal diseases; 15, Psoric diseases; 16, 
 Scorbutic diseases; 17, Diseases produced by 
 venoms; 18, Organic diseases: and forty-seven 
 genera. 
 
 This and the four preceding systems were very 
 poor competitors of CuUen's nosology which was 
 finally, in France at least, replaced by Pinel's 
 nosology. 
 
 Vitet (1778,) arranges diseases into eight 
 
Il8 DARWIN, PINEL, BAUMES. 
 
 classes: i, Fevers; 2, Inflammations; 3, Pain- 
 ful diseases ; 4, Convulsions ; 5, Debilities ; 6, 
 Evacuatory diseases ; 7, Diseases by retention 
 of the solid and liquid matters ; 8, Diseases of 
 the mind : forty-three orders, and three hundred 
 and ninety-four genera. (A worse system even 
 than Sagar's.) 
 
 Darwin (1794-1796) adopts four classes: i, 
 Diseases of irritation ; 2, Diseases of sensation ; 3, 
 Diseases of volition ; 4, Diseases of association : 
 eleven orders ; forty-one genera ; and four hun- 
 dred and seventy-seven species. (An original and 
 ingenious, but inconsistent, obscure and unprac- 
 tical system.) 
 
 Pinel's (1798,) Jiosographie philosophique consists 
 of five classes : i, Fevers; 2, Phlegmasiae ; 3, 
 Haemorrhages ; 4, Neuroses ; 5, Organic le- 
 sions : twenty-two orders ; and one hundred 
 and forty-one genera. 
 
 Baumes published in 1801 a work with the 
 title of Fondemens de la science methodique des 
 maladies, in which he regards diseases as likely to 
 result from the increase or from the diminution 
 of certain chemical agents existing in the animal 
 economy, such as caloric, oxygen, nitrogen, 
 hydrogen, and phosphorus. This arrangement 
 consists of five classes ; several sub-classes ; 
 
BAUMES. 119 
 
 ninety-seven genera ; and a great number of 
 species and sub-species. 
 
 CLASS I. Calorineses : diseases in which 
 the dominant phenomena seem to consist of an 
 alteration in the quantity of animal heat. 
 
 Sub-class i. Supercalorineses: diseases caused 
 by an augmentation of the animal heat. 
 
 Sub-class 2. Discalorineses : diseases in which 
 the predominant phenomena seem to be owing to 
 a diminution of the animal heat. 
 
 CLASS IL Oxygeneses ; diseases in which 
 the state of the system seems to be allied to an 
 alteration in the normal quantity of oxygen in 
 the economy. 
 
 Sub-class /. Disoxygeneses : diseases caused 
 by a notable diminution in the quantity of oxygen 
 in the body. 
 
 Sub-class 2. Superoxygeneses : diseases where 
 the oxygen is in excess. 
 
 CLASS IIL Hydrogeneses : diseases in 
 which the mucous secretion, the fats, the bile, 
 the milk, offer characters of predominence or 
 degeneration. 
 
 CLASS IV. Azoteneses : essentially putrid 
 diseases, formed by the predominence of nitrogen 
 in the economy. 
 
 CLASS V. Phosphoreneses : diseases attrib- 
 
I20 TOURDES. 
 
 uted to an excess or a diminution of the phos- 
 phate of lime, or to its decomposition. 
 
 Supplementary elass. This class contains seven 
 genera and certain sub-genera consisting princi- 
 pally of traumatisms. 
 
 Pinel and Bricheteau, from whose article this 
 and several of these abstracts were made, say, 
 '' We have almost nothing to say of Mr. Baumes' 
 nosology, composed in a moment of efferves- 
 cence, This work, long since judged, is 
 
 already of the domain of history, and is a new 
 proof of the great errors which may be com- 
 mitted by a man of talent " 
 
 Tourdes published, in 1803, a new classification 
 of diseases, consisting of four classes, nineteen 
 orders, and fifty-one genera, founded upon the 
 existence of three elementary tissues which he 
 says form the basis of all the organs ; these are 
 the nervous, fibrous, and cellular or lymphatic, 
 tissues. 
 
 Class I. Diseases of the fibrous or irritable 
 tissue. 
 
 Class II. Diseases of the nervous and' sensi- 
 tive tissue. 
 
 Class III. Diseases of the cellular or lym- 
 phatic tissue. 
 
 Class IV. Complicated diseases. This class 
 
RECAMIER. 121 
 
 embraces simultaneous diseases of several sys- 
 tems or different tissues. 
 
 Tourtelle, in his Elemens de medecine Theorique 
 et Pratique (1805,) inserts a system of nosology in 
 which diseases are divided into six classes ; one 
 hundred and eighty-two genera ; and seven 
 hundred and nine species. 
 
 Class I. Pyrexiae. 
 Class 1 1. Flux. 
 Class III. Suppressions. 
 Class IV. Neuroses. 
 Class V. Cachexiae. 
 Class VI. Vitia. 
 
 R^camier's system of nosology, extracted from 
 the article of Pinel and Bricheteau in the Die- 
 tionaire des Sciences Medicales 18 19, is as fol- 
 lows : 
 
 FIRST SECTION. Physiological diseases. 
 
 Class I. Alterations of the secretions. 
 Class II. Phlegmasiae. 
 Class III. Fevers. 
 Class IV. Neuroses. 
 Class V. Cachexiae. 
 
122 CRICHTON. 
 
 SECOND SECTION. Anatomical diseases. 
 
 Class VI. Solution of the tissues. 
 
 Class VII. Displacements. 
 
 Class VIII. Physical vices of the arterial, ven- 
 ous or lymphatic circulation. 
 
 Class IX. Physical vices of the digestive, lacry- 
 mal, salivary, bilious, urinary, 
 spermatic, and uterine excretions. 
 
 Class X. Deformities, congenital or accidental. 
 
 Class XI. Foreign bodies. 
 
 Each class contains four orders, and certain 
 genera and species. 
 
 Crichton's system consists of eight classes; 
 thirty orders ; and one hundred and seventy- 
 eight genera. 
 
 Parr, the author of the London Medical Dic- 
 tionary, who so ably criticised the nosographers 
 that were contemporaneous with, or preceded 
 him, omitted classes and recognized only orders, 
 of which he made twelve; genera, thirty -four; 
 species, two hundred and twenty-one ; and a 
 number of sub-species and of varieties. 
 
 The following is a synopsis of Parr's system 
 from which most of the species and all the sub- 
 species and varieties are omitted. 
 
123 
 
 SYNOPSIS OF PARR S SYSTEM. 
 
 Order I. Pyrexiae. 
 
 Genus I. hit er mitt ens, 
 [5 species]. 
 
 Genus II. Exacerbans. 
 [3 species]. 
 
 Genus III. Continua. 
 
 Sp. I. Synocha. 
 " 2. Typhus. 
 
 [3 sub-species]. 
 " 3. Synochus. 
 
 Order II. Phlegmasiae. 
 
 Genus I. 
 
 Sp. I. Phleg-mon. 
 
 2. Ophthalmia. 
 
 3. Phrenitis. 
 
 4. Cynanche. 
 
 5. Pneumonia. 
 
 6. Hepatitis. 
 
 7. Carditis. 
 
 8. Gastritis. 
 
 9. Enteritis. 
 
 10. Nephritis. 
 
 11. Cystitis. 
 
 Inflaminatio. 
 
124 
 
 SYNOPSIS OF parr's SYSTEM. 
 
 Sp. 
 
 12. 
 
 Hysteritis. 
 
 
 << 
 
 13- 
 
 Odontalgia. 
 
 
 
 
 ^Various sub-species]. 
 
 
 
 Genus II. 
 
 Phlogosis. 
 
 Sp. 
 
 I. 
 
 Erythema. 
 
 
 it 
 
 2. 
 
 Phrenitica. 
 
 
 (( 
 
 3- 
 
 Anginosa. 
 
 
 <( 
 
 4- 
 
 Pneumonica. 
 
 
 a 
 
 5- 
 
 Puerperalis. 
 
 
 
 
 Genus III. 
 
 Catarrhus. 
 
 Sp. 
 
 I. 
 
 Coryza. 
 
 ^4 sub-species\ 
 
 
 << 
 
 2. 
 
 Dysenteria. 
 
 
 a 
 
 3- 
 
 Phthisis. 
 
 
 a 
 
 4- 
 
 Coeliaca. 
 
 
 ii 
 
 5- 
 
 Leucorrhoea. 
 
 
 it 
 
 6. 
 
 Cystirrhoea. 
 
 
 11 
 
 7- 
 
 Gonorrhoea. 
 
 
 <( 
 
 8. 
 
 Leucorrhois. 
 
 
 
 
 Genus IV. 
 
 Arthritis. 
 
 
 
 4 species]. 
 
 
 
 Genns V. 
 
 Exostosis. 
 
 Sp, 
 
 , I. 
 
 Periostea. 
 
 
SYNOPSIS OF PARRS SYSTEM. 12$ 
 
 Order III. Eruptiones. 
 
 Genus I, Exanthemata. 
 
 [13 species]. 
 
 Genus II. Efflorescentia. 
 [9 species]. 
 
 Order IV. Profluvia. 
 
 Genus I. Haemorrhagia. 
 [9 species, including Haematuria]. 
 
 Genus II. Apocenosis^ 
 [9 species, including Diabetes and Diuresis.] 
 
 Order V. Suppressorii. 
 
 Genus L Constrictoria. 
 
 Sp. I. Dysphagia. 
 " 2. Obstipatio. 
 " 3. Polypus. 
 
 Genus IL Aiihelatio. 
 
 Sp. I. Asthma. 
 " 2. Dyspnoea. 
 
 [8 sub-species]. 
 
 Genus IIL Epischesis. 
 [9 species, among which] 
 
 Sp. 5. Ischuria 
 
 a. Renalis 
 
126 
 
 SYNOPSIS OF PARR S SYSTEM. 
 
 b. Ureterica 
 
 c. Vesicalis 
 
 d. Urethralis. 
 Sp. 6. Dysuria 
 
 a. Ardens 
 
 b. Spasmodica 
 
 c. Compressionis 
 
 d. Irritata. 
 
 " 8. Dyspermatismus 
 
 a. Organicus 
 
 b. Spasmodicus. 
 
 Order VI. Spasmi. 
 
 Sp. 
 
 
 Genus L Tonos. 
 
 I. 
 
 2. 
 
 3- 
 
 4- 
 5- 
 
 Trismus. 
 
 Tetanus. 
 
 Contractura. 
 
 Priapismus. 
 
 Strabismus. 
 
 
 Genus II. Clonos. 
 '\\ species]. 
 
 Order VII. Adynamiae. 
 
 Genus I. Coma. 
 [4 species]. 
 
SYNOPSIS OF PARR S SYSTEM. 
 
 Genus II. Anepithymia. 
 [7 species]. 
 
 Order VIII. Paranoias. 
 
 Genus I. Morositas. 
 [3 species]. 
 
 Genus II. Halhicinatio. 
 
 Sp. I. Satyriasis. 
 "• 2. Nymphomania. 
 " 3. Erotomania. 
 
 Gen74s III. Vesania. 
 [3 species]. 
 
 Order IX. Cachexiae. 
 
 Genus I. Impetigo. 
 
 Sp. I. Scorbutus. 
 
 " 2. Syphilis. 
 
 " 3. Aurigo. 
 
 " 4. Phaenigmus. 
 
 '' 5. Melasma. 
 
 "■ 6. Rubigo. 
 
 Genus II. Macula. 
 
 Sp. I. Ecchymosis. 
 "■ 2. Petechia. 
 
 127 
 
128 SYNOPSIS OF parr's SYSTEM. 
 
 Order X. Intumescentiae. 
 
 Genus I. Tuber, 
 [i6 species]. 
 
 Genus IL Phleginatia. 
 [8 species, including Hydrocele]. 
 
 Ge7ius III. Cystis. 
 [6 species]. 
 
 Genus IV. Emphysema. 
 [3 species]. 
 
 Order XL Ectopiae. 
 
 Genus I. Hernia. 
 [8 species]. 
 
 Genus II, Prolapsus. 
 [7 species, including Exocyste]. 
 
 Genus III. Luxatio. 
 [21 species]. 
 
 Order XII. Plagae. 
 
 Genus I Dialysis, 
 [7 species]. 
 
 Genus II CI as is, 
 [4 species]. 
 
SWEDIAUR, YOUNG, RICHERAND. 1 29 
 
 Genus III, Diastasis. 
 Sp. I. Symphisis Pubis. 
 
 Swediaur enumerates five classes, thirty-two 
 orders ; and one hundred and thirty-eight genera. 
 
 Young, in his system of practical nosology, 
 adopts five classes: (i,) Paraneurismi, diseases 
 of the nervous and muscular system; (2,) Par- 
 haemasiae, diseases of the sanguiferous system ; 
 (3,) Pareccrises, diseases of the secretions ; (4,) 
 Paramorphiae, structural diseases; (5,) Ectopiae, 
 displacements: seven orders; and seventy-nine 
 genera. 
 
 Richerand, in his nosographie ckirurgicale, fourth 
 edition, adopts only three classes : (i,) Physical 
 lesions resulting from the action of a mechanical 
 cause ; (2,) Organic or structural lesions ; (3,) 
 Vital lesions : and fourteen orders. 
 
 Richerand afterwards introduced a new classi- 
 fication consisting of eight classes: (i,) Diseases 
 which affect all the organic systems ; (2,) Dis- 
 eases of the sensitive apparatus ; (3,) Diseases of 
 the locomotory apparatus ; (4,) Diseases of the 
 digestive apparatus ; (5,) Diseases of the circula- 
 tory apparatus ; (6,) Diseases of the respiratory 
 apparatus ; (7,) Diseases of the cellular system ; 
 (8,) Diseases of the sexual organs : and sixteen 
 orders. 
 
130 good's table of classification. 
 
 Good's system comprises six classes: (i,) 
 Coeliaca, diseases of the digestive function ; (2,) 
 Pneumatica, diseases of the respiratory function ; 
 (3,) Haematica, diseases of the sanguineous func- 
 tion ; (4,) Neurotica, diseases of the nervous func- 
 tion; (5,) Genetica, diseases of the sexual func- 
 tion ; (6,) Eccritica, diseases of the excernent 
 function ; and is further divided into orders, 
 genera and species, as follows. 
 
 DOCTOR good's ** TABLE OF CLASSIFICATION." * 
 
 CLASS. 1. COELIACA. 
 
 Diseases of the digestive function. 
 
 Ord. L Enterica. 
 Affecting the alimentary canal. 
 
 Gen. 1. Odontiay 
 Misdentition. 
 
 Spec. I. O. Dentitionis, (Teething.) 
 " 2. " Dolorosa, (Toothache.) 
 " 3. " Stuporis, (Toothedge.) 
 " 4. " Deformis, (Deformity of the teeth.) 
 
 * Extracted from " The Study of Medicine," Vol. i. 
 London, 1822. 
 
GOOD S TABLE OF CLASSIFICATION. I3I 
 
 Spec. 5. O. Edentula, (Toothlessness.) 
 
 " 6. *' Incrustans, (Tartar of the teeth.) 
 " 7. *' Excressens, (Excrescent gums.) 
 
 Gen. 11. PtyalisinuSy 
 Ptyalism. 
 
 Spec. I. P. Acutus, (Salivation.) 
 
 " 2. *' Chronicus, (Chronic ptyalism.) 
 " 3. '' Iners, (Drivelling.) 
 
 6^^;/. ///. Dysphagia, 
 Dysphagy. 
 
 Spec. I. D. Constricta, (Constrictive dysphagy.) 
 " 2. ** Atonica, (Atonic disphagy.) 
 " 3. " Globosa, (Nervous quinsy.) 
 " 4. " Uvulosa, (Uvular dysphagy.) 
 ** 5. " Linguosa, (Lingual disphagy.) 
 
 Gen, IV. Dipsosis, 
 Morbid thirst. 
 
 Spec. I. D. Avens, (Immoderate thirst.) 
 " 2. " Expers, (Thirstlessness.) 
 
 6^^?2. V, Limosis, 
 Morbid appetite. 
 
 Spec. I. L. Avens, (Voracity.) 
 " 2. " Expers, (Long fasting.) 
 
132 good's table of classification. 
 
 spec. 3. " Pica, (Depraved appetite.) 
 
 " 4. " Cardialgia, (Heart-burn, Water- 
 brash.) 
 
 5. " Flatus. (Flatulency.) 
 
 6. " Emesis, (Sickness, vomiting.) 
 
 7. '' Dyspepsia, (Indigestion.) 
 
 Gen. VI. Colica^ 
 Colic. 
 
 Spec. I. C. Ileus, (Iliac passion.) 
 
 " 2. " Rhachialgia, (Colic of Poitou, Pain- 
 ters colic.) 
 
 " 3. " Cibaria, (Surfeit.) 
 
 *' 4. " Flatulenta, (Wind colic.) 
 
 ^' 5. " Constipata, (Constipated colic.) 
 
 " 6. " Constricta, (Constrictive colic.) 
 
 Gen. VII. Coprostasis^ 
 Costiveness. 
 
 Spec. I. C. Constipata, (Constipation.) 
 " 2. '* Obstipata, (Obstipation.) 
 
 Gen. VIII. Diarrhoea, 
 Looseness. 
 
 Spec. I. D. Fusa, (Feculent looseness.) 
 " 2. " Biliosa, (Bilious looseness.) 
 
good's table of classification. 133 
 
 spec. 3. " Mucosa, (Mucous looseness.) 
 
 4. " Chylosa, (Chylous looseness.) 
 
 5. " Lienteria, (Lientery.) 
 
 6. " Serosa, (Serous looseness.) 
 
 7. " Tubularis, (Tubular looseness.) 
 
 8. " Gypsata, (Gypseous looseness.) 
 
 Gen. IX. Cholera, 
 Cholera. 
 
 Spec. I. C. Biliosa, (Bilious cholera.) 
 " 2. " Flatulenta, (Wind cholera.) 
 " 3. " Spasmodica, (Spasmodic cholera.) 
 
 Gen. X. Enter olithus^ 
 Intestinal concretions. 
 
 Spec. I. E. Bezoardus, (Bezoar.) 
 
 " 2. " Calculus, (Intestinal calculus.) 
 " 3. " Scybalum, (Scybalum.) 
 
 Gen. XI. Helmmthia^ 
 Worms. 
 
 Spec. I. H. Alvi, (Alvine worms.) 
 " 2. " Podicis, (Anal worms.) 
 "3. " Eri'atica, (Erratic worms). 
 
134 GOODS TABLE OF CLASSIFICATION. 
 
 Gen. XII. Proctica^ 
 Proctica. 
 
 Spec. I. P. Simplex, (Simple proctica.) 
 
 " 2. '* Spasmodica, (Spasmodic stricture ot 
 
 the rectum.) 
 " 3. " Callosa, (Callous stricture of the 
 
 rectum.) 
 '' 4. " Tenesmus, (Tenesmus.) 
 " 5. " Marisca, (Piles.) 
 " 6. " Exania, (Prolapse of the fundament.) 
 
 Ord. II. Splanchnica, 
 Affecting the coUatitious viscera. 
 
 Gen. I. Icterus^ 
 Yellow Jaundice. 
 
 Spec. I. I. Choloeus, (Biliary jaundice.) 
 
 " 2. '* Chololithicus, (Gall-stone jaundice.) 
 
 " 3. " Spasmodicus, (Spasmodic jaundice.) 
 
 " 4. " Hepaticus, (Hepatic jaundice.) 
 
 " 5. " Infantum, (Jaundice of infants.) 
 
 Gen. II. Melaena, 
 Melena. 
 
 Spec. I. M. Choloea, (Black, or green jaundice.) 
 " 2. " Cruenta, (Black vomit.) 
 
good's table of classification. 
 
 I3S 
 
 Geii. III. Chololithus, 
 Gall-stone. 
 
 Spec. I. C. Quiescens, (Quiescent gall-stone.) 
 '* 2. " Means, (Passing of gall-stones ) 
 
 Gen. IV. Parabysma^ 
 
 Spec. I 
 2 
 
 3 
 
 4 
 
 5 
 6 
 
 Visceral turgescence. 
 
 P. Hepaticum, (Turgescence of the 
 
 liver.) 
 
 " Splenicum, (Turgescence of the 
 spleen.) 
 
 " Pancreaticum, (Turgescence of the 
 pancreas.) 
 
 " Mesentericum, (Turgescence of the 
 mesenter}^) 
 
 " Intestinale, (Turgescence of the in- 
 testines.) 
 
 " Omentale, (Turgescence of the 
 omentum.) 
 
 " Complicatum, (Turgescence com- 
 pounded of various 
 organs.) 
 
136 good's table of classification. 
 
 CLASS. 11. PNEUMATICA. 
 
 Diseases of the respiratory function. 
 
 Ord. I. Phonica, 
 Affecting- the vocal avenues. 
 
 Gen. I. Coryza^ 
 Running at the nose. 
 
 Spec. I. C. Entonica, (Entonic coryza.) 
 " 2. " x\tonica, (Atonic coryza.) 
 
 Gen. II. Polypus^ 
 Polypus. 
 
 Spec. I. P. Elasticus, (Compressible "polypus.) 
 " 2. " Coriaceus, (Cartilaginous polypus.) 
 
 Gen. III. Rhonchus, 
 Rattling in the throat. 
 
 Spec. I. R. Stertor, (Snoring.) 
 " 2. *' Cerchnus, (Wheezing.) 
 
 Gen. IV. Aphonia, 
 Dumbness. 
 
 Spec. I. K. Elinguium, (Elingual dumbness.) 
 " 2. " Atonica, (Atonic dumbness.) 
 " 3. " Surdorum, (Deaf-dumbness.) 
 
good's table of classification. 137 
 
 Gen. V. Dysphonia, 
 Dissonant voice. 
 
 Spec, I. D. Susurrans, (Whispering voice.) 
 " 2. " Puberum, (Voice of puberty.) 
 " 3. ** Immodulata, (Immelodious voice.) 
 
 Geu. VI. Psel/zsmus, 
 Dissonant speech. 
 
 Spec. I. P. Bambalia, (Stammering.) 
 '* 2. " Blaesitas, (Misenunciation.) 
 
 Ord. II. Pneumonica, 
 
 Affecting the lungs, their membranes, or motive 
 
 power. 
 
 Gen. I. Bex, 
 Cough. 
 
 Spec. I. B. Humida, (Common or tumid cough.) 
 " 2. '' Sicca, (Dry cough.) 
 " 3. " Convulsiva, (Hooping cough.) 
 
 Gen. II. Laryngysinus, 
 Laryngic suffocation. 
 
 Spec. I. L. Stridulus, (Stridulous constriction of 
 
 the larynx.) 
 
138 good's table of classification. 
 
 Gen. III. Dyspnoea J 
 Anhelation. 
 
 Spec. I. D. Chronica, (Short-breath.) 
 
 " 2. " Exacerbans, (Exacerbating anhela- 
 tion.) 
 
 Gen. IV. Asthma^ 
 Asthma. 
 
 Spec. I. A. Siccum, (Dry or nervous asthma.) 
 " 2. " Humidum, (Humid or commom 
 
 asthma.) 
 
 Gen. V. Ephialtes, 
 Incubus. 
 
 Spec. I. E. Vigilantium, (Day-mare.) 
 " 2. " Nocturnus, (Night-mare.) 
 
 Gen. VI. Sternalgia, 
 Suffocative breast-pang. 
 
 Spec, I. S. Ambulantiura, (Acute breast-pang.) 
 ^* 2. " Chronica, (Chronic breast-pang. 
 
 Gen. VII. Fleuralgia^ 
 Pain in the side. 
 
 Spec. I. P. Acuta, (Stitch.) 
 
 '* 2. " Chronica, (Chronic pain in the side.) 
 
good's table of classification. 139 
 
 CLASS. III. HAEMATICA, 
 Diseases of the sanguineous function. 
 
 Ord. I. Pyretica, 
 Fevers. 
 
 Gen. I. Ephemera, 
 Diary fever. 
 
 Spec, I. E. Mitis, (Wild diary fever.) 
 " 2. " Acuta, (Acute diary fever.) 
 " 3. " Sudatoria, (Sweating fever.) 
 
 Gen, II, Anetus, 
 Intermitting fever. Ague. 
 
 A. Quotidianus, (Quotidian ague.) 
 " Tertianus, (Tertian ague.) 
 " Quartanus, (Quartan ague.) 
 ** Erraticus, (Irregular ague.) 
 "■ Complicatus, (Complicated ague.) 
 
 Gen. Ill Epanetus^ 
 Remittent fever. 
 
 Spec, I. E. Mitis, (Wild remittent.) 
 
 " 2. " Malignus, (Malignant remittent.) 
 " 3. " Hectica, (Hectic fever.) 
 
 ^pec. 
 
 I. 
 
 n 
 
 2. 
 
 (( 
 
 3. 
 
 <( 
 
 4. 
 
 <( 
 
 5. 
 
140 GOOD S TABLE OF CLASSIFICATION. 
 
 Gen. IV. Enecia^ 
 Continued fever. 
 
 Spec. I. E. Cauma, (Inflammatory fever.) 
 " 2. " Typhus, (Typhus fever.) 
 " 3. " Synochus, (Synochal fever.) 
 
 Ord. II. Phlogotica, 
 Inflammations. 
 
 Gen. I. Apostema^ 
 Aposteme. 
 
 A. Commune, (Common aposteme.) 
 ** Psoaticum, (Psoas abscess.) 
 " Hepaticum, (Abscess of the liver.) 
 " Empyema, (Lodgement of matter in 
 the chest.) 
 " 5. " Vomica, (Vomica.) 
 
 Gen. II. Phlegmoney 
 Phlegmon. 
 
 Spec. I. P. Communis, (Common phlegmon.) 
 
 2. " Parulis, (Gumboil.) 
 
 3. " Auris, (Imposthume in the ear.) 
 
 4. " Parotidea, (Parotid phlegmon.) 
 
 5. " Mammae, (Abscess of the breast.) 
 
 6. "■ Bubo, (Bubo.) 
 
 7. " Phimotica, (Phimotic phlegmon.) 
 
 Spee. 
 
 I. 
 
 n 
 
 2. 
 
 It 
 
 3- 
 
 n 
 
 4- 
 
GOOD S TABLE OF CLASSIFICATION. I4I 
 
 Gen. III. FJiyma^ 
 Tubercle. 
 
 Spec. I. P. Hordeolum, (Sty.) 
 
 " 2. '' Furunculus, (Boil.) 
 
 " 3. " Sycosis, (Sycous phyma.) 
 
 " 4. " Anthrax, (Carbuncle.) 
 
 Ge72, IV. lonthiis, 
 Whelk. 
 
 Spec. I. I. Varus, (Stone-pock.) 
 
 " 2. " Corymbifer, (Carbuncled face, Rosy 
 
 drop.) 
 
 Gen. V. PhlysiSj 
 Phlysis. 
 
 Spec. I. P. Paronychia, (Whitlow.) 
 
 Gen. VI. Erythema y 
 Inflammatory blush. 
 
 Spec. I. E. Oedematosum, (Edematous inflam- 
 mation.) 
 
 " 2. '* Erysipelatosum, (Erysipelatous in- 
 flammation.) 
 
 " 3. " Gangraenosum, (Gangrenous inflam- 
 mation.) 
 
 " 4. " Vesiculare, (Vesicular inflammation.) 
 
142 good's table of classification. 
 
 spec. 5. E. Pernio, (Chilblain.) 
 " 6. " Intertrigo, (Fret.) 
 
 Gen. V 11. Empresma^ 
 Visceral inflammation. 
 
 Spec. I. E. Cephalitis, (Inflammation of the 
 
 brain.) 
 
 2. " Otitis, (Ear-ache.) 
 
 3. " Parotitis, (Mumps.) 
 
 4. " Paristhmitis, (Quinsy.) 
 
 5. " Laryngitis, (Inflammation of the 
 
 larynx. 
 
 6. " Bronchitis, (Croup.) 
 
 7. " Pneumonitis, (Peripneumony.) 
 
 8. " Pleuritis, (Pleurisy.) 
 
 9. " Carditis, (Inflammation of the heart.) 
 
 10. " Peritonitis, (Inflammation of the 
 
 peritoneum.) 
 
 11. " Gastritis, (Inflammation of the 
 
 stomach.) 
 
 12. " Enteritis,(Inflammation of the bowels.) 
 
 13. " Hepatitis, (Inflammation of the liver.) 
 
 14. " Splenitis, (Inflammation of the spleen.) 
 
 15. " Nephritis, (Inflammation of the 
 
 kidneys ) 
 
 16. " Cystitis,(Inflammation of the bladder.) 
 
good's table of classification. 143 
 
 spec. 17. E. Hysteritis, (Inflammation of the 
 
 womb.) 
 " 18. " Orchitis, (Inflammation of the tes- 
 ticles.) 
 
 Gen. VIIL Ophthalmia^ 
 Ophthalmy. 
 
 Spec. I. O. Taraxis, (Lachr3^mose ophthalmy.) 
 
 " 2. '' Iridis, (Inflammation of the iris.) 
 
 " 3. " Purulenta, (Purulent ophthalmy.) 
 
 '' 4. " Glutinosa, (Glutinous ophthalmy.) 
 
 " 5. *' Chronica, (Lippitude, Blear eye.) 
 
 Gen. IX. CatarrhuSj 
 Catarrh. 
 
 Spec. I. C. Communis,(Cold in the head or chest.) 
 " 2. " Epidemicus, (Influenza.) 
 
 Gen. X, Dysenteria^ 
 Dysentery. 
 
 Spec. I. D. Simplex, (Simple dysentery.) 
 " 2. " Pyrectica, (Dysenteric fever.) 
 
 Gen. XL Btic?iemia, 
 Tumid leg. 
 
 Spec. I. B. Sparganosis, (Puerperal tumid leg.) 
 . " 2. " Tropica, (Tumid leg of hot climates.) 
 
144 good's table of classification. 
 
 Gen. XII. Arthrosia. 
 Articular inflammation. 
 
 Spec. I. A. Acuta, (Acute rheumatism.) 
 
 '* 2. " Chronica, (Chronic rheumatism.) 
 
 " 3. "• Podagra, (Gout) 
 
 " 4. " Hj^drarthrus, (White-swelling.) 
 
 OrD. III. EXANTHEMATICA, 
 
 Eruptive fevers, Exanthems. 
 
 Gen. I. EnanthesiSy 
 Rash, Exanthem. 
 
 Spec. I. E. Rosalia, (Scarlet-fever.) 
 *' 2. " Rubeola, (Measles.) 
 " 3. "■ Urticaria, (Nettle-rash.) 
 
 Gen. II. Emphlysis, 
 Ichorous exanthem. 
 
 Spec. I. E. Miliaria, (Miliary fever.) 
 
 " 2. " Aphtha, (Thrush.) 
 
 " 3. " Vaccinia, (Cow-pox.) 
 
 " 4. " Varicella, (Water-pox.) 
 
 " 5. " Pemphigus, (Vesicular or bladdery 
 
 fever.) 
 
 " 6. " Erysipelas, (St. Anthony's fire.) 
 
good's table of classification. 145 
 
 Gen. III. Empyesis, 
 Pustulous exanthem. 
 
 Spec. I. E. Variola, (Small-pox.) 
 
 Gen. IV. Aftthraciay 
 Carbuncular exanthem. 
 
 Spec. I. A. Pestis, (Plague.) 
 " 2. '* Rubula, (Yaws.) 
 
 Ord. IV. Dysthetica, 
 Cachexies. 
 
 Gen. I. Plethora^ 
 Plethora. 
 
 Spec. I. P. Entonica, (Sanguine phthora.) 
 " 2. " Atonica, (Serous plethora.) 
 
 Gen. II. Hae^norrhagia^ 
 Haemorrhage. 
 
 Spec. I. H. Entonica, (Entonic Haemorrhage.) 
 " 2. *' Atonica, (Atonic Haemorrhage.) 
 
 Gen. III. Marasmus^ 
 Emaciation. 
 
 Spec. I. M. Atrophia, (Atrophy.) 
 
 " 2. " Climactericus, (Decay of nature.) 
 
146 good's table of classification. 
 
 spec. 3. M. Tabes, (Decline.) 
 
 " 4. " Phthisis, (Consumption.) 
 
 Gen. IV. Struma, 
 Scrophula. 
 
 Spec. I. S. Vulgaris, (King's evil.) 
 
 Gen. V. Carcinus, 
 Cancer. 
 
 Spec. I. C. Vulgaris, (Common cancer.) 
 
 Gen. VI. Lues, 
 Venereal disease. 
 
 Spec. I. L. Syphilis, (Pox.) 
 
 " 2. "• Syphilodes, (Bastard pox.) 
 
 Gen. VII. Elephantiasis, 
 Elephant-skin. 
 
 Spec, I. E. Arabica, (Arabian elephantiasis, 
 
 Black leprosy.) 
 " 2. *' Italica, (Italian elephantiasis.) 
 " 3. *' Asturiensis, (Asturian elephantiasis.) 
 
 Gen. VIII. Catacausis, 
 Catacausis. 
 
 Spec. I. C. Ebriosa, (Inebriate catacausis.) 
 
good's table of classification. 147 
 
 Gen. IX. PorpJiyrUy 
 Scurvy. 
 
 Spec. I. P. Simplex, (Petecchial scurvy.) 
 *' 2. '' Haemorrhagica, (Land-scurvy.) 
 " 3. "• Nautica, (Sea-scurvy.) 
 
 Gen. X. Exarigia, 
 Exangia. 
 
 Spec. I. E. Aneurisma, (Aneurism.) 
 " 2. " Varix, (Varix.) 
 " 3. " Cyania, (Blue-skin,) 
 
 Gen. XL Gangraena, 
 Gangrene. 
 
 Spec. I. G. Sphacelus, (Mortification.) 
 
 " 2. " Ustilaginea, (Mildew-mortification.) 
 
 " ' 3. " Necrosis, (Dry gangrene.) 
 
 " 4. '' Caries, (Caries.) 
 
 Gen. XII. UlcuSy 
 Ulcer. 
 
 6/>^^. I. CJ. Incarnans, (Simple healing ulcer.) 
 " 2. '* Vitiosum, (Depraved ulcer.) 
 " 3. " Sinuosum, (Sinuous ulcer.) 
 " 4. " Tuberculosum, (Warty, excrescent 
 
 ulcer.) 
 ** 5. " Cariosum, (Carious ulcer.) 
 
148 good's table of classification. 
 
 CLASS. IV. NEUROTICA, 
 
 Diseases of the nervous function. 
 
 Ord. I. Phrenica, 
 Affecting the intellect. 
 
 Gen. I. Ecphronia^ 
 Insanity, Craziness. 
 
 Spec, I. E. Melancholia, (Melancholy.) 
 " 2. *' Mania, (Madness.) 
 
 Gen. II, Empathema, 
 Ungovernable passion. 
 
 Spec. I. E. Entonicum, (Empassioned excite- 
 ment.) 
 ** 2. '* Atonicum, (Empassioned depres- 
 sion.) 
 " 3. *' Inane, (Hair-brained passion.) 
 
 Gen. III. Alusia, 
 Illusion, Hallucination. 
 
 Spec. I. A. Elatio, (Sentimentalism, Mental ex- 
 extravagance.) 
 " 2. " Hypochondrias, (Hypochondrism, 
 
 Low spirits.) 
 
good's table of classification. 149 
 
 Gen. IV. Aphelxia, 
 Revery. 
 
 Spec. I. A. Socors, (Abscence of mind.) 
 " 2. •* Intenta, (Abstraction of mind.) 
 " 3. " Otiosa, (Brown-study.) 
 
 Gen. V. Paroniria, 
 Sleep-disturbance. 
 
 Spec. I. P. Ambulans, (Sleep-walking.) 
 " 2. '* Loquens, (Sleep-talking.) 
 " 3. " Salax, (Night-pollution.) 
 
 Gen. VI. Moria, 
 Fatuity. 
 
 Spec. I. M. Imbecillis, (Imbecility.) 
 " 2. " Demens, (Irrationality.) 
 
 Ord. II. Aesthetica, 
 Affecting the sensation. 
 
 Gen. I. Par op sis, 
 Morbid sight. 
 
 Spec, I. P. Lucifuga, (Night-sight.) 
 " 2. " Noctifuga, (Day-sight.) 
 " 3. " Longinqua, (Long-sight.) 
 
ISO good's table of classification. 
 
 ^ec 
 
 ■ 4. 
 
 
 5. 
 
 
 6. 
 
 
 7- 
 
 
 8. 
 
 
 9- 
 
 
 10. 
 
 
 II. 
 
 
 12. 
 
 
 13- 
 
 P. Propinqua, (Short-sight.) 
 
 " Lateralis, (Skue-sight.) 
 
 " Illusoria, (False-sight.) 
 
 " Caligo, (Opaque cornea.) 
 
 " Glaucosis, (Humoral opacity.) 
 
 " Catarracta, (Cataract.) 
 
 " Synizesis, (Closed pupil.) 
 
 ** Amaurosis, (Drop serene.) 
 
 " Staphyloma, (Protuberant eye.) 
 
 "■ Strabismus, (Squinting.) 
 
 Spec. 
 
 I. 
 
 
 2. 
 
 
 3- 
 
 
 4- 
 
 
 5. 
 
 
 6. 
 
 (7^?;. //. Paracusis^ 
 Morbid hearing. 
 
 P. Acris, (Acute hearing.) 
 " Obtusa, (Hardness of hearing.) 
 " Perversa, (Perverse hearing.) 
 " Duplicata, (Double hearing.) 
 " Illusoria, (Imaginary sounds.) 
 " Surditas, (Deafness.) 
 
 Gen. III. ParosmiSf 
 Morbid smell. 
 
 Spec. I. P. Acris, (Acute smell.) 
 ** 2. " Obtusa, (Obtuse smell.) 
 " 3. " Expers, (Want of smell.) 
 
good's table of classification. 151 
 
 Gen, IV. Parageusis, 
 Morbid taste. 
 
 Spec. I. P. Acuta, (Acute taste.) 
 *' 2. " Obtusa, (Obtuse taste.) 
 " 3. " Expers, (Want of taste.) 
 
 Gen. V. Par apsis, 
 Morbid touch. 
 
 Spec. I. P. Acris, (Acute sense of touch or gen- 
 eral feeling.) 
 
 " 2. " Expers, (Insensibility of touch or 
 
 general feeling.) 
 
 " 3. '* Illusoria, (Illusory sense of touch or 
 
 general feeling.) 
 
 Gen. VI. Neuralgia, 
 Nerve-ache. 
 
 Spec. I. N. Faciei, (Nerve-ache of the face.) 
 " 2. •' Pedis, (Nerve-ache of the foot.) 
 " 3. " Mammae, (Nerve-ache of the breast.) 
 
152 
 
 good's table of classification. 
 
 spec. I 
 
 2 
 
 3 
 
 4 
 
 5 
 6 
 
 7 
 8 
 
 OrD. III. CiNETICA, 
 
 Affecting the muscles. 
 
 Gen. I. Entasia, 
 Constrictive spasm. 
 
 E. Priapismus, (Priapism.) 
 
 "■ Loxia, (Wry-neck.) 
 
 " Articularis, (Muscular stiff-joint.) 
 
 " Systremma, (Cramp.) 
 
 " Trismus, (Locked-jaw.) 
 
 " Tetanus, (Tetanus.) 
 
 " Lissa, (Rabies, Canine madness.) 
 
 " Acrotismus, (Suppressed pulse.) 
 
 Gen. II. Clonus y 
 Clonic spasm. 
 
 Spec, I. C. Singultus, (Hiccough.) 
 " 2. '' Sternutatio, (Sneezing.) 
 ' Palpitatio, (Palpitation.) 
 
 * Nictitatio, (Twinkling of the eye 
 lids.) 
 
 ' Subsultus, (Twitching of the ten 
 dons.) 
 
 * Pandiculatio, (Stretching.) 
 
 3- 
 4- 
 
 5. 
 6. 
 
spec. 
 
 I. 
 
 (< 
 
 2. 
 
 << 
 
 3- 
 
 <( 
 
 4. 
 
 <( 
 
 5. 
 
 good's table of classification. 153 
 
 Gen. HI. Sync I onus, 
 Synclonic spasm. 
 
 S. Tremor, (Trembling.) 
 '' Chorea, (St. Vitus' dance.) 
 " Ballismus, (Shaking palsy.) 
 '* Raphania, (Raphania.) 
 " Beriberia, (Barbiers.) 
 
 Ord. IV. Systatica, 
 
 Affecting several or all the sensorial powers 
 simultaneously. 
 
 Gen, /, Agrypnia^ 
 Sleeplessness. 
 
 Spec. I. A. Excitata, (Irritative wakefulness.) 
 " 2. " Pertaesa, (Chronic wakefulness.) 
 
 Gen. II. Dysphoria, 
 Restlessnes. 
 
 Spec. I. D. Simplex, (Fidgets.) 
 " 2. " Anxietas, (Anxiety.) 
 
 Gen. Ill Antipathia, 
 Antipathy. 
 
 Spec. I. A. Sensilis, (Sensile antipathy.) 
 
 2. '' Insensilis, (Insensile antipathy.) 
 
154 good's table of classification. 
 
 Gen. IV. Cephalaea^ 
 Head-ache. 
 
 Spec. I. C. Gravans, (Stupid head-ache.) 
 
 2. " Ecstasis, (Ecstasy.) 
 
 3. " Catalepsia, (Catalepsy.) 
 
 4. " Lethargus, (Lethargy.) 
 
 5. '' Apoplexia, (Apoplexy.) 
 
 6. " Paralysis, (Palsy.) 
 
 CLASS. V. GENETICA, 
 Diseases of the sexual function. 
 
 Ord. L Cenotica, 
 Affecting the fluids. 
 
 Gen. /. Paramenia J 
 Mismenstruation. 
 
 Spec. I. P. Obstructionis, (Obstructed menstrua- 
 tion.) 
 " 2. " Difficilis, (Laborious mentruation.) 
 " 3. " Superflua, (Excessive menstruation.) 
 " 4. " Erroris, (Vicarious menstruation.) 
 " 5. " Cessatronis, (Irregular cessation of 
 
 the menses.) 
 
GOOD S TABLE OF CLASSIFICATION. 1 55 
 
 Genus II. Leucorrhoea, 
 Whites. 
 
 Spec. I. L. Communis, (Common whites.) 
 " 2. ** Nabothi, (Labour-show.) 
 " 3. *' Senescentium, (Whites of advanced 
 
 life.) 
 
 Gen, III. Blennorrhoea^ 
 Gonorrhoea. 
 
 Spec. I. B. Simplex, (Simple urethral running.) 
 " 2. " Luodes, (Clap.) 
 " 3. ** Chronica, (Gleet.) 
 
 Gen. IV. Spermorrhoea^ 
 Seminal flux. 
 
 Spec. I. S. Entonica, (Entonic seminal flux.) 
 " 2. " Atonica, (Atonic seminal flux.) 
 
 Gen. V. GalactiUy 
 Mislactation. 
 
 Spec. I. G. Praematura, (Premature milk-flow.) 
 
 ** 2. " Defectiva, (Deficient milk-flow.) 
 
 *' 3. " Depravata, (Depraved milk-flow.) 
 
 " 4 " Erratica, (Erratic milk-flow.) 
 
 " 5. '* Virorum, (Milk-flow in males.) 
 
156 good's table of classification. 
 
 Ord. II. Orgastica, 
 AiEfecting the org-asm. 
 
 Gen. I. Chlorosis. 
 Green-sickness. 
 
 Spec. I. C. Entonica, (Entonic green-sickness.) 
 " 2. " Atonica, (Atonic green-sickness.) 
 
 Gen. IT. Proeotia. 
 Genital precocity. 
 
 Spec. I. P. Masculina, (Male precocity.) 
 " 2. " Feminina, (Female precocity.) 
 
 Gen. III. LagnesiSy 
 Lust. 
 
 Spec. I. L. Salacitas, (Salacity.) 
 
 " 2. " Furor, (Lascivious madness.) 
 
 Gen. IV. Agenesiuy 
 C Male sterility. 
 
 Spec. I. A. Impotens, (Male impotency.) 
 
 " 2. '* Dyspermia, (Seminal-mis-emission.) 
 " 3. *' Incongrua, (Copulative incongruity.) 
 
good's table of classification. 157 
 
 Gen, V. Aphoria, 
 Female sterility, Barrenness. 
 
 Spec, I. A. Impotens, (Barrenness of impotency.) 
 " 2. *' Paramenica, (Barrenness of mis-men- 
 struation.) 
 " 3. "■ Impercita, (Barrenness of irrespon- 
 
 dence.) 
 " 4. ** Incongrua, (Barrenness of incon- 
 gruity.) 
 
 Gen. VI. Aedoptosis^ 
 Genital prolapse. 
 
 Spec. I. A. Uteri, (Falling down of the womb.) 
 " 2. " Vaginae, (Prolapse of the vagina.) 
 " 3. " Vesicae, (Prolapse of the bladder.) 
 " 4. " Complicata, (Complicated genital 
 
 prolapse.) 
 " 5. " Polyposa, (Genital excrescence.) 
 
 Ord. III. Carpotica, 
 Affecting the impregnation. 
 
 Gen. I. ParacyesiSy 
 Morbid pregnancy. 
 
 Spec. I. P. Irritativa, (Constitutional derange- 
 ment of pregnancy.) 
 
158 good's table of classification. 
 
 Sp€c. 2. " Uterina, (Local derangement of 
 
 pregnancy.) 
 " 3. "■ Abortus, (Abortion.) 
 
 Gen. II. Parodynia^ 
 Morbid labour. 
 
 P. Atonica, (Atonic labour.) 
 
 " Implastica, (Unpliant labour.) 
 
 '* Sympathetica, (Complicated labour.) 
 
 *' Perversa, (Preternatural presenta- 
 
 tion.) 
 " Amorphica, (Impracticable labour.) 
 " Pluralis, (Multiplicate labour.) 
 " 7. " Secundaria, (Sequential labour.) 
 
 Gen. III. Eccyesis, 
 Extra-uterine-fetation. 
 
 Sj)ec. I. E. Ovaria, (Ovarian exfetation.) 
 ^' 2. '* Tubalis, (Tubal exfetation.) 
 " 3. *' Abdominalis, (Abdominal exfetation.) 
 
 Ge7t. IV. Pseudocyesis, 
 Spurious pregnancy. 
 
 Spec. I. P. Molaris, (Mole.) 
 
 " 2. *' Inanis, (False conception.) 
 
 •yec. 
 
 I. 
 
 << 
 
 2. 
 
 << 
 
 3. 
 
 << 
 
 4. 
 
 <( 
 
 5. 
 
 <4 
 
 6. 
 
good's table of classification. 159 
 
 CLASS. VI. ECCRITICA, 
 
 Diseases of the excernent function. 
 
 Ord. I. Mesotica, 
 Affecting the parenchyma. 
 
 Gen. I. Polysarcia, 
 Corpulency. 
 
 Spec. I. P. Adiposa, (Obesity.) 
 
 Ge7t. II. Emphyma^ 
 Tumour. 
 
 Spec. I. E. Sarcoma, (Sarcom.atous tumour.) 
 " 2. " Encystis, (Encysted tumour.) 
 " 3. " Exostosis, (Bony tumour.) 
 
 Gen. III. Parostia, 
 Mis-ossilication. 
 
 Spec. I. P. FragiHs, (Fragility of the bones.) 
 " 2. " Flexilis, (FlexiHty of the bones.) 
 
 Gen. IV. Cyrtosis, 
 Contortion of the bones. 
 
 Spec. I. C. Rhachia, (Rickets.) 
 ** 2. " Cretinismus, (Cretinism.) 
 
i6o good's table of classification. 
 
 Gen. V. Osthexia^ 
 Osthexy. 
 
 Spec. I. O. Infarciens, (Parenchymatous os- 
 thexy.) 
 " 2. " Implexa, (Vascular osthexy.) 
 
 Ord. II. Catotica, 
 Affecting internal surfaces. 
 
 Gen. I. HydropSy 
 Dropsy. 
 
 Spec. I. H. Cellularis, (Cellular dropsy.) 
 
 ** 2. *' Capitis, (Dropsy of the head.) 
 
 "• 3. "■ Spinae, (Dropsy of the spine.) 
 
 " 4. " Thoracis, (Dropsy of the chest.) 
 
 " 5. " Abdominis, (Dropsy of the belly.) 
 
 '' 6. " Ovarii, (Dropsy of the ovaries.) 
 
 " 7. " Tubalis, (Dropsy of the Fallopian 
 
 tubes.) 
 
 " 8. " Uteri, (Dropsy of the womb.) 
 
 " 9. " Scroti, (Dropsy of the scrotum.) 
 
 Gen. II. Emphysema^ 
 Inflation, Wind-dropsy. 
 
 Spec. I. E. Cellulare, (Cellular inflation.) 
 " 2. " Abdominis, (Tympany.) 
 
good's table of classification. i6i 
 
 Gen. III. Paruriay 
 Mismicturition. 
 
 Spec. I. P. Inops, (Destitution of urine.) 
 
 2. " Retentionis, (Stoppage of urine.) 
 
 3. " Stillatitia, (Strangury.) 
 
 4. '* Mellita, (Saccharine urine, Diabetes.) 
 
 5. " Incontinens, (Incontinence of urine.) 
 
 6. " Incocta, (Unassimilated urine.) 
 
 7. " Erratica, (Erratic urine.) 
 
 Gejt. IV. Lithia, 
 Urinary calculus. 
 
 Spec. I. L. Renalis, (Renal calculus.) 
 
 " 2. " Vesicalis, (Stone in the bladder.) 
 
 OrD. III. ACROTICA, 
 
 Affecting the external surface. 
 
 Gen. I. EphidrosiSy 
 Morbid sweat 
 
 E. Profusa, (Profuse sweat.) 
 '* Cruenta, (Bloody sweat.) 
 " Partialis, (Partial sweat.) 
 " Discolor, (Coloured sweat.) 
 '' Olens, (Scented sweat.) 
 " Arenosa^ (Sandy sweat.) 
 
 Spec. 
 
 I. 
 
 
 2. 
 
 
 3. 
 
 
 4- 
 
 
 5. 
 
 
 6. 
 
i62 good's table of classification. 
 
 Gen. II. ExanthesiSy 
 Cutaneous blush. 
 
 Spec. I. E. Roseola, (Rose-rash.) 
 
 Gen. III. Exorniiay 
 Papulous skin. 
 
 Spec. I. E. Strophulus, (Gum-rash.) 
 " 2. " Lichen, (Lichenous-rash.) 
 
 " 3. " Prurigo, (Pruriginous-rash.) 
 " 4. " Milium, (Millet rash.) 
 
 Gen. IV. Lepidosis, 
 Scale-skin. 
 
 Spec. I. L. Pityriasis, (Dandriff.) 
 
 " 2. " Lepriasis, (Leprosy.) 
 
 *' 3. " Psoriasis, (Dry-scall.) 
 
 " 4. " Icthyiasis, (Fish-skin.) 
 
 Gen. V. Ecphlysisy 
 Blains. 
 
 Spec. I. E. Pompholyx, (Water-blebs.) 
 
 *' 2. " Herpes, (Tetter.) 
 
 " 3. ** Rhypia, (Sordid-blain.) 
 
 " 4. " Eczema, (Heat eruption.) 
 
good's table of classification. 163 
 
 Gen. VI. Ecpyesis, 
 Humid scall. 
 
 Spec. I. E. Impetigo, (Running scall.) 
 
 *' 2. •* Porrigo, (vScabby scall.) 
 
 " 3. " Ecthyma, (Papulous scall.) 
 
 " 4. " Scabies, (Itch.) 
 
 Gen. VII. Malis, 
 Cutaneous vermination. 
 
 Spec. I. M. Pediculi, (Lousiness.) 
 '' 2. •* Pulicis, (Flea-bites.) 
 " 3. " Acari, (Tick-bite.) 
 ** 4. " Filariae, (Guinea worm.) 
 " 5. " Oestri, (Gad-fly bite.) 
 " 6. " Gordii, (Hair worm.) 
 
 Gen. VIII Ecphymay 
 Cutaneous excrescence. 
 
 Spec. I. E. Caruncula, (Caruncle.) 
 
 " 2. *' Verruca, (Wart.) 
 
 " 3. " Clavus, (Corn.) 
 
 " 4. " Callus, (Callus) 
 
 Gen. IX. Trichosis, 
 Morbid hair. 
 
 Spec. I. T. Setosa, (Bristly hair.) 
 " 2. " Plica, (Matted hair.) 
 
1 64 good's table of classification. 
 
 spec. 3. 
 
 4. 
 
 5- 
 6. 
 
 7. 
 8. 
 
 Spec. I 
 2 
 
 3 
 
 4 
 
 5 
 6 
 
 T. Hirsuties, (Extraneous hair.) 
 " Distrix, (Forky hair.) 
 " Poliosis, (Gray hairs.) 
 " Athrix, (Baldness.) 
 " Area, (Areated hair.) 
 ** Decolor, (Miscolored hair.) 
 
 Gen. X. EpichrosiSy 
 Macular-skin. 
 
 E. Leucasmus, (Weal-skin.) 
 
 '' Spilus, (Mole.) 
 
 " Lenticula, (Freckles.) 
 
 *' Ephelis, (Sun-burn.) 
 
 '* Aurigo, (Orange-skin.) 
 
 " Poecilia, (Pye-balled-skin.) 
 
 " Alphosis, (Albino-skin.) 
 
 Good's classification is exhaustive but his 
 nomenclature very fanciful. The following are 
 among the manv blemishes contained in his sys- 
 tem of classification. 
 
 Abscess of the breast, bubo, and gum-boil, are 
 placed as species of the same genus ; sty is in the 
 same genus as anthrax ; chilblain with erysipela- 
 tous inflammation ; croup with peritonitis, inflam- 
 mation of the brain, carditis, nephritis, cystitis, 
 etc. ; gout with white swelling ; aphtha with 
 pemphigus and erysipelas ; priapism with wry- 
 
ALIBERT. 165 
 
 neck and locked-jaw, etc., and yet Good is con- 
 sidered as the greatest of all classifiers. 
 
 Alibert, in his Nosologie natiirelle ou les maladies 
 du corps humain disiribiiees par fajnilles^ groups 
 diseases, in accordance with the organs affected, 
 into certain classes, families and genera as fol- 
 lows: 
 
 First class. Trophopathies, or diseases which 
 attack the functions of assimilation. 
 
 First family. Gastroses, diseases whose princ- 
 ipal seat is in the stomach ; thirteen genera. 
 
 Second family. Enteroses, enteric diseases ; 
 ten genera. 
 
 Third family. Choloses, diseases of the biliary- 
 apparatus ; eleven genera. 
 
 Fourth family. Uroses, diseases of the urinary 
 appai'atus ; twelve genera. 
 
 Fifth family. Pneumoses, diseases of the 
 respiratory organs ; eight genera. 
 
 Sixth family. Angioses, diseases of the cir- 
 culatory system ; nineteen genera. 
 
 Seventh family. Leucoses, diseases of the se- 
 rous and lymphatic system ; twelve genera. 
 
 Eighth family. x\denoses, diseases of the gland- 
 ular system ; five genera. 
 
 Ninth family. Ethmoplecoses, diseases of the 
 cellular tissuse ; six genera. 
 
1 66 HOSACK, RAIGE-DELORME. 
 
 Tenth family. Blennoses, diseases of the mu- 
 cous membranes ; eleven genera. 
 
 This system of nosography does not appear to 
 have been completed. 
 
 Doctor Hosack's system consists of eight 
 classes ; twenty-five orders ; and one hundred 
 and ninety-eight genera. 
 
 The Dictiomiaire de Medecine, second edition 
 Paris 1841, Volume 23rd, p. 240, contains an 
 article with the heading pathologie, by Raige- 
 Delorme, and in this article is included a classi- 
 fication of diseases which is here reproduced as 
 an example of the decline of nosography in the 
 country of its birth. 
 
 raige-delorme's classification. 
 
 CLASS I. General diseases whose anatomical 
 conditions are unknow^n. 
 
 Order i. Pyrexiae. 
 
 Genus i. Essential pyrexiae. 
 
 '* 2. Pyrexiae having, besides their febrile 
 phenomena, certain constant an- 
 atomical or physiological charac- 
 ters. 
 
 *' 3. Exanthematic pyrexiae. 
 
 *^ 4. Symptomatic pyrexiae. 
 
RAIGE-DELORME. 167 
 
 Order 2. General cachaectic diseases. 
 
 (Tuberculosis, melanosis, and the divers 
 
 degenerations.) 
 
 CLASS II. Mixed diseases. 
 (General and local.) 
 
 CLASS III. Local diseases. 
 Order i. Phlegmasiae. 
 
 Order 2. Haemorrhagiae. 
 
 Order 3. Diseases which result in degenera- 
 tion of the tissues ; an analogous or a 
 heterologous organic production : 
 tubercle, cancer, melanosis, etc. 
 
 Order 4. Dropsies. 
 
 Order 5. Fluxes. 
 
 Order 6. Pneumatoses. 
 
 CLASS IV. Neuroses. — Diseases characterised 
 
 by a trouble in the functions of the nervous 
 
 system, without appreciable textural 
 
 lesions. 
 
 The different genera of neuroses are, 
 Neuroses of the cephalo-rhachidian centres ; 
 
l68 COMMENTS ON DELORME'S SYSTEM. 
 
 Neuroses of the senses ; 
 Neuralgiae ; 
 
 Neuroses of the respiratory organs ; 
 Neuroses of the heart ; 
 Neuroses of the digestive organs. 
 
 CLASS V. Virulent diseases. 
 (Syphilis, variola, vaccinia.) 
 
 CLASS VI. Poisoning. 
 CLASS VIL Asphyxiae. 
 
 CLASS Vin. Mechanical or Surgical diseases^ 
 
 This comparatively modern classification and 
 its nomenclature, abound in the greatest inconsis- 
 tencies and inaccuracies, and in the most flagrant 
 violations of the simplest rules of classification 
 and nomenclature, to say nothing of the pathol- 
 ogical inaccuracies and the defective definitions. 
 
 The name of the first class is objectionable on 
 account of its length and obscurity. The author^ 
 instead of naming the second genus of the first 
 order of this classs, attempts to describe it. In 
 the second order of the first class he mixes tuber- 
 culosis and melanosis with the '' different degen- 
 erations " and repeats them in the third order of 
 
COMMENTS ON DELORME'S SYSTEM. 1 69 
 
 the third class. The second class is as objection- 
 able as the first class. Among the orders of the 
 third class are jumbled up, phlegmasiae, haemor- 
 rhagiae, dropsies, fiuxes, and pneumatoses. He 
 defines, and inaccurately too, instead of naming, 
 the third order of this third class. 
 
 Taking into consideration the excellent work, 
 in the direction of arrangement, performed in 
 France for more than a century prior to the ap- 
 pearance of this classification, it is past compre- 
 hension that so inexact and unsatisfactory a classi- 
 fication should have appeared from the pen of a 
 writer in the great medical encyclopedia of a 
 country so renowned for its medical talent. 
 
 All of the nosographers so far mentioned have 
 enumerated only a very few of the affections of 
 the uro-genital apparatus. 
 
 A number of other nosographies which have 
 more or less merit are noticed under the head of 
 bibliography. 
 
I/O 
 
 WILLIAMS. 
 
 As pertinent to the subject, Doctor Williams' 
 tabular arrangement of structural diseases or 
 diseases of nutritition is here reproduced from 
 the American edition of his work published in 
 the year 1853.* 
 
 Increased. — Hypertrophy- 
 Diminished. — Atrophy 
 
 Induration 
 
 Softening 
 
 Transformation 
 
 
 3 
 m 
 
 
 
 il\ 
 
 Contraction 
 
 Dilatation 
 
 Obstruction 
 
 Compression 
 
 Displacement 
 
 Rupture, etc. 
 
 tr. 
 
 O 
 
 a, 
 Q 
 
 Euplastic 
 
 Cicatrices 
 
 False membranes 
 
 f Cirrhosis 
 ^ 1 .• Fibro-cartilajje 
 
 i CaCOplaStlC^ r.r^v tnh^rrlS 
 
 o 
 
 O 
 
 i 
 
 Aplastic 
 
 Non- 
 malignant 
 
 Malignant 
 
 I Gray tubercle 
 [ Atheroma, etc. 
 
 ^ Yellow tubercle 
 I Calareous matter, 
 
 etc. 
 ( Cysts 
 ^ Tumors 
 ( Hydatids, etc. 
 
 C Carcinoma 
 < Encephaloma 
 I Melanosis, etc. 
 
 * Principles of medicine, etc., by Charles J. B. Williams, 
 M. D., F. R. S. etc. American edition by Meredith Clymer, 
 M. D., Philadelphia 1853. The American editor has contrib- 
 uted much to exact nomenclature, particularly in his writings 
 of the last twenty years. 
 
AITKEN 171 
 
 ON THE PRINCIPLES OF CLASSIFICATION. 
 
 Sir William Aitken, in his " Science and 
 Practice of Medicine," third edition, published 
 in London in the year 1864, under the head 
 ** Principles of Classification," says : 
 
 " Many systems of nosology have been adopted 
 from time to time ; and as valuable general prin- 
 ciples have been adduced from some, the grounds 
 on which diseases have been classified may be 
 briefly described under the following nine heads . 
 
 " I. The nature of the ascertained causes of 
 disease. On this principle two classes of dis- 
 eases are recognised: (i,) Diseases arising from 
 general causes ; (2,) Diseases arising from specific 
 causes. 
 
 " II. The pathological states and conditions 
 which attend diseases. The principle of this 
 classification consists in determining alterations 
 of the structure or the chemical composition of 
 parts, from which names are given to the dis- 
 ease 
 
 " III. The properties, powers, or functions of 
 an organ or system of organs being deranged, 
 dictates a classification in which the most prom- 
 inent effects or phenomena of morbid states are 
 considered as the disease 
 
 *' IV. The diseases comprehended under the 
 
172 AITKEN. 
 
 two latter principles of classification are some- 
 times inaccurately and loosely brought together 
 under the heads of structural and functional dis- 
 eases. The diseases of function, for instance, be- 
 ing made to embrace the neuroses, haemorrhages, 
 and dropsies; while inflammation, tubercle, can- 
 cer, melanosis, hypertrophy and atrophy are the 
 subordinate classes of the diseases of structure. 
 
 " V. A basis of classification has been adopted, 
 founded on the pathological nature of the dif- 
 ferent morbid processes, but the arrangement of 
 the orders and subdivisions is determined by the 
 anatomical arrangement of the textures and or- 
 gans of the animal hody, as originally developed 
 by Bichat. 
 
 " VI. A ground of classification exists, having 
 reference to the general nature and localisation 
 of the morbid states. It comprehends three 
 classes: (i,) Diseases which occupy the whole 
 system at the same time, and in which all the 
 functions are simultaneously deranged. These 
 have been named general diseases, such as fevers ; 
 (2,) Constitutional affections, meaning thereby 
 diseases which display themselves in local lesions 
 in any part but not in all parts at the same time — 
 e.g., rheumatism, gout ; (3,) Local morbid pro- 
 cesses. 
 
 "VII. Applying the principles of a purely 
 
SAVIGNAC, STARK. 1/3 
 
 humoral pathology, we have a classification con- 
 sisting of — a. Fevers ; b. Dyscrasiae — e. g., tabes, 
 chlorosis, scorbutus, dropsy, diabetes, pyaemia, 
 tuberculosis, carcinoma ; c. Constitutional dis- 
 eases, induced by, — (i,) specific agents, (2,) veget- 
 able substances. 
 
 *' Such is Wunderlich's arrangement of dis- 
 eases (1852). 
 
 " VIII. Mr. de Savignac, Professor of Clinical 
 Medicine at the Naval School of Toulon, has re- 
 cently (1861) propounded a nosological arrange- 
 ment (which he considers a natural one) founded 
 on what he believes to be the ' elements ' of dis- 
 ease. His so called elements seem to be vague 
 general expressions, or names to denote the lead- 
 ing phenomena of diseases or the unknown cause 
 of such phenomena 
 
 " IX. Doctor Stark, of Edinburgh, has recently 
 (1864) proposed an arrangement embracing six- 
 teen classes: (i,) Fevers; (2,) Diseases of the 
 brain, etc, ; (3,) Diseases of the heart and organs 
 of circulation; (4,) Diseases of the organs of 
 respiration ; (5,) Diseases of the organs of diges- 
 tion ; (6,) Diseases of the urinary organs ; (7,) 
 Diseases of the organs of generation ; (8,) Dis- 
 eases of the organs of locomotion ; (9.) Diseases 
 of the skin and cellular tissue ; (10,) Diseases of 
 uncertain seat ; (11,) Malformation ; (12,) Debility 
 
1/4 STARK, FARR. 
 
 at birth, and premature birth; (13,) Old age; 
 (14,) Sudden deaths; (15,) Violent or unnatural 
 deaths ; (16,) Causes not specified 
 
 " Classification conducted on the plan 
 
 proposed by Doctor Stark is inconsistent with 
 any intelligible principle of arrangement. 
 
 " None of these nine principles of classification 
 lead to a perfectly philosophical or purely nat- 
 ural classification, because diseases are not yet 
 sufficiently understood to permit us to see clearly 
 their mutual relations ; and the best recommend- 
 ation of any one of them would be a negative 
 one — namely, that of doing the least possible vio- 
 lence to our imperfect knowledge regarding the 
 natural affinities or alliances of diseases, of which 
 we have at present only a sort of instinctive 
 
 recognition 
 
 The system adopted by Sir W. Aitken in 
 nearly all the editions of his work is that of 
 Doctor William Farr, and consists of five classes 
 as follows: (i,) Zymotic diseases, four orders; 
 (2,) Constitional diseases, two orders ; (3,) Local 
 diseases, eleven orders ; (4,) Developmental dis- 
 eases, four orders ; (5,) Lesions from violence 
 tending to sudden death, six orders. In all 
 twenty-seven orders. 
 
 Doctor Farr's system, says Sir W. Aitken, 
 was discussed at several meetings of the statist- 
 
ROYAL COLLEGE OF PHYSICIANS. 1 75 
 
 ical congress of the European nations, in Paris 
 (1855), ^"d in Vienna (1857), where a nomen- 
 clature similar to the English was adopted, but 
 no definite classification was agreed upon. 
 
 LABORS OF THE ROYAL COLLEGE OF 
 PHYSICIANS OF LONDON. 
 
 A joint committee, of which Doctor William 
 Farr was a member, appointed by the Royal 
 College of Ph3'sicians of London to draw up a 
 nomenclature of diseases, published its first re- 
 port in the year 1869, after more than ten years 
 of labor. In this report, one thousand one hun- 
 dred and forty-six diseases are enumerated, ex- 
 clusive of human parasites of which fifty-five are 
 counted. The committee very properly offered 
 this nomenclature as only provisional and sug- 
 gested that it be subjected to decennial revisions. 
 The main object of the work, as set forth in the 
 preface, was to lay " the foundation for a nomen- 
 clature of diseases in any language extant on the 
 earth." 
 
 This nomenclature has been reprinted by 
 order of the chief of the United States Marine 
 Hospital Service, in 1874, and a few years ago a 
 part of the first decennial revision was printed by 
 order of the New York State Board of Health. 
 
1/6 AMERICAN MEDICAL ASSOCIATION. 
 
 In the year 1869 the American Medical Asso- 
 ciation appointed a committee "to determine 
 what alterations, if any, are necessary, to adapt 
 the Provisional Nomenclature of the Royal Col- 
 lege of Physicians of London to general use in 
 the United States." This Committee reported, 
 in 1870, ** that the English nomenclature was not 
 adapted to this end, and recommended the ap- 
 pointment of a new committee to prepare a 
 nomenclature of their own." The new commit- 
 tee was appointed with Dr. Francis Gurney 
 Smith, as Chairman and, in 1872, presented its 
 report and nomenclature, based upon the English 
 system. A minority report was then submitted to 
 the Association. Both reports were accepted, but 
 only the following resolution, appended to the 
 minority report was adopted. 
 
 ** Resolved, That the Nomenclature and classi- 
 fication just submitted by the committee be pub- 
 lished in the Transactions ; that one thousand 
 extra copies be printed in pamphlet form and 
 distributed to the profession, and that the ques- 
 tion of the adoption of the proposed Nomencla- 
 ture and classification by this body be postponed 
 till the next annual meeting." 
 
 The extra copies of the nomenclature v/ere dis- 
 tributed in accordance with the resolution offered 
 by the minority of the committee, and at the 
 
ROYAL COLLEGE OF PHYSICIANS. 1 7/ 
 
 next annual meeting (1873) of the Association a 
 majority report was again presented. But it 
 was urged that the American nomenclature was 
 inferior to the English and after some discussion, 
 the following resolutions were adopted. 
 
 *' Resolved, That in the opinion of this Asso- 
 ciation, it is inexpedient to adopt the nomencla- 
 ture and classification presented by the majority 
 of the committee on nomenclature at the meeting 
 in Philadelphia." 
 
 " Resolved, That a committee of three be ap- 
 pointed by the President, whose duty it shall be 
 to communicate the foregoing resolution to the 
 proper committee of the Royal College of 
 Physicians of London, and to negotiate for the 
 representation of the American Medical Associa- 
 tion in the first decennnial revision of their 
 nomenclature." 
 
 The committee was duly appointed, but has 
 never made any report. 
 
 In the second edition of the official nomencla- 
 ture of the Royal College of Physicians of Lon- 
 don (1885), it seems as though the committee had 
 failed to take advantage of many of the medical 
 advances of the decade, for, aside from the viola- 
 tions of established principles of nomenclature 
 and classification which it contains, much of the 
 
178 THE DERMATOLOGISTS. 
 
 old medical terminolog-y is retained, and many 
 symptoms are still classed as diseases. 
 
 It is needless to indulge in any extended crit- 
 icism of this new nomenclature, since it has al- 
 ready been so fairly and exhaustively reviewed. 
 The reader is therefore referred to the excellent 
 critical analysis of the London nomenclature by 
 Doctor A. Rabagliati, of Bradford, England. 
 This review, which is well worthy of the most 
 careful study, first appeared in the *' Medical 
 Press and Circular," and then in book form.* 
 
 The dermatologists have contributed largely 
 to systematic arrangement for a century past. 
 Their bibliography begins with the nomenclature 
 of Celsus, of Mercurialis (1572), and of Riolan 
 (1610), from which they trace their systematic ar- 
 rangement of dermatoses down to Auspitz f 
 (1881) and Bronson X (1884 and 1887). Their 
 
 * Some remarks on the classification and nomenclature of 
 diseases, by A. Rabagliati, M. A., M. D., reprinted from the 
 Medical Press and Circular. — London, Bailliere, Tyndall, and 
 Cox. 1886. 
 
 t For a very extended dermatographical bibliography, and 
 synopsis of divers systems, see Auspitz' system der Haut- 
 krankheiten, Vienna 1881. 
 
 I E. B. Bronson. The objects of dermatological classifica- 
 tion, with especial reference to Auspitz' system. Journal of 
 cutaneous and venereal diseases. Vol. II, June 1884. 
 
THE DERMATOLOGISTS. 1/9 
 
 work however requires a very extensive revision, 
 if not an entire reconstruction. 
 
 The preceding outline of the history of noso. 
 graphy, and of the synopses of a few of the old 
 systems, is here given with the view of placing 
 the reader in possession of the methods of the 
 nosogfaphers in a compact form, in order that he 
 may see almost at a glance the defects of the early 
 essays and compare them with the modern sys- 
 tems before he contributes his share to the im- 
 provement of this science. 
 
 A few of the nosographers, to whose labors 
 allusion has been made in the historical outline 
 have worked with great fidelity and earnestness 
 for the improvement of this science, while the 
 great majority have simply copied their prede- 
 cessors and reproduced their most obvious errors 
 without the least attempt at correction. 
 
 Some of the rules formulated by the early writ- 
 ers are appended to this history. 
 
 E. B. Bronson. A study of the considerations relating to 
 the classification of skin diseases with an attempt to construct 
 a logical system in accordance with fundamental principles of 
 etiology. Pamphlet, pp. 19. Reprinted from the Journal of 
 cutaneous and genito-urinary diseases. October 1887. 
 
i8o 
 
 RULES FOR THE GUIDANCE OF THE 
 NOSOGRAPHER. 
 
 The following rules, for the guidance of noso- 
 graphers, laid down by Cullen, Parr, Linnaeus 
 and Young, are given in full because of their 
 general excellence and because they illustrate so 
 well the principles of nomenclature and classi- 
 fication, besides carrying with them the authori- 
 tative weight of these eminent men who labored 
 with so much ardor for the advancement of noso- 
 graphy. 
 
 Cullen's nosography appeared in the year 1769. 
 He therefore had the benefit of the experience 
 of Sauvages, Linnaeus and Vogel. He endeav- 
 ored to improve upon them, and formulated cer- 
 tain rules for distinguishing genera, species, and 
 varieties. These rules are here reproduced, al- 
 though some of them do not now possess the 
 value which they may have had at the time of 
 their publication.* 
 
 cullen's rules for distinguishing 
 
 GENERA, species AND VARIETIES. 
 
 I. "Those who have turned their attention to 
 this subject hitherto, have not I think proceeded 
 with due consideration. They have gone at once 
 
 * Edinburgh edition 1800. 
 
cullen's rules. i8i 
 
 to constitute the principal genera of the classes 
 and orders, without sufficiently attending to the 
 species of diseases. Now nature has made noth- 
 ing but species ; the structure of genera is an ef- 
 fort of the human mind, v/hich, till the species 
 are well known and understood, must be falla- 
 cious and uncertain ; and indeed, in constituting 
 genera, unless we have perpetual reference to 
 the species, all our labor will prove futile and 
 vain. 
 
 2. " It is certainly a very difficult thing in 
 nosology to say what is a true species, or what is 
 only a variety ; as those marks which serve to 
 distinguish species from varieties in zoology and 
 botany, are not to be found in diseases. I there- 
 fore considered it as safest and even necessary to 
 enumerate many varieties. And as I esteem such 
 a distinction very useful in practice, I have every- 
 where endeavored to make it : not always indeed 
 with equal certainty, but often, at least, with 
 some degree of probability. 
 
 3. " When any disease, under Avhich several 
 men labour, exhibits, in each individual, all the 
 symptoms that characterise a certain species, I 
 would not consider that these were different 
 species, because the symptoms prevailed in one 
 patient in a greater or less degree, than in an- 
 
i82 cullen's rules. 
 
 other. And I am of opinion that diseases which 
 differ only in a degree, constitute merely varieties 
 of a certain species. 
 
 4. " Accordingly in distinguishing a variety 
 from a species, there is only room for doubt 
 when, in the diseases of different persons, any 
 symptoms are wanting which generally accom- 
 pany a species, or when others are present. 
 
 5. " When any of the usual symptoms are 
 wanting ; and we can distinguish between those 
 that are more and those that are less essential, 1 
 consider the absence of such symptoms as indica- 
 tive of a variety only. 
 
 6. '* When to the characteristic symptoms, 
 others are added, which can be reckoned the 
 symptoms of symptoms, rather than the symp- 
 toms of the cause, they constitute only a variety. 
 
 7. ** Again, when these additional symptoms 
 are quite unusual, while, at the same time, the 
 principal circumstances of the disease are little 
 or not at all changed ; these too afford only a 
 variety. 
 
 8. " When any genus of disease may arise from 
 different causes, the diversity of the cause may 
 occasion likewise diversity in the species, though 
 not always ; for when the difference is small, and 
 the symptoms at the same time are little affected 
 
cullen's rules. 185 
 
 by it, that difference will constitute only a 
 variety. 
 
 9. "A genus of disease may, in the same man-^ 
 ncr, produce different species, according to the 
 diversity of its seat; but as often as the seat is 
 different, while there is no difference either with 
 respect to the structure of the part or Jts func- 
 tions, this diversity of seat can only indicate a 
 variety." 
 
 In the edition of 1827, Cullen remarks, that in 
 nosology, by beginning with the characters of the 
 class, and from thence descending to orders and 
 genera, the term genus has been very universally 
 applied to species, and that, by imitation, he had . 
 been led to do the same thing, for, of the one hun- 
 dred and thirty three genera which he had estab- 
 lished in his first edition, a hundred are properly 
 species, and admit of no farther division except 
 into varieties. He further said, "the characters 
 of diseases are formed by a concourse of various 
 symptoms, every particular of which, in the 
 language of methodical writers, is a nota or 
 mark : now, in forming the character, the first, 
 and the most important rule is, that these marks 
 should be neither more nor fewer than are ab- 
 solutely necessary. If we have more, we pass 
 from characters or definitions to descriptions ; 
 
i84 cullen's rules. 
 
 Ave leave persons in doubt when they find a dis- 
 ease with the strictly essential character, by add- 
 ing other circumstances which they may suppose 
 to be equall}^ necessary. The nosologists have 
 been faulty in giving both superfluous and de- 
 ficient characters. 
 
 " A second rule is, that the marks which we 
 employ should be sufficiently evident, and if pos- 
 sible, constantly present at every period of the 
 disease, these at least (that) are the most charac- 
 teristic. Nosologists transgress against this rule 
 when the marks are taken from the duration, 
 and much more from the event of the disease. 
 To affirm that a disease is a fatal one, is indeed a 
 part of its history, but cannot serve as a charac- 
 ter when we first view the disease. 
 
 " The third rule is, that the notae chosen 
 should be expressed in clear and very intelligible 
 terms, and, if possible, in terms the meaning of 
 
 which is already fixed in science The 
 
 want of due precision of language affects many 
 parts of all our systems. It is well known, that 
 the want of precision in the use of terms for a 
 long time retarded the perfection of botany ; and 
 it has been the greatest merit of Linnaeus, that 
 he gave much more precision, and a determined 
 meaning to almost every word employed in that 
 
parr's rules. 185 
 
 science, which he did by forming a delineato 
 J)lantae, by fixing a term for every part of a 
 plant, and for all the circumstances in which 
 these parts can vary. But we will not bring 
 nosology to a good condition till something of 
 the same kind, a delineatio morbi, be attempted, 
 which ought to consider all the symptoms that 
 -enter into a specific character in another view 
 than that taken by the pathologists, who only 
 trace them to their causes. Here we ought to 
 •examine the symptoms more minutely with re- 
 spect to the variety of their appearance, and affix 
 terms to them accordingly. 
 
 " The fourth rule, is that the characters should 
 be absolutely free and independent from all 
 
 theory and hypothesis Every species 
 
 ought to have the character of its genus ; and in 
 naming or distinguishing species, it is sup- 
 posed sufficient merely to name the genus, and 
 to add such marks as distinguish the species." 
 
 parr's rules. 
 
 Under the head of classification Dr. Parr says : 
 I. "It is said that nature has created only 
 species : it is not true ; for she has created only 
 individuals. The similarity of these has occa- 
 sioned the establishment of species. Individuals, 
 
i86 parr's rules. 
 
 differing in circumstances arising from accident ; 
 in plants and animals, from soil and climate ; in 
 diseases, from constitution ; in minerals, from lo- 
 cality, are styled varieties ; and these, when cir- 
 cumstances are changed, return to the species 
 from which they started. These distinctions,, 
 though apparently simple and obvious, are how- 
 ever, necessary ; for naturalists have usually be- 
 gun at the other extremity, and formed ' meth- 
 ods,' classes, and orders before they have estab- 
 lished species and, at this moment, in nosology 
 and mineralogy, the greatest impediments to im- 
 provement arise from the uncertainty of what 
 are species. Even in botany this difficulty was 
 once so great, that more than half of Tourne- 
 fort's supposed species have been found to be 
 varieties only. Three-fourths of Sauvages' species 
 
 of diseases are varieties or symptoms.* 
 
 2. " This is the first step in arrangement ; for 
 the establishment of species consists in ascertain- 
 ing identity ; of genera similarity. A striking 
 discriminating mark, in many species, sometimes 
 
 * The criticism made, by Dr. Parr of Sauvages' species of 
 diseases, three quarters of a century ago, will apply, to a very 
 great extent, to the two editions of the modern English 
 nomenclature, for they both include many symptoms classed 
 as diseases. 
 
parr's rules. 187 
 
 establishes a genus ; at others, a general similar- 
 ity. The conduct of botanists, however, has dif- 
 fered in this part of their labor, from the differ- 
 ence of their dispositions. Some naturalists^ 
 catching hastily at analogies, have included nu- 
 merous species under a genus : others more wary 
 and exact, have retrenched them too rigorously. 
 The latest botanists have rendered the genera 
 more, sometimes too, numerous ; but this of the 
 two is the more venial error, since new dis- 
 coveries continually enlarge them. 
 
 3. " An order is an association of genera ; but 
 orders are usually too comprehensive, including^ 
 too great a number of genera ; and to facilitate 
 investigation, these are often divided into sepa- 
 rate groups, as in mineralogy the species are 
 sometimes divided into sub-species. Each is a 
 proof of imperfection in arrangement. 
 
 4. "A class contains the different orders; and 
 though in reality, it should be the last, or nearly 
 the last, labourer, it has usually been the first ; 
 and to make the system elegant in appearance^ 
 the classes have been few and comprehensive." 
 
-1 88 
 
 APHORISMS RELATING TO CLASSIFICATION, 
 TAKEN CHIEFLY FROM THE 
 PHILOSOPHIA BOTANICA OF LINNAEUS, 
 BY DOCTOR THOMAS YOUNG. 
 
 Of generic characters. 
 
 1. *' The foundation of methodical science con- 
 sists of two parts, arrangement and nomenclature. 
 
 2. ''Arrangement is either theoretical, relating 
 to classes, orders, and genera, or practical, relat- 
 ing to species and varieties. 
 
 3. " Arrangement or method is either synop- 
 tical or systematic. 
 
 4. *' A synopsis depends on arbitrary divisions 
 proceeding in pairs at each step, and is not ad- 
 missible in botany, except as a key or index. 
 
 5. '* A system proceeds in its arrangement by 
 five steps ; classes, orders, genera, species, and 
 varieties. 
 
 6. "System is the Ariadnean thread, without 
 which all is confusion. 
 
 7. '' Species m natural history are supposed to 
 have been originally created distinct. 
 
 8. '"■ Varieties may be as numerous as the in- 
 dividuals which have been produced. 
 
 9. " Genera are determined in botany from the 
 agreement of the parts of fructification. 
 
LINNAEUS AND YOUNG. 1 89 
 
 10. '* Classes are deduced from the regular 
 agreement of many genera, in the parts which 
 characterise them. 
 
 11. "An order is a subdivision of a class, in-^ 
 tended for convenience. 
 
 12. ** Species and genera depend on nature ; 
 varieties often on cultivation ; classes and orders 
 on a combination of nature and art. 
 
 13. '* Habit is a general agreement in growth 
 and appearance. 
 
 14. " Habit is to be silently consulted in form- 
 ing genera, but must not and cannot be de- 
 scribed. 
 
 15. "No positive rules can be laid down re^ 
 specting identity of genus. 
 
 16. " Few genera are without some cases of 
 accidental deviation. 
 
 17. " Each genus is commonly characterised by^ 
 some decided singularity of form. 
 
 18. "Genera thus marked must be kept dis-^ 
 tinct or united accordingly. 
 
 19. " The more constant the mark in different 
 species, the better distinction it affords. 
 
 20. " Different parts are the most constant in 
 different genera ; but scarcely any part is ever 
 wholly invariable. 
 
190 APHORISMS OF LINNAEUS 
 
 21. ** A generic character is the definition of a 
 genus, and may be of three kinds, factitious, es- 
 sential, or natural. 
 
 22. " An essential character affords a singular 
 and appropriate criterion of the genus. Its ex- 
 cellence depends on its brevity. 
 
 23. *' A factitious character distinguishes the 
 genus only from others of the same artificial 
 order. 
 
 24. " A natural character contains everything 
 remarkable that is found in all the species of the 
 genus. It may often require alteration when new 
 species are discovered. 
 
 25. ''A factitious character is a substitute for 
 an essential one, which is always the best when 
 it can be obtained. A natural character is a work 
 of great labor, but, when completed, it is the 
 basis of all systems, the guardian of genera, and 
 is applicable to every correct and practicable 
 mode of arrangement. 
 
 26. "No character can be infallible unless it 
 has been compared with all the species of the 
 genus. 
 
 27. " A generic character must not contain 
 comparisons, except with things perfectly well 
 known. 
 
 28. " The character must be expressed in se- 
 
AND YOUNG. I9I 
 
 lect, accurate, distinct, and compendious terms, 
 sufficient in number, but not superfluous. 
 
 29. "The character must remain invariable in 
 every possible system that can be adopted. With 
 this precaution, the introduction of a new system 
 is no misfortune. 
 
 30. " A genus may consist of a single species, 
 although it more usually contains several species. 
 
 31. " What is established respecting the charac- 
 ters of genera must be understood, with some 
 latitude, of those of classes. 
 
 32. " Classes are more arbitrary than genera, 
 orders than either. 
 
 33. " The more naturally classes are established 
 the better. 
 
 34. '* Great difficulty arises from the excessive 
 length or number of classes and orders. 
 
 35. ''Genera which are allied to each other 
 ought to stand together. 
 
 Of names. 
 
 36. " He who establishes a new genus is bound 
 also to give it a name. 
 
 37. " A generic name must be decided on be- 
 fore a specific one is formed. 
 
192 APHORISMS OF LINNEAUS 
 
 38. " No man in his senses would employ a 
 generic name destitute of etymological meaning. 
 
 39. " Generic names consisting of two entire 
 and separate words are prohibited. 
 
 40. " Generic names consisting of two Latin 
 words united together are scarcely to be tol- 
 erated. Such compounds of Greek origin, on 
 the contrary, are elegant. 
 
 41. " Generic names of hybrid origin, for in- 
 stance partly Greek and partly Latin, are to be 
 rejected. 
 
 42. " Generic names including other generic 
 names are unworthy of a scientific nomenclature. 
 
 43. " Generic names ending in oides are pro- 
 hibited. 
 
 44. '* Generic names derived from others by 
 the addition of a sjdlable are disapproved. 
 
 45. *' Generic names very nearly resembling 
 each other are likely to cause confusion. 
 
 46. '' Generic names not derived from Greek 
 or Latin are forbidden. 
 
 47. '' Generic names common to natural history 
 and anatomy, pathology, therapeutics, or the 
 arts, are to be avoided. (Thus lichen must not 
 be a genus of diseases : and I have been obliged 
 to change the name spiloma into spilosis, having 
 
AND YOUNG. I93 
 
 found that the botanists had taken possession of 
 this too.) 
 
 48. '* Generic names contradicting the proper- 
 ties of some of the species are bad. 
 
 49. " Generic names must not be identified with 
 those of natural classes or orders. 
 
 50. " Diminutives and derivatives of a similar 
 nature are allowable as generic names. (The 
 diminutives of other generic names are however 
 scarcely admissible.) 
 
 51. " Adjectives are inferior to substantives as 
 generic names. 
 
 52. " Generic names which have already been 
 employed are to be preferred where it can be 
 done without inconvenience. (Sometimes how- 
 ever it is better to employ a new term than to 
 alter materially the application of an old one.) 
 
 53. " Such generic names as express an essen- 
 tial character or habit are the best. 
 
 54. "An ancient name should be employed for 
 a genus long established. 
 
 55. "A good name once established ought not 
 to be changed, even for a better or more ancient 
 one. 
 
 56. " If a genus is to be divided, the old name 
 
194 APHORISMS OF LINNAEUS 
 
 must remain attached to the most common 
 species. 
 
 57. " Generic names are to be written in Latin 
 letters, the Greek letters being expressed accord- 
 ing to the established custom. 
 
 58. ''The sounds of generic names are to be 
 softened as much as possible. 
 
 59. *' Long and harsh names are to be avoided. 
 Names should scarcely exceed twelve letters. 
 
 60. " Terms of art ought not to be employed 
 for generic names. 
 
 61. " Names of classes and orders are to be 
 governed by the same rules as those of genera. 
 The name is to be single ; not unmeaning, hybrid, 
 barbarous, equivocal, inapposite, personal, too 
 long, nor harsh. 
 
 62. '• Names of classes and orders should in- 
 clude their characteristic marks. 
 
 Of specific differences. 
 
 > 
 
 63. " A perfect name includes a generic and a 
 specific name. All solid learning in natural his- 
 tory, agriculture, and medicine, depends on the 
 knowledge of species. 
 
 64. "A legitimate specific name or character 
 distinguishes the species from all others of the 
 
AND YOUNG. I95 
 
 same genus. Trivial names, often called specific 
 names, are subjected to no very accurate rules. 
 
 65. " All specific characters which distinguish 
 the species from others, not of the same genus, 
 arc superfluous and bad. 
 
 66. ** Trivial names are only limited to a single 
 word. (Substantives have an advantage over ad. 
 jectives, as being more convenient when brevity 
 is required ) 
 
 6y. " Specific characters must be taken from 
 circumstances not subject to vary. 
 
 68. " Magnitude affords no specific distinction. 
 (Thus the degree of putrescency scarcely affords 
 a sufficient distinction between nervous and pu- 
 trid fever.) 
 
 69. " Comparisons with other genera are to be 
 excluded from specific characters. 
 
 70. " Comparisons with other species of the 
 same genus are bad. 
 
 71. *' Care must be taken to exclude varieties 
 from the rank of species. 
 
 72. *' Each species must bear the name of the 
 genus. 
 
 73. " The specific name must always follow the 
 generic. The idea of the genus must occur first 
 to the mind. 
 
196 APHORISMS OF LINNAEUS 
 
 74. " A specific name without the generic is 
 like a bell without a clapper. 
 
 75. " The specific name must not be united to 
 the generic as a termination. 
 
 "jd. "A genuine specific character is either 
 synoptic or essential. 
 
 jj. " A synoptic specific character distinguishes 
 the species of the genus by successive subdivi- 
 sions into two portions. In large genera such 
 subdivisions are often indispensable. 
 
 78. " An essential specific character exhibits a 
 single distinction, appropriate to one species 
 only. 
 
 79. '' The shorter a specific character can be 
 made, the better, provided that it be sufficient. 
 
 80. *' Specific characters must contain only 
 such words as are necessary for distinguishing 
 the species from others of the same genus. 
 
 81. '' When a genus contains only one species, 
 a specific character is superfluous. (There may 
 however be cases in which a character, pointed 
 out as likely to be essential, by a person well 
 acquainted with the species, may be useful in dis- 
 tinguishing it from others subsequently dis- 
 covered.) 
 
 82. *' When a new species of a genus is dis- 
 
AND YOUNG. IQ/ 
 
 covered, the characters of all the other species 
 must be accommodated to it, if they become in- 
 adequate. 
 
 83. " The words forming- a specific character 
 are not to be compounds resembling generic 
 names, nor purely Greek, but Latin ; and the 
 more simple they are, the better. 
 
 84. ** The specific character ought not to be 
 embellished by the flowers of rhetoric, but natu- 
 ral and faithful. 
 
 85. *' The specific character admits neither 
 comparatives nor superlatives. 
 
 86. " The specific character must be expressed 
 in positive terms, not negative. (Privatives are 
 often unavoidable, although in some measure 
 objectionable ) 
 
 87. '* Resemblances, if ever employed for spe- 
 cific characters, must be striking and well known. 
 
 88. '* Adjectives mrast immediately follow their 
 substantives. 
 
 89. *' Conjunctive particles are to be excluded 
 from specific characters, except v/here they are 
 necessary to the sense. 
 
 90. " Successive adjectives are not to be sep- 
 arated by commas. 
 
 91. " A specific character must never contain 
 
198 APHORISMS OF LINNAEUS 
 
 a parenthesis, whether distinguished or not by 
 the appropriate mark. A parenthesis is bad, as 
 implying a defect of order. 
 
 Of varieties. 
 
 92. ** To the generic name and specific charac- 
 ter the distinction of a variety may be added, 
 where it exists. 
 
 93. *' The generic names, the specific character, 
 and the marks of varieties, are to be printed in 
 different types. 
 
 94. '' Very slight varieties are to be disre- 
 garded. 
 
 95. ''The specific character must agree with 
 all the varieties, as far as is practicable. 
 
 96. " It is often as difficult and as important to 
 reduce varieties to their proper species, as 
 species to their proper genus. 
 
 Of Synonyms, 
 
 97. " Among the synonyms enumerated, the 
 most approved name is to be set down first. 
 
 98. "Authors who have employed the same 
 synonyms are to be quoted together. 
 
 99. " Each synonym is to begin a new line. 
 
AND YOUNG. I99 
 
 100 ** Synonyms must be accompanied by 
 the names of the authors, and the pages of the 
 works in which they are to be found." 
 
 The student of nosography may, with profit, 
 consult the modern system of " Laws of Botanical 
 Nomenclature'' which was adopted by the Inter- 
 national Botanical Congress held at Paris in 
 August, 1867, and which was published together 
 with a historical introduction and a commentary 
 by Alphonse De Candolle. 
 
200 BIBLIOGRAPHY. 
 
 SECTION III. 
 
 NOSOGRAPHICAL BIBLIOGRAPHY. 
 
 A chronological list of the works on nosography that have 
 appeared from the time of Felix Platerus to the present. 
 
 Platerus, (Felix) — Praxeos Medicae, etc. Bas- 
 iliae, 1602. 
 
 Warenius, (Henricus) — Nosologia. Leipsiae, 
 1605. 
 
 Petraeus, (Henricus) — Nosologia Harmonica, 
 Dogmatica, et Hermetica. Mar- 
 burgi, 1614. 
 
 Junius, (Adrianus) — Nomenclator. Francofurti, 
 1620. 
 
 JOHNSTONUS, (J.) — Idea Universalis Medicinae. 
 Amsteldami, 1644. 
 
 SCHOENFELD, (Phillipus Jacobus) — Nosologia. 
 Ingolstadii, 1675. 
 
 Sauvages, (Frangois Boissier de) — Nouvelles 
 classes des Maladies Dispos^es dans 
 un Ordre Semblable a celui des 
 Botanistes, Comprenant les Genres 
 et les especes. Montpellier, 1732. 
 
BIBLIOGRAPHY. 201 
 
 Sauvages, (F. B. de)— Nosologia Methodica. 
 Lugduni, 1760, Geneva, 1763. 
 
 Hebenstreit, (Johannes Ernestus) — Program- 
 mata, Ordo Morborum Causalis. 
 Leipsiae, 1754— 1757. 
 
 Hebenstreit, (J. E.) — Exegesis nominum grae- 
 corum, quae morbos definiunt. Lip- 
 siae, 175 1 — 1761. 
 
 Linnaeus, (Carolus) — Genera morborum. Up- 
 salae, 1759 — 1763. 
 
 VoGEL, (Rudolphus Augustus) — Dissertatio, Def- 
 initiones Generum Morborum. Goet- 
 ingae, 1764. 
 
 Plenk, (J. J.) — Novum Systema Tumorum qui 
 hi morbi in sua genera et species 
 rediguntur. Vienna, 1767. 
 
 Cullenus, (Guiliemus) — Synopsis Nosologiae 
 Methodicae in Usum Studiosorum. 
 Edin., 1769, — 1772, — 1780. 
 
 Cullen, (William) — A synopsis of Methodical 
 Nosology, etc., translated, from the 
 fourth edition, by Henry Wilkins, 
 M. D. Philadelphia, 1793. 
 
 Cullen, (W.) — Nosology, etc., translated from 
 the Latin. Edin., 1800. 
 
202 BIBLIOGRAPHY. 
 
 CuLLENUS, (G.) — Synopsis nosologiae melh- 
 odicae, etc., editio sexta, 1803. 
 
 CULLEN, (W.) — The works of, edited by John 
 Thomson, M. D., etc. Edin., 1827. 
 
 Sagar, (J. B. M.) — Systema morborum symp- 
 tomaticorum secundum classes, or- 
 dines, et genera, cum characteribus. 
 Vienna, 1771. Editio tertia, 1783. 
 
 Macbride, (David) — A Methodical Introduction 
 to the Theory and Practice of 
 Physic. London, 1772. 
 
 Selle, (Christ. T.) — Rudimenta Pyretologiae 
 Methodicae. Berlin, 1773. 
 
 Ackermann, (J. F.) — Programma sistens nosolo- 
 giam Holsaticam. Kiloniae, 1773. 
 
 Hartung, ( ) — Diss, de generali mor- 
 
 borum divisione. Aug. Trev., 1777. 
 
 Hennemann, (Guil. Josephus) — Primae lineae 
 nosologiae animalium. Goettingae, 
 
 1778, 
 
 VlTET, (Louis) — Medecine expectante. Lyons, 
 1778. (Containing a nosological 
 method.) 
 
 Haartmann, (J. J.) — Diss. Sciagraphiae mor- 
 borum. Aboae,^i779. 
 
BIBLIOGRAPHY. 203 
 
 CiRlLLio, (D.) — Nosologiae Methodicae Rudi- 
 
 menta. Napoles, 1780. 
 TODE, (J. C.) Copenhagen, 1781. 
 
 Daniel, (Chris. Fredericus) — Sjstema aegritu- 
 
 dinum. Leipsiae, 1781. 
 GlESEKE, ( ) — Animadversiones in systema 
 
 nosologicum. Goettingae, 1781. 
 
 Vachier, ( ) — ** Methode nosologique.** 
 
 Paris, 1785. 
 
 Wallis, (George) — Nosologia methodica ocu- 
 lorum ; or a treatise on diseases of 
 the eyes ; selected and translated 
 from the Latin of Francis Boissier 
 de Sauvages, with annotations. 
 London, 1785. 
 
 Van Heuvell, ( ) — Tentamen nosolog- 
 
 icum, sistens morborum a vitio vis 
 vitalis divisionem et dispositionem 
 practicam. Lugduni Batav., 1787. 
 
 Sprengel, (Curtius) — Rudimentorum nosologiae 
 dynamicorum prolegomena. Hallae, 
 1787. 
 
 Baldinger, (E.g.) — Opuscula Medica, containing 
 among other dissertations, animad- 
 versionum in systema nosologiae, 
 specimina 1 et IL Goettingae, 1787-8. 
 
204 BIBLIOGRAPHY. 
 
 LaUTH, (Thomas) — Nosologia chirurgica. Ar- 
 
 gentorati, 1788. 
 Ploucquet, (Guil. Godofredus) — Delineatio sys- 
 
 tematis nosologici naturae accomo- 
 
 dati. Tiibingae, 1791. 
 Ploucquet, (G. G.) — Onomatopoeae nosologiae 
 
 fundamenta. Tubingae, 1793. 
 Dyrsen, ( ) — Diss, primae lineae systematis 
 
 morborum aetiologici. Goettingae, 
 
 1792. 
 
 Arnemann, (Justus) — Synopsis Nosologiae. 
 Goettingae, 1793. 
 
 ASSUR, ( ) — Diss. Animadversiones ad sys- 
 
 tema nosologica usitatiora. Regio- 
 montis, 1794. 
 
 Darwin, (Erasmus) — Zoonomia. London, 1794 — 
 1795. 
 
 Grunner, (Chris. Gottfr.) — Nosologia Historica. 
 lenae, 1795. 
 
 MUNCK, ( ) — Diss, sistens nonnulas circa 
 
 nosologiam methodicam observa- 
 tiones. Lundini, 1796. 
 
 Caillau, (Jean Marie) — Premieres lignes de 
 nosologic enfantine. Bordeaux, 1797. 
 
 PiNEL, (Philip) — Nosoi^raphie philosophique. 
 Paris, 1798 — 1818. 
 
BIBLIOGRAPHY. 20$ 
 
 Castel, (Louis) — Analyse critique et impartiale 
 de la nosographie philosophique de 
 Pinel. Paris, An VII. 
 
 Hoffmann, (Philip) — Grundriss eines systems 
 der Nosologie und Therapie. Elber- 
 feld, 1798. 
 
 Callisen, (H.) — Systema Chirurgiae Hodiernae. 
 Containing a classification of sur- 
 gical diseases. Copenhagen, 1798. 
 
 Nebel, (E. L. W.) — Specimen nosologiae bru- 
 torum cum hominum morbis com- 
 paratae. Giessae, 1798. 
 
 Villars, (de Grenoble) — Tableau nosographique 
 servant d'introduction a la con- 
 naissance des maladies internes et 
 externes, 1798. 
 
 WiLLAN, (Robert) — Description and Treatment 
 of cutaneous diseases. London, 
 1798 — 1807. 
 
 Brera, (Valeriano Luigi) — Classificazione delle 
 malatie secondo i principi di Brown, 
 si premette una definizione dei vo- 
 caboli propri del sistema Brovvniano. 
 Venet., 1799. 
 
 Horn, (Ernst) — Versuch einer praktischen noso- 
 logie der fieber. Brunsvic, 1800. 
 
206 
 
 BIBLIOGRAPHY. 
 
 Baumes, (J. B. Th.) — Fondemens de la science 
 methodique des maladies. Mont- 
 pellier, 1801. 
 
 Baumes, (J. B. Th.) — Essai d'un syst^me 
 chimique de la science de Thomme. 
 Nismes. an VI. 
 
 Meyer, ( ) — Diss, integram et systematicam 
 
 morborum divisionem dari non 
 posse una cum nonnullis observa- 
 tionibus de principio nosologiae 
 Reschlaubianae subjecto. Franco- 
 furti ad Viadrum, 1801. 
 
 Tourdes, (J.) — Esquisse d'un syst^me de noso- 
 logic, fonde sur la physiologic et la 
 therapeutique. Strasbourg, 1802. 
 
 Bayle, (G. L.) — Considerations sur la nosologic, 
 la medecine d'observation, et la 
 medecine pratique, suivies d'observa- 
 tions pour servir a I'histoire des 
 pustules gangreneuses. Paris, 1802. 
 
 Abernethy, (John) — Sui'gical observations, con- 
 taining a classification of tumors, 
 etc. London, 1804. 
 
BIBLIOGRAPHY. 20/ 
 
 Abernethy, (J.) — " An attempt to form a classi- 
 fication of tumors according to their 
 anatomical structure." In the Sur- 
 gical works of John Abernethy, 
 F. R. S. From the sixth London edi- 
 tion. Hartford, Connecticut, 1825. 
 
 Crichton, (Alex.) — A synoptical table of dis- 
 eases, exhibiting their arrangement 
 in classes, orders, genera, and spe- 
 cies. London, 1804. 
 
 ToURTELLE, (E.) — Elemens de medecine theorique 
 et pratique. 1805. 
 
 Salva, (D. F.) — Discorso sobre la necesidad de 
 reformar los nombres de los morbos, 
 y plan para hacerlo. Barcelona, 1807. 
 
 Parr, (Bartholomew) — The London Medical 
 Dictionary. 1809. Article nosology. 
 
 SWEDIAUR, F. (18 1 2.) — In Hosack's system of 
 Nosology. 
 
 Young, (Thom^as) — An introduction to medical 
 literature, including a system of 
 practical nosology. London, 18 13. 
 
 Davidge, (J. B.) — Nosologia methodica: classium 
 et generum, et specierum, et varieta- 
 tum series morborum exhibens. 
 Edit. 2d. Baltimore, 181 3. 
 
208 BIBLIOGRAPHY. 
 
 RiCHERAND, (Anthelme)— Nosographie chirur- 
 gicale 4ieme edition, 1815. 5ieme 
 eHition, 1821. 
 
 Herritz, (Aloysius Benedictus) — Diss, sistens 
 notiones quasdam de summis mor- 
 borum generibus. Viennae, 181 5. 
 
 DURET, (J. J.)— Tableau d'une classification 
 generale des maladies. Paris, 181 5. 
 
 Good, (John Mason) — A physiological system of 
 nosology, with a corrected and sim- 
 plified nomenclature. London, 1817. 
 
 Good, (J. M.) — The study of medicine. London, 
 1822. 
 
 Bateman, (Thomas) — Delineations of cutaneous 
 diseases, etc. London, 1817. 
 
 Seigneur-Gens. — Nosographie Generale. 18 18. 
 
 Alibert, (Le Baron J. L.) — Nosologic naturelle, 
 ou les maladies du corps humain dis- 
 tribuees par families. Paris, 1818 — 
 1838. 
 
 Hosack, (David) — A system of practical nosol- 
 ogy, etc. New York, 18 18 — 1821. 
 
 PiNEL ET Bricheteau. Article nosographie 
 dans le Dictionaire des Sciences 
 Medicales. Tome 36. Paris, 18 19. 
 
BIBLIOGRAPHY. 209 
 
 Barbier, (J. B. Q.) — Precis de nosologic et de 
 therapeutique (unfinished). Paris, 
 1827. 
 
 BoiSSEAU, (F. G.) — Nosologic organique, ou 
 traite complct de medecinc pratique. 
 4 vol. 8 vo. Paris, 1828. 
 
 Struve, (L. a.) — Synopsis morborum cuta- 
 neorum secundum classes, genera, 
 species et varietates. Berlin, 1829. 
 
 PlORRY, (P. A.) — Traite de Medecinc Pratique 
 et de Pathologic iatrique on medi- 
 cale : Polygraphies ou generalites. 
 Vol. I, 1841. 
 
 Delorme, (Raige) — Article pathologic in the 
 Dictionnaire de Medecine, second 
 edition, vol 23. Paris, 1841. 
 
 BOUILLAUD, (J. B.) — Traite de Nosographie med- 
 icalc. Paris, 1846. 
 
 AlTKEN, (William) — Science and practice of 
 medicine. Article nosology — con- 
 taining Doctor William Farr's classi- 
 fication. 
 
 The nomenclature of diseases drawn up by a 
 joint committee of the Royal College of Physi- 
 cians of London. London, 1 869. 
 
 A nomenclature of diseases with the reports of 
 
2IO BIBLIOGRAPHY. 
 
 the majority and of the minority of the commit- 
 tee thereon. Presented to the American Medical 
 Association at the meeting held in Philadelphia^ 
 May, 1872. Philadelphia, 1872. 
 
 Nomenclature of diseases prepared for the use 
 of the medical officers of the United States 
 Marine Hospital Service, by the Supervising- 
 Surgeon, John M. Woodworth, M. D., being the 
 classification and English-Latin terminology of 
 the provisional nomenclature of the Royal Col- 
 lege of Physicians, London. Washington, 1874. 
 
 Nomenclature of diseases. State Board of 
 Health of New York (No. 65). New York, 1883. 
 
 Paul, (F. T.) — A classification of the new. 
 growths of the urinary system (Blad- 
 der, Prostate, and Kidney). British 
 Medical Journal, January 12th, 1884^ 
 
 Bronson, (E. B.) — The objects of dermatological 
 classification, with especial reference 
 to Auspitz' system. Pamphlet, pp. 
 Reprinted from the Journal of Cu- 
 taneous and Venereal Diseases. VoL 
 II, June, 1884. 
 
 The nomenclature of diseases drawn up by a 
 joint committee appointed by the Royal College 
 of Physicians of London. Second edition, being 
 the first revision. London, 1885. 
 
BIBLIOGRAPHY. 211 
 
 Rabagliati, (A.) — Some remarks on the classifi- 
 cation and nomenclature of diseases. 
 (Reprinted from the Medical Press 
 and Circular). London, 1886. 
 
 Smith, (Joseph R., U. S. Army)— On the best 
 form of report of the sick and 
 wounded of Armies. A paper read 
 before the Section on Military and 
 Naval Surgery and Medicine of the 
 Ninth International Medical Con- 
 gress. September, 1887. 
 
 BroNSON, (E. B.) — A study of the considerations 
 relating to the classification of skin 
 diseases with an attempt to con- 
 struct a logical system in accordance 
 with fundamental principles of etiol- 
 ogy. Pamphlet, pp. 19. Reprinted 
 from the Journal of Cutaneous and 
 Genito-urinar}^ diseases. October, 
 1887. 
 
212 
 
 SECTION IV. 
 
 BASIS AND METHOD OF THE CLASSIFICATION 
 
 AND CHARACTER OF THE NOMENCLATURE 
 
 OF THE DISEASES OF MAN. 
 
 Many high authorites opposed to classification. To think is 
 to classify. Characteristics of good classifiers. Modern 
 classifiers use terms of classification arbitrarily without taking 
 the pains to define these terms. Nosography on the basis of 
 symptoms misleading and retrogressive. Anatomy the only 
 stable basis for nosography. Description and definition of dis- 
 eases. Methods of the nosographer. The use of the dead 
 languages in nomenclature. The names of men should not be 
 applied to diseases. Suggestions for an improved classifica- 
 tion of diseases. A consense of views necessary in the use of 
 terms of classification. Questions suggested for discussion 
 at the Tenth International Medical Congress. Definitions of 
 the terms of classification. 
 
 As preliminary to the further consideration of 
 human nosography, the following questions may 
 with propriety be propounded : 
 
 1. Is there need of classification of any kind ? 
 
 2. If so, what should be the basis of the classi- 
 fication of diseases ? 
 
 3. What should be the character of the nomen- 
 clature of diseases ? 
 
 4. What should be the method of the classifica- 
 tion of diseases ? 
 
NEED OF CLASSIFICATION. 21 3 
 
 An answer to each of these questions will now 
 be submitted to the decision of the medical pro- 
 fession, for no official nosography should be 
 established except with the concurrence of the 
 medical profession. 
 
 I. IS THERE NEED OF CLASSIFICATION OF 
 
 ANY KIND? 
 
 Despite the well known aphorism, " system is 
 the Ariadnean thread without which all is confu- 
 sion," some of the highest authorities in science 
 have been opposed to methodical arrangement. 
 Among them may be cited the celebrated Buffon. 
 Many of the physicians of the present time do 
 not approve of classification notwithstanding the 
 fact that medicine is a science only by reason of 
 the methodical arrangement of diseases, and that 
 these physicians themselves are constantly classi- 
 fying, for they think and therefore classify, and it 
 is a fact that to think is to classify, therefore in 
 thinking they classify nolens volensj^ To think of 
 
 * " Looking to the experience of the past, it cannot, 
 
 with any reason, be urged that systematic arrangements, if 
 consistent with existing knowledge ever cramp or hamper a 
 man in carrying out scientific investigations ; on the contrary, 
 they enable him to sec more clearly in what direction his la- 
 bor must be advanced, and demonstrate more forcibly than 
 otherwise the deficiencies of his knov/lege." (Aitken.) 
 
214 BASIS OF CLASSIFICATION. 
 
 an object is to recognise the properties which dif- 
 ferentiate it from other objects and consequently 
 place it in its proper class. — Particular illustra- 
 tions need not be given. — But to make a general 
 classification accurate and useful requires pro- 
 found thinking, a good understanding, sound 
 judgment, persevering study, careful observa- 
 tion, persistent labor, untiring industry, and the 
 co-operation of many men possessing these quali- 
 ties. Nosotaxy however to be of practical utility 
 to the medical profession, and of much benefit to 
 mankind, requires more than the co-operation of 
 many men. It exacts the prompt and substantial 
 aid of the very great majority of all true physi- 
 cians in the world. 
 
 The answer to the first question is that there is 
 great need of a classification of the diseases of 
 man, established upon a proper basis, which shall 
 constitute an epitome of the science of medicine. 
 
 2. WHAT SHOULD BE THE BASIS OF THE 
 CLASSIFICATION OF DISEASES? 
 
 During this century nosography has not ad- 
 vanced so rapidly as might have been reasonably 
 expected. Among the chief reasons of this hin- 
 derance are ; (i,) that the establishment of a 
 proper basis for its development has never been 
 
BASIS OF CLASSIFICATION. 21$ 
 
 agreed upon by the medical profession, and (2,) 
 that no particular system of classification has been 
 officially adopted by the profession. Individuals 
 and certain nations having- each some special sys- 
 tem of classification and nomenclature of diseases, 
 with no apparent aim toward uniformity. In 
 sundry nosographical arrangements the words 
 groups, sections, classes, orders, families, tribes, 
 genera, and species, are so loosely and carelessly 
 employed that it is difficult to understand the 
 meaning which these terms are intended to con- 
 vey, used, as they often are, in violation of estab- 
 lished principles of classification, for many classi- 
 fiers employ them arbitrarily and do not take the 
 pains to give their own definitions of these arbi- 
 trary terms. 
 
 The starting point in nearly all the systems of 
 nosography is the symptom. This has led astray 
 many nosographers who, mistaking symptoms for 
 diseases, placed these symptoms in the category 
 of diseases, notwithstanding the existing excellent 
 rules for the guidance of the student of noso- 
 graphy. The system of Cullen having been 
 judged the best was, for many years, in general 
 use, and yet it was full of the most glaring errors, 
 some of which he acknowledged in after years. 
 Many of Parr's suggestions were excellent, but 
 his system was as ill founded as those of his pre- 
 
2l6 BASIS OF CLASSIFICATION. 
 
 decessors. Pinel's " nosographie philosophique ^ 
 which superseded the nosology of Cullen in 
 France, has long- been obsolete. It failed, even 
 after a very considerable number of revisions, 
 probably because it was established upon the 
 same faulty basis as that of former systems. The 
 nosographical contributions of Recamier, of 
 Richerand and of others had no better success. 
 More than forty years ago Doctor Williams 
 classified and tabulated certain diseases upon a 
 physio-pathological basis, but there halted. 
 
 It seems clear that the great defect of all these 
 systems is the lack of a stable basis upon which 
 to erect the structure of nosography. This defect 
 was long ago realised but not remedied, and 
 nosography had already shown signs of decay 
 when it was almost entirely reconstructed by 
 Doctor William Farr and by the Royal College 
 of Pysicians of London. But even the modern 
 English system is full of inconsistencies although 
 it is declared to be founded upon anatomy. 
 
 It is noteworthy that nearly all the early gen- 
 eral nosographers were at either extreme of 
 adopting very few or very many classes, and that 
 they failed to agree as to what should constitute 
 classes, orders, genera, species, or symptoms, for 
 these are scattered throughout what at first sight 
 seem to be the most methodical arrangements. 
 
BASIS OF CLASSIFICATION. 21/ 
 
 Thus phlegmasiae are placed among classes by 
 Sauvages, Linnaeus, and Sagar, and among or- 
 ders by Cullen, Vogel, Macbride, and Good. 
 These, and many other blemishes already pointed 
 out, occur from the time of Sauvages to that of 
 Hosack, and are owing partly to the fact that too 
 little attention has been bestowed upon species 
 notw^ithstanding the caution of Cullen who, how- 
 ever, fell into the error he so much wished to 
 avoid, and partly to the state of knowledge of 
 physiology and morbid anatomy at that epoch. 
 Although Doctor Good based his nosology upon 
 physiology, he reaffirmed many of the errors of 
 the older authors. 
 
 This want of agreement, and the absence of a 
 substantial foundation and of associated harmoni- 
 ous labor, have given rise to the greatest confu- 
 sion in the use of terms and in arrangement. 
 This confusion and the tendency of each noso- 
 grapher to reproduce the inaccuracies of his pre- 
 decessors, have greatly impeded the progress of 
 nosography and have led to much unfavorable 
 criticism and to the frequently asked question, 
 *' of what use is nosography '* ? — This question is 
 now often sneeringly asked by those who fail to 
 appreciate the fact that, without the existing sys- 
 tematic arrangement of diseases, they could not 
 have learned, and could not intelligently and sue- 
 
2l8 BASIS OF CLASSIFICATION. 
 
 cessfully practise, medicine. — In the beginning of 
 this century nosography was not regarded with 
 much favor by many learned physicians both in 
 England and on the continent of Europe, and the 
 mass of the profession spoke of it contemptu- 
 ously. Doctor Parr, in commenting thereon 
 says : '' nosology is seldom mentioned but to be 
 ridiculed and despised." * 
 
 Under the same head, Parr says : 
 
 *' Systems are the work of our own minds ; for 
 nature advances by almost imperceptible shades ; 
 and where we cannot point out the termination 
 of one family, and the commencement of another, 
 it is only confessing that the intermediate link is 
 unknown : thus when our knowledge advances 
 the advantages of our system lessen, for our lim- 
 its are lost 
 
 " If a foundation could be obtained, it was ap- 
 parently by considering the disorder as connected 
 with an internal change, which would then afford 
 what might be styled an object, whose properties 
 we might examine. . 
 
 " The great advantage of nosology is distinc- 
 tion, discrimination, etc We still 
 
 want a delineatio morbiiu imitation of tht, delineatio 
 plantae in Linnaeus." 
 
 * The London Medical Dictionary. London, 1809. 
 
BASIS OF CLASSIFICATION. 219 
 
 How can proper distinction, discrimination, 
 and a delineatio morbi be made unless nosography 
 have a stable foundation such, for instance, as 
 can be built from anatomy ? As early as the 
 year 1801 Bayle was of opinion that nosography 
 should be founded upon anatomy, but the idea 
 was never fully carried out, although Alibert 
 named his families of diseases in accordance with 
 the organs affected, although Richerand and 
 others made similar attempts, and although the 
 modern English system is avowedly founded 
 upon anatomy."^ 
 
 It was an error of much consequence on the 
 part of the nosographers to make symptoms the 
 foundation of the science instead of using them 
 as one of the means by which to discover individ- 
 ual diseases. An anatomical foundation would in 
 no way have lessened the importance of symp. 
 tomatology and of semeiology, for, however sub- 
 stantial might have been the foundation of noso- 
 graphy, its superstructure could never have been 
 built without proper methods of detecting and of 
 expressing the characteristics of diseases. It is 
 
 * The latest work of Sauvages (published a year after his 
 death) contained a symptomatica!, an etiological, and an 
 anatomical arrangement, but the etiological and anatomical 
 were held in entire subordination to the symptomatical ar- 
 rangement. 
 
220 BASIS OF CLASSIFICATION. 
 
 chiefly by the aid of symptoms and signs that in- 
 dividual affections are recognised and species 
 established, and it is from species that the super- 
 structure rises. 
 
 While due consideration should be given to 
 symptoms, it would, in the present state of 
 science, seem unwise to attempt to make a 
 delineatio morbi solely upon the basis of symp- 
 toms, for, without placing under contribution 
 aetiology and pathoanatomy, it would not be 
 possible to fix a term for every circumstance in 
 which the morbid conditions might vary. For 
 example, in the case of a deformity, the descrip- 
 tion of its external charaters would be insufficient 
 and its definition inexact if the cause and pathic 
 properties were not set forth. This cause may 
 be an injury, or a previous disease, or the de- 
 formity may be congenital. Again, an echmatic 
 affection may be owing to a congenital anomaly, 
 to a previous disease, or to an injury. A tumor 
 may consist of fat, or of muscular or fibrous tis- 
 sue, of cartilage, or of bone, or of cellular ele- 
 ments which are rapidly proliferated to be soon 
 destroyed. In such cases, symptoms would in- 
 dicate simply the existence of a tumor of a cer- 
 tain size and shape and its immediate effects, but 
 not its anatomical properties. To make the de- 
 scription of an abnormal condition of the human 
 
BASIS OF CLASSIFICATION. 221 
 
 body accurate and its definition exact, all the cir- 
 cumstances connected with it should be closely 
 scrutinised and analyzed, whether they be ex- 
 ternal manifestations, or physical signs brought 
 to light by the aid of certain tests systematically 
 applied, as for instance, in the case of the sense 
 of hearing in auscultation, of touch in palpation, 
 or of other methods of physical exploration. At 
 the same time the greatest importance should be 
 attached to the causes and to the pathic proper- 
 ties of these conditions as revealed by the mod- 
 ern appliances for determining the anatomical 
 and other characters of diseases, such as chemical 
 tests, the electrical apparatus, the microscope, 
 the polariscope, and other instruments of pre- 
 cision. 
 
 Cullen speaks of the difficulty he experienced 
 in determining what is really a true species and 
 what is onh' a variety, and finds it necessary to 
 enumerate many varieties. Tliis difficulty doubt- 
 lessly arose from his adopting a system based 
 upon symptoms rather than upon anatomy. Some 
 of his rules for discriminating between species 
 and varieties would now be of little value and 
 must have been very unsatisfactory in his own 
 time. For instance, it could not have been easy 
 to form a clear conception of what is " a symp- 
 tom of a symptom," or of "a symptom of a 
 
222 BASIS OF CLASSIFICATION. 
 
 cause." The " symptoms of symptoms " have 
 been defined as " effects which result from 
 the symptoms of a disease, but which are not 
 necessarily allied to the disease," and the follow- 
 ing example is given: "thus the debility which 
 results from the frequency of the alvine evacua- 
 tions in dysentery is a symptom of symptoms." 
 All this has been handed down from the time of 
 CuUen and seemingly accepted without demur or 
 comment on the part of the profession and re- 
 corded by such authors as Dunglison, Littre and 
 Robin, and other writers of eminence. From 
 symptoms effects cannot arise, for symptoms are 
 only manifestations of a morbid condition which 
 is itself the effect of a cause. The idea of an ef- 
 fect arising from a manifestation is therefore most 
 irrational. The debility which results from such 
 phenomena as the frequent alvine evacuations in 
 dysentery is a consequence and not a symptom 
 of the dysentery. The outward manifestations of 
 dysentery are the frequent bloody alvine evacua- 
 tions accompanied by tenesmus. The analysis of 
 these symptoms furnishes a sign upon which to 
 base the diagnosis of the disease. 
 
 There are no ** symptoms of a cause " any 
 more than ;here are " symptoms of symptoms." 
 The cause produces an effect — disease — which 
 
BASIS OF CLASSIFICATION. 223 
 
 effect manifests itself by certain general or local 
 symptoms. 
 
 Of late years it has been proposed to employ 
 two classifications and nomenclatures, one for the 
 clinician, based upon the characters of the symp- 
 toms of disease, and one for the pathologist, to 
 be used in the autopsy room. Such a system 
 would be entirely unnecessary if a single classi- 
 fication and nomenclature were placed upon a 
 proper foundation. 
 
 The modern botanical classification is based 
 upon the reproductive organs of plants, that is, 
 upon anatomy. 
 
 Zoological classification is likewise based upon 
 anatomical characters, and this basis was adopted 
 to a certain extent by Buffon, notwithstanding 
 his general opposition to methodical arrange- 
 ment, by Pennant in his history of quadrupeds, 
 published in 1781, and by other zoologists of their 
 time. 
 
 Looking at the inorganic world, it will be seen 
 that the classification of minerals is based upon 
 their chemical properties. The system adopted 
 by the mineralogists includes classes, orders, 
 species and varieties. 
 
 The chemical nomenclature of the present, the 
 result of more than a century of arduous labor, is 
 based upon the composition of compound sub- 
 
224 BASIS OF CLASSIFICATION. 
 
 stances, so that the name of a chemical compound 
 generally indicates its exact composition. 
 
 All systematic studies of those sciences wherein 
 the greatest advances have been made during 
 this century, are established each upon a rational, 
 a substantial basis, except medicine ; and w^hy 
 the good example set by the naturalists has not 
 been more generally followed by medical writers, 
 it is not easy to explain. 
 
 A nosography based upon sysmptoms cannot 
 be accurate and must necessarily fall. 
 
 To be of practical utility, the classification of 
 diseases should be based upon anatomy. This is 
 the answer to the second question. 
 
 In this work therefore, an attempt is made to 
 raise the superstructure of nosography upon this 
 foundation. 
 
 Dr. Clymer, whose opinion was asked in rela. 
 tion to the question of the basis of classification 
 of diseases, writes as follows : 
 
 "The first attempts towards a classification of 
 diseases are, necessarily along the lines of symp- 
 toms. They are the objective marks of disorder ; 
 the salient signs that compel attention. In an 
 early state of study, with defective knowledge of 
 substance and its properties, they offer the one 
 conception of departure from sound working we 
 can have. True scientific research is bottomed 
 
BASIS OF CLASSIFICATION. 22$ 
 
 on observation. The unknown cannot be made 
 the subject of positive thought. Cognition is 
 conditioned on experience, which comes through 
 perception ; and a right understanding of phe- 
 nomena must be within the limitations of ex- 
 periences, and can be studied successfully only 
 by this method. 
 
 " When we get to a better knowledge of sub- 
 stance, its forces, and their variations, the artifice 
 classification, based on positive data, becomes 
 possible. It will be more or less perfect in 
 proportion to the degree and fulness of such 
 knowledge. Berkeley says : ' We know a thing 
 when we understand it ; and we understand it, 
 when we can interpret, or tell what it signifies.' 
 
 " When the square of the hypotheneuse is 
 geometrically demonstrated, no one has a right 
 to his own notion about it. 
 
 " Facts of phenomena arise from facts of sub- 
 stance, otherwise they are facts of fancy. Symp- 
 toms looked at alone as such and not coupled 
 with the suffering substance whose speech they 
 are, and by which its troubles are told, will mis- 
 guide or give no hint of the true state of things. 
 Necessitated correlation of matter and force is a 
 primal law. No change in the customary expres- 
 sion of an activity, whether by increase, lessen- 
 ing, arrest or perversion, may happen, without, 
 
226 DESCRIPTION AND DEFINITION. 
 
 at like time, a change, coarse or fine, in the plas- 
 mode. Hence, as a matter of fact, there can be 
 no such thing- as mere functional disorder apart 
 from structural damage. This would be an ab- 
 straction, as it supposes a quality without sup- 
 port, which is meaningless and contradictory. 
 We can neither know, or be ignorant of an ab- 
 stract thing. 
 
 *' Facts of quantitative or qualitative disturb- 
 ance, made known by objective or subjective 
 tokens, can, therefore, be only truly expressed in 
 terms of substance." 
 
 DESCRIPTION AND DEFINITION. 
 
 Summarising what has already been stated as 
 to the scope of nosography, it is found to include: 
 (i,) the description; (2,) the definition; (3,) the 
 nomenclature ; and (4,) the classification of dis- 
 eases. 
 
 The description of a disease is the setting forth, 
 in detail, of its cause, nature, pathoanatomy, 
 and symptoms. 
 
 The definition of a disease is the statement of 
 its peculiar, dominant, and constant characteris- 
 tics so concisely and clearly, that it can be readily 
 recognised. 
 
 Description and definition are too often con- 
 
CHARACTER OF THE NOMENCLATURE. 22/ 
 
 founded. An exact definition is the summary of 
 an accurate description. It takes from such de- 
 scription only what is essential to precisely 
 characterize a disease and distinguish- it from any 
 other disease. An exact definition can therefore 
 be deduced from the analysis only of a complete 
 description. 
 
 In the description of a disease there may be 
 symptoms and other conditions which are com- 
 mon to two or to more than two diseases. To in- 
 troduce such characters into a definition would 
 vitiate and render it useless. 
 
 The methodical nosographer first describes a 
 morbid condition. From this description he ex- 
 tracts the definition and from the definition ob- 
 tains the correct name of the disease which he 
 accordingly classifies. 
 
 3. vVHAT SHOULD BE THE CHARACTER OF 
 THE NOMENCLATURE OF DISEASES? 
 
 Nosonomy,^ or the nomenclature of diseases is 
 that division of nosography about which there is 
 
 * Nosonomy, from v66oi^ disease, and ovojuaf name. The 
 words know and name are said to be traceable to the same 
 root. Diseases to be properly named should therefore first be 
 well known. 
 
228 CHARACTER OF THE NOMENCLATURE. 
 
 the least agreement among both the ancient and 
 modern authors ; consequently, of all scientific 
 nomenclatures, that of medicine is confessedly 
 the most defective. Of the many good rules pre- 
 scribed for naming diseases, few have been ob- 
 served, and many of the most absurd and mean- 
 ingless terms, anciently adopted, are still 
 obstinately retained. A pernicious habit of in- 
 accuracy among writers has been the outcome of 
 this faulty nomenclature which now proves to be 
 one of the greatest detriments to the science and 
 art of medicine. Although repeatedly pointed 
 out, no concerted international action has been 
 taken for the remedy of this evil. The nearest 
 approach to reformation is indicated by the work 
 done, in the past thirty years, by the medical pro- 
 fession of the advanced European nations, more 
 particularly of England. Most of the labor, how- 
 ever, was individual, and performed by the late 
 Doctor William Farr, of London, who is entitled 
 to the highest praise for his devotion to this sec- 
 tion of nosography. He has done much to ad- 
 vance nomenclature, but there remains much 
 more of the same kind of work to be accom- 
 plished. 
 
 Sir W. Aitken, who has also given great atten- 
 tion to the question of nomenclature, summarises 
 ** the considerations which have generally reg- 
 
CHARACTER OF THE NOMENCLATURE. 229 
 
 ulated the naming of diseases " as follows: *'(i,) 
 some names have been taken from the part 
 affected — e. g., peripneumonia, podagra, opthal- 
 mia, dysentery ; (2,) the most characteristic 
 symptoms have furnished the name — e. g., ileus, 
 tenesmus, paralysis, diarrhoea, dyspnoea, coma ; 
 (3,) some names have been taken from these two 
 circumstances combined — e. g., cephalalgia, otal- 
 g-ia, cardialgia, odontalgia, hysteralgia ; (4,) an 
 alteration of tissue upon which subsequent 
 changes depend being recognised as the essen- 
 tial element of the disease, it is named accord- 
 ingly — e. g., pleuritis, peritonitis ; (5,) such 
 alteration not being discovered, the first tangi- 
 ble link in the chain of causation has been 
 used instead — e. g., m.elancholia, cholera, typhus ; 
 (6,) when a lesion tending to sudden death at 
 once follows the application of a cause, that cause 
 may name the disease — e. g., lightning, prussic 
 acid, arsenic, scald, sun-stroke, cut, stab, frost- 
 bite, etc. : (7,) a considerable number of names of 
 diseases have been derived from some imaginary 
 resemblance to external objects — e. g., elephanti- 
 asis, cancer, polypus, anthrax, etc. ; (8,) there are 
 still many names the origin of vi^hich it is not 
 easy to trace." 
 
 Faulty as are these and many other terms, it is 
 extremely difficult to fill their places with suit- 
 
230 CHARACTER OF THE NOMENCLATURE. 
 
 able expressions. That this will in time be ac- 
 complished — perhaps however not until two or 
 three generations of physicians shall have passed 
 away — is reasonably to be anticipated. Mean- 
 while it is to be hoped that durmg the present 
 generation good substitutes will be offered for 
 such caconymous terms as podagra, rheumatism, 
 apoplexy, melancholia, ileus, dysentery, diar- 
 rhoea, cholera, typhus and typhoid fevers, 
 variola, diphtheria, hydrophobia, elephantiasis, 
 lupus, leprosy, anthrax, cancer, chancre, chan- 
 croid, scrofula, syphilis, and a host of other 
 equally inappropriate names of diseases. 
 
 Many of these terms are used in this essay — 
 but under protest — until, by general agreement, 
 correct terms shall be substituted. 
 
 " The perfection of a science depends, in no 
 inconsiderable degree, upon the perfection of 
 its language ; and the perfection of every lan- 
 guage upon its simplicity and precision." * 
 
 The language of medicine should be euphoni. 
 ous, simple, expressive, and accurate, for, its ob- 
 ject is not only to describe and define diseases 
 with precision, but to mirror the medical ex- 
 perience, wisdom, and genius of the past as well 
 as of the present. Nosographical nomenclature 
 
 * John Mason Good. 
 
CHARACTER OF THE NOMENCLATURE. 23 1 
 
 is the most important part of medical language 
 and consists of the technical terms therein used. 
 This nomenclature should be based upon the 
 structural characters, of the affections of the hu- 
 man body ; therefore the names given to diseases 
 should convey to the mind an exact idea of the 
 morbid conditions which these names are de~ 
 signed to express, at least a strong endeavor 
 should be made toward the attainment of that 
 end.* As a general rule these names should be 
 
 * " The exactness of names and the uniformity of terms 
 render more facile and prompt the knowledge of a science, 
 and an expressive and characteristic denomination makes a 
 profound impression upon the mind which necessarily puts 
 the object designated into the place of its designation."^ 
 (Paraphrased from Condillac by Pinel.) 
 
 Condilliac in commenting upon nomenclature propounded 
 the following aphorism. " Les sciences se reduisent d des 
 langues Hen faztes." This may be liberally translated into,, 
 sciences may be reduced to exact language. 
 
 " It is the exactness and also the good use of words, or 
 more generally of signs, which should be considered as the 
 criterion of the truth ; it is to their vague character, to the un- 
 certain and confused manner in which they are employed, that 
 should be attributed imperfect notions, prejudices, errors, and 
 all vicious habits of the mind. 
 
 " In nearly all the departments of medicine, the language is 
 ill constructed. It has been more and more corrupted by the 
 false application of words borrowed from the other sciences^ 
 
232 CHARACTER OF THE NOMENCLATURE. 
 
 Latin or Latinised Greek, or of Greek or Latin 
 derivation but should not be compounded of 
 Latin and Greek. To avoid confusion it is de- 
 sirable that one name only be adopted lor each 
 individual disease. When a disease already bears 
 several names, if one of these be accurate it 
 should be adopted to the exclusion of the super- 
 fluous or improper names, otherwise a correct 
 term should be coined, and the other names 
 should be placed under the head of equivalents, 
 synonyms, or caconyms, as the case may be. 
 
 The names of men applied to diseases are ex- 
 tremely objectionable, convey no idea of the 
 nature of these diseases, and even fail to flatter 
 vanity. It happens sometimes that a disease 
 bears the names of tv\ro persons whose descrip- 
 tion thereof is the same. May it not also happen 
 that one and the same disease is very differently 
 described by two or even three persons, each giv- 
 ing his name to the disease, so that two or three 
 diseases may be enumerated where only one 
 exists ? The resulting confusion and perplexity 
 would, in such a case, be most discouraging to 
 earnest students. The fashion of giving men's 
 
 and by a certain insignificant and ridiculous jargon which has 
 too often been adopted by physicians owing to a culpable re- 
 spect for popular prejudices." (Cabanis.) 
 
CHARACTER OF THE NOMENCLATURE. 233 
 
 names to diseases has continued through so long- 
 a series of years that it has grown into a con- 
 firmed and mischievous habit. If this sentimental, 
 but mistaken, notion of honoring or of rewarding 
 merit could have been limited, no great harm 
 would have ensued. The evil is however already 
 an offensive blot upon the nomenclature of medi- 
 cine, and threatens to mar the best pages of 
 medical literature. Will it not be a most agree- 
 able relief to the senses of the heedful reader 
 when authors shall have banished from their 
 treatises such terms as Addison's disease, Base- 
 dow's disease, Bright's disease, Charcot's disease, 
 Duchenne's disease, Dupuytren's contraction, 
 Graves' disease, Hodgkins' disease, Meniere's 
 disease, Pott's disease, and very many more of 
 kindred names which express no notion of the 
 nature of the affections bearing such pseu- 
 donyms ? 
 
 The names of regions of country — e. g., Bar- 
 badoes leg ; of animals — e. g., lupus, elephantia- 
 sis ; of vegetables — e.g., hay fever; of some of 
 the elements — e. g., St. Anthony's fire ; and 
 other names too absurd and too numerous to 
 particularise have been given to diseases. 
 
 The same faulty nomenclature exists in the 
 fundamental science and associated arts of medi- 
 cine. 
 
234 CHARACTER OF THE NOMENCLATURE. 
 
 It is to be hoped that the much desired general 
 reformation in medical nomenclature will soon 
 begin, but the bad foundation must first be 
 sapped by a radical change in the nomenclature 
 of the fundamental science and associated arts of 
 medicine. 
 
 The answer to the third question is that the 
 nomenclature of diseases, to be exact, should be 
 based upon the true nature of morbid conditions 
 and should be characterized by simplicity, brev- 
 ity and accuracy. 
 
 Inasmuch as many of the words employed by 
 the earliest nosographers are now largely used, 
 and inasmuch as their use will probably be con. 
 tinued for a long time, it is proper that the inten- 
 tion of their coinage be clearly understood. 
 Doctor John Mason Good's nosology contains a 
 full explanation of many of the terms employed 
 by Sauvages and other contemporaneous nosog- 
 raphers, and also a table of some of the medical 
 prefixes and terminals with a brief statement of 
 the senses in which they are applied. This table 
 of prefixes and terminals is here reproduced for 
 the benefit of those who may desire to know their 
 exact meaning as understood when they were 
 coined. 
 
235 
 good's table of prefixes and terminals 
 with the senses in which they 
 
 ARE USED * 
 
 Prefixes. 
 
 A, («), Diminution or less quality or power. 
 
 fFor the most part 
 A^^ „^ u t ^ ^ ^ iterative, duplicate^ 
 
 rff.' ^?;f ■ * V ' ^''^ or augmented ac: 
 
 tion : but often m^ 
 determinate. 
 
 Cata, cat, {>iaraj nar). 
 
 Dia, (<5ta), Separation ; secernment ; or secretion. 
 
 Dys, (5i»5), Morbid state or action generally, em- 
 phatical, when accompanied with dis- 
 tress or difficulty. 
 
 Ec, ex, (£«, £^), ] r^ i. f 4. J 
 
 Epi, ep, eph, (£^z, £^, £^), t ^"t «f; outwards r 
 Hyper, (^^£^), f «^^^*' ^^ove. 
 
 Hj^po, {v7to), Under. 
 
 En, (er), Within ; below ; applied to places. Su- 
 periority ; excess or intensity ; applied 
 to quantity or quality. 
 
 * A more extended table of prefixes and terminals is to be 
 found at the end of Volume I, of Piorry's " Trate de Medi- 
 cine Pratique et de Pathologie latrique ou Medicate,. 
 Generalites." 1841. 
 
236 PREFIXES AND TERMINALS. 
 
 Para, {itapa), Morbid state or action generally ; 
 and hence synonymous with dys\ 
 except in a few terms derived from 
 anatomy, in which it imports apud^ 
 " bordering on," as in parotitis, pa- 
 ronychia. 
 
 Peri, {itepi), Circuit; circumference. 
 
 Terminals. 
 
 Algia, {aXyia)^ Pain or ache. 
 
 "] Morbid action, pow- 
 Asmus, osmus, {a6^a, odjuoi) | er, or possession 
 Esmus, ismus, (£(^mo?, idjao^), \- generally ; but 
 Esis, osis, {e6i?, (iodi<^)j mostly very inde- 
 
 terminate. 
 
 lasis, {ladii)^ Cutaneous eruption, unconnected 
 
 with fever as its cause. 
 Itis, {iri7^), Organic inflammation. 
 
 Kele, cele, i^i'n'^v), Covered protrusion of a soft 
 
 part. 
 Odes, (ta^T^s), Like ; akin to. 
 Oma, (o^ywa), External protuberance. 
 Ptoma, {TtTGo^ia)^ Naked prolapse of a soft part. 
 Rhoea, (/^oza), Preternatural flux of any fluid ex- 
 cept blood. 
 Rhagia, {pocyia)^ Preternational flux of blood. 
 
METHOD OF THE CLASSIFICATION. 23/ 
 
 Latin terminals. 
 Igo, Diffuse or migratory action or motion. 
 
 rn ' • \ ' \ Simple diminutive terminations, 
 lilaris, ularis, j ^ 
 
 Osus, Simple augmentive termination. 
 
 4. WHAT SHOULD BE THE METHOD OF THE 
 CLASSIFICATION OF DISEASES? 
 
 Nosotaxy or the classification of diseases. — The 
 fourth division of nosography relates to the 
 grouping of those diseases that have been de- 
 scribed, defined, and named, and to their arrange- 
 ment into distinct classes, orders, genera, and 
 species. This is called taxonomy * or classifica- 
 tion. 
 
 Next to nomenclature, classification has exhib- 
 ited the most diversified and incongruous views. 
 At the close of the last, and in the beginning of 
 this century, classification was in such fashion 
 that ^M^rj prominent physician thought himself 
 bound to construct a new classfication of dis- 
 eases. The result was that no two systems agreed ; 
 and that nearly all classifiers not only repeated the 
 
 * Taxonomy, from ra'^z?, arrangement, and v6/ioi, a law; 
 and, for the sake precision and brevity, nosotaxy, the classifi- 
 cation of diseases. 
 
^38 METHOD OF THE CLASSIFICATION. 
 
 heresies of their predecessors, but often made 
 greater mistakes, so that nosograpby soon fell 
 into disrepute and contempt. The excessive 
 ^eal displayed b)'' many of these classifiers in en- 
 deavoring* to promote nosography, and their pre- 
 mature publication of imperfect and ill digested 
 systems, are among the main causes of the re. 
 tardation of its progress. 
 
 Sir W. Aitken, in his warm advocacy of meth- 
 ical arrangement, predicts a glorious future for 
 nosography. 
 
 He says, under the head *' principles of classi- 
 fication " : 
 
 " A perfectly philosophical or natural system 
 of classification aims at having the details of its 
 plan to agree in every respect with the facts as 
 they exist in nature, and to be as it were a * trans- 
 lation of the thoughts of the Creator into the 
 language of man.' To effect this end, arrange- 
 ments, as they naturally exist, require to be 
 traced out, not devised. The tracts in which our 
 knowledge is as yet deficient, may be shortly in- 
 dicated under the following heads: (i,) the 
 affinities or alliances of diseases with each 
 other ; (2,) the morbid anatomy of diseased parts? 
 (3,) the communication, propagation, inoculation, 
 generation, development, course, and spontaneous 
 natural termination of diseases ; (4,) the connec- 
 
METHOD OF THE CLASSIFICATION. 239 
 
 tion of the phenomena recognised during life 
 with the facts of morbid anatomy ; (5,) the geo- 
 graphical distribution of diseases ; (6,) the suc- 
 cession of diseases, so far as they can be traced 
 through past ages ; the peculiarities they have 
 exhibited at different periods in the world's his- 
 tory, or within comparatively recent cycles of 
 years. "But," he further says, "the time has 
 not yet come for a classification on a basis so 
 comprehensive — simply because the material 
 does not yet exist; and attempts to make so- 
 called natural systems of arrangement must end 
 in disappointment, on account of the uncertain 
 and fluctuating data on which they must be 
 based." 
 
 It is true that the whole of the material does 
 not yet, and may never, exist for " a perfectly 
 philosophical or natural system of classification," 
 but there is enough good material at hand, 
 which, if wisely used, will greatly improve the 
 present systems of classification. It surely is not 
 the part of wisdom to wait an indefinite time to 
 begin this work. Had the early nosographers 
 waited for the " proper time to come," this 
 science would, to-day, scarcely be in existence. 
 But they quickly made use of such material as 
 was then at hand and their labors have led largely 
 to the advances which are at present enjoyed. 
 
240 METHOD OF THE CLASSIFICATION. 
 
 The succeeding generations of nosographers wil 
 doubtless profit by the good work — and by the 
 errors too — of the preceding, and it may possibly 
 be many centuries before the fond hope of Sir W. 
 Aitken can be realised, but the beginning should 
 be made now. 
 
 The task of improving the classification of dis- 
 eases may be begun by individuals, but individual 
 labor should, with good grace, be submitted to 
 the criticism and correction of other individuals 
 and of organized associations of the medical pro- 
 fession, first of the country of these individuals, 
 then of all countries of the world. 
 
 The study of the nosography of the past, show- 
 ing, as it does, such great diversity in the many 
 systems, such lack of agreement among the no- 
 sographers, such confusion in classification, and 
 such eccentricity in nomenclature, must needs 
 lead to the conclusion that it is not possible, in 
 the existing state of medical science, for any one 
 person, or for a single association, or even for the 
 medical profession of one or of several nations to 
 produce a complete general nosography. The un- 
 successful efforts already made in this direction 
 for the past century and a half are good evi- 
 dences of the correctness of this proposition. 
 Many individuals may each prepare the nosog- 
 raphy of one apparatus of the human body and 
 
METHOD OF THE CLASSIFICATION. 24I 
 
 thus doubtless give substantial aid in the cause of 
 nosography and contribute thereto much valua- 
 ble material ; but, in view of the progressive 
 character of medical science, the details of all 
 such work must necessarily be provisional and 
 constantly subjected to alterations and revisions. 
 The final decision of questions relating to the 
 general principles of nosography, and tending to 
 make the nomenclature of medicine uniform in 
 all countries, should be made by an assembly of 
 representant physicians of all nations, through in- 
 ternational conferences, so that every individual 
 member of the medical profession may know that 
 his voice shall be heard for or against the adop- 
 tion of any proposed method of nomenclature 
 and classification of the diseases of man. By this 
 means only can a comprehensive system of no- 
 sography be compiled which will be of practical 
 utility to all nations for the purposes of vital 
 statistics and of the medical reports of armies, 
 navies, and general hospitals, or for the use of 
 students, teachers and investigators. 
 
 The answer to the fourth question is that the 
 excellent method of classification, borrowed from 
 the botanists, by the early medical classifiers, 
 should be re-adopted with the modifications in- 
 dicated below. 
 
 If the majority of the medical profession of the 
 
242 METHOD OF THE CLASSIFICATION. 
 
 world should decide in favor of classifying the 
 diseases of the human body, as heretofore, like 
 systems of botany, it would seem rational to base 
 the classification upon anatomy in its broadest 
 sense ; and such a basis is the one which offers 
 the greatest advantages and the widest scope in 
 theory and in practice. A knowledge of the 
 gross appearances and of the construction and re- 
 lations of the several parts of the body ; of the 
 minute structure of the tissues and organs ; of 
 the development and abnormities of the organs; 
 of the functions of the apparatuses ; and of the 
 nature of morbid conditions, is of the utmost im- 
 portance. Nay more, a mastery of these various 
 branches of anatomy is essential to the study of 
 the natural history of diseases. By its aid, all de- 
 viations from the normal state of the body or any 
 part thereof are at once recognised. It remains 
 only to differentiate these abnormal conditions 
 and to define, name, and classify them. These, it 
 seems, are sufficient grounds for the adoption of 
 the anatomical basis for the nosography of man. 
 It is therefore suggested that all diseases, in- 
 juries, and congenital abnormities be grouped 
 into families, one family for each apparatus of 
 the body, and one or more than one family for 
 general diseases. Some of the families should 
 have two or more than two branches, and fami- 
 
METHOD OF THE CLASSIFICATION. 243 
 
 lies and their branches should be divided into 
 classes, orders, genera, species, sub-species, varie- 
 ties and sub-varieties. 
 
 It is of the utmost importance that, in the med- 
 ical profession, there be a consense of views con- 
 cerning not only nomenclature and methodical 
 arrangement but also the use of the terms of 
 classification. Notwithstanding the fact that the 
 early nosographers indicated, as best suited to 
 the purposes of nosography, the simple arrange- 
 ment of diseases into classes, orders, genera, 
 species, and varieties, the most recent of the 
 modern medical classifiers begins with classes 
 and after orders introduces " sub-orders, tribes, 
 and families," next to which he places genera, 
 species, and varieties. Such a method only leads 
 to confusion, complication, and uncertainty. Sim- 
 ilar methods have been tried in medicine and 
 found wanting in clearness and accuracy. 
 
 The plan proposed in this work does not in- 
 clude sub-orders, or tribes. Families are applied 
 to the groups of diseases dwelling in the appara- 
 tuses of the body. 
 
 The nosographer who lays before the profes. 
 sion a system of classification is in duty bound to 
 give an exact definition of each and every term 
 of classification which he employs, in order that 
 he may be rightly understood. 
 
244 QUESTIONS FOR THE TENTH 
 
 Only those terms of classification that are ap- 
 proved by the medical profession should be used 
 in a special or in a general nosography. 
 
 The sooner the question of method is put to a 
 vote, after free discussion in an association rep- 
 resenting the medical profession of the whole 
 world, the better it will be for the cause of ac- 
 curate nomenclature and classification. 
 
 Therefore the following questions are sug- 
 gested for discussion at the Tenth International 
 Medical Congress. 
 
 1. Shall there be instituted an International 
 system of nomenclature and classification of the 
 diseases of man ? 
 
 2. If so, what shall be the basis of this nomen- 
 clature and classification ? 
 
 3. What shall be the character of the nomen- 
 clature ? 
 
 4. What shall be the method of the classifica- 
 tion ? 
 
 5. What shall be the nature of the terms used 
 in the classification ? 
 
 6. Shall these terms be defined ? 
 
 In case the first question — shall there be insti- 
 tuted an international system of nomenclature 
 
INTERNATIONAL CONGRESS. 245 
 
 and classification of the diseases of man? — be de- 
 cided in the affirmative, it is further suggested : 
 
 1. That the International Medical Congress es- 
 tablish a permanent section on the nomenclature 
 and classification of the diseases of man, to be 
 composed of physicians and surgeons represent- 
 ing the medical profession of all nations. 
 
 2. That all national medical associations like- 
 wise establish each a section on the nomenclature 
 and classification of diseases, composed of physi- 
 cians and surgeons representing different regions 
 of country, in order that their knowledge of the 
 peculiarities presented by disease in differing 
 climates may be made available in the work to be 
 accomplished. 
 
 3. That state, city, and special medical associa- 
 tions, through their presiding officers, each ap- 
 point a committee on the nomenclature and 
 classification of diseases. — This can be effected 
 without, in any way, deranging the machinery of 
 these associations. 
 
 4. That the city and special associations report 
 to the State Associations such action as they may 
 take upon the proceedings of their committees. 
 
 5. That the reports of the city and special 
 associations be embodied in the report of the 
 
246 INTERNATIONAL CONGRESS. 
 
 State committee, and the consolidated reports be 
 presented to the State Association for action and 
 transmission to the national association. 
 
 6. That the national association refer the state 
 report to the national section on nomenclature, 
 etc., for a report after careful examination and 
 free discussion. The report to be acted upon by 
 the National Association and forwarded, or pre- 
 sented by a delegate, to the section on nomen- 
 clature and classification of the International 
 Medical Congress. 
 
 7. That the section on nomenclature and classi- 
 fication of the International Medical Congress 
 then revise the several national reports, consoli- 
 date them, and present their conclusions to the 
 Congress whose decision thereon should be final. 
 
 These suggestions are made in the belief that 
 they point to a fair method of obtaining the views 
 and the vote of the whole medical profession on 
 a subject of the vastest importance to mankind, 
 and also to the most expeditious way to attain 
 the desired end of compiling a uniform nomen- 
 clature and classification of diseases that may be 
 of practical utility to all nations. 
 
247 
 
 DEFINITIONS OF THE TERMS OF 
 CLASSIFICATION. 
 
 The following definitions of the terms of classi- 
 fication are modeled upon botanical nomencla- 
 ture, except those of family, class, and order, 
 which do not here occupy the same relative posi- 
 tions as in works on Botany and Zoology. 
 
 1. Families of diseases.'*' — A family is a group of 
 diseases dwelling in an apparatus of the human 
 body and affectmg, in a greater or less degree, 
 the organs of this apparatus and consequently its 
 function. Therefore affections of the organs of 
 an apparatus, and also general diseases affecting 
 several apparatuses at once, should be grouped 
 into families. 
 
 2. Branches of families. — A branch of a family 
 of diseases is a division of the family predicated 
 upon affections peculiar to sex ; as in the case of 
 the family of affections of the uro-genital appara- 
 tus which should be divided into two branches, 
 (i,) andrology, (2,) gynaecology; or upon the 
 
 * Family, — ixovafamilia, a family, and famulus, a servant, 
 and SjxtXta, an assembly, and the Hebrew word which means 
 to labor, — is the most general term, being those who are 
 bound together upon the principle of dependence. 
 
 Family includes in it every circumstance of connexion and 
 relationship. (Crabb.) 
 
248 DEFINITIONS OF THE 
 
 affections of an apparatus which includes two, or 
 more than two subsidiary apparatuses, as in the 
 cases of the cephalo-rhachidian, nutritive, and 
 cutaneous apparatuses. 
 
 3. Classes!^ — A class of diseases is ordinarily 
 defined as a division of diseases grouped together 
 on account of their common characteristics. In 
 this case, however, the term class is used to 
 signify a group of diseases which, though possess- 
 ing different characteristics, affect a particular 
 organ. In this system, therefore, the classes have 
 reference to, and bear the anatomical denomina- 
 tion of, the organs of an appparatus. 
 
 4. Orders.^ — Kw order is an association of 
 genera or a group of the general morbid condi- 
 tions of allied affections of particular organs. 
 The orders, therefore, refer to the general de- 
 
 * Class, from classis very probably from the Greek nXocdii, 
 a fraction, division, or class. Class is more general than order. 
 " Classification is a branch of philosophy which is not attaina- 
 ble by art only, it requires a mind peculiarly methodical by 
 nature, that is capable of distinguishing things by their 
 generic and specific differences ; not separating things that 
 are alike ; nor blending things that are different." (Crabb.) 
 
 t Order, from ordo, from opx^'^y a row, which is a species 
 of order, is applied to everything which is disposed. The 
 order lies in consulting the time, the place and the object, so 
 as to make them accord. (Crabb.) 
 
TERMS OF CLASSIFICATION. 249 
 
 nomination of the morbid condition of the organs 
 of an apparatus. 
 
 5. Genera!^ — A genus is an assemblage of spe- 
 cies possessing certain characters in common. 
 The genera, therefore, refer to the particular de- 
 nomination of the morbid condition of the organs 
 of an apparatus. 
 
 A single species having distinctive characters 
 that seem of more than specific value may con- 
 stitute a genus. 
 
 6. Species.\ — A species is a permanent series of 
 similar individual affections associated on account 
 of their common properties. These properties 
 are to be determined only by the closest observa- 
 tion of abnormal conditions of the human body. 
 Species, says Cullen, " are ready made by na- 
 ture" (he would have been more exact had he 
 said, the individual diseases which constitute 
 species are ready made by nature) ; the nosog- 
 
 * Genus, from gignere, from yevstv, to engender, " is a 
 class of objects divided into several subordinate species." 
 (Webster.) 
 
 t Species, from spicere, to behold, signifies literally the 
 form or appearance, and in an extended sense that which 
 comes under a particular form. Species is a term used by 
 philosophers, classing things according to their exiernal or in- 
 ternal properties." (Crabb.) 
 
250 DEFINITIONS OF THE 
 
 rapher has only to discover and name them, but 
 the orders and genera he must construct — not 
 according to fancy, but to reason and to definite 
 rules. Species are therefore named in accordance 
 with the general specific properties of the affec- 
 tions of the organs of an apparatus. 
 
 7. Sub-species. — A sub-species is a subordinate 
 species, possessing distinctive characters that arc 
 of more specific value than those of a variety. 
 On this account it occupies a middle position be- 
 tween the species and the variety. 
 
 8. Varieties!^ — A variety is a form of species 
 possessing peculiarities that differentiate it from 
 the typical characteristics of the species. The 
 varieties are therefore named in accordance with 
 the particular specific properties of the affections 
 of the organs of an apparatus. 
 
 9. Stib-varieties. — A sub-variety is a subordinate 
 variety or a division of a variety. It may indi- 
 cate morbid properties differing in their charac- 
 teristics from those typical of varieties, or may 
 
 * Variety, from varius which probably comes from varus a 
 speck or speckle, because this is the best emblem of variety. 
 Variety seems to lie in the things themselves. A variety can- 
 not exist without an assemblage. Variety strikes on the 
 mind, and pleases the imagination with many agreeable 
 images; it is opposed to dull- ««2/ic?rwi/y." (Crabb.) 
 
TERMS OF CLASSIFICATION. 2$ I 
 
 indicate the special cause of the affection. The 
 sub-varieties, therefore, relate partly to the spe- 
 cial character and partly to the aetiology of the 
 affections of the organs of an apparatus. 
 
 10. Symptoms^' — A symptom is a manifestation 
 of disease. It is perceptible to the senses, even 
 of the patient. 
 
 11. Signs. — The sign of a disease is the indica- 
 tion of its presence. It may be (i,) a sign per se, 
 indicating disease apart from symptoms, or (2,) 
 an inferential sign deduced from the analysis of a 
 symptom or of a group of symptoms. 
 
 The symptoms and signs, without which ac- 
 curate classification would be impossible, serve to 
 detect individual diseases and establish species, 
 and from the species the classification is con- 
 structed, for out of them spring the genera and 
 the orders, the varieties and the sub-varieties. 
 Therefore the position of symptoms and signs is 
 next in order to the fundation stone of no- 
 sography. 
 
 Symptoms of diseases, being their manifesta- 
 tions or those phenomena which are apparent to 
 the senses of the observer or even of the patient, 
 
 * Symptom, from 6vVf with, and ictjerstv, to fall. To fall 
 in with. Any perceptible change in the human body. 
 
252 TERMS OF CLASSIFICATION. 
 
 differ very materially from the signs, these being 
 deduced from the analysis of the symptoms. 
 Therefore the symptoms are noticeable by any- 
 body, but unless rightly interpreted are generally 
 of little value. It is only the wise and experi- 
 enced physician, after analyzing a group of symp- 
 toms and properly interpreting them, who can 
 perceive what is correctly termed the sign of a 
 disease.* 
 
 * The following note is paraphrased from Double's " Se?ne~ 
 iologie Generale. A collection of symptoms properly analyzed 
 becomes the sign of a disease. The sign is a conclusion 
 which the mind draws from the symptoms thus analyzed. 
 Therefore the sign belongs to the understanding and the 
 symptom to the senses. The sign of a disease may exist with- 
 out symptoms. It is said by Fernel that all symptoms are 
 signs but that all signs are not symptoms. Symptoms are 
 observed only in disease, but there are signs which belong to 
 health. It is not generally said that a man shows symptoms 
 of health, but that he shows signs of health. 
 
253 
 
 SECTION V. 
 
 REVIEW OF THE MORBID STATES AND MORBIFIC 
 
 PROCESSES. THE BACTERIA, PTOMAINES, 
 
 LEUCOMAINES, AND EXTRACTIVES. 
 
 Analysis of some of the terms used in general pathology 
 and of those contained in the synopsis of morbid states and 
 morbific processes, together with remarks on these stales 
 and processes. Summary of the present state of knowl- 
 edge of the bacteria, ptomaines, leucomaines, and " extrac- 
 tives." The relations borne, to medicine and surgery, by these 
 microorganisms and alkaloids of putridity. Classifications of 
 the bacteria, ptomaines and leucomaines. Uniformity in their 
 nomenclature and classification much needed. Remarks on 
 the neoplasms and on their classification. 
 
 As already stated, the synopsis of morbid 
 states and morbific processes is intended as a 
 suggestion of a ground-work for the classification 
 of diseases, but inasmuch as new terms are 
 therein proffered, and changes, tending to greater 
 precision, made in many of those that are in 
 general use, some explanation is due respecting 
 the nature of the new words and the foundation 
 of the changes in the old terms. Therefore most 
 of the terms contained in the synopsis will now 
 be defined, analyzed and, as far as practicable, 
 reasons given for their introduction. 
 
254 ALTERATIONS OF THE BLOOD. 
 
 In this attempt to correct defective words and 
 to coin new terms, prefixes and terminals which 
 are in general use will be employed, such as 
 hyper which signifies over, above, excess, and will 
 be applied in the sense of increase, and hypo 
 which signifies under, below, and will be applied 
 in the sense of decrease. The terminal aemiay 
 from ai}ia, blood, will be employed in preference 
 to osis so often improperly used in that connec- 
 tion. The middle section of each term com- 
 pounded of three roots will also be explained and 
 its etymology given in a foot note. 
 
 I. ALTERATIONS IN THE QUANTITY, QUALITY, 
 AND COMPOSITION OF THE BLOOD. 
 
 I. Hyperaemia* is here used in its strict signi- 
 fication of a superabundance of blood, an in- 
 crease of its whole quantity in the body, and 
 is offered to replace '■'plethora vera,' poly- 
 aemia, and hyperaematosis. Hyperaemia has 
 often been wrongly employed to signify local 
 congestion or the accumulation of blood in the 
 capillary vessels, or even inflammation. In the 
 Lexicon of Medicine, etc., of the New Sydenham 
 Society, London 1886, hyperaemia is defined as 
 
 * vitipt over, above, excess, and atjxa, blood. Above the 
 normal amount of blood. 
 
ALTERATIONS OF THE BLOOD. 2$ 5 
 
 *' an excessive amount of blood in the vessels of a 
 part ; a local overfilling of the blood-vessels, so 
 that they are distended with blood and give more 
 or less increased redness to the part, with some 
 swelling. When hyperaemia continues there 
 may be oedema of the part from effusion of 
 serum, or there may be haemorrhage." There is 
 nothing in this definition, or rather description^ 
 to indicate general overplus of blood. It is, in 
 reality, a definition of congestion whose proper 
 place is under the caption of disturbances in the 
 circulatory apparatus. 
 
 2. Hypoaemia,* meaning an insufficiency of 
 blood, a decrease of its whole quantity in the 
 body, is introduced in place of anaemia which 
 literally signifies absence of blood. The inten- 
 tion in the coinage of the word anaemia was to 
 express the idea of a lessening of the red blood 
 cells, and it has failed to do so. The privative 
 alpha in this, and in many other words to which 
 it is affixed, leading to misconception of the con- 
 dition intended to be designated. Therefore 
 all w^ords so prefixed should be rejected, except 
 where the a is absolutely needed, as in atrophy^ 
 when cessation of nutrition is intended to be ex- 
 
 * From vTtOy under, beneath, below, and aipta, blood. Be- 
 low the normal amount of blood. 
 
256 ALTERATIONS OF THE BLOOD. 
 
 pressed, and in local anaemia when there is 
 literally no blood in the capillary vessels of a 
 part; e. g., local capillary anaemia caused by 
 ischaemia arising from constriction of the capil- 
 laries, the plugging of a neighboring arteriole, 
 etc. 
 
 The term hypoaemia was formerly used to in- 
 dicate the presence of blood in the anterior 
 chamber of the eye, although there is not a sylla- 
 ble in this word to show that it has reference to 
 the eye. Hypoaemia was also used synonym- 
 ously with ecchymosis, sugillatio. "Anaemia, 
 used {by the French) S3monymously with oligaemia, 
 is a want, or deficiency of blood ; the condition 
 of the body after great loss of blood; exsan- 
 guinity. There may either be a defect in the to- 
 tal quantity of blood, as occurs for a short time, 
 perhaps, after profuse haemorrhages, or a dimi- 
 nution in the relative amount of red corpuscles 
 as compared with the other constituents of the 
 fluid, as in chlorosis." * 
 
 This mixed definition, not of anaemia, but of 
 hypoaemia, hypoerythrocythaemia, hyperhy- 
 draemia and hypohydraemia, is very confused 
 and confusing. 
 
 * Lexicon of Medicine, etc. New Sydenham Society. 
 
ALTERATIONS OF THE BLOOD. 25/ 
 
 3. Hyperhydraemia* signifies increase of blood- 
 water which is not indicated by the commonly 
 used word hydraemia whose meaning is simply 
 blood-water, although it has been defined, by 
 high authorities, " as a watery condition of the 
 blood depending on defect of albumen and fibrin, 
 or on retention of water from arrest of the cu- 
 taneous or renal secretions." 
 
 Hyperhydraemia is the outcome, of profuse 
 haemorrhage, exhausting diseases, or starvation. 
 
 4. Hypohydraemia signifies decrease of blood- 
 water, and is the outcome of those diseases in 
 which much water is consumed in, or discharged 
 from, the body, as in cholera, erysipelas, acute 
 articular rheumatism, puerperal fever, typhus 
 and typhoid fevers, conditions producing poly- 
 uria, etc. 
 
 To express the idea of deficiency of serum in 
 the blood, Piorry adopted the term anhydraemia 
 which means absence of blood-water and is there- 
 fore inexact. 
 
 5. Hyperinosaemiaf signifies increase in the 
 tendency to the formation of blood-fibrin, while 
 hyperinosis indicates " over activity of muscular 
 fibre." The term hyperinosis was suggested by 
 
 * ijdoop, water. 
 
 t vitep, excess, i'i, i'roi, muscle, fibre, and at/ia, blood. 
 
258 ALTERATIONS OF THE BLOOD. 
 
 F. Simon to express the idea of " excess of fibrin 
 in the blood ; such as occurs in acute rheuma- 
 tism and in erysipelas, when it may amount to 
 upwards of one per cent." But this, like many 
 other imperfectly constructed terms, fails to con- 
 vey the intended idea, unless the final is be re- 
 placed by aemiuy 
 
 6. Hypoinosacmia signifies decrease in the 
 tendency to the formation of blood-fibrin. Flint* 
 uses the term hypinosis to signify imperfect 
 coagulation of the blood, but it really means de- 
 creased activity of muscular fibre. 
 
 Hypoinosaemia appears to be the more exact 
 term. " It has been observed in some acute 
 infectious diseases, in acute icterus, in death 
 from asphyxia, and in death from certain poisons, 
 such as sulphuretted hydrogen and hydrocyanic 
 acid." 
 
 7. Hyperleucontaemia signifies increase of 
 blood-albumen.f There being no Greek word 
 for albumen, the term leucontaemia is offered to 
 signify blood-albumen, from A.«v«ov, white of Ggg, 
 which is albumen. 
 
 * A. Flint, Principles and Practice of Medicine. 1886. 
 t The substance formerly called albumen of the blood is in 
 reality serine and metalbumen. {Flint's Physiology.) 
 
ALTERATIONS OF THE BLOOD. 2$^ 
 
 8. Hypoleucontaemia signifies decrease of 
 blood-albumen. Hypoalbuminosis, a hybrid word 
 and therefore inadmissible, has been used ta 
 designate a deficiency of albumen in the blood. 
 A condition existing in starvation or after a co- 
 pious haemorrhage. 
 
 9. Hyperalonaemia* signifies increase of blood- 
 salts. 
 
 10. Hypoalonaemia signifies decrease of blood- 
 salts. These alterations in the quantity of the 
 saline elements of the blood play an important 
 part in diseases. 
 
 11. Hyperchromataemiaf signifies increase of 
 blood-color. The coloring matter of the red 
 corpuscles of the blood is called haemaglobine 
 which is a hybrid word. It is sometimes dif- 
 fused in the blood owing to disintegration of the 
 red corpuscles, and thus the blood is increased in 
 color. The term haemoglobinaemia is used to 
 designate this condition, but its composition ren- 
 ders it hybrid as well as tautological. It is taken 
 from ai'/iict, blood, globulus^ globule, and the term- 
 inal ai'fxay blood. Hyperchromataemia seems to^ 
 indicate clearly an increase in the blood-color. It 
 
 * vita'py increase, ocXi, aXoov (genitive plural), salt salts,. 
 and ai'/xa, blood. 
 f xpoojiioCf color. 
 
26o ALTERATIONS OF THE BLOOD. 
 
 is for the pathoanatomist and clinician to de- 
 termine and interpret its causes and effects. 
 
 12. Hypochromataemia signifies decrease of 
 blood-color. As there is increase, so, in all prob- 
 ability, many circumstances arise to cause a de- 
 crease in the color of the blood. 
 
 13. Hyperleucocythaemia signifies increase of 
 white blood-cells. Leucocythaemia* is the term 
 ordinarily used, but it only means white blood- 
 cells, and expresses a normal condition. The 
 other terms, leucocytosis and lukaemia, sug- 
 gested by Virchow are quite as indefinite ; the 
 latter meaning white blood, which is lymph* 
 This eminent pathoanatomist adopts the word 
 leucocytosis to express the idea of a temporary 
 increase in the number of white corpuscles, but 
 the term entirely fails to convey such an idea. 
 In the case of a great and permanent increase of 
 white blood-cells he uses leucocythaemia or 
 lukaemia, both equally misleading. 
 
 In hyperleucocythaemia, the red blood-cells 
 are generally decreased in number, so that the 
 two conditions hyperleucocythaemia and hy- 
 poerythrocythaemia occur in conjunction. 
 
 Hypoxanthine has been found in considerable 
 
 * Xevxoif white, Mvdrti, pouch, bag, — cell. 
 
ALTERATIONS OF THE BLOOD. 261 
 
 quantity in cases of hyperleucocythaemia. 
 (Gamgee,) 
 
 14. Hypoleucocythaemia signifies decrease of 
 white blood-cells. 
 
 15. Hypererythrocythaemia* signifies increase 
 ot red blood-cells. Plethora,t plerosis, — meaning 
 repletion, and intended to mean a superabund- 
 ance of blood in the system but failing to do so ; 
 hence the division of plethora into general and 
 local, — hyperaemia, polyaemia, polycythaemia, 
 polyhyperaemia (!), angioplerosis, erythraemia 
 (red blood), have all been used, improperl}'- of 
 course, to designate increase of red blood-cells, 
 
 16. Hypoerythrocythaemia signifies decrease 
 of red blood-cells. Anaemia is generally, and im- 
 properly, used to express this condition. An- 
 aemia literally means absence of blood, and 
 should be restricted to the expression of the idea 
 of local absence of blood, — local anaemia, — such 
 as occurs in ischaemia which may be a temporary 
 or a permanent arrest of blood in a part, the lat- 
 ter arising from constriction of the capillaries, 
 from plugging of a neighboring arteriole, or 
 from some other cause. 
 
 ♦ epvQpoS, red. 
 
 t Plethora, from xXrfBoi, a great number. 
 
262 ALTERATIONS OF THE BLOOD. 
 
 17. Hyperlipaemia signifies increase of blood- 
 fat, and is generally called lipaemia (blood-fat), a 
 normal condition which is very variable in the 
 blood-plasma. It increases after the ingestion of 
 fatty substances until the blood may acquire a 
 milky appearance. Fat has been known to in- 
 crease in the blood of diabetics, in certain affec- 
 tions of the liver, in phthisis, in chronic alcohol- 
 ism, and in fat embolism. 
 
 18. Hypolipaemia signifies decrease of blood- 
 fat. 
 
 19. Hyperphysaemia signifies increase of blood- 
 gas. The gases which exist normally in the 
 blood are carbon dioxyde, oxygen, and nitrogen, 
 either in solution, or in combination with organic 
 or inorganic compounds. Their increase gives 
 rise to abnormal states which will not here be 
 discussed. The reader is therefore referred for 
 further information on this interesting subject to 
 Paul Bert's experiments, and to works on general 
 pathology in which are found articles on the ef- 
 fects of high atmospheric pressure, air embolism, 
 etc. 
 
 20. Hypophysaemia signifies decrease of blood- 
 gas. The ill effects of this condition are fully 
 treated of in the works to which allusion has 
 been made above. But a word may be said in 
 
ALTERATIONS OF THE BLOOD. 263 
 
 reference to the effects of rarefaction of the at- 
 mosphere on the respiration and on the blood, 
 such as are felt during the ascent of high moun- 
 tains. The name of the " mountain disease or 
 anoxyaemia " has been given to the condition of 
 individuals who, thus breathing an insufficient 
 amount of oxygen, take more but shorter inspira- 
 tions than normally, suffer head-ache, epistaxis 
 and other haemorrhages, and are soon overcome 
 by fatigue, cold, sleep, and in some cases by 
 death. The same phenomena occur during 
 baloon ascensions. A notable instance is re- 
 corded by Tissandier, sole survivor of three who 
 had ascended to a great height in the baloon 
 Zenith."^ Jourdanet has published an interesting 
 work, in two volumes, upon the influence of at- 
 mospheric pressure on the life of man, based 
 upon a long experience and many observations 
 made principally in Mexico. f 
 
 21. Hyperglycaemia signifies increase of blood- 
 sugar. Glycaemia, blood-sugar, is a normal con- 
 dition. It is only when the sugar exceeds in 
 amount two parts and a half in one thousand of 
 blood that it causes any disturbance. It then 
 
 * Academie des Sciences 25 Avril 1875, La relation de M. 
 G. Tissandier, seul survivant. 
 
 t Sur I'influence de la pression de I'air sur la vie de rhomme» 
 Paris 1875. 
 
264 ALTERATIONS OF THE BLOOD. 
 
 shows itself in the urine and constitutes what is 
 known as glycosuria. It arises from the disas« 
 similation of certain alimentary substances. 
 
 22. Hypoglycaemia signifies decrease of blood- 
 sugar. 
 
 23. Acetonaemia signifies acetone in the bloods 
 That acetone is found in the blood in connection 
 with disease is not doubted, but its exact import 
 is still unsettled. On the other hand it has been 
 asserted that '' acetone is a normal product of 
 tissue metamorphosis." 
 
 24. Ammoniaemia signifies ammonia in the 
 blood. Ammonium carbonate is formed in stag- 
 nant, decomposed urine in the pelves of the kid- 
 neys or in the bladder, and absorbed and carried 
 into the circulation, or may be absorbed from the 
 intestines. In cases of stagnation of urine in the 
 bladder, a bacterial ferment is said to have been 
 discovered which possesses the property of con- 
 verting urea into ammonium carbonate. 
 
 This ferment is often introduced from without 
 through the use of unclean catheters. 
 
 "It was suggested by Frierichs, in 1852, that 
 uraemic phenomena are due to the conversion of 
 urea into ammonium carbonate in the blood, but 
 there is no ground for believing that such conver- 
 sion actually occurs during life." (Gamgee.) 
 
ALTERATIONS OF THE BLOOD. 265 
 
 25. Hyperuraemia signifies increase of blood- 
 urea. Uraemia means blood-urea, but it is 
 generally used in the sense of accumulation in 
 the blood of the elements of the urine. May 
 not the group of phenomena called urinary in- 
 toxication be due to the accumulation in the 
 blood, of acetone together with ammonium car- 
 bonate, urea, and other deleterious excrementi- 
 tious substances, such as the " extractives " ? 
 
 In an experimental study of the poisonous prop- 
 erties of the urine of different animals, Charrin 
 concludes " that the urea is not the toxic agent 
 of the urine." 
 
 Hyperuraemia indicates the increase of a nor- 
 mal constituent of the blood (urea). 
 
 26. Hypouraemia signifies decrease of blood- 
 urea. 
 
 27. Hyperuricaemia signifies increase of blood- 
 uric acid. Flint first suggested the term uric- 
 aemia which simply means blood-uric acid, and 
 Murchison adopted the word lithaemia (from 
 Xi'Qoij stone), stone in the blood, meaning uric 
 acid in the blood which is a normal condition. 
 
 A great increase of uric acid in the blood has 
 been observed by Garrod in the disease called 
 gout. 
 
266 ALTERATIONS OF THE BLOOD. 
 
 28. Hypouricaemia signifies decrease of blood- 
 uric acid. 
 
 29. Cholaemia signifies bile in the blood. In 
 morbid conditions where the exit of the bile from 
 the liver is impeded, the bile is absorbed by the 
 lymphatics and carried into the circulation. The 
 constituents of the bile creating certain toxic ef- 
 fects, and the bilirubin staining most of the tis- 
 sues of the body and producing the condition 
 known as icterus or jaundice. 
 
 30. Hypercholesteraemia signifies increase of 
 blood-cholesterin. Flint jr. asserted, in 1862, 
 *' that the cholesterin of bile is a result of an ex- 
 cretory function of the liver not previously 
 recognised, and that it is an excrementitious 
 principle derived chiefly from the disassimilation 
 of nervous tissue," and has given the name of 
 cholesteraemia to the accumulation of cholesterin 
 in the blood. He attributes grave toxic effects 
 to such accumulation. Up to the present date 
 Doctor Flint holds the same opinion on this sub- 
 ject. Some of the French, English and German 
 writers take issue with Doctor Flint in his view 
 that hypercholesteraemia is capable of producing 
 the toxic effects attributed to " grave-jaundice." 
 
 31. Hypocholesteraemia signifies decrease of 
 blood-cholesterin. 
 
SEPTICAEMIA, PTOMAINES. 26/ 
 
 32. Melanaemia signifies black pigment in the 
 blood. The different views respecting the pro- 
 duction of this condition will not here be dis- 
 cussed. The reader is therefore referred to works 
 on general pathology.* 
 
 33. Septicaemia f signifies putrid infection of 
 the blood. This is due to infection of the blood 
 with the poisons of putrefied animal substances. 
 These animal poisons are now known to be 
 alkaloidal, and are named ptomaines, from Tcroo/xa, 
 cadaver, and zV, in, eV, within, opposed, to e'k 
 without. The terminal in, or ine, is ordinarily 
 employed by chemists to designate alcaloids. 
 There is nothing in this etymology to denote an 
 alkaloid, therefore ptomaine is not a word of 
 precision. if 
 
 The ptomaines may be evolved in severely in- 
 jured parts of the human body followed by rapid 
 decomposition, before suppuration takes place, 
 or in blood effused in the great cavities of the 
 
 * There are other changes in the constituents of the blood, 
 but they are not sufficiently well known to be here considered, 
 
 t From 6r}7tTo<iy putrid, and ai/ia, blood. 
 
 \ Selmi derives ptomaine " from nronfioLy a carcase, a dead 
 body, and ivoy denoting material ; or in, from the Latin inus 
 belonging to." But ivo does not seem to mean material, and 
 even if it should have such a signification, material is too ob- 
 scure to designate alkaloid. 
 
268 PTOMAINES. 
 
 body such as the pleura or peritoneum, or may 
 be ingested with food, and thus be absorbed and 
 infect the blood. 
 
 They are called ptomaines because of their 
 original discovery in putrid cadavers. 
 
 As some of the readers of this work may de- 
 sire to study the subject more extendedly than it 
 can be here presented, only a brief account, with 
 some references, will be given of the discovery 
 of ptomaines, and of the investigations, of their 
 nature, toxic properties, and mode of develop- 
 ment, now going on in Europe and America. 
 
 Discovery, in medicine, is generally slow and 
 gradual, and results from the labors of many 
 men. The first discoverer may only observe the 
 effect, another finds the cause, still another dis- 
 covers the generic substance and perhaps its 
 properties, then investigators arise who discover 
 species and varieties, and finally come those 
 practical men who are able to interpret the 
 phenomena directly or indirectly connected with 
 them and from their analysis of these phenomena 
 deduce the remedial means to be taken. 
 
 Ptomaines!^ — The history of the discovery of 
 
 * Doctor A. M. Brown defines a ptomaine, " considered 
 from a purely chemical point of view, as the cyclical nucleus 
 of a proteid molecule that has undergone complete destruc- 
 tion in the process of putrefaction." 
 
PTOMAINES. 269 
 
 ptomaines is a notable illustration of the forego- 
 ing statement. In 1822 Gaspard, and in 1856, 
 Professor Panum, of Copenhagen, found putrid 
 substances to contain active poisons the nature of 
 which they could not ascertain. In 1868, Berg- 
 mann and Schmiedeberg believed that they found 
 in contaminated blood a crystallizable nitrogenous 
 substance, which they called sepsine and which 
 they had found in putrid yeast. Their discovery 
 was contested. In 1869, Zeulzer and Sonnen- 
 schein are said to have obtained from putrescent 
 animal matter an alkaloid having the properties 
 of atropia. Rosch and Fassbender also found, in 
 putrescent animal matter, an amorphous salt giv- 
 ing reactions similar to those of digitaline. Dupre 
 and Bence Jones extracted, from the liver, a salt, 
 giving the fluorescence of sulphate of quinia, 
 which they named animal chinoidine. 
 
 Professor Armand Gautier, of Paris, found, in 
 1872, that, while undergoing putrefaction, the 
 fibrin of the blood gave a small quantity of com- 
 plex alkaloids, fixed and volatile. The late Pro- 
 fessor Selmi, of Bologna (1870, -75, -78, -80) ar- 
 rived at similar results in his experiments with 
 putrefied human tissues, and announced that un- 
 der these conditions, toxic organic alkalies, 
 analogous to vegetable alkalies, were formed. 
 Since then these substances have been studied, 
 
2/0 PTOMAINES. 
 
 especially by Gianetti and Corona (1880), Brouar- 
 del and Boutmy (1881), Bouchard (1882-3), Gau- 
 tier and Etard (1886), and Brieger (1886). 
 
 Ncncki (1876) appears to have been the first to 
 indicate the chemical formula of a ptomaine. 
 
 Gautier divides the animal alkaloids into two 
 distinct groups, ptomaines and lejicomaines.^ The 
 first are the products of organic matter in putre- 
 faction, the second, of the living organism in 
 health and in disease. 
 
 Ptomaines vary in different phases of putrefac- 
 tion. Brieger has found successively in the dead 
 human body ; choline, neuridine, cadaverine, pu- 
 trescine, trimethylamijie^ and mydaleine. Besides 
 the above, Gautier enumerates the following 
 ptomaines ; parvoline^ hydrocollidine, collidine, and 
 saprine. 
 
 These alkaloids are evolved through microbic 
 fermentation generally after death ; but are more 
 or less toxic when ingested with food. 
 
 In a recent article, Professor Vaughan, of the 
 University of Michigan, divides the ptomaines 
 into two classes; (i,) those containing oxygen: 
 (2,) those containing no oxygen. *' Among the 
 
 * Gautier gave to the alkaloids of the human organism the 
 name of leucomaines " to indicate their albumenoid origin." 
 
PTOMAINES. 271 
 
 most important members of the second class are 
 the following : 
 
 1. '' Collidine — Cs Hn N, discovered by Nencki 
 in 1876, in gelatine allowed to putrefy with infu- 
 sion of pancreas. 
 
 2. " Parvoline — Cb H13 N, discovered by Gau- 
 tier in 1 88 1, as a product of the putrefaction of 
 fish. Parvoline is an oily base, of amber color 
 and boils at 200° C. It is slowly soluble in wa- 
 ter, freely soluble in ether, alcohol and chloro- 
 form. 
 
 3. " Hydrocollidine — Ce Hia N, discovered by 
 Gautier and Etard in 1882, also from putrid fish. 
 It is an oily liquid, boiling at 210° C. It is very 
 poisonous, seven milligrammes being sufficient 
 to kill a pigeon. Death is preceded by nervous 
 excitement and tetanic convulsions. 
 
 4. ''Base — Ci7 H38 N4, discovered by Gautier 
 and Etard in 1882. It is not poisonous. 
 
 5. "■ Base — Cio Hi N, discovered by Guareschi 
 and Mosso in 1883, in putrid beef. It is not 
 poisonous, or is so only in very large quantity. 
 
 6. '* Neuridine — Ce Hi4 Na, discovered by 
 Brieger in 1884. It is wholly inert, and its im- 
 portance depends upon its presence in nearly all 
 putrid matter and upon the fact that it gives all 
 
2/2 PTOMAINES. 
 
 the general alkaloidal reactions, and for this 
 reason may be mistaken for some vegetable 
 poison by the toxicologist. 
 
 7. " Tyrotoxicon'^ — Cs Hs N2, discovered by 
 Vaughan in 1885, in poisonous cheese, and found 
 by himself and others later in milk, ice cream, 
 custard, cream puffs, etc. This is a highly poison- 
 ous body, producing nausea, vomiting, collapse 
 and death. 
 
 8. "■ Cadaverine — Cs Hia N,, discovered by 
 Brieger in the cadaver. It is inert 
 
 9. '' Putrescine- — C* H12 Na, also discovered by 
 Brieger, is not poisonous. 
 
 10. " Mydaleine, — The chemical composition of 
 this ptomaine has not been determined. It di- 
 lates the pupils and elevates the temperature 
 from 1° to 2° when injected under the skin. 
 
 *' Among the oxygen containing ptomaines, the 
 most important are : 
 
 I. '^ Neurine — Cs His NO, contracts the pupil, 
 lessens the respirations, hastens the action of the 
 heart, causes profuse diarrhoea and the involun- 
 tary emission of urine. 
 
 * See the Report of Doctor Vaughan to the Michigan State 
 Board of Health for 1885. 
 
 According to Gautier putrid cheese yields neuridine. 
 
PTOMAINES. 273 
 
 2. " Choline — Cs Hib NO2, is found in small 
 quantity in the bile as well as in putrid matter. 
 It is less powerful in action than neurine, which 
 it resembles. 
 
 3. '* Gadiymie — O Hia NO2, discovered by 
 Brieger, is not poisonous." 
 
 Doctor A. M. Brown* arranges the ptomaines 
 into "■ two classes, the non-oxygenous and oxy- 
 genous. The first come from the pyridic bases 
 of Gautier, or those ptomaines which, besides be- 
 ing the most abundant, persist throughout the 
 whole of the putrefactive process." 
 
 " NON-OXYGENOUS ALKALOIDS. 
 
 1. '' Par vo line y C9 H13 N. — This was the first 
 ptomaine chemically analysed and defined. It 
 was discovered by Gautier and Etard in the 
 putrefactive products of the mackerel and horse 
 
 flesh It is described by them as an oily 
 
 base 
 
 2. '' Hydro-Collidine, Cs H 3 N. — This base has 
 also been obtained from the putrefactive pro- 
 ducts of the mackerel and horse, and even ox 
 
 * A treatise on the animal alkaloids, cadaveric and vital ; or 
 the ptomaines and leucomaines, etc. London, 1887, p. 31 
 et seq. 
 
274 PTOMAINES. 
 
 flesh it is very poisonous, even in very small 
 
 quantities. 
 
 3. ''Base, Ci7 Hse N*. — The analysis 
 
 which Gautier and Etard have made of this 
 chloroplatinate enables them to establish the 
 formula C17 Hxs N4 2 H CI. 
 
 4. " Base, Cio His N. — This ptomaine was dis- 
 covered in 1883, by Guareschi and Mosso, who 
 isolated it by the Gautier-Etard method from the 
 
 putrid fibrine of the bullock It has also 
 
 been detected among the basic products arising 
 from the putrefaction of cephalopod pulps 
 
 5. " Collidine, Cs Hn N. — Was extracted by 
 Nencki, in 1876, from the putrefactive products 
 
 of gelatine and of bullock pancreas, 
 
 {mixed with water) 
 
 6. '' Neuridine, Ce H14 N2. — This base is one of 
 the most constant products of the putrefaction of 
 albumenoid substance. The ptomaine was dis- 
 covered in 1884 hy Brieger, who has since de- 
 tected it in the putrescent matters of flesh, fish, 
 
 decaying cheese, etc Chemically pure 
 
 neuridine is not toxic. 
 
 7. " Cadaverine, Ce Hn Na. — In bodies subjected 
 to prolonged putrefaction, Brieger has met with 
 a base of very difficult purification, to which he 
 has given the name of cadaverine. Boeckersh 
 
PTOMAINES. 275 
 
 has separated it from herring brine, and quite re- 
 cently — 1884 — the alkaloid has been detected in 
 marine cephalopod pulp. The ptomaine is not 
 toxic. 
 
 8. '' Putre seine, C* H12 N2. — Like the preceding 
 ptomaines, it is obtained from the flesh of the 
 mammifera, and from herring brines. It is not 
 toxic. 
 
 9. '' Mydaleme. — In the mother liquors from 
 which the preceding bases have been isolated 
 owing to the varying solubility of their platini- 
 chlorides, there remains a toxic alkaloid which 
 has also been isolated, but in too small quantities 
 to permit of its complete study. The analysis of 
 it is suggestive of a diamine similar to those we 
 have been dealing with ...... 
 
 "OXYGENOUS ALKALOIDS. 
 
 " These bases serve as the connecting link be- 
 tween the ptomaines and the leucomaines. With 
 the exception of gadinine they are to be met with 
 in the normal tissues as well as in putrescent 
 animal materials. 
 
 (C Hs) \ 
 I. " Neurine, Q, Hi, N (O H)= N O H. 
 
 Ca Hs y 
 
 *' Hydrate of trimethylvinylammonium. 
 
276 PTOMAINES. 
 
 " It is known that the breaking up of a complex 
 compound with a watery solution of baryta, the 
 lecithine present in the animal economy, by tak- 
 ing- up or fixing the water, furnishes besides 
 phosphoglyceric and stearic acids, and a base 
 choline Cs His NO2 the synthesis of which 
 Wurtz effected in treating trimethylamine with 
 oxyde of ethylene in the presence of water 
 
 C Ha\ (C H3)3 x 
 
 0+ (C H3)3 N + Ha 0= N. O H 
 
 C H2/ Ca H4 O H/ 
 
 " This synthesis characterises choline as the 
 hydrate of trimethylhydroxethylene — ammon- 
 ium. Treated with hydriodic acid, choline is 
 converted into an iodide of iodethylene-trimythyl- 
 ammonium 
 
 (C H3)3 \ (C H3) 3 \ 
 
 N. 0H + 2HI = 2H20+ NI. 
 
 Ca H4 O H / Ca H4 I / 
 
 " The oxyde of silver transforms this latter 
 body into a new base neurine which is a hydrate 
 of trimethylvinylammonium 
 
 (C H8)3 \ (C H3)3 \ 
 
 N. I + Ag 2 O = 2 Ag I + N. O H. 
 
 C2 H4 I / Ca Ha / 
 
 " This is the neurine that has been met with by 
 Brieger in the products of cadaveric putrefac- 
 
PTOMAINES. 277 
 
 tion, when it arises from the breaking up of 
 lecithine. It is a syrupy base soluble in water in 
 any proportion, strongly alkaline ; its chloro- 
 platinate well crystallised may be removed from 
 the mother liquors of the neuridine. This base 
 is toxically interesting. 
 
 (C H3)3 X 
 
 2. '' Choline, Cb H15 N O, = N. O H. 
 
 C2 H4— O H / 
 
 Hydrate of trimethylhydroxethylenine — am- 
 monium. 
 
 " It is Strieker who has isolated this body from 
 the bile. It is distinguished from neurine by the 
 composition and formula of constitution as given 
 above. The choline is a base which is elaborated 
 both during normal life of the tissues, and during 
 their bacterial destruction, and is therefore, both 
 ptomaine and leucomaine. Brieger has isolated 
 it by crystallising in the form of picrate of choline 
 in the mother liquors from which he derives the 
 neurine 
 
 Choline is less toxic than neurine. 
 
 3. " Muscarine, Ce H13 N Os, was discovered by 
 Schmiedeberg and Koppe in the toadstool — 
 agaricus muscarius. Schmiedeberg and Hartnack 
 have accomplished its synthesis by oxydising 
 
278 PTOMAINES. 
 
 choline with nitric acid ; this permits muscarine 
 to be regarded as an aldehydic alkaloid. 
 
 (C H8)8 X 
 
 N O H. 
 
 ** Brieger has isolated it along with ethylene- 
 diamine in putrid fish meat. Muscarine is found 
 present in the mother liquors, in which the 
 chloride of platinum has precipitated the ethy- 
 lene-diamine 
 
 Muscarine is a violent poison. 
 
 4. " Gadinine, O Hie N O2. — Brieger obtains 
 this body at the same time and along with the 
 preceding base from the cod-fish — gadus callarius 
 — in process of putrefaction. This alkaloid has 
 
 not been isolated in a free state Its salts 
 
 are not toxic. 
 
 5 and 6. Bases, C» His N^ Oe, and O Hx, Na O4. 
 — Pouchet has published since 1880, quite a 
 series of interesting works on the ptomaines. He 
 endeavours to isolate by a somewhat similar 
 method to that of Stas and Drugendorff, the 
 alkaloids of the residuary liquors resulting from 
 its industrial treatment of bones, flesh, and debris 
 of every kind, by dilute sulphuric acid 
 
 " In the course of his researches, Brieger has 
 detected other alkaloids still less defined or 
 
PTOMAINES. 279^ 
 
 simply indicated, which are having now his care- 
 ful study " 
 
 brieger's nomenclature. 
 
 The following table is arranged after Brieger's 
 nomenclature; the several ptomaines occupy the 
 relative positions in which they appear in the 
 French translation of his work.* 
 
 I. Ptomaine of peptone. 
 I. Peptoxiyie. 
 
 II. Ptomaines of putrefied meat. 
 
 1. Neuridine 
 
 2. Neiirine 
 
 3. Choline. 
 
 III. Ptomaines of putrefied fish. 
 
 1. Ethylene-diamine 
 
 2. Animal muscarine 
 
 3. Gadinine 
 
 4. Triethylamine. 
 
 IV. Ptomaines of putrefied cheese. 
 
 1. Neuridine 
 
 2. Trimethylamine. 
 
 * L, Brieger, Microbes, ptomaines et maladies. Ouvrage 
 tradnit de I'Allemand par les Docteurs Roussy et Winter^ 
 Paris, 1887. 
 
2So PTOMAINES. 
 
 V. Ptomaines of putrefied gelatine. 
 
 1. Isophenyl-ethylamiyie of Nencku 
 
 2. Neiiridine of gelatine 
 
 3. Dhnethylamirie. 
 
 VI. Ptomaine of putrid yeast. 
 I. Dimethylamifie of yeast. 
 
 VII. Ptomaines of the human cadaver. 
 
 1. Choline 
 
 2. Neuridine 
 
 3. Cadaverine 
 
 4. Putrescine 
 
 5. Saprine 
 
 6. Trimethylamine 
 
 7. Mydaleine, 
 
 When putrefaction occurs at a low tempera- 
 ture the toxic alkaloids are developed slowly, and 
 ^ice-versa. 
 
 In the different states of putrefaction of human 
 •cadavers, Brieger has found ptomaines which 
 disappear to be replaced by others. Lecithine^ 
 which exists normally, is followed by choline^ 
 then other alkaloids are elaborated. On the 
 •second day neuridine^ which is accompanied by 
 choline, is found. The choline soon begins to 
 disappear in favor of trifnethylamijte. The neurid- 
 ine then increases ; the greater quantity being 
 
PTOMAINES. 281 
 
 furnished by the intestines, the large parenchy- 
 matous organs containing but little of this salt. 
 On the seventh day of putrefaction the choline 
 disappears while the neuridine lasts until the 
 fourteenth day. For two days after the beginning 
 of putrefaction there is no poison as the first two 
 alkaloids are not toxic. Cadaverhie increases dur- 
 ing the whole process of putrefaction. With 
 cadaverine, putreschie and saprine are ordinarily 
 found. Choline and trimethylamine are not toxic 
 except in large quantity. The really strong 
 poisons are not developed until fifteen days from 
 the beginning of putrefaction. Mydaleine is not 
 developed until three weeks. It is the most toxic 
 of all the alkaloids. Injected in small quantity into 
 guinea-pigs and rabbits, it causes inflammation of 
 the mucous membranes, dilatation of the pupils, 
 and increase of the body temperature. An mjec- 
 tion containing half a centigramme of mydaleine 
 caused the sudden death of a cat. It gives rise to 
 profuse diarrhoea and vomiting. (Gautier). 
 
 Nicati and Rietsch have obtained, from pure 
 cultures of the cholera bacillus, a ptomaine 
 which, they say, produces symptoms of cholera 
 when injected into the body of an animal. 
 
 Gautier says that the typhoid fever bacillus of 
 Eberth does not cause putrefaction, but that the 
 liquids in which it has lived contain a trace of a 
 
282 PTOMAINES. 
 
 base which possesses the property of dilating the 
 pupils, and causes diarrhoea, and very soon 
 death. 
 
 From cultures of the tetanus bacillus, growing- 
 in connection with a non-pathogenic organism 
 from which it has not yet been freed in pure cul- 
 tures, Brieger has separated a ptomaine which he 
 calls tetanin, and which, injected hypodermically, 
 produces, in animals, symptoms similar to those 
 induced by inoculation with the organisms them- 
 selves, namely symptoms of tetanus.* (Com- 
 municated by Doctor Prudden). 
 
 Brieger has " obtained from mussels, (i,) a non- 
 poisonous substance; (2,) a substance which is 
 isolated by means of platinum chloride, and 
 which produces energetic salivation and diar- 
 rhoea ; (3,) the specific virus, which combines 
 only with the tetrahedral platinum chloride. It 
 possesses the characteristic properties of curare ; 
 (4,) an analogous body, probably a decomposi- 
 tion-product. It is an energetic poison and occa- 
 sions shiverings. Non-poisonous mussels, if 
 brought in from the offing and deposited in the 
 harbor, become poisonous, but lose this property 
 again if returned to the open sea. (Is the de- 
 velopment of the poisonous principles occasioned 
 
 * Deutsche Med. Wohenschr. Apl. 14th, 1887, p. 303. 
 
PTOMAINES. 283 
 
 by the mussels feeding- npon sewage-matters?"*) 
 
 Carles has discovered in decayed salt cod-fish a 
 red micrococcus, and describes the condition un- 
 der the name of red stock-fish. 
 
 Gautier asserts that putrid fish yields a poison 
 which has the same composition and action 
 as muscarine. 
 
 Gautier desiring to ascertain if the saliva of the 
 higher orders of animals contains a poison similar 
 to the venom of serpents, found, in the saliva of 
 man a toxic alkaloid which narcotises birds. This 
 alkaloid, he says, resembles cadaveric alkaloids^ 
 is soluble in water, is not an albumenoid and is in^ 
 destructible by a heat of 212". 
 
 The study of ptomaines is of very great im- 
 portance alike in chemistry, pathology and legal 
 medicine. Particularly in the last named depart-^ 
 ment of medicine, when it is considered that 
 most of the ptomaines are liable to be mistakeit 
 for such vegetable alkaloids as strychnia, vera- 
 tria, nicotia, hyoscyamia, atropia, etc. 
 
 The body of a man w^ho has died from the ef- 
 fects of a poison does not contain ptomaines until 
 decomposition has been fairly established, but the 
 ptomaines are found under the same condition of 
 
 * Chemical News, June 1886. 
 
-284 PTOMAINES. 
 
 putrefaction when the cause of death is other 
 than poison. 
 
 Doctors Brouardel and Boutmy report that 
 having analyzed the viscera " of a person asphyx- 
 iated by charcoal fumes, they found them free 
 from poison. Eight days later the same viscera 
 were again subjected to analysis and found to 
 contain a solid organic base presenting the gen- 
 eral characteristics of alkaloids, and toxic enough 
 to kill, even in small doses, frogs and guinea pigs. 
 This shows that putrefaction gives rise to organic 
 -alkaloids when no poisoning has taken place." 
 
 On another occasion they " found a venenous 
 ptomaine in a subject poisoned by arsenious acid, 
 thereby agreeing with Professor Selmi who, in 
 1873, met with the same ptomaine in two subjects 
 also poisoned by arsenic. Hence it is seen that 
 ptomaines will form as well in subjects who come 
 to their death without poison, as in those who 
 died from the ingestion of a poison, like arsenic, 
 possessing strong antiseptic properties." 
 
 Some of the ptomaines are very poisonous to 
 man when ingested with food. An illustrative 
 case of ptomaine poisoning is related as follows : 
 *' Twelve persons who had eaten a tainted goose 
 containing an alkaloid resembling conia, offered 
 all the symptoms of dangerous poisoning. One 
 of them even died in a few hours, after copious 
 
PTOMAINES. 285. 
 
 vomitings, although no other cause of death but 
 the presence of ptomaine could be detected^ 
 Hence it may be concluded that ptomaines can 
 cause the death of man as well as of animals — as 
 they are known to do. Much time is not neces- 
 sary for the formation of these alkaloids, for the 
 goose above mentioned had been bought at the 
 market on the very morning of the poisoning ac- 
 cident, and had passed the regulation inspec- 
 tion." 
 
 This should be a warning to those who have 
 acquired a taste for what is called *' high game," 
 which is game in a more or less advanced state 
 of decay and in which ptomaines have already 
 been formed. 
 
 The reported cases of poisoning ascribed to 
 eating partridges that were supposed to have fed 
 on the cocculus indicus or fish-berry, were, in all 
 probality, ptomaine poisoning. 
 
 Doctor Lauder Brunton, of London, cautions 
 the people against the indiscriminate use of the 
 digestive ferments and of artificially digested 
 foods as likely to contain poisonous alkaloids. 
 This caution may be extended to the case of 
 canned foods. 
 
 The existence of ptomaines has been denied, 
 but the weight of evidence is overwhelmingly 
 in favor of their formation in putrid animal mat- 
 
2S6 LEUCOMAINES. 
 
 ter. Some of them are said to be very noxious, 
 while others possess scarcely any toxic proper- 
 ties. They are not developed until putrefaction 
 is established, therefore refrigeration of the body 
 has been recommended as the simplest means of 
 retarding decomposition in case a medico-legal 
 investigation should be necessary to establish the 
 presence or absence of poison in the body. 
 
 A case in point, is related, of a sudden death, 
 where there were suspicions of poisoning. Doc- 
 tor Brouardel, who had charge of the inquiry, 
 caused the body to be immediately conveyed to 
 the Paris Morgue for refrigeration. An examina- 
 tion was duly made and no poison was found in 
 the body. Had decomposition begun, a doubt 
 would have arisen, and its solution would have 
 been very difficult if not impossible if a ptomaine 
 ihad been found and could not be easily dis- 
 tinguished from a poisonous vegetable alkaloid. 
 
 Leucomaines. — There have been many differences 
 of opinion respecting the origin of leucomaines. 
 According to Bouchard, alkaloids are found in 
 animal matter where microscopic mushrooms 
 live and swarm ; and he regards them as pro- 
 ducts of the disintegration of vegetable or- 
 ganisms. He thinks that, if these bacteria, living 
 in animal matter, manufacture alkaloids, it may 
 be asked if other bacteria, swarming in a living 
 
LEUCOMAINES. 287 
 
 organism may not produce analogous substances. 
 To verify this supposition he examined the urine 
 of patients affected with infectious diseases and 
 constantly found therein some of these alkaloids. 
 However, distinct traces of such alkaloids are 
 found in the urine of healthy persons, but this 
 does not prove that they are not developed from 
 forms of vegetable organisms. It was long ago 
 shown that, in health, there are great quantities 
 of microbia in the alimentary canal ; this being 
 the case, alkaloids may be formed in the intes- 
 tines, absorbed, and finally eliminated with the 
 urine. 
 
 Bouchard has shown that all recent fecal mat- 
 ter contains alkaloids in amount proportionate to 
 the quantity to microbia, and formulates the fol- 
 lowing propositions : 
 
 1. Alkaloids exist in the healthy human body ; 
 
 2. They are manufactured in the digestive 
 tube, and are apparently elaborated from vegeta- 
 ble organisms, agents of intestinal putrefaction ; 
 
 3. The alkaloids of normal urine represent a 
 part of the alkaloids of the intestines, absorbed 
 into the system and eliminated by the kidneys ; 
 
 4. Diseases which tend to increase intestinal 
 putrefactions, augment, by this process, the 
 amount of the urinary alkaloids. 
 
288 LEUCOMAINES. 
 
 5. While regarding as probable that these 
 alkaloids, in certain infectious diseases, have for 
 origin the microbia infesting the solids and fluids, 
 it may be positively asserted that, in typhoid 
 fever especially, a part, at least, of the urinary 
 alkaloids are intestinal products. 
 
 According to Gautier, leucomaines are only in 
 part the products of bacterian ferments. He has 
 shown that they do not all spring from this 
 source for, he and others have found that the 
 body contains the following named crystallizable 
 alkaloids ; Karniney Adenine, Guanine , Sarkine^ 
 Xanthocreatinine, Crusocreatinine, Amphicreatinine^ 
 Xanthine, and Pseudoxanthine, besides the "extrac- 
 tives" which are very toxic. He accounts for 
 their development as follows : he has demon- 
 strated that the higher animals are anaerobic * 
 in a considerable proportion, and it is now 
 acknowledged that nearly two tenths of man's 
 disassimilations are produced at the expense of 
 the tissues themselves without any aid of oxy- 
 gen ; the tissues living, in part, after the manner 
 
 * The terms aerobia and anaerobia, were proposed by 
 Pasteur to designate two classes of low organisms. The 
 former incapable of living without free oxygen, and the latter 
 multiplying itself indefinitely without the aid or presence of 
 oxygen. 
 
LEUCOMAINES. 289 
 
 of anaerobic or putrid ferments ; the animal cells 
 are then comparable, by their action on organic 
 matter, to bacteria, and in their products of dis- 
 assimilation should be found the same substances 
 as in the products of putrid fermentation of the 
 albumenoids. These alkaloids have been found 
 not only in the urine, but in the blood, in the 
 saliva, etc. 
 
 In a physiological state, these poisons are 
 eliminated by the kidneys, skin, and alimentary 
 canal, when they have not been consumed by the 
 oxygen of the blood, for they are ordinarily very 
 oxydizable. 
 
 When the aeration of the blood is imperfect, 
 leucomaines or substances of their nature accu- 
 mulate in the blood and give rise to morbid 
 processes. Along with these substances there are 
 others (the " extractives " ), equally nitrogenous 
 but not alkaloidic, which always accompany them 
 and are endowed with still greater toxic proper 
 ties. If the elements of the tissues can act as do 
 microbia and engender, like them, toxic products, 
 it should be admitted that certain infections are 
 not heterochtonous. The action of these poisons 
 differs from that of animated beings by the fol- 
 lowing characters : 
 
 I. They act only when they are found in ap- 
 preciable quantity in the organism. 
 
290 LEUCOMAINES. 
 
 2. Their consequences have an intensity pro- 
 portionate to quantity. 
 
 3. These consequences are almost immediate, 
 there being no incubation. 
 
 Gautier thinks that an appreciable distinction 
 may be made between bacterial and autochtonous 
 alkaloids. But other observers entertain the be- 
 lief that it is not possible in the present state of 
 knowledge of the subject to indicate the precise 
 point where the former series ends and the latter 
 begins, for, some of them are common to both 
 types. 
 
 Doctor A. M. Brown has arranged the leu. 
 comaines as follows : 
 
 " I. The Uric Leucomaine Group. — 
 Betaines. 
 
 Betaine is the representative of this group, hav- 
 ing the chemical formula of 
 
 (C H3), = N — O 
 a Hii N Oa = I 
 
 C Ha — C O. 
 
 " The base was originally discovered in beet- 
 root in 1866 by Scheifler, and in 1869 Liebreich 
 detected its presence in human urine. 
 
 I. Karnine^ O Ha N4 Os. — Commences the 
 natural series of alkaloids of the urine groups. 
 The base was isolated from imported meat by 
 
LEUCOMAINES. 29I 
 
 Weidel, and afterwards in yeast waters by 
 Schutzenberger. 
 
 2. Adenine, C» H* N*. — Discovered by Kossel 
 in 1885. 
 
 3. Guanine, Cb Hs Ns O. — Discovered in 1884 
 by Unger, and since met with in a great number 
 of products of animal nature ; in the flesh, the 
 organs and the excremental matters of certain 
 mammifera, in fowls, and fish, and also in certain 
 plants. 
 
 4. Sarkine or hypoxanthine, Cs H* N* O. — Found 
 in certain plants, but for the most part in animal 
 tissues. 
 
 5. Xanthine, Cb H4 N4 O*. — Is widely distrib- 
 uted in the organism, in almost all the liquids and 
 tissues of the animal economy from the splitting 
 up of neucleine. The base was first isolated by 
 Marcet in 18 19. 
 
 6. Fseudo-xanthine, C* He Ns O. — Discovered 
 by Gautier in the muscular tissue of the higher 
 animals. 
 
 *' These last four leucomaines form a distinct 
 group, as to community of origin, with analogous 
 chemical properties : — (i,) They all possess a com- 
 bination (C5 H4 N4) of a remarkable stability, 
 analogous in certain respects to the stability of 
 pyridic compounds. (2,) They can all give up 
 
292 LEUCOMAINES. 
 
 cyanhydric acid, and two of them, xanthine and 
 hypoxanthine, may be obtained synthetically in 
 operating with the same cyanhydric acid. (3,) 
 All of them are derived from albumenoid sub- 
 stances by reactions which are identical in origin. 
 (4,) Three of them present in a high degree that 
 insolubility in water which the pyridic com- 
 pounds exhibit. 
 
 '' Hydrocyanic acid forms the chemical skeleton 
 of that cellular nucleus which is the most active 
 phenomenon of vitality. 
 
 •' II. The Kreatinine Leucomaine Group. 
 
 1. That well known base, Kreatinine^ 
 
 NH CO 
 
 C4 Ht Ns O N H = C I 
 
 N (C Ha) — C H, 
 
 heads the list of the other new alkaloids dis- 
 covered by Gautier since 1881. They are all of 
 fresh-meat origin. Kreatinine was discovered by 
 Liebig in the action of chlorohydric acid on 
 Kreatine, and Pettenkofer afterwards found it in 
 human urine. 
 
 2. Xantho-creatinine, C» Hio N4 O. — The most 
 abundant of these bases, is of cadaveric odour, 
 soluble in cold water, and with a strongly alkal- 
 ine reaction. 
 
 3. Crusocreatinine, Ce Hs N* O. — Possessing the 
 
LEUCOMAINES. 293 
 
 general properties of Kreatinine which it strongly 
 resembles in chemical elements and alkalinity. 
 
 4. Amphicreatinine, Ca Hia Nt O4. — Corresponds 
 with two molecules of Kreatme plus the C N H 
 groupment, thus having the closest analogy to 
 Kreatine, although the formula seems to differ 
 widely from it. 
 
 " III. An unclassified Group — According 
 TO THEIR Sources. 
 
 1. From the urine. — A uride — allantoine — and a 
 base — Karnine — already known, a second alka- 
 loid has been discovered with the formula Ct H14 
 N4 O.. 
 
 2. From the blood and important viscera. — Alka- 
 loids have been met with in appreciable quanti- 
 ties. 
 
 3. Fro7n the spleen. — Mr. Morel, of Lille, has ob- 
 tained an alkaloid isolated in deliquescent crys- 
 tals. 
 
 4. From the intestines. — A base which seems to 
 belong to the pyridic group isolated from 
 choleraic dejections. 
 
 5. From the saliva. — Gautier has determined 
 the existence of an alkaloid in human saliva. 
 
 6. From the venoms of certain snakes and batra- 
 chians as well as certain mollusca and fishes. — 
 
294 LEUCOMAINES AND EXTRACTIVES. 
 
 From this latter class, Brieger has identified an 
 active principle in the mytiloxin and has given its 
 formula as C« His N O2." 
 
 The ^^ Extractives^ — It has been ascertained, 
 that the ptomaines and leucomaines are accom- 
 panied by equally nitrogenous but not alkaloidic 
 substances the exact nature of v^hich is not yet 
 know^n. But the fact has been verified that they 
 are endowed with greater toxic properties than 
 the ptomaines and leucomaines. They are called 
 the extractives for convenience of distinction. 
 Not being well known, they cannot yet be prop- 
 erly named. 
 
 '* According to the different sources of poison- 
 ing ; there are different indications, signs, 
 
 or symptoms, capable of classification as below : 
 (i,) Poisoning by the ' extractives * is attended by 
 hyperthermia. (2,) Poisoning by the ' animal 
 alkaloids' is accompanied by hypothermia. (3,) 
 A combination or succession of hyperthermic and 
 hypothermic phenomena may become manifest, 
 according to the combination or alternation of 
 poisoning by the deleterious physiological pro- 
 ducts, or their antagonistic action." (Brown, 
 quoted from Aitken). 
 
 The body of man in health may become pois- 
 oned by the gradual accumulation, within itself, 
 of deleterious substances normally elaborated but 
 
LEUCOMAINES AND EXTRACTIVES. 295 
 
 imperfectly eliminated. Hence the slow and in- 
 sidious onset of much ill health, from which re- 
 covery is correspondingly slow. Constitutional 
 diseases such as gout and rheumatism being 
 examples of the effects of this auto-infection. 
 (Aitken). How this auto-infection takes place 
 Doctor Brown says, can only be understood and 
 explained by the mode in which the phenomena 
 of life are regarded. ** Life is the result of the 
 combination of many physiological processes, in 
 the concurrent exercise of the bodily functions 
 which are essentially relative and contingent on 
 each other, implying at the same time a series of 
 partial and local deaths. Thus it is that the 
 organism lives on conditions of incessant elemen- 
 tary disintegrations." 
 
 Man resists the auto-infection to which he is 
 constantly exposed; ''(i,) by the elimination 
 through the liver, the kidneys, the skin, the 
 lungs, and the intestinal mucous membrane ; (2,) 
 by the destruction of the toxic products by oxy- 
 genation, which consists in a continuous combus- 
 tion of the leucomaines by the oxygen of the 
 blood, in which they are consumed, or partially 
 in the tissues and organs." 
 
 The foregoing summary of the present state of 
 knowledge of the ptomaines, leucomaines and 
 " extractives," is abstracted from the works of 
 
296 GENESIS OF INFECTIOUS DISEASES. 
 
 Hallopeau, * Cornil and Babes, f Gautier, J 
 Brieger, || Brunton, ||| Brown, § Aitken, §§ and 
 from the Chemical News. T[ 
 
 The fact that the genesis of infectious diseases 
 is bacteria or at least ptomainic, is accepted by 
 many experienced pathoanatomists and practising 
 physicians, and also by surgeons, particularly in 
 the case of septicaemia occurring after severe in- 
 juries or after surgical operations. 
 
 The study of the clinical aspects of the 
 ptomaines, leucomaincs, and " extractives," so 
 well begun by Doctor Lauder Brunton and Sir 
 William Aitken of London, by Professor Peter of 
 Paris, and by other clinicians, will surely lead 
 
 * Traite Elementaire de Pathologic Generale. Paris 1887. 
 
 t Les Bacteries, etc. Paris 1886. 
 
 \ Sur les alcaloides derives de la destruction bacterienne ou 
 physiologique des tissues animaux. Bulletin de V Academie 
 de Medecine. Paris 1886. 
 
 II Microbes Ptomaines et Maladies. Ouvrage traduit de 
 TAllemand par le Dr. Roussy et J. Winter. Paris 1887. 
 
 III On disorders of digestion, their consequences and treat- 
 ment. London 1886. 
 
 § A Treatise on the Animal Alkaloids, Cadaveric and Vital ; 
 or the Ptomaines and Leucomaines. London 1887. 
 
 §§ On the Animal Alkaloids, etc. American edition. Phila- 
 delphia 1887. 
 
 t The "Chemical News," 1886-7. 
 
PYOSAPRAEMIA, BACTERIA. 29/ 
 
 many physicians earnestly to consider this very 
 important subject. 
 
 For convenience and a clearer understanding- 
 of the subject it would be well for a number, if 
 not all, of the bio-chemists, who are engaged in 
 the investigation of the ptomaines, leucomaines 
 and "extractives," to have a conference for the 
 purpose of constructing a uniform nomenclature 
 and classification of these toxic agents. 
 
 34. Pyosapraemia* signifies putrid-pus infec- 
 tion of the blood. The term pyaemia is ordina- 
 rily employed to designate the condition above 
 named, because it was originally believed that 
 pus cells effected an entrance into the circulation. 
 It is now known that the pus of a wound does 
 not pass into the blood current, but that the ele- 
 ments of putrid-pus make their way mto the 
 blood. Therefore the term pyosapraemia is the 
 more exact. 
 
 Pyosapraemia differs from septicaemia both 
 clinically and pathically. Septicaemia often oc. 
 curs before the formation of pus, and the blood is 
 poisoned in the manner already stated, while 
 pyosapraemia may not show itself until several 
 weeks after the infliction of a wound. In sep- 
 ticaemia there are generally no secondary ab- 
 
 * From levo?, pus, 6a7tpoi, putrid, and atpiocj blood. 
 
298 BACTERIA. 
 
 scesses. In pyosapraemia infective thrombi, 
 swarming with microorganisms, are formed in 
 the veins and carried into circulation to cause 
 multiple abscesses in the viscera and other parts 
 of the body distant from the spot injured. In 
 these thrombi, the staphylococcus and streptococcus 
 Pyogenes are found. 
 
 A word concerning bacteria in general may not 
 here be out of place, for their importance in 
 medicine and surgery is undoubted by those who 
 have critically examined the whole subject. The 
 great question, not yet solved, is to what extent 
 the bacteria themselves constitute the morbific 
 cause, and to what extent this cause is to be 
 sought in the infection of the blood by the alka- 
 loids which these microorganisms manufacture. 
 
 Bacteria. — Towards the end of the seventeenth 
 century, Leuwenhoek discovered the leptothrix 
 and vibrio in the saliva and faeces, and believed 
 these microorganisms to be animalcules. It was 
 not until 1838 that they were looked upon as 
 bacteria. In his thesis for the doctorate in science 
 (1853) Ch. Robin classed vibriones and bacteria 
 with algae and yeast fungi. It is, however, only 
 in the last fifteen or twenty years that bacteria 
 have been largely studied in their relation to dis- 
 ease. These studies were not instituted until 
 some time after Davaine and Pasteur had demon- 
 
BACTERIA. 299 
 
 strated the connection of bacteria with certain 
 diseases of the lower animals, notably anthrax. 
 
 The microbia are so largely diffused in the air, 
 water and earth, and the destructive properties 
 of these infinitely small organisms are so great 
 that they have been styled the masters of the 
 world. The schizomycetes, which contribute 
 most of the pathogenic species, as their name im- 
 plies, are multiplied by division and with great 
 rapidity. They are parasitic, living upon organ- 
 ized substances which they destroy by causing 
 fermentation and putrefaction. They float in the 
 air mixed with dust, are found in stagnant water, 
 in sewers, in sluggish streams flowing through 
 cities, in harbors, on the sea coast, and even in 
 the depths of the ocean ; in fact wherever they 
 find sustenance. They occur in large quantities 
 in the mouth and in the fecal matter of man and 
 beast. In the soil their quantity is prodigious, 
 particularly in damp places, or during rainy 
 season. Duclaux has shown that the germination 
 of plants cannot take place in a soil which has 
 been deprived of microorganisms, and that plants 
 cannot utilise organic substances until these have 
 been modified by the microbia. 
 
 The bacteria infest the human body by effect- 
 ing entrance principally through the respiratory 
 and digestive organs. Cheese and fermented milk 
 
300 BACTERIA. 
 
 are filled with microorganisms. It is said that 
 the gastric juices arrest their growth. Pasteur 
 and Duclaux are of opinion that digestion cannot 
 be effected without their intervention. 
 
 The schizomycetes probably appeared among 
 the first vegetables. Van Tieghem has found 
 them in coal. They have always occured in the 
 mouth of man. Zopf and Miller have found rods 
 of leptothrix upon the teeth of Egyptian mum- 
 mies. (Cornil and Babes.) 
 
 Since 1870 Cohn and other bacteriologists have 
 devoted much time and labor to the study and 
 arrangement of pathogenic microorganisms, and 
 Budd, PoUender, Naegeli, Zopf, Van Tieghem, 
 Koch, Rabenhorst, Fliigge, Sternberg, and many 
 others have contributed valuable material in 
 illustration of the assertion that ''infectious dis- 
 eases are due to a living contagion." * This 
 statement, respecting infectious diseases, made, 
 as a hypothesis, many years ago, by Henle, Sir 
 Henry Holland, and J. K. Mitchell, of Philadel- 
 
 * As long- ago as the middle of the eighteenth century, 
 Needham, Buffon, Spellanzani, Bonnet, and others, had 
 demonstrated the existence of low organisms in putrid matter, 
 but without clearly understanding their nature, although they 
 considered these organisms as factors in the production of 
 disease. 
 
BACTERIA. 301 
 
 phia, is now, by most pathoanatomists, considered 
 as demonstrated. 
 
 Davaine seems to have been the first to estab- 
 lish that these microorganisms are vegetable and 
 not, as originally believed, animal parasites. Cohn 
 placed them in the class of Schizospores (cleav- 
 ing spores) and found that they contained no 
 chlorophyll. Naegli named them Schizomycetes 
 (cleaving fungi), and Billroth asserted that they 
 consisted of only one species, which he called 
 coccobacteria septica. 
 
 Cohn has divided morphically the schizomy- 
 cetes into four groups : 
 
 1. Sphero-bacteria, or globular bacteria, cocci \ 
 
 2. Microbacteria, or bacteria in rods, short rods; 
 
 3. Desmobacteria, or bacilli, long rods ; 
 
 4. Spiro-bacteria, or spiral bacteria, spirilla. 
 
 SYNOPSIS 
 
 OF corn's classification of bacteria. 
 
 Schizophytes. — Thallophytes being developed 
 by division or by endogenous germinative cells. 
 
 First tribe. — A. Free cells united by two or by 
 four. 
 
 Spherical cells chroococcus (Naegli). 
 
 Cylindrical cells . . . ,synechococcus (Naegli). 
 
302 BACTERIA. 
 
 B. Cells united in zoogloeae by an amorphous 
 
 substance. 
 
 a. Cellular membrane confounded with the in- 
 
 tercellular substance. 
 Sphericial cells. . . .micrococcus (Hallier). 
 Cylindrical cells. . .bacterium (Dujardin). 
 
 b. Intercellular substance arranged in concen- 
 
 tric layers. 
 
 Round cells glaeocapsa. 
 
 Cylindrical cells glaeothece. 
 
 C. a. Cells forming circumscribed zoogloeae 
 
 of definite form, families arranged in 
 
 plates of a single layer. . . .merismopedia. 
 Round cells arranged in a network of 
 
 zoogloeae .... clathrocystis. 
 Cylindrical and cuneiform cells, families 
 
 divided by constriction. . .coelosphaerium. 
 Cells forming families with several layers 
 
 united in cubical, colorless corpuscles, 
 
 with quarternary arrangement . . .sarcina. 
 Very great but undetermined number of 
 
 colorless cells .... ascococcus. 
 
 Second tribe, nematogenes. — Filamentous cells. 
 
 A. Without ramifications : 
 
 I. Cylindrical, colorless, with little marked 
 division, very slender, short, bacillus \ — long, 
 leptothrix. 
 
BACTERIA. 303. 
 
 2. Cylindrical filaments, thicker and longer^ 
 beggiatoa. 
 
 3. Broken, with colorless conidia, crenothrix. 
 
 4. Spiral, short, and undulated filaments, vi- 
 briones ; — short, with rigid spirals, spirillum ; — 
 long, with flexible spirals, containing phyco- 
 chrome, spirocyth ; — long filaments and flexible 
 spirals, spirulina. 
 
 5. Filaments in beads without phycochrome, 
 streptococcus. 
 
 6. Cylindrical and colorless zoogloeae, myconos^ 
 toe ; — in beads, nostoc ; — filaments thinned at one 
 extremity, rivolaria. 
 
 B. Filaments with false ramifications, clado^ 
 thrix ; — cylindrical and colorless fila- 
 ments, streptothrix, 
 
 synopsis of 
 
 zopf's pleomorphic classification of 
 
 the schizomycetes * 
 
 Zopf divides the schizomycetes (fission-fungi) 
 into four groups : Coccaceae ; Bacteriaceae ; 
 Leptotricheae ; Cladotricheae ; sixteen genera : 
 Streptococcus ; Merismopedia ; Sarcina ; Micro- 
 
 * Taken in greater part from Crookshank* 5 Manual of 
 Bacteriology, Second edition, 1887. 
 
304 BACTERIA. 
 
 coccus; Ascococcus; — Bacterium; Spirillum; 
 Leuconstoc ; Bacillus ; \ribrio ; Clostridium ; — 
 Crenothrix ; Beggiatoa ; Phragmidiothrix ; Lep- 
 tothrix, Cladothrix ; — and one hundred and 
 ninety-five species. 
 
 Group I. Coccaceae. 
 
 Possessing, so far as known, only cocci, and 
 thread forms resulting from the juxtaposition of 
 cocci. The fission occurring in one or several 
 directions. 
 
 Genera: i, Streptococcus \ 2, Micrococcus \ 3, 
 Merisinopedia\ 4y Sarcina-, ^^ Ascococcus, 
 
 Genus L Streptococcus (chain cocci). 
 
 Divide in only one direction. The cocci are 
 generally united in the form of chains. 
 
 Species. 
 
 Species associated with disease in man and 
 animals. 
 
 1. Streptococcus pyogenes. .Pathogenic in man 
 
 and animals. 
 
 2. " ** malignus. .Saprophytic in 
 
 man, patho- 
 genic in ani- 
 mals. 
 
BACTERIA. 305 
 
 3. Streptococcus pygenes aureus Pathogenic 
 
 in man and 
 animals. 
 
 4. " " albus Pathogenic in 
 
 man and ani- 
 mals. 
 
 5. " " citreus .... Pathogenic in 
 
 man and ani- 
 mals. 
 
 6. *' cereus albus . . Associated with pus, 
 
 but not pathogenic 
 in man or animals. 
 
 7. " cereus flavus. .Associated with pus, 
 
 but not pathogenic 
 in man or animals. 
 
 S. " erysipelatosus.. Pathogenic in man 
 
 and animals. 
 
 9. '* toxicatus Pathogenic (?) 
 
 10. " in puerperal fever. .Possibly sapro- 
 
 phytic only. 
 
 11. " in endocarditis Possibly sapro- 
 
 phytic only. 
 
 12. " in diphtheria Possibly sapro- 
 
 phytic only. 
 
 13. " articulorum .. Saprophytic in man, 
 
 pathogenic in ani- 
 mals. 
 
306 BACTERIA. 
 
 14. Streptococcus in cerebro-spinal meningitis. . . 
 
 Possibly saprophytic only. 
 
 15. " in yellow-fever. .Possibly saprophy- 
 
 tic only. 
 
 16. " in dental caries. .Possibly saprophy- 
 
 tic only. 
 
 17. " variolae etvacciniae. .Pathogenic in 
 
 man (?) and 
 animals (?). 
 
 Species associated with disease in animals. 
 
 18. Streptococcus of swine-erysipelas ... Patho- 
 
 genic (?). 
 
 19. " of cattle plague Pathogenic. 
 
 20. " of foot and mouth disease " 
 
 21. " of septicaemia consecu- 
 
 tive to anthrax " 
 
 22. " septicus ** 
 
 23. '* of progressive tissue ne- 
 
 crosis in mice " 
 
 24. * " perniciosus Pathogenic (?). 
 
 25. " bombycis Pathogenic. 
 
 26. " insectorum Possibly saprophytic 
 
 only. 
 
 Species unassociated with disease. 
 
 27. Streptococcus viscosus. . . .Zymogenic sapro- 
 
 phyte. 
 
BACTERIA. 307 
 
 28. Streptococcus coronatus . . Simple saprophyte. 
 
 29. " radiatus ** " 
 
 30. ** flavus desidens. . " ** 
 
 Genus II. Merismopedia^ (Plate-cocci). 
 
 Divide in two directions, forming lamellae or 
 plates. 
 
 Species. 
 Species associated with disease. 
 
 1. Merismopedia gonorrhoeae. Pathogenic in man, 
 
 2. Micrococcus tetragonus. .Saprophytic in man, 
 
 pathogenic in ani- 
 mals. 
 
 3. Diplococcus albicans tardissimus.. Saprophytic 
 
 in man. 
 
 Species unassociated with disease. 
 
 4. Micrococcus citreus conglomeratus. .Simple 
 
 saprophyte- 
 
 5. " subflavus Simple saprophyte. 
 
 6. " albicans amplus. .. " ** 
 
 Genus III. Sarcina, (Packet-cocci). 
 Divide in three directions, forming colonies in 
 cubes or packets. 
 
 Species, 
 
 Unassociated with disease. 
 
 I. Sarcina lutea Chromogenic saprophytes. 
 
3o8 
 
 BACTERIA. 
 
 Sarcina aurantiaca.Chromogenic saprophytes. 
 
 " ventriculi Simple saprophytes. 
 
 " intestinalis 
 
 " urinae 
 
 " litoralis 
 
 " Ritenbachii 
 
 " hyalina 
 
 alba 
 
 Genus IV. Micrococais^ (Mass-cocci). 
 
 Divide in one direction, after division the cocci 
 may remain aggregated in irregular heaps, but 
 never form chains. 
 
 Species. 
 
 Species associated with disease in man. 
 
 I. Micrococcus in scarlatina Possibly only 
 
 saprophytic, 
 in measles. . . . Possibly only saprophytic, 
 in whooping 
 
 2. 
 3. 
 
 4- 
 
 5. 
 6. 
 
 cough 
 in haemophilia 
 neonatorum 
 
 in typhus 
 
 in acute yellow 
 atrophy 
 in dental caries 
 in gangrene . . . 
 
 <( 
 
BACTERIA. 309 
 
 9. Micrococcus pyogenes tenuis. .Possibly only 
 
 saprophytic. 
 la " in rabies Pathogenic (?). 
 
 In animals. 
 
 11. " of septicaemia in rabbits Pathogenic. 
 
 12. " of pyaemia " '* " 
 
 13. " of progressive suppuration in 
 
 rabbits " 
 
 14. " parvus ovatus ** 
 
 15. " of pyaemia in mice " 
 
 In plants. 
 
 16. Micrococcus amylivorus Pathogenic (?)► 
 
 Species unassociated with disease. 
 
 17. Micrococcus cyaneus.. . .Chromogenic sapro- 
 
 phyte. 
 
 18. " aurantiacus. Chromogenic saprophyte^ 
 
 19. " chlorinus. .. " «« 
 
 20. *' violaceus. .. " " 
 
 21. " luteus ** " 
 
 22. " rosaceus ... ** " 
 
 23. " haematodes " " 
 
 24. " candidus Simple saprophyte. 
 
 25. ** candicans '* ** 
 
 26. " foetidus 
 
 27. ** crepusculum " " 
 
 28. " cinnabareus " " 
 
310 BACTERIA. 
 
 29. Micrococcus flavus lique- 
 
 faciens .... Simple saprophyte. 
 
 30. " '* tardigradus 
 
 31. " versicolor 
 
 32. " viticulosus 
 
 33. " lacteus faviformis. 
 
 34. " fulvus 
 
 Genus V. Ascococcus, (Pellicle-cocci). 
 
 Are like the micrococci, but the cocci grow in 
 characteristic gelatinous pellicles. 
 
 Species. 
 
 Unassociated with disease. 
 
 I. Ascococcus Billrothii. Zymogenic saprophyte. 
 
 Group II. Bacteriaceae. 
 
 *" Possessing mostly cocci, rods (straight or bent), 
 and thread forms (straight or spiral). The first 
 may be absent, and the last possess no distinc- 
 tion between base and apex. Division, as far as 
 known, occurs in one direction. 
 
 Genera: i, Bacterium] 2 y Spirillum; 3, Vibrio; 
 4, Leuconstoc] 5, Bacillus', 6, Clostridium. 
 
 Genus I. Bacterium. 
 Cocci and rods, or only rods, which are joined 
 
BACTERIA. 311 
 
 to form threads. Spore-formation absent or un- 
 known. 
 
 Species. 
 
 Species associated with disease in man and 
 animals. 
 
 1. Bacterium pneumoniae crouposae. ... Patho- 
 
 genic (?); possibly 
 only saprophytic 
 in man, patho- 
 genic in animals. 
 
 2. " pseudo — pneumonicum.. Saprophytic in 
 
 man, patho- 
 genic in ani- 
 mals. 
 
 3. " Neapolitanum Saprophytic in man, 
 
 pathogenic in ani- 
 mals. 
 14. "in rhinoscleroma. Pathogenic in man (?). 
 
 5. " in diphtheria Saprophytic in man (?), 
 
 pathogenic in ani- 
 mals. 
 
 6. " saprogenes Saprophytic in man, 
 
 pathogenic in ani- 
 mals. 
 
 7. " decalvans Saprophytic. 
 
312 BACTERIA. 
 
 Species associated with disease in animals. 
 
 8. Bacterium in diphtheria of calves Patho- 
 
 genic (?). 
 
 9. " in diphtheria of pigeons. . . . Pathogenic* 
 ID. ** cholerae gallinarum 
 
 11. " septicum agrigenum 
 
 12. " of septicaemia in rabbits. . . . 
 
 13. *' of Davaine's septicaemia. . . . 
 
 14. " septicum sputigenum 
 
 15. " crassum sputigenum 
 
 16. *' pneumonicum agile 
 
 17. *' oxytocum perniciosum 
 
 18. " cavicida 
 
 19. " coli commune 
 
 20. *' lactis aerogenes 
 
 21. Panhistophyton ovatum 
 
 In plants. 
 
 22. Bacterium hyacinthi Pathogenic (?). 
 
 Species unassociated with disease. 
 
 23. Bacterium synxanthum. .Chromogenic sapro- 
 
 phyte. 
 
 24. *' indicum Chromogenic saprophyte* 
 
 25. " rubrum " " 
 
 26. " prodigiosum.. " " 
 
 27. " luteum " " 
 
 28. '* violaceum ... " " 
 
it l« 
 
 (( 11 
 
 BACTERIA, 313 
 
 29. Bacterium brun- 
 
 neum..Chromogenic saprophyte. 
 
 30. *' fluorescens 
 
 putidum 
 
 31. " fluorescens 
 
 liquefaciens 
 
 32. " ureae Zymogenic saprophyte. 
 
 33. *' aceti " •' 
 
 34. " Pasteurianum. . " ** 
 
 35. " liodermos Simple " 
 
 36. *' multipediculum .... ** " 
 
 37. " ramosum lique- 
 
 faciens. " " 
 
 38. " Zopfii 
 
 39. ** merismopedioides . . 
 
 40. " Fflugeri 
 
 41. " photometricum " 
 
 42. *• litoreum ** 
 
 43. " fusiforme " " 
 
 44. ** navicula " " 
 
 45. Proteus vulgaris 
 
 46. " mirabilis 
 
 47. '* Zenkeri *• 
 
 48. Bacterium termo 
 
 49. *' lineola ** 
 
 it 
 ft 
 « 
 
 n n 
 
 (( tt 
 
 It 
 
 Genus II. Spirillum. 
 Threads screw-form, made up of short or long 
 
314 BACTERIA. 
 
 rods only, or of rods and cocci. Spore-formation 
 absent or unknown. 
 
 Species. 
 
 Species associated with disease in man and 
 animals. 
 
 1. Spirillum Obermeieri Pathogenic. 
 
 2. ** cholerae Asiaticae. Pathogenic in man (?), 
 
 possibly only sapro- 
 phytic. Pathogenic 
 in animals. 
 
 3. " Finkleri.. . .Saprophytic in man. Patho- 
 
 genic in animals. 
 
 4. " tyrogenum . Saprophytic. Pathogenic in 
 
 animals. 
 
 5. " sputigenum. Saprophytic. Pathogenic in 
 
 animals. 
 
 Species unassociated with disease. 
 
 6. Spirillum plicatile Simple saprophyte. 
 
 7. " serpens 
 
 8. " tenue 
 
 9. " undula 
 
 10. *' volutans 
 
 11. " Rosenbergii 
 
 12. '* attenuatum 
 
 13. " leucomelaneum. .. 
 
BACTERIA. 315 
 
 Genus III. Leuconstoc. 
 
 Cocci and rods. Spore-formation present in 
 
 cocci. 
 
 Species. 
 Unassociated with disease. 
 I. Leuconstoc mesenteroides Zymogenic sa- 
 prophyte. 
 
 Genus IV. Bacillus. 
 
 Cocci and rods, or rods only, forming straight 
 or twisted threads. Spore-formation present 
 either in rods or cocci. 
 
 Species. 
 
 Species associated with disease in man and 
 
 animals. 
 
 1. Bacillus leprae Pathogenic. 
 
 2. ^ " in syphilis Pathogenic (?) ; possibly 
 
 only saprophytic. 
 
 3. " typhosus Pathogenic (?) ; possibly 
 
 only saprophytic. 
 
 4. " malariae. ..Pathogenic in man (?), patho- 
 
 genic in animals. 
 
 5. " of choleraic diarrhoea from 
 
 meat poisoning. .Pathogenic. 
 
 6. " pyogenes foetidus.. Saprophytic in man, 
 
 pathogenic in animals. 
 
3l6 BACTERIA. 
 
 7. Bacillus in septicaemia in man. .Saprophytic. 
 
 8. " in gangrenous septicaemia. " 
 
 9. " tuberculosis Pathogenic. 
 
 10. ** antracis " 
 
 1 1. " mallei " 
 
 12. " of malignant oedema (ani- 
 
 mals) " 
 
 13. " of septicaemia of mice " 
 
 14. *' of ulcerative stomatitis in 
 
 the calf *' 
 
 1 5. *' swine-typhoid " 
 
 16. " swine-erysipelas ** 
 
 17. " in tetanus (animals) Pathogenic (?). 
 
 18. " alvei (animals) Pathogenic. 
 
 Species unassociated with disease. 
 
 19. Bacillus ianthinus. .Chromogenic saprophyte. 
 
 20. " pyocyaneus .. " '* 
 
 21. ** cyanogenus .. " " 
 
 22. " acidi lactici Zymogenic 
 
 23. " Fitzianus " 
 
 24. " subtilis Simple 
 
 25. ** figurans ** 
 
 26. *' of jequirity 
 
 27. " caucasicus 
 
 28. " dysodes 
 
 29. " Hansenii " 
 
 30. " erythrosporus " 
 
 It 
 ti 
 t( 
 
 tt <i 
 
 tt u 
 
 It tt 
 
 tt 
 tt 
 
BACTERIA. 
 
 317 
 
 31. Bacillus septicus Simple saprophyte. 
 
 32. 
 33- 
 34- 
 35. 
 36. 
 37. 
 38. 
 
 ' saprogenes 
 
 ' foetidus 
 
 * putrificus coli 
 
 ' coprogenus foetidus. 
 
 * aerophilus 
 
 * mesentericus fuscus. 
 
 * " vulgatus 
 
 it 
 If 
 « 
 II 
 If 
 II 
 
 Genus V. Vibrio. 
 
 Threads screw-form in long or short links. 
 Spore-formation present. 
 
 Species. 
 
 Unassociated with disease. 
 
 I. Vibrio rugula Zymogenic saprophyte. 
 
 Genus VI. Clostridium. 
 
 Same as bacillus, but the spore-formation is in 
 characteristically enlarged rods. 
 
 Species. 
 Associated with disease in animals. 
 
 1. Clostridium of symptomatic anthrax. . .Patho- 
 
 genic. 
 
 Unassociated with disease. 
 
 2. Clostridium butyricum. Zymogenic saprophyte. 
 
 3. " polymyxa. ** " 
 
3l8 BACTERIA. 
 
 Group III. Leptotricheae. 
 
 Possessing cocci, rods, and thread fornns (which 
 show a distinction between base and apex). The 
 last straight or spiral. 
 
 Genera : i, Crenothrix ; 2, Beggiatoa ; 3, Phrag- 
 midiothrix ; 4, Lepothrix. 
 
 Genus I. Crenothrix. 
 
 Threads articulated ; cells sulphurless; habitat 
 water. 
 
 Species, 
 
 Unassociated with disease. 
 I. Crenothrix Kiihniana Simple saprophyte. 
 
 Genus 11. Beggiatoa. 
 Threads unarticulated ; cells with sulphur 
 granules ; habitat water. 
 
 Species. 
 Unassociated with disease. 
 
 1. Beggiatoa alba Simple saprophyte. 
 
 2. " mirabilis '* ** 
 
 3. *' roseopersicina. .Chromogenic ** 
 
 Genus III. Pkragmidiothrix. 
 
 Threads jointless ; successive subdivision of the 
 cells is continuous ; cells sulphurless ; habitat 
 water. 
 
BACTERIA. 319 
 
 Species, 
 Unassociated with disease. 
 I, Phragmidiothrix multiseptata. . .Simple sapro- 
 phyte. 
 
 Genus IV. Leptothrix. 
 Threads articulated or unarticulated ; succes- 
 sive subdivisions of cells not continuous; cells 
 sulphurless. 
 
 Species. 
 Associated with disease. 
 
 1. Leptothrix buccalis Saprophytic. 
 
 2. " gigantea " 
 
 Group IV. Cladotricheae. 
 
 Possessing cocci, rods, threads, and spirals. 
 Thread-forms provided with false branchings. 
 Genus, Cladothrix. 
 
 Genus I. Cladothrix. 
 
 Species. 
 
 Unassociated with disease. 
 
 1. Cladothrix dichotoma Saprophyte. 
 
 2. " Foersteri " 
 
 Associated with disease. 
 
 3. Actinomyces Pathogenic. 
 
320 BACTERIA. 
 
 This classfication although very defective is the 
 most easily followed and seems to give a clearer 
 view of existing knowlege of schizomycetes than 
 any of the others. 
 
 FlUgge divides the bacteria into four classes: 
 
 1. Fungi 
 
 2. Mycetozoa 
 
 3. Blastomycetes 
 
 4. Schizomycetes. 
 
 Most of the pathogenic organisms belonging to 
 the fourth class, he reckons the following as 
 members of this class : 
 
 1. Micrococcus 8. Beggiatoa 
 
 2. Ascococcus 9. Spirillum 
 
 3. Sarcina 10. Spirochaete 
 
 4. Clathrocystis 11. Streptothrix 
 
 5. Bacterium 12. Cladothrix 
 
 6. Bacillus 13. Myconstoc. 
 
 7. Leptothrix 
 
 Of doubtful relation to the schizomycetes are 
 the crusothrix, sphaerotilus, spiromonas, rhab- 
 domonas, Monas Okeini, and Warmingii vinosa. 
 (Communicated by Doctor Biggs). 
 
 The arrangement of Fliigge, being the same as 
 that of Rabenhorst, is one of the most recent and 
 is considered as the best by many histologists. 
 
 The " classifications of bacteria " are as vary 
 
BACTERIA. 321 
 
 ing and unsatisfactory as they are numerous. A 
 short time ago the suggestion was made, to a dis- 
 tinguished bacteriologist, that it would be very 
 desirable to establish a uniform nomenclature 
 and classification of microbia. He replied that 
 the time had not yet come for this, because 
 knowledge on the subject of bacteria is insuf- 
 ficient to permit of such classification. 
 
 A similar reply has often been made in connec- 
 tion with the classification of diseases. The 
 proper time, however, to begin to classify is al- 
 ways the present, for, it should be remembered 
 that to think is to classify. But to classify well 
 requires of the thinker that he shall think well ; 
 and well directed thoughts are likely to lead to 
 great advances. 
 
 If the bacteriologists should decide to work in 
 unison and in harmony with the single purpose 
 of advancing science, setting aside all personality, 
 the first and wisest step to take would be, after 
 having agreed upon a proper basis and method 
 of nomenclature and classification, to describe 
 fully and accurately the known bacteria, then 
 carefully analyze the descriptions, and deduce 
 therefrom the definitions which will almost in- 
 variabl}'' furnish correct names. Thus they would 
 establish a uniform and true classification which 
 would be understood by the whole profession. 
 
322 BACTERIA. 
 
 The outcome of the needed investigations 
 would be the proper construction of the genera, 
 the gathering together of the species, the relega- 
 tion to the lower rank of varieties, of many that 
 now stand as species, and the discovery of new 
 species. Much greater advances would thus be 
 made than by waiting indefinitely for ** the 
 proper time to come." Then the clinicians would 
 be able to use to advantage the knowledge at- 
 tained of the nature and pathic properties of 
 these deadly enemies of suffering humanity. 
 
 The study entailed by the preparation of the 
 summary of the present state of knowledge of 
 the bacteria, ptomaines, leucomaines and ''ex- 
 tractives," has led to the following conclusions : 
 
 1. That pathohistology needs to be recon- 
 structed on the basis of bio-chemistry. 
 
 2. That hygiene should be given a position of 
 much greater importance that it has ever oc- 
 cupied. 
 
 3. That prophylaxy should be placed on a 
 firmer footing than heretofore. 
 
 4. That the State should come in aid with 
 money and laws, to further the views of the 
 medical profession in the means proposed for 
 preventing disease and hindering epidemics. 
 
 5. That therapy should be subjected to many 
 
DISTURBANCES IN THE CIRCULATION. 323 
 
 modifications, in correspondence with the great 
 advances in pathohistology. 
 
 6. That the junior student (the Doctor of the 
 future) should devote more time to laboratory 
 work, and to experimental medicine, and should 
 be more thoroughly trained to methods of pre- 
 cision than m the past. 
 
 II. Disturbances in the Circulatory 
 Apparatus. 
 
 I. Ischaemia, from t'dx^ty, to check, to restrain, 
 and at'jua, blood, signifies arrest of blood, and is 
 employed only in the sense of a local disturbance 
 in the circulation. It arises from constriction of 
 the capillaries owing to disturbance in the vaso- 
 motor nerves. The plugging of an arteriole is 
 also a factor in the production of ischaemia. It 
 is too, the effect of frost-bite of the tips of the 
 toes, fingers, ears or nose. The result of ischaemia 
 is local capillary anaemia which may be followed 
 by colliquative necrosis in certain tissues, and in 
 others by moist or by dry gangrene. 
 
 If there should not be sufficient constriction of 
 the capillaries to arrest the circulation in a given 
 part, but enough to interfere with nutrition, the 
 condition would be one of local capillary /lyjfo- 
 aeinia. 
 
324 DISTURBANCES IN THE CIRCULATION. 
 
 The term ischaemia has been improperly used 
 to designate " local arterial anaemia," and also 
 the '* retention or suppression of an habitual flux 
 of blood as of the haemorrhoidal, menstrual, flux, 
 or of epistaxis." 
 
 2. Athroisaemia, — from aBpotdna, accumulation, 
 and ai'jAa, blood, — signifies blood accumulation, 
 congestion. It is a more exact term than conges- 
 tion which is applied alike to the accumulation of 
 any other fluid. The French employ the term 
 engorgement to designate the state of a part 
 gorged with blood or some other fluid. The 
 words synathroismus, haemostasia and many 
 others have been suggested to take the place of 
 consrestion. But some of them are used in dif- 
 ferent senses, as for instance haemostasia which^ 
 besides signifying stagnation of blood, is made to 
 do duty in designatmg a means to arrest haemor- 
 rhage ; haemostatic being derived therefrom. 
 
 " Congestion, — from conger Oy I heap up, — is de- 
 fined as the accumulation of blood in the blood 
 vessels of an organ." 
 
 *• Active congestion expresses the condition of 
 overfulness of blood vessels arising from paralj^sis 
 of the vaso motor and increased energy of the 
 vaso-dilator nerves, such as occurs in the surface 
 redness of active exercise, or in the early stage of 
 inflammation." ** Passive congestion — from pass- 
 
DISTURBANCES IN THE CIRCULATION. 325 
 
 tvus, suffering, — is an overplus of blood in the 
 capillary vessels of a part, associated with impair- 
 ment of the vital relations between the blood and 
 the minute elements of the texture, as the cause 
 of the sluggish flow of blood in the capillaries." 
 (Aitken.) 
 
 These descriptions are good and clear, but 
 there is no S3dlable in the word congestion to in- 
 dicate that it is the blood which is heaped up. 
 
 3. Phlegmasia; inflammation. (See p. 52.) 
 
 4. Lymphexosmosis signifies a transudation 
 from lymph-vessels. 
 
 5. Lymphorrhagia signifies a flow from a rent 
 l3Mnph-vessel. Rhagia has been wrongly applied 
 exclusively to flow of blood. It simply means a 
 breaking forth, and may therefore be used as a 
 terminal to lympho as well as to haemo. 
 
 6. Haemorrhagia signifies a flow from a rent or 
 cut blood vessel. 
 
 7. Haemodiapedisis signifies an oozing of blood 
 through the walls of vessels. This is commonly 
 but wrongly confounded with haemorrhage 
 which always implies a solution of continuity. 
 
 8. Thrombosis, — from ^pon§o<iy a clot, and gdou, 
 — signifies coagulation. The coagulation may 
 take place in a blood vessel, or in the heart ; 
 
326 ALTERATIONS OF STRUCTURE. 
 
 hence angiohaemothrombus, cardiohaemothrom- 
 bus. 
 
 9. Embolismus, from e^fioXo^, a plug — signifies 
 simply plugging. An angioembolus is a vessel- 
 plug. 
 
 III. Pathengenetic Alterations of 
 Structure. 
 
 The terms pathogenetic and pathengenetic 
 should not be confounded. Pathogenetic is an 
 adjective signifying that which generates, disease 
 generating, while pathengenetic, — from Eyyevrji, 
 sprung from, — signifies that which is generated, 
 engendered by disease. In other words a pathen- 
 genetic affection is a disease which has sprung 
 from, or has been engendered by a preexistmg 
 disease. This word was suggested by Doctor 
 Alfred L. Carroll. (See p. 56.) 
 
 1. Hypertrophy, — from vTtEpy over, above, — 
 signifies over nourishment, and is here used in its 
 true meaning of increased nutrition and not in- 
 creased bulk. (See pp. 53-55.) 
 
 2. Hypotrophy, — iVo, u:ider, — signifies de- 
 creased nutrition, and is here employed in its 
 strict sense of diminished nutrition. (See pp. 
 .53-55.) 
 
 3. Auxesis is used in the sense of enlargement, 
 
RETROGRADE METAMORPHOSES. 327 
 
 increase, and is substituted for hypertrophy. 
 (See pp, 52-55O 
 
 4. Ectasis signifies dilatation, expansion. (See 
 
 P- S7-) 
 
 5. Stenosis signifies contraction, stricture. (See 
 
 p. 56.) 
 
 6. Ecmasis signifies obstacle, obstruction. (See 
 P- 57.) 
 
 IV. Retrograde Metamorphoses. 
 
 1. Necrosis, — from vexpoco, I kill, — signifies 
 death. As it is here used, death of a part. The 
 following are the principal necrotic processes 
 named by the pathoanatomists: Coagulation, 
 colliquative and cheesy necrosis, ulceration, and 
 humid and dry gangrene. 
 
 2. Meiosis, — from ^Eioo/xaj decrease, — signifies 
 a decrease in the size of a part which may or may 
 not shrivel. Meiosis is here employed to signify 
 a decrease in the size of an organ, whatever may 
 be the cause of the retrogression. It is offered as 
 a substitute for atrophy which should be used 
 solely to signify cessation of nutrition, in which 
 sense it is a precursor of mortification. (See p. 
 
 54.) 
 
 3. Degeneration of tissues is their substitution 
 
328 NEOPLASMS. 
 
 by subordinate elements, such as granules and 
 fat, and amyloid, colloid, mucoid, hyaline, inoid, 
 and sclerous substances. 
 
 4. Infiltration of tissues is the permeation of 
 any texture by a fluid, or by a solid substance in 
 suspension or in solution. Examples : fatty, pig- 
 mentary, calcareous, uric, infiltration. 
 
 V. Neoplasms. 
 
 The name neoplasm was given by Burdach to 
 the new formations whose fundamental tissue he 
 regarded as consisting of morbid cellular sub- 
 stance. Virchow adopted the term, and nearly 
 all pathoanatomists have since done so, in the 
 sense of the morbid growths arising from simple 
 division or from endogenous multiplication of 
 preexisting cells. 
 
 It has been questioned if, strictly, there can be, 
 in the human body, such a development as a new- 
 growth. In reality the growth is new to the 
 particular part whence it springs, though it may 
 be composed of the same tissues that exist nor- 
 mally in this part. In this sense it may be said 
 that the new-growth must be composed of tissues 
 lying within the possibilities of the individual. 
 In the other sense it must be entirely foreign. 
 The examples given are : (i,) a growth composed 
 
NEOPLASMS. 329 
 
 of feathers would be a new-growth in man ; (2,) a 
 growth composed of hairs would be a new- 
 growth in a bird. But some histologists would 
 say there are, in this sense, strictly new-growths 
 in man, e. g., actinomycosis, rhinoscleroma, etc., 
 which are not even composed of animal sub- 
 stances, but of vegetable microorganisms. 
 
 The term neoplasm cannot yet be rejected 
 when used in the sense of a growth representing 
 the excessive development of tissues which are 
 identical with or, at least, resemble those of the 
 normal constituents of the body. ** Though the 
 cells of human neoplasms may deviate in their 
 appearance from the cells of normal tissues, this 
 deviation is not so extreme that their analogues 
 cannot be met with in some parts of the normal 
 body during intra or extra uterine life." 
 
 It may be of interest to trace, from the early 
 writers, the history of the development of the 
 present knowledge of neoplasms, which were 
 called tumors and are still so named by many 
 pathoanatomists. Paul Broca, in his, " Traite des 
 Tu7neurs'' (1866), has given a more full and com- 
 plete account of this development than most 
 other authors. The following is therefore, in 
 part, abstracted from his classical work. 
 
 The word tumor, which Broca uses under pro- 
 test, signifies, he says, in its most general accepta- 
 
330 NEOPLASMS. 
 
 tion, any increase of volume, abnormal prom- 
 inence, or new production, apparent or con- 
 cealed, internal or external. 
 
 The ancients, and their followers until the re- 
 naissance, and even many during the seventeenth 
 and eighteenth centuries, have divided the tu- 
 mors into three great groups: tumores secundum 
 naturam^ supra naturam, praeter naturam. These 
 terms were accepted by all but with no consense 
 as to the exact signification which they should 
 bear. In the first group were placed the im- 
 pregnated uterus, and the consequent enlarge- 
 ment of the mammae. In the second group were 
 included those tumors arising from the displace- 
 ment of natural parts, such as fractures, and dis- 
 locations of bones, etc. In the third group were 
 the tumors that arise, not from the natural parts, 
 but from the development of new tissues or the 
 accumulation of the humors. This last group 
 formed one of the grand divisions of surgery.* 
 
 * The surgical Pentateuch was divided into five books : 
 {i,) Wounds; (2,) Ulcers; (3) Fractures ; (4.) Luxations ; 
 (5,) Praelernatural tumors. The fifth book constituting more 
 than three-founhs of surgery. In it were placed, dry gan- 
 grene, skin diseases, and all other maladies that could not 
 enter into the first four b^oks. Galen wrote of Tumores 
 praeter naturam, and, says Broca, this Galenic doctrine is 
 reproduced in several of his other works. Tagault's, In- 
 
NEOPLASMS. 331 
 
 Thus in this fourth group the most dissimilar 
 diseases were placed side by side, simply because, 
 according to the Galenic doctrine, they were 
 supposed to spring from the same causes. All 
 the praeternatural tumors were said to arise from 
 the accumulation of one of the humors of the 
 economy, hence they were also called humoral 
 tumors. They resulted either from fluxion or 
 from congestion. — Fluxion occurred when a nat- 
 ural humor was attracted to, and remained in, the 
 affected part, and congestion when the humor 
 was engendered in loco. The humors enumerated 
 by the Galenists were four: (i,) the blood ; (2,) 
 the bile ; (3,) the phlegm ; (4,) the atrabile or 
 melancholy. Giving rise to phlegmons, erysipe- 
 las, oedema, scirrhus. Later a fifth was added, 
 the windy humor, which produced emphysema 
 or pneumatosis (inflation). Then there were 
 mixed tumors, those caused by two or several 
 humors. 
 
 stitutiones Chirurgicae, Paris 1543, contains a book, De 
 iumoribiis praeter naturam. This author appears to be the 
 first to give an analytical classification of tumors which he 
 groups in accordance with the five species of humors ; the 
 fifth species being the windy humor, producing infiationes. 
 Broca traces down to Didier, of Montpellier, 171 1, the ancient 
 arrangement of tumors into the three groups, the last of which 
 being tumores praeter naturam. 
 
332 NEOPLASMS. 
 
 Humorism was succeeded by solidism, and this 
 latter doctrine, in its turn, was overwhelmed by 
 the advances of anatomy, and the tumores praeter 
 naiuram ceased to exist after phlegmons, erysipe- 
 las, oedema, and emphysema were removed from 
 the group. The term tumor whose nosographical 
 acceptation became more restricted, was finally 
 reserved to designate accidental productions, in 
 the organism, characterized by the formation of 
 new tissue. 
 
 The Galenists supposed scirrhous tumors ta 
 spring from the accumulation of atrabile. The 
 innovators of the seventeenth century failed ta 
 find this mythical humor, but discovered lymph 
 which served to establish a new theory of tumors. 
 It is plain that the solidists were humorists with- 
 out being aware of the fact, for they thought 
 most tumors due to the extravasation of lymph ; 
 that their various forms, and their various term- 
 inations, resulted from the different degrees of 
 crudity, coction, acidity, alcalinity, density^ 
 acrimony, depravation, or fermentation of this 
 capricious humor ; and that these phenomena 
 varied as the lymph was naturally more or less 
 thick, or stagnant, and that the affected part pos- 
 sessed greater or less heat. 
 
 While the theory of the day ascribed to most 
 tumors a common cause, the practical physicians 
 
NEOPLASMS. 333 
 
 discovered great diversity instead of the pre- 
 tended unity of cause. Under the sway of the 
 atrabile theor}^ also this contradiction had become 
 apparent, and, to escape from the dilemma, the 
 foundation was laid of a doctrine more likely, as 
 it was thought, to be adopted. The atrabile 
 theory was so vague that it possessed an almost 
 indefinite elasticity in the minds of its promotors 
 and yielded to all their fancies. Lymph, on the 
 contrary, had a real existence, had been seen and 
 analyzed, and though the characters attributed 
 to it were far from being exact, they were form- 
 ulated with precision. One of these characters 
 was its coagulability by heat, and the appearance 
 of a scum at the surface of the water in which 
 tissues impregnated with lymph were boiled. 
 The anatomical study of tumors consisted in boil- 
 ing them, and, as nearly all furnished a scum, it 
 was concluded that they were of lymphatic 
 origin. This experiment was believed to estab- 
 lish the unity of cause of nearly all tumors. 
 This unity of cause granted, it was necessary 
 to explain why it was that some of these tumors 
 were benign and others malignant. The promo- 
 tors of the theory then had recourse to the hypo- 
 thesis of degeneration, that is to say, the trans- 
 formation of benign into malignant tumors by 
 reason of the depravation of the lymph. The 
 
334 NEOPLASMS. 
 
 Galenists had already offered a similar explana- 
 tion, for they regarded cancer as inflamed or 
 degenerated scirrhus. But the adherents of the 
 lymph doctrine applied the degeneration hypo- 
 thesis to all, even to scrophulous and lipomatous, 
 tumors, to cysts and to wens. The degeneration 
 hypothesis seems to have been a compromise be- 
 tween the lymph theory, and clinical observation 
 which proved the diversity as against the unicity 
 of cause of tumors. This hypothesis was ad- 
 mitted by all without inquiry as to its actual or 
 possible demonstration. The Galenists had in- 
 vented it to save the atrabile doctrine, and the 
 solidists to save the lymph doctrine. This de- 
 generation hypothesis has survived the wreck of 
 the two doctrines, and exists in the minds of 
 many unto this day, as do other false doctrines. 
 
 Such were the vagaries of the seventeenth and 
 eighteenth centuries respecting the nature of tu- 
 mors. The first step in advance was made by 
 Littre who, in 1704, discovered a certain tumor 
 to be composed of adipose tissue. Afterwards, 
 in 1709, he proposed that tumors of this genus be 
 named lipomata. Here then was a distinct 
 demonstration of an abnormal development of a 
 normal tissue. But as this was contrary to the 
 existing doctrine, no attention was paid to the 
 statement. Soon after, new observations showed 
 
NEOPLASMS. 33$. 
 
 that other tumors were formed, by the morbid 
 increase of preexisting elements, without the in- 
 tervention ot extravasated lymph. It was partic- 
 ularly the study of encysted tumors and wens 
 which led to this conclusion. Astruc and others 
 thought that these tumors resulted from the dila- 
 tation of lymphatic vessels. Louis rejected this 
 hypothesis, and said that cysts were formed in 
 the cellular tissue, their walls being composed of 
 condensed cellular and not of a new tissue. In 
 1775, Girard attributed the formation of sebac- 
 eous cysts to the obliteration of the ducts of 
 sebaceous glands. So that gradually, cysts and 
 wens were removed from the category of de- 
 generating tumors, since they were supposed not 
 to be of lymphatic origin. Finally scrophulous 
 tumors were also removed from this category. 
 Then all the other tumors were united in a single 
 group under the name of fleshy tumors, by the 
 advocates of the lymph theory. The extravasated 
 and hardened lymph caused scirrhus, and when 
 this lymph fermented the scirrhus was changed 
 into cancer. Certain tumors were supposed to 
 remain scirrhous and therefore benign, some 
 were transformed into cancer and were therefore 
 malignant, while others were cancerous and 
 therefore malignant from the beginning. All this 
 depended upon the freaks of the lymph. There 
 
33^ NEOPLASMS. 
 
 was no pathoanatomy in those days, so this con- 
 fusion respecting tumors is not to be wondered 
 at. Still some advance was made, though of a 
 negative character, for it consisted in the elimina- 
 tion, from the group, of morbid states which 
 were not properly tumors. 
 
 The question what is cancer, was put by the 
 Academy of Lyons, and a prize offered for some 
 approach to its solution. Peyrilhe to whom, in 
 1773, the prize was awarded, announced as his 
 conclusion that it was as difficult to define as to 
 cure cancer. 
 
 John Hunter gave the last stroke to the de* 
 generation theory, and though his was also a 
 lymph theory, it was of another kind of lymph. 
 The lymph of the solidists was a dead substance 
 cast away by the lymph vessels, a foreign body 
 which underwent lermentation, etc., but that of 
 Hunter was a transudation, from the blood- 
 vessels, endowed with the property of coagulat- 
 ing and of becoming organized. Here then is an 
 implied suggestion that tumors might be re- 
 garded as organs superadded to the economy, for 
 he considered that their tissues were nourished, 
 as the tissues of the normal parts of the body, 
 and increased in size by virtue of this nutrition. 
 In his ''Lectures on the Principles of Surgery,'' he 
 defines a tumor as ** a circumscribed enlargement 
 
NEOPLASMS. 337 
 
 in a part from disease ; not strictly a disease of a 
 natural circumscribed part, as a thickened dis- 
 eased gland." Tumors, he says, '* seem to de- 
 pend on an accumulation of extravasated co- 
 agulable lymph, either in the adipose or cellular 
 
 membrane or both The increase of cancer 
 
 is much in the same way." He divides tumors 
 into solid and encysted. Solid tumors are sub- 
 divided into ''three species: (i,) Warts; (2,) 
 Polypi; and (3,) An entirely new substance in the 
 cellular membrane, often irregular, and attached 
 by loose cellular membrane to the surrrounding 
 parts." Among the encysted tumors he places 
 hydatids and most of the known cysts. He 
 classes tubercles under the head of ** spurious 
 tumors." 
 
 The advent of Bichat, and of his creation of 
 general anatomy, from which pathoanatomy is- 
 sued, changed, much for the better, the aspect of 
 the question of tumors and gave a basis for their 
 classification. His premature death did not re- 
 tard the progress of general and pathoanatomy, 
 because he had inspired his disciples with his 
 own great zeal in the pursuance of these newly 
 created departments of anatomy. Laenec was 
 the foremost of his followers in the application of 
 anatomy to the study of disease. It was in 
 December 1804 that he produced the ^' note sur 
 
338 NEOPLASMS. 
 
 ranatomie pathologiqiie.'* This was the starting- 
 point of general pathology. 
 
 Laenec divided accidental tissues into two 
 great categories: (i,) Those having analogues 
 among the normal tissues ; (2,) Those having no 
 analogues among normal tissues. Since then, for 
 brevity, they have been designated as homolog- 
 ous and heterologous tumors. 
 
 He reckoned as many homologous tumors as 
 there »are normal tissues : i. e. osseous, fibrous, 
 fibro-cartilaginous, cartilaginous, cellular or adi- 
 pose, horny, etc., and added hairs produced in 
 certain cysts, the adventitious serous membranes 
 discovered by Bichat, and giving rise to certain 
 encysted tumors, etc. 
 
 Of heterologous tumors he numbered four ; 
 (i,) Tuberculous; (2,) Scirrhous; (3,) Encephal- 
 oid ; and (4,) Melanotic. 
 
 He used the term encephaloid to designate 
 those soft cancerous tumors which, on gross in- 
 spection, bear a resemblance to cerebral sub- 
 stance. It will be remembered that, even then, 
 soft cancers were, by many, regarded as degen. 
 crated scirrhous tumors, still believed to be be- 
 nign. He'declared that the two types — encephal- 
 oid and scirrhus — remained distinct from first to 
 last, and^that they were composed of tissues 
 which were never interchangeable. While on 
 
NEOPLASMS. 339 
 
 the one hand this statement was an advance, dis- 
 posing as it did of the question of fermentative 
 degeneration, on the other hand it still left a 
 doubt as to the real character of scirrhus. En- 
 cephaloid and scirrhus being regarded as two 
 different diseases, and the former being cancerous, 
 the nature of the latter should have been, but 
 was not, stated. What added to the existing con- 
 fusion was that the two diseases had been found 
 in the same individual, and that, aside from the 
 difference in physical appearance, the symptoms 
 of the two were analogous, they showed the 
 same tendency to recurrence, and their termina- 
 tion was the same. Clinical observation and 
 pathoanatomy were apparently at varience. The 
 microscope had not yet come in aid to settle the 
 vexed question. It will not seem strange then 
 that the doctrine of Broussais, ascribing to in- 
 flammatory action the formation of all tumors, 
 should have been so readily embraced. At 
 length however it was abandoned and even the 
 most devoted of Broussais' pupils returned to 
 Laenec's classification. 
 
 While the French were endeavoring to solve 
 certain questions connected with tumors, the 
 English were laboring in the same direction. 
 John Hunter had given the right impulse to the 
 cancer question, and his successors were striving 
 
340 NEOPLASMS. 
 
 to determine which of the many tumors should 
 be classed as malignant, and which benign. 
 Among these men were Sir Everard Home, Wil- 
 liam Hey, Samuel Sharpe and John Abernethy. 
 
 In the beginning of this century there was 
 founded in London a " Society for investigating 
 the nature and cure of cancer." That society 
 then appointed a committee, consisting of Doc- 
 tors Baillie, Sims, and Willan, Messrs. Sharpe, 
 Home, Pearson and Abernethy, with Doctor 
 Denman as Secretary, charged to prepare a pro- 
 gramme consisting of thirteen queries relating to 
 the nature, diagnosis and management of cancer. 
 These queries to be answered by the profession 
 at large. The programme was issued in the year 
 1802, and was reprinted in the Edinburgh Med- 
 ical Journal, July 1806. The effort was fruitless, 
 and the society soon ceased to exist, but individ- 
 uals continued the work; among them. Hey, 
 Burns, Home, Wardrop, Abernethy and Law- 
 rence. 
 
 " Fungus haematodes " regarded as non-malig- 
 nant by Hey, Burns and Wardrop and as malig- 
 nant by Young, was confounded with erectile 
 tumors by Maunoir, and was not, for a long time, 
 classed as a variety of encephaloid carcinoma. 
 Hey and Burns were the first to call attention to 
 these pulsating tumors containing extravasated 
 
NEOPLASMS. 341 
 
 blood ; then Wardrop, Else, Bradley, Young, 
 Travers and Sir Astley Cooper, contributed each 
 his share to their study. 
 
 John Abcrnethy* appears to have been the 
 first to propose an anatomical classification of 
 tumors, Laenec's contribution having been made 
 several months later (December 1804). Abernethy 
 believed that a proper understanding of the sub- 
 ject could be attained only by associated labor, — 
 but this was, for the time, rendered impossible by 
 the dissolution of the Cancer Society, — and un- 
 dertook his task with the modest statement that, 
 though imperfect, his arrangement would, he 
 hoped, awaken the attention of many others to 
 the question. 
 
 He defined a tumor as a swelling due to some 
 new growth, and excluded mere enlargements of 
 natural parts. He divided tumors into several 
 genera, the first genus being sarcoma to which he 
 devoted the greater part of his study. He 
 adopted this ancient word to designate those 
 growths having a " fleshy feel," and recognised 
 eight species: 
 
 I. Common vascular sarcoma; 2. Adipose sar- 
 
 * John Abernethy ; Surgical Observations. Containing "An 
 attempt to form a classification of tumors according to their 
 anatomical structure." London 1804. 
 
342 NEOPLASMS. 
 
 coma ; 3. Pancreatic sarcoma ; 4. Cystic sar- 
 coma ; 5. Mammary sarcoma ; 6. Tuberculous 
 sarcoma ; 7. Medullary sarcoma ; 8. Carcinoma- 
 tous sarcoma. 
 
 One genus included osseous and cartilaginous 
 tumors. Another genus the cysts. 
 
 Then followed the labors of Lawrence who re- 
 moved from the category of cancer '* benign 
 fungus" of the testicle, of Sir Everard Home 
 who regarded the so called scirrhus of the pros- 
 trate as simply a general or partial enlargement 
 of that body, and of Sir Astley Cooper who ex- 
 cluded from the class of cancers certain enchon- 
 dromata, tubercles of the testicle, etc. 
 
 Cruveilhier, Rokitanski, Velpeau, Walshe, and 
 others of their da}^ contributed largely to the 
 literature and knowledge of tumors, but that 
 which afforded the greatest aid in their study was 
 the advent of the cell-doctrine of Raspail (1825) 
 and Royer-Collard (1826-28), rendered possible 
 by the application of the compound achromatic 
 microscope (1824) to the study of the human 
 tissues in health and disease. Most of the old 
 questions so long in debate were then surren- 
 dered for what became tangible and visible. 
 From that time many entered the new field of in- 
 vestigation and there soon appeared exhaustive 
 works on normal and pathohistology, among 
 
NEOPLASMS. 343 
 
 which may be cited those of Mandl, Hassall, 
 Lebert, Wedl, Vogel and Kolliker. Finally 
 Virchow's cellular pathology came as a beacon 
 to give the brighter light that guided the patho- 
 anatomist in the right direction to further re- 
 search. Cohnheim's publications represent the 
 advances which Virchow's labors had suggested, 
 and the recent discoveries in embryogeny now 
 come to sustain the modern school of patho- 
 histology and serve to explain and strengthen 
 Miiller's aphorism, propounded in 1838, and 
 adopted by this school, to the effect that the sub- 
 stance of all tumors has its analogue in some 
 tissue existing normally in embryonic or after- 
 life.* This is known as the law of Miiller. 
 
 Virchow, who published his lectures on tu- 
 mors long before the views of Waldeyer and 
 Duval were known, adopted the law of Miiller, 
 and constructed the following arrangement of 
 *' tumors," dividing them into four groups. 
 
 1. Tumors formed at the expense of the ele- 
 ments of the blood, for example haematomata, etc. 
 
 2. Tumors formed by the retention of the pro- 
 
 * In 1804 Laenec had recognised some tumors having an- 
 alogues among the normal tissues, but Miiller advanced a step 
 farther in declaring that the substance of all tumors has its 
 analogue in the normal economy. 
 
344 NEOPLASMS. 
 
 ducts of secretion, those which result from the 
 dilation of secreting cavities, due to retention of 
 the product of secretion of the glands, for exam- 
 ple, glandular cysts, hygromata, etc. 
 
 3. Tumors which result from the proliferation 
 of the elements of the primitive tissues of the 
 organism. This class is divided into histioid tu- 
 mors formed by a single tissue, organoid tumors, 
 which reproduce the configuration of an organ, 
 and teratoid tumors, resembling by the assemblage 
 of different organs, an incomplete being. Each 
 of these classes is itself divided and sub-divided. 
 
 4. The fourth group comprises mixed tumors, 
 composed of the elements of several of the pre- 
 ceding tumors. 
 
 The high reputation of this great Master in 
 pathoanatomy has caused his nomenclature and 
 classification of tumors to be largely accepted by 
 the profession without question. This classifica- 
 tion ansv/ered a good purpose twenty-five years 
 ago, and was a forward step, but the advances 
 since made in pathohistology forbid its continued 
 use. Nevertheless, there are many phj^sicians 
 and surgeons who still adhere to this arrange- 
 ment of tumors. In the present light of science, 
 probably no one sees better than Professor 
 Virchow the faults of this as well as of all other 
 
NEOPLASMS. 345 
 
 classifications, and if his occupations should per- 
 mit him to undertake its reconstruction, he 
 doubtless would do so consistently on the anat- 
 omical basis which does not abrogate, but rather 
 enforces, Muller's law. He would probably aban- 
 don the word tumor, and reject the haematomata 
 and also the cysts. He would drop the terms 
 histioid and organoid, place the teratoid growths 
 under the caption terata, and make a very dif- 
 ferent disposition of the mixed growths of his 
 fourth group. 
 
 Forster has arranged tumors into three groups 
 as follows : 
 
 1. ** Tumors formed of a simple tissue, and 
 sometimes even of a single element of this tissue; 
 for example, fibroma, osteoma, etc. 
 
 2. " Tumors having a complex arrangement, 
 the analogue of which can be found in the 
 economy ; for example, papilloma, cyst. 
 
 3. "Tumors formed of cells having their an- 
 alogues in the economy, but arranged in a man- 
 ner other than physiological. This group in- 
 cludes sarcoma, carcinoma, epithelioma, lym- 
 phatic tumors, under which may be classed the 
 organic lesions of typhoid fever, tubercle, syphil- 
 itic gummata, and true lymphoma." 
 
 This arrangement is confusing and unsatisfac- 
 tory, for genera belonging to entirely different 
 
34^ NEOPLASMS. 
 
 orders are grouped together, and lesions of 
 typhoid fever, tubercle, and syphilitic gummata 
 are included among tumors and placed in the 
 third group amidst pathic conditions to which 
 they bear no relationship. 
 
 Broca,* in his classification, goes back to 
 Laenec's two categories : homologous and hete- 
 rologous tumors, and begins with the following 
 propositions : 
 
 " I. All heteromorphous tumors are heterolog- 
 ous. Ex. : cancers ; 
 
 " 2. All homologous tumors are homoeomorph- 
 ous. Ex. : lipomata ; 
 
 " 3. There exists a third category of tumors 
 which are at the same time homoeomorphous 
 and heterologous. Ex. : epitheliomata. 
 
 ** Therefore all accidental productions may be 
 divided as follows : 
 
 " I. Heteromorphous tumors. 
 
 " 2. Homoeomorphous tumors : a, heterolog- 
 ous ; b, homologous. 
 
 He includes in his classification of "accidental 
 productions " many morbid states which do not 
 properly belong to the class tumors as the follow- 
 ing synopsis will show. 
 
 * Traitlde Tumeurs," Paris 1866. Vol. I. 
 
broca's synopsis. 347 
 
 Broca's classification of the 
 "accidental productions." 
 
 CLASS I.— HoMOEOMORPHOUs Productions. 
 Divided into: Homologues, ist sub-class; 
 Heterologues, 2nd sub-class. 
 
 Sub-class I. — Homoeomorphous and homologous 
 
 productions. 
 
 Divided into two orders : A. Accidental productions 
 
 formed by the hypertrophic development of the organs 
 
 or of their elements. B. Accidental productions of new 
 
 formation. 
 
 A. Accidental productions formed by the 
 hypertrophic development of the organs or of 
 their elements. 
 
 I. Hypertrophy affecting at the same time, and 
 in a manner about uniform, all the elements of 
 the organ : Simple, general, or regular hyper- 
 trophy. 
 
 T3 f Hypertrophy of the glands, lymphatic glands, mus- 
 
 u 
 
 o 
 
 o 
 E 
 
 cles, heart, mucous membranes, skin, sub-cutaneous 
 tc •, cellular tissue {elephantiasis), bones (hyperostosis), 
 ■5 I of certain organs such as the clitoris, the labia 
 c^ (^ minora, the tongue, etc. 
 
 Of the muscles (very rare), tendons (nodus), epi- 
 dermis (corns, callosities), skin and sub-cutaneous 
 J cellular tissue (pedunculated elephantiasic tumors), 
 § i mucous membranes and sub-mucous cellular tissue 
 (mucous polypi, condylomata, hypertrophy of the 
 pylorus, etc.). 
 
348 
 
 broca's synopsis. 
 
 2. Hypertrophy affecting unequally the several 
 elements of a complex organ, one of these ele- 
 ments often developing itself at the expense of 
 the others : Partial or irregular hypertrophy. 
 
 o 
 
 
 
 
 Occupying particularly the papillae (warts). 
 Occupying certain parts of the derma (con- 
 dylomata). Occuping the sebaceous or the sud- 
 oriparous glands. 
 
 tj f Occupying the papillae (cauliflower vegetations 
 3 ^ I of the external genital organs, of the cervix uteri, 
 8 ^ -{ of the maxillary sinus, etc., granulations of the 
 c £ I conjunctiva .''). 
 
 g [ Occupying the mucous glands and follicles. 
 
 5? 
 
 a. Irregular hypertrophy occupying a part or 
 all of the lobes of an acinous gland (uniglandular 
 adenoma or adenoid tumor) of Velpeau. 
 
 b. Hypertrophy occupying many small glands 
 ■{ comprised in the same region. Transition to 
 
 heterology (multiglandular adenomata, polyade- 
 nomata or glandular cancroids of the sebaceous, 
 sudoriparous, uterine, labial, and rectal glands, 
 etc.). 
 
BROCA S SYNOPSIS. 
 
 349 
 
 B. Homocomorphous and Homologous pro- 
 ductions of new formation. 
 
 That may be divided into two groups, accord- 
 ing as their autogenous elements are compound 
 or simple. 
 
 c 
 
 e 
 
 V 
 
 c 
 
 o 
 
 o, 
 
 B 
 o 
 U 
 
 a. Tumors formed "] 
 principally of vessels | 
 or of sanguineous cavi- I 
 ties whose parieties are j 
 similar to the parieties | 
 of the vessels. J 
 
 b. Tumors formed of ^ 
 a tissue analogous to 
 
 V in 
 
 ^S O 
 
 that of the uterus, that 
 is to say of fibrous ^ 
 tissue and of fibro- 
 muscular cells. 
 
 c. Tumors formed of' 
 one or of several ho- 
 moeomorphous and ho- 
 mologous membranes, 
 which circumscribe one 
 or several cavities. 
 
 U 
 
 Arterial. 
 Venous. 
 
 tn o ™ 
 PC *- £ 
 
 Fibrous tumors of 
 the uterus and of the 
 neighboring regions. 
 
 i 
 
 I. Cysts developed 
 in preexisting cavities 
 (progeneiic cysts). 
 
 2. Cysts of entirely 
 new formation (neo- 
 ^ genetic cysts). 
 
 d. Tumors formed of 'j 
 the transitory or defin- ( ^^ i . 
 itive tissues of the r'^°''^°"'^^^- 
 ^ teeth. J 
 
350 
 
 BROCA S SYNOPSIS. 
 
 ' a. of adipose ) a. Diffuse. — Fatty infiltration of the organs, 
 tissue. . . . I b. Circumscribed. — Lipomata. 
 
 •a 
 E 
 
 c 
 o 
 
 u 
 
 3 
 
 -o 
 o 
 
 in 
 
 «^ 
 C 
 
 e 
 
 JJ 
 "o. 
 E 
 c?5 
 
 a. Reparative ossifi- 
 cation 
 
 io. 
 
 b. of osseous 
 tissue 
 
 '•"T£ro„10steomata. 
 
 Callus, new bone 
 necrosis, etc. 
 
 I. In con- 
 tinuity with 
 the bone 
 (exostoses 
 and osteo- 
 phytes). 
 
 2. With- 
 out conti- 
 nuity with 
 the bone 
 (free bony 
 tumors). 
 
 c. of cartilaginous < Of the skeleton, 
 
 tissue chondromata ) Of the soft parts. 
 
 d. of fibrous or 
 connective tissue 
 or of fibro-plastic 
 elements, transi- 
 tory, passing 
 promptly into the 
 fibrous stale. 
 
 Cicatrices. In- 
 flammatory indu- 
 ration. Organized 
 a. Productions { false membranes. 
 
 of traumatic or of 
 inflammatory ori- 
 J gin. 
 
 Fibrous knobs of 
 nerve trunks after 
 amputation. 
 
 b. Idiopathic produc- ) 
 tions formmg circum- > Fibromata, 
 scribed tumors. S 
 
 e. Epithelial elements, forming a^j 
 particular tissue, without mixture f tt 
 of other elements. Transition to | 
 
 (^ heterology. 
 
 J 
 
broca's synopsis. 351 
 
 Sub-class II. — Homoeomorphous and heterologous 
 productions, 
 
 I. Fibrous and fibro-plas- ttt * . ' * • * • 
 
 .. , ^ . u » 1 Warty tumors of cicatrices, 
 
 tic elements in about equal •( a * • 1 . u 1 
 
 . I Anatomical tuberculous tumors. 
 
 " P [ Certain fungi of the dura mater. 
 
 2. Autogenous and permanent fibro-plastic ele- < nuclear, 
 ments Fibroids. \ fibrillary. 
 
 3. Autogenous epithelial elements. ... \ °, ., !?'... 
 
 T7^;*u^i,««,o \ of the mucous 
 Epithelioma, j . 
 
 ^ f membranes. 
 
 4. Disks with multiple nuclei or myeloplaxes )y, 1 • j. 
 forming the autogenous clement. . . . ' \ ^ 
 
 Simple melanosis 
 5. Autogenous pigmentary elements. \ (rare in man, com- 
 mon in the horse). 
 
 '1 
 
 6. Elements of entirely new formation ) Pseudadenomata 
 imitating the form of glandular culs-de- > (or heteradeno- 
 sac, but forming a heterologous tissue. . . ) mata.) 
 
352 broca's synopsis. 
 
 CLASS II. — Heteromorphous Productions 
 (all are heterologous). 
 
 A. Accidental productions forming part of the 
 economy. 
 
 1. Tumors of a high organization, and of a greater or 
 less vascularity of their own, containing specific ele- 
 ments called cancerous elements, pure or mixed with 
 adventitious elements : Cancers. 
 
 2. Tumors of a much lower organization, deprived of 
 vessels and containing specific elements called tuber- 
 culous elements : Tubercles. 
 
 B. Accidental heteromorphous production 
 which does not form a part of the economy : 
 Pus. 
 
 CLASS III. — Amorphous Productions. 
 
 ' of gelatiniform matter Simple colloid. 
 
 of very small corpuscles which belong neither [ Syphilitic 
 to nuclei nor to cells ) gummata. 
 
 of coagulated fibrin, without ( a^x-,,^ „i .„ ^t ♦u ^ 
 ^ A ^ ai^ cu ^ Active clots of the ar- 
 o { tendency to fibrous or nbro- < <. • „ e 
 cu' , . •' . .. ) teries or of aneurysms. 
 
 "' plastic organization ( ^ 
 
 of fat granules, cholesterincrys-l Cretacious. atheroma- 
 tals. sundry crystals, and cal- calcareous, and 
 
 sah?"'.^". ..." .Tr"'!" j ^°P^^^ ^"P°^^'^' ^^^• 
 
 CLASS IV. — Encysted Parasitic Animals. 
 
 Hydatids. 
 
NEOPLASMS. 355 
 
 Cornil and Ranvier make some improvement 
 on the preceding arrangements, but instead of 
 gathering together like genera, they rank as or- 
 ders several of these genera. They divide the 
 ** tumors " into ten groups as follows : * 
 
 Group I. — " Comprises tumors formed of a 
 tissue analogous to embryonic tissue. We might 
 employ a new word to indicate this analogy, but 
 we prefer to make use of the old word sarcoma, 
 though it has been employed in very different 
 senses by different authors. This group only 
 contains one genus, sarcoma, of which there are 
 a great number of species and varieties. 
 
 Group II. — "Contains tumors formed of a tis- 
 sue, the type of which is found in connective 
 tissue. This tissue is sometimes mucous, and 
 the tumor is called myxoma, sometimes fibrous 
 and called fibroma (Verneuil), or inoma, from 
 t'ro?, fibre (Paget), sometimes adipose, when 
 called lipoma. In some cases the tissue under- 
 goes hypertrophic aberration affecting the size of 
 the cells ; this is the case in carcinoma, which 
 
 * Cornil and Ranvier, Manual of Pathological Histology, 
 second edition. Translated by A. M. Hart. London 1882. Na 
 change in Cornil and Ranvier's classification of tumors has 
 been made since their first edition which was published in 
 1869. 
 
354 NEOPLASMS. 
 
 would be better called alveolar fibroma ; in 
 others, the cells atrophy, as in tubercle, glanders 
 and syphilitic gummata. This second group 
 therefore contains the varieties myxoma, fibroma, 
 lipoma, carcinoma, tubercle, glanders, and syphil- 
 itic gummata. 
 
 Group III. — "Contains tumors formed of car- 
 tilaginous tissue, of which there is but one genus, 
 chondroma. 
 
 Group IV. — *' Is composed of tumors formed 
 of osseous tissue, osteoma. 
 
 Group V. — " Tumors, formed of muscular tis- 
 sue or myoma, are divided into two kinds, ac- 
 cording as the fibres of new formations are 
 striated or non-striated : myoma of striated fibres, 
 myoma of non-striated fibres. 
 
 Group VT. — "Tumors formed of nervous tis- 
 sue are of two varieties : the medullary neuroma 
 containing nerve cells, and the fasciculated 
 neuroma containing nerve tubes. 
 
 Group VII. — " In this are tumors formed of 
 blood-vessels, or angioma. 
 
 Group VIII. — " Contains tumors composed of 
 lymphatic vessels, lymphangioma, and those 
 which reproduce the structure of lymphatic 
 glands, lymphadenoma. 
 
 Group IX. — •' Contains tumors composed of 
 
NEOPLASMS. 355 
 
 epithelium of new formation. They are divided 
 into four varieties according as the cells are ar- 
 ranged in irregular masses, epithelioma, or in 
 papillae, papilloma, or in culs-de-sac, adenoma, or 
 in cavities of new formation, cysts. 
 
 Group X. —Contains mixed tumors, containing^ 
 a great number of tissues ; they are found 
 specially during intra-uterine life." 
 
 Cornil and Ranvier* say ** We wish to 
 
 treat simply from the histological point of view, 
 and have therefore included under the head of 
 inflammation and haemorrhage what seemed to 
 us to rightly belong to them, blood-tumors, hy- 
 gromata, for example. We also think we have a 
 right to reproach Virchow with having invented 
 new words, drawn from gross physical characters, 
 whereby to designate certain tumors, instead of 
 employing words representative of the tissues. 
 Thus he uses the word psammoma to signify a 
 tumor of the meninges, because it contains cal- 
 careous granules similar to fine sand, and the 
 word glioma is applied to tumors of the brain 
 because they are of a consistency analogous to 
 glue. He thus departs from the classification 
 which Miiller's law suggests, and which we in- 
 tend to follow absolutely." 
 
 * Op. cit. pp. 123-124. 
 
3S6 NEOPLASMS. 
 
 At page 125, the same authors write: "The 
 classification of tumors which we propose differs, 
 it will be seen, notably from those hitherto pub- 
 lished. It is an anatomical classification. It can- 
 not consequently serve to determine the degree 
 of gravity of a tumor. No anatomical classifica- 
 tion can at present answer this legitimate desire 
 of the physician. To determine the degree of 
 gravity of a tumor, knowledge of the order, 
 species, and variety to which it belongs can alone 
 be depended upon. The sole general considera 
 lion, which may be advanced on the subject of 
 the benignity or malignity of tumors, is that the 
 most serious are those which determine, the 
 formation of a large quantity of embryonic ele- 
 ments, at the expense of which they grow 
 rapidly. Our classification has the advantage of 
 being purely histological and of being based on 
 one law and on one consideration which seems to 
 us to be supreme, that is, the general arrange- 
 ment of the morbid tissue and the distribution of 
 the elements composing it." 
 
 Cornil and Ranvier, adopting the aphorism of 
 Miiller, endeavor to conduct their classification 
 on the anatomical basis, but even at the beginning 
 are inconsistent, for instead of grouping the tu- 
 mors in accordance with the histogeny of the 
 tissues, they mix connective tissue with epithelial 
 
NEOPLASMS. 357 
 
 growths ; thus they place in group second, in- 
 oma, myxoma, lipoma (connective tissue growths), 
 with carcinoma (epithelial growth), and then add 
 tubercle, glanders, and syphilitic gummata, which 
 have no legitimate place in this group. Instead 
 of placing in one and the same group, sarcoma, 
 myxoma, inoma, lipoma, chondroma, and os- 
 teoma, which are all connective tissue growths, 
 they scatter them in four distinct groups. 
 
 They make varieties of medullary and fasci- 
 culated neuromata which are in reality species ; 
 and epithelioma and adenoma which are genera 
 are also set down as varieties. 
 
 They class papilloma as a variety of epithelial 
 growth, while in truth it is a papillary or villous 
 inoma, and should be so named and not called 
 papilloma. They include too the cysts, which 
 should be placed under a distinct and separate 
 caption. 
 
 The mixed tumors, described by them as 
 formed especially during intra-uterine life, belong 
 properly to the teratisms and should be classified 
 accordingly. 
 
 This all shows how inconsistent and fallible 
 men can be ; even those whose minds are richly 
 stored with knowledge. Therefore nothing in 
 medicine should be taken for granted because ut- 
 tered by one high authority. Every assertion, 
 
358 NEOPLASMS. 
 
 theory, discovery, and new method or process, 
 should be put to the most searching tests by 
 many laborers, and, before they are accepted, 
 should pass through the expurgating crucible of 
 criticism which will clear away the dross of 
 error and misconception, and bring forth the 
 genuine glitter of the pure and precious truths 
 of science. This is the right path to advancement. 
 Hasse thinks that neoplasms probably arise in 
 tissues in different conditions — embryonic, grow- 
 ing, mature, retrogressive. They are regarded as 
 new formations because they are more or less in- 
 dependent of the matrix tissue. They behave 
 like independent, isolated bodies, except that they 
 draw their sustenance from the organism ; they 
 have their autonomy, so that they bear no relative 
 increase or decrease of size with the organism. 
 Examples: A neoplasm, in a fat subject, does not 
 decrease in size upon the supervention of emacia- 
 tion ; and a neoplasm, in a lean subject, does not 
 increase in size upon the supervention of cor- 
 pulency. " The neoplasm assumes properties 
 distinct from its surroundings, the individual ele- 
 ments of the growth become affected in some 
 w^ay and they are rendered dissimilar to their 
 neighbors. There is no limiting or directing in- 
 fluence of the surrounding tissues on the new 
 growth. The result is development of a tissue of 
 
NEOPLASMS. 359 
 
 abnormal type, a local anatomical misforma- 
 tion." 
 
 Cohnheim is of opinion that neoplasms cannot 
 be regarded as localised hyperplasias because 
 they generally differ in their histogenesis from 
 the matrix tissue, and because this histogenesis is 
 so different from the formative processes orig- 
 inating in inflammation. His views of the em- 
 bryonic theory are substantially as follows : 
 Many forms of neoplasms are developed at all 
 ages, they originate too in apparently normal 
 tissues, and are due to the persistence of embry- 
 onic germinal tissues in the otherwise mature 
 organism ; taking their rise in what may be 
 called belated rudiments — foci of formative em- 
 bryonic tissue which have not been utilised in 
 elaborating normal tissues, and so have lingered 
 on unchanged. In other words such a growth is 
 an atypical new-formation starting in a latent 
 embr)^onic rudiment. The germs of the growth 
 may be very small and elude observation, being 
 embryonic cells, or may be quite recognisable 
 among the normal elements. These germs may 
 long remain inactive, but when external condi- 
 tions, supply of nutriment, and relation to sur- 
 rounding tissues are favorable, they begin to 
 multiply, start into a new life and form a neo- 
 
3^0 NEOPLASMS 
 
 plasm.* Cohnheim's arguments in favor of his 
 theory have explained the otherwise unaccount- 
 able heterogeny of many neoplasms. He says : 
 many new-growths are hereditary ; they may 
 exist at birth or develop in infanc}'^ ; they show a 
 preference for sites where, in early develop- 
 mental stages, complication of structure happens ; 
 where different epithelial formations pass one 
 into the other, as the lips, stomach, anus, and 
 cervix uteri ; or where the entire -process of de- 
 velopment is complex, as the genital apparatus ; 
 also the atypical structures. 
 
 In order to fully understand the blastodermic 
 theory of the development of neoplasms, it is 
 necessary to pass in review the changes which 
 take place in the human blastoderm. The follow- 
 ing, which exposes the most recent views of the 
 subject, is abstracted from Duval's physiology. 
 
 " Originally the human organism consisted of 
 a single cell, the ovule, which when fecundated 
 begins to undergo certain transformations, the 
 first of which being segmentation. As soon as 
 the ovule is divided in four segments, these limit 
 between themselves, by their slight separation, a 
 space called the segmentation cavity. As the 
 
 * It is well known how often new-growths take their start* 
 ing point from traumatisms. 
 
NEOPLASMS. 361 
 
 segmentation goes on, this cavity increases more 
 and more, and finally the segmented ovule be- 
 comes a hollow sphere whose parieties are con- 
 stituted by a layer of cells comparable to epithelia. 
 The large cavity circumscribed by this layer of 
 cells still bears the name of segmentation cavity. 
 Then take place transformations which differ 
 somewhat in different animals, but may neverthe- 
 less be brought to the following type : that is to 
 say to the formation of a gastrula. One of the 
 hemispheres of the hollow sphere becomes fiat, 
 then is gradually invaginated in the interior of 
 the other hemisphere. A new cavity, called the 
 invagination or gastrula cavity, is thus produced, 
 w^hich corresponds to the future intestinal cavity. 
 " The segmentation cavity is then reduced to a 
 mere chink separating two cellular layers : the one 
 of the layers, which corresponds to the interior of 
 the original intact hemisphere of the hollow 
 sphere, is called the external layer, the other, 
 which corresponds to the interior of the invagi- 
 nated hemisphere is called the internal layer. 
 Soon the internal layer, by multiplication of its 
 cells, is divided into two layers, one of which be- 
 ing the internal layer proper, and the other the 
 middle layer or mesoblast. The mesoblast there- 
 fore occupies a position, in what was the segmen- 
 tation cavity, between the internal and external 
 
362 NEOPLASMS. 
 
 layers. Such is the origin and development of the 
 blastodermic vesicle, and such are the relations 
 of its three layers. The epiblast or external 
 horny layer retains its cellular character, and 
 from it is derived the epidermis. 
 
 " The entoblast or internal layer furnishes the 
 epithelium of the future intestinal mucous mem- 
 brane and of that of its annexes, of the great 
 majority of glands, and of the lungs. 
 
 "The mesoblast or middle layer. The cells of 
 of this layer undergo much more complicated 
 transformations than those of the other two 
 layers. Some of them are transformed into nerve 
 tissue, into muscle tissue, and into all the forms 
 of connective tissue ; others preserve their cellu- 
 lar state, but are changed in form and diffused in 
 the fibrous element of connective tissue, ** they 
 are called embryonic or mesoblastic cells — cells 
 of tendons, cartilage, bone — ; the others swim in 
 a fluid — blood cells, etc." * 
 
 Rindfleisch and Lancereaux based their classi- 
 fications of the new-growths upon the derivative 
 tissues of the blastoderm, and divided these new- 
 growths into two great classes ; (i,) that in which 
 the generative tissue is derived from the meso- 
 
 ♦ Mathias Duval. Cours de Pysiologie. Sixieme edition. 
 Paris, 1887. 
 
NEOPLASMS. 363 
 
 blast ; (2,) that in which the generative tissue is 
 derived from the entoblast and epiblast. The 
 first being formed of connective tissue, the second 
 of epithelium, of epidermis, or of their derivatives. 
 Hallopeau adopted this basis of classification in 
 the first edition of his work, but in the second 
 edition he says: "to-day the soundness of this 
 division may be doubted in view of the late em- 
 bryogenic researches of Waldeyer, showing that 
 the entoblast and mesoblast are derived from the 
 invagination of the epiblast; in that case the 
 mesoblast has not the same individuality as the 
 others, for, elements of different nature are 
 therein united. Duval had arrived independently 
 at the same conclusion. 
 
 In his work on Physiological Chemistry (1880), 
 Gamgee, in treating of the epithelium of the 
 mucous membranes, says : 
 
 " This epithelium is mainly derived from the 
 hypoblast, though in some cases it takes its 
 origin in the epiblast (epithelium of mouth and 
 salivary glands), in others from the mesoblast 
 (certain portions of the epithelium of the genito- 
 urinary tract). In short, the epithelium of the 
 mucous membranes is possessed of diverse chem- 
 ical attributes and is developed in several ways ; 
 it does not therefore possess any common charac- 
 ters which permit of a general description." 
 
364 NEOPLASMS. 
 
 The clinical basis is out of the question because, 
 if an arrangement were attempted on such a 
 foundation, the malignant and non-malignant 
 growths would have to appear under separate 
 heads ; for instance, epithelioma and carcinoma 
 would have to be placed in the same order as 
 sarcoma, etc. It would be against all rules of 
 nosography to arrange growths in accordance 
 with their benignity or malignity, for this belongs 
 to prognosis which occupies its proper rank in 
 methodical arrangement. 
 
 Rindfleisch still adheres to the blastodermic 
 basis,* and defines a tumor as ** an excess of de- 
 generative local development." 
 
 The classification which he now promulgates 
 is based upon the duality of the embryonic ele- 
 ments (His.), namely, (i,) archiblastic tissues, 
 which, besides the epithelial casing of the epiblast 
 and entoblast, include the muscular and nervous 
 elements that are generally credited to the meso- 
 blast; (2,) the /<3:r<a;^/<2^^/^ tissues, the products of 
 the peripheric vessel-forming matrix, of the area 
 opaca of the embryo, which from the periphery 
 grow into archiblastic layers, and serve to bind 
 them together and nourish them. If, says Rind- 
 
 * Ed. Rindfleisch. Elements de Pathologie. Traduction 
 Fran9aise du Docteur J. Schmitt. Paris 1886. 
 
NEOPLASMS. 365 
 
 fleisch, this theory be accepted, a natural and 
 fruitful division of tumors may be made into two 
 groups: "The first group include tumors 
 which are exclusively the products of the inter- 
 mediary apparatus of nutrition — the primitive 
 parablasts. From the beginning they show their 
 connection with the vascular system, by forming 
 around a vessel a little focus of embryonic tissue 
 rich in cells. This may in time produce the high- 
 est types of the tissues of the parablastic series. 
 After this manner are produced lipoma, fibroma, 
 myoma, enchondroma, endothelioma, angioma, 
 etc. But in a great number of cases the neoplasm 
 does not reach full development, and the tumor 
 remains formed of an imperfect connective tissue 
 such as is found in inflammatory neoplasms — 
 connective tissue with round or fusiform cells — 
 this is sarcoma. This imperfect maturation of 
 tissue gives a new criterion of the degree of de- 
 generation, and irregularity of development. In 
 fact the amount of production is in inverse ratio 
 to the perfectness of the tissue. The excessive 
 formative activity seems to have the one object 
 of producing an enormous amount of cells. It is 
 in this way that the disease destroys an organ 
 and pervades the whole economy. In this strug- 
 gle, the individual development of the cell goes 
 on with difficulty. Still the most exuberant sar- 
 
366 NEOPLASMS. 
 
 comata have a tendency to reproduce certain 
 characters of the site where they are developed — 
 as ossification, pigmentation, etc. 
 
 "The second group includes the epithelial tu. 
 mors. Here the epiblast and entoblast, either 
 alone or mixed with the parablasts, determine 
 the essential nature of the tumor. Here too are 
 produced many young epithelial cells which 
 rarely reach full development but resemble the 
 epithelial cells which are proper to the site. 
 Thus are formed the subdivisions of adenomata. 
 Much more frequent are the true carcinomata in 
 which the epithelial proliferation is completely 
 atypical and very rapid and abundant, the young 
 cells inordinately accumulating on the chosen 
 ground. Carcinomata and sarcomata, in conse- 
 quence of this luxuriant cell proliferation, have a 
 common property which allows them to be in- 
 cluded in the same clinical group as that of 
 medullary tumors." 
 
 It is thus Rindfleisch reaches his classification 
 which is as follows : 
 
neoplasms. 367 
 
 Rindfleisch's Classification of Tumors. 
 
 Group I. Hyperplastic Tumors. 
 Site; Bone, Skin, Glands. 
 
 1. Enchondrosis 
 
 2. Exostosis 
 
 3. Verruca 
 
 4. Papilloma 
 
 5. Hypertrophied glands with equal develop. 
 
 ment of all their tissues. 
 
 a. Lymphoma (lymph-glands, spleen). 
 
 b. Struma hyperplastica (thymus, prostate). 
 
 c. Cysts by retention (atheroma, mucous polyps 
 
 of the intestines and uterus).* 
 
 Group II. Heteroplastic Tumors. 
 (True tumors). 
 
 A. Tumors issued from the vasculo-connective 
 substance — Parablastic neoplasms (His). Histioid 
 tumors (Virchow). 
 
 * Here then is a series of growtlis which Rindfleisch classi- 
 fies as tumors, but in the second group (true tumors), is an 
 implied statement that the first group consists of tumors that 
 are not tumors. This, however, is but a venial fault as com- 
 pared with others contained in this very unsatisfactory classi- 
 fication. 
 
368 NEOPLASMS. 
 
 a. Where the tissues reach perfect maturation. 
 
 1. Fibroma 
 
 2. Lipoma 
 
 3. Enchondroma 
 
 4. Myxoma 
 
 5. Angioma 
 
 6. Osteoma 
 
 7. Endothelioma. 
 
 b. Where the tissues do not reach perfect 
 maturation. 
 
 I. Sarcoma 
 
 a. Fusocellular sarcoma (small cells). 
 
 b. Fusocellular sarcoma (large cells). 
 
 c. Simple globocellular sarcoma. 
 
 d. Lymphadenoid globocellular sarcoma. 
 
 B. Tumors having their origin in the tegu- 
 mentary or glandular epithelium {archiblastic 
 heteroplasms). 
 
 I. Epithelioma 
 
 a. Pavement epithelium tumors, 
 
 b. Cylindrical epithelium tumors. 
 
 c. Glandular epithelium tumors. 
 
 There stops this nevsr arrangement of tumors. 
 It is so obviously incomplete, inconsistent, and 
 unsatisfactory that an extended commentary 
 thereon would be superfluous. 
 
NEOPLASMS. 
 
 369 
 
 I. Connective 
 tissue tumors. 
 
 Mr. Butlin, excluding the cysts, divides tumors 
 into two orders and fourteen genera as follows:* 
 
 1. Lipoma 
 
 2. Fibroma 
 
 3. Chondroma 
 
 4. Osteoma 
 
 5. Myxoma 
 -j 6. Lymphoma 
 
 7. Myoma 
 
 8. Neuroma 
 
 9. Angeioma 
 
 10. Sarcoma 
 
 11. Endothelioma 
 
 II. Epithelial j "• PT"°™^ 
 
 ^ K i^. Adenoma 
 
 tumors 
 
 ( 14. Carcinoma, 
 
 Six modern classifications of tumors — all dif- 
 ferent — , from Virchow to Butlin and Rindfieisch, 
 are given for comparison. If, in the whole range 
 of nosography, there existed only this diversity 
 in arrangement, it would be sufficient to warrant 
 a loud call for a better understanding among in- 
 vestigators, for associated labor, and for a general 
 consense of views in the profession, as the only 
 means to put an end to this confusion of names 
 
 * Article Tumors, by Henry Trentham Butlin, F. R. C. S„ 
 in the International Encyclopedia of Surgery, 1884. 
 
370 NEOPLASMS. 
 
 whose outcome has been confusion of ideas. 
 Only one classification of tumors is really wanted 
 and this should be compiled, partly from those 
 now existing, and partly from the new material 
 which must come forth as a result of the study 
 entailed by such compilation. 
 
 The foregoing statements render it clear that 
 the law of Miiller, or the blastodermic theory 
 cannot stand for the foundation of any classifica- 
 tion. However, neither the former nor the latter 
 should be lost sight of, for they both afford great 
 aid alike in the study of morbid growths and in 
 their arrangement. The true basis of the classi- 
 fication should be anatomy in its broadest, most 
 comprehensive sense, leading from biogeny to 
 pathogeny. It is upon this basis, in accordance 
 with the dominant structure in their composition, 
 that the arrangement of neoplasms, (as far as 
 genera), has been made in the table of morbid 
 states and morbific processes, which is offered 
 only as a suggestion of a ground-work for the 
 classification of diseases. 
 
 In the table of morbid states and morbific pro- 
 cesses Neoplasmata stand for class, and this class 
 is divided into five orders: i, Desmoneoplas- 
 mata ; 2, Myoneoplasmata ; 3, Neuroneoplas- 
 mata; 4, Angioneoplasmata ; and 5, Epithelioneo- 
 plasmata : and fourteen genera. Thus indicating 
 
NEOPLASMS. 371 
 
 the tissues of which the growths are chiefly com- 
 posed. 
 
 The first order consists of eight genera ; the 
 second order, of one genus ; the third order, of 
 one genus ; the fourth order, of one genus ; and 
 the fifth order, of three genera. 
 
 The third genus of the first order is named 
 inoma, — from i'?, zVo?, fibre — , as suggested long 
 ago by Sir James Paget. This term is preferable 
 to, because more exact than, fibroma which is a 
 hybrid. However, in the table it appears in 
 brackets. 
 
 The fifth genus of this first order is named 
 neuroglioma instead of the original glioma of 
 Virchow. Neuroglioma was used by Klebs, 
 Heller, and Renaut (1885). They employed this 
 word because they thought that the growth con- 
 tained nerve elements. Ziegler and others de- 
 nied that neurogliomata contain nerve elements. 
 Hallopeau insists upon the use of glioma because, 
 as he says, it contains no nerve elements. 
 
 The term neuroglioma is used here simply be- 
 cause the growth it is intended to designate is 
 composed of neuroglia, nerve-glue. Used in such 
 a sense this word will surely not indicate that the 
 growth in question contains nerve elements other 
 than nerve-glue. Glioma is objectionable because 
 
372 NEOPLASMS. 
 
 it means a growth composed of glue without in- 
 dicating the kind of glue. 
 
 The second order, myoneoplasmata, consists of 
 only one genus, myoma, and this genus of two 
 species, (i,) rhabdomyoma, composed chiefly of 
 striated muscular fibres, and (2,) leiomyoma, 
 composed chiefly of smooth muscular tissue. 
 
 The third order, neuroneoplasmata, consists of 
 one genus, neuroma, and this genus of two spe- 
 cies, (i,) medullary neuroma, containing nerve 
 cells; (2,) fasciculated neuroma, containing nerve 
 tubes. 
 
 The fourth order, angioneoplasmata, consists 
 of one genus, angioma, and this genus of two 
 species, (i,) haemangioma, composed chiefly of 
 blood vessels ; (2,) lymphangioma, composed 
 chiefly of lymph vessels. 
 
 The fifth order, epithelioneoplasmata, consists 
 of three genera, (i,) epithelioma, (2,) carcinoma, 
 (3,) adenoma. Each genus has its species and 
 these their varieties. Some of these species are 
 now in dispute, and it is hoped that the question 
 of their retention or rejection will very soon be 
 settled. The epithelioneoplasmata may be said 
 to be panblastic,* that is to say that they are de- 
 
 * Panblastic (Clymer). 
 
BLASTOMATA. 373 
 
 rived from the meso and from the ento and epi- 
 blast. 
 
 VI. Blastomata. 
 
 The reasons for suggesting the term blastoma 
 are given at page 58. 
 
 Blastomata are detached from neoplasmata, be- 
 cause of the fact that neoplasmata spring from 
 the normal tissues of the body generally without 
 the intervention of extraneous substances, while 
 the blastomata are now all regarded as infective 
 in character and as proceeding from parasitic 
 invasion. From the point of view of the Bacteri- 
 ologists, blastomata have a better right to the ti- 
 tle neoplasmata than the growths now bearing 
 that name. In the one case the growths are en- 
 dogenous (native), in the other exogenous, (for- 
 eign invaders compelling the organism to build 
 their dwellings which they consume and de- 
 stroy.) 
 
 The seventh genus of blastomata, actinomy- 
 cosis, is a disease of the lower animals, but it oc- 
 casionally invades the human body. The para- 
 sites actinomyces enter the body with the food 
 taken, and effect lodgment in the tissues of the 
 mouth through an accidental abrasion, multiply, 
 cause inflammation of the surrounding tissues 
 and soon a neoplasm, resembling a tuberculous 
 
374 BLASTOMATA. 
 
 nodule, is developed which consists chiefly of 
 round cells. The neoplasm may go on increasing 
 in size or may break down and suppurate. In the 
 slimy detritus little pale-yellow grains of the 
 fungus may be detected. The organism may 
 also occur in nodular tumors in the lungs, and 
 subcutaneous and intermuscular tissues. It is 
 the cause of ** wooden tongue " and also of dis- 
 eases which have been described, before their 
 true nature was understood, as bone-canker, bone 
 tubercle, osteo-sarcoma, etc., (Crookshank). 
 
 The eighth genus of blastomata, rhinoscleroma, 
 was formerly confounded with syphilis and lupus, 
 but it greatly differs from them in its anatomical 
 characters, and is not in the least degree con- 
 trolled by antisyphilitic medication. It has been 
 observed in Austria, Hungary, Italy, and Central 
 America. Hebra and Kaposi described it in 
 1870, and since that time, the subject has been 
 largely discussed, particularly by Mikulicz, 
 Frisch, Chiari, Klebs, Auspitz, Eppinger, Pel- 
 lizari, Alvarez, and Rindfleisch. (Cornil and 
 Babes). 
 
 Rhinoscleroma is characterized by a thickening 
 and induration of the nasal septum and mucous 
 membrane, of the integument of the nose and 
 lips, and of the pharyngo-laryngeal mucous mem- 
 brane. It begins in the nose and finally invades 
 
BLASTOMATA. 375 
 
 the other parts. It shows itself under the form 
 of smooth or granulous, hard, elastic, and shiny 
 nodosities of light red or gray color and painful 
 under pressure. These growths extend deeply 
 into the derma and slightly resemble keloides^ 
 showing neither hairs nor glandular mouths. The 
 neighboring parts are tumefied, the nose is flat- 
 tened and enlarged at its anterior extremity ; the 
 wings of the nose are stiff and immovable ; and 
 the nasal orifices are narrowed. The upper lip 
 is indurated from invasion of the disease which 
 may reach the gums and buccal membrane, at 
 the same time that the infection is propagating 
 itself from the nasal fossae to the palatine cur- 
 tain, to the pharynx and even the larynx. A 
 glottic stenosis necessitating trachoeotomy may 
 even be the result. The progress of rhinoscleroma 
 is very slow, the primitive nodule may be four or 
 five years in reaching a superficial extent of four 
 or five centimetres. There are cases of fifteen 
 or twenty years standing. (Cornil and Babes.) 
 
 According to Auspitz, Alvarez, and Rind- 
 fleisch, the skin in rhinoscleroma is infiltrated 
 with small cells, its vessels are sclerosed and im- 
 bedded in the same cells. It contains also proto- 
 plasmic polynucleated giant cells, and also bac- 
 teria and hyaline bodies. Alvarez has lately said 
 
376 CYSTS. 
 
 that he is disposed to look upon these as dilated 
 lymphatics rather than cellular elements. 
 
 VII. Cysts. 
 
 The cysts are detached from the class neoplas- 
 mata because cysts that are not parasitic or tera- 
 tic are not neoplastic, and the parasitic and tera- 
 tic cysts should be placed respectively in the 
 classes Parasiti and Tcrata. 
 
 Most of the recent writers upon neoplasms ex- 
 clude the cysts from the caption neoplasmata. 
 A cyst is a cavity whose contents are circum- 
 scribed by fibrous tissue, or some other more or 
 less complex structure, with or without a lining- 
 of epithelium or endothelium, according to its 
 genesis. 
 
 Sir James Paget* separates the cysts from the 
 tumors, but includes parasitic and teratic cysts in 
 the one class cysts, as have done most other 
 writers. 
 
 Mr. Butlin f divides cysts into : 
 
 * Lectures on Surgical Pathology, edited by Dr. Turner, 
 t Loc. Cit. 
 
CYSTS. 377 
 
 I. Cysts formed by distension of previously 
 existing sacs or tubes. 
 
 1. Retention cysts. 
 
 2. Exudation cysts. 
 
 3. Blood cysts. 
 
 4. Lymph cysts. 
 
 II. Cysts of new formation. 
 
 1. Extravasation cysts. 
 
 2. Parasitic cysts. 
 
 3. Cysts formed in areolar tissue. 
 
 4. Cysts formed by union of papillary processes. 
 
 5. Cysts from changes in cells. 
 
 III. Cysts of uncertain origin. 
 
 Are not the cysts (II. 3.) formed in areolar tis- 
 sue the same as (I. 2.) the exudation cysts, and 
 {I. 4.) the lymph cysts ? 
 
 Parasitic cysts have no place in II, for they be- 
 long properly to the caption Parasiti. 
 
 Cysts of uncertain origin (III,) naturally sug- 
 gest that an endeavor should be made to find the 
 origin of these cysts in order that they be named 
 and rightly classified. 
 
 Retention cysts are exemplified by the glandu- 
 lar cysts formed, in preexisting epithelial cavi- 
 ties, by organic or mechanical closure of a gland 
 duct, causing an accumulation of its natural se 
 
378 CYSTS. 
 
 cretion behind the obstruction, and dilatation 
 into a cyst. The retention cysts occur in the 
 skin, mamma, uterus, intestine, and kidney* 
 Canals lined with epithelium, such as the bile 
 ducts, ureters, vermiform appendix, seminal 
 tubes, etc., develop into cysts by local dilatation 
 from obstruction. 
 
 Endothelial cysts are often classed as retention 
 cysts, but are not of that nature. They are 
 properly exudation cysts, and occur either in 
 natural spaces of the connective tissue, such as 
 bursae and tendon sheaths, in false membranes, 
 or in obstructed lymphatics, and their contents^ 
 though varying with their mode of origin, consist 
 generally of lymph. 
 
 Blood cysts are due to haemorrhage in pre- 
 existing cysts, in closed cavities, or in connective 
 tissue which eventually encloses completely the 
 extravasated blood. They are all therefore blood 
 extravasation cysts. 
 
 Lymph cysts, commonly called hygromata, are 
 the same as endothelial cysts, and are the out- 
 come of obstruction of lymph vessels, or of dila- 
 tation of lymph spaces. They may also be lymph 
 extravasation cysts. 
 
 Degeneration cysts result from a necrotic pro- 
 cess. They occur in the substance of organs and 
 sometimes of tumors, and their contents are the 
 
CYSTS. 379 
 
 products of disintegration of the substance of the 
 organ or of the tumor. 
 
 Cysts formed around foreign bodies such as 
 bullets, etc., and around parasites, should be 
 classed under their appropriate captions and not 
 with neoplasmata. 
 
 Waldeyer and Malassez regard ovarian cysts as 
 epitheliomata. If this view be correct, such 
 cysts should be classed as varieties of epithelio- 
 mata. 
 
38o 
 
 CONCLUSIONS. 
 
 Among the conclusions drawn from the pre- 
 ceding considerations are : 
 
 1. That the systematic arrangement of diseases 
 upon a proper basis must give to medicine an as- 
 sured position among the sciences ; and that even 
 in its imperfect state, it has contributed marvel- 
 ously to the advancement of medical art during 
 this century. 
 
 2. That the only stable basis for nosography is 
 anatomy. 
 
 3. That an accurate description and an exact 
 definition of diseases are essential to a precise 
 and practical nosography. 
 
 4. That a nomenclature, to be satisfactory, 
 must not admit the application of the names of 
 men to diseases, or any name which does not con« 
 vey an intelligible idea of a morbid condition. 
 
CONCLUSIONS. 381 
 
 5. That the nomenclature of diseases can be 
 much improved only after a very great change 
 for the better shall be made in the fundamental 
 science and associated arts of medicine. 
 
 6. That the most useful and practical classifica- 
 tion of diseases is that in which these are grouped, 
 in accordance with the apparatuses of the body, 
 into families, branches of families, classes, orders, 
 genera, species, sub-species, varieties, and sub- 
 varieties. 
 
 7. That the purpose of the nosographer should 
 be to guide the practising physician to the 
 end of any case of disease. 
 
 8. That a complete nosography should include 
 the history, pathoanatomy, diagnosis, prognosis, 
 and treatment of diseases, and for ready refer- 
 ence, should contain not less than five synoptical 
 tables : (i,) 21 synposis of the morbid states and 
 morbific processes of the body ; (2,) a synopsis of 
 the genera and species of diseases ; (3,) a synop- 
 sis of the classes, orders, genera, species, sub- 
 species, varieties, and sub-varieties of diseases; 
 {4,) a synopsis of the aetical factors of diseases ; 
 
3^2 CONCLUSIONS. 
 
 and (5,) a synopsis of the symptoms and signs of 
 diseases ; also a full alphabetical index. 
 
 9. That any system of general nosography, to 
 be of utility to scientific investigators, practising 
 physicians, and vital statisticians, should be the 
 result of the conjoint labors of the medical pro- 
 fession of all the civilized nations of the world. 
 
INDEX. 
 
 383 
 
 Abortus . 
 
 103, 158 
 
 Abscess 
 
 82 
 
 Acetonaemia 
 
 46, 264 
 
 Achores 
 
 82 
 
 Acrotica 
 
 161 
 
 Acrotismus 
 
 152 
 
 Actinomycosis 
 
 49.373 
 
 Adenoma 
 
 49 
 
 Adenoses . . . 
 
 165 
 
 Adipsia 
 
 99. 114 
 
 Adynamiae 
 
 , , 108, III, 126 
 
 Aedopsophia 
 
 104 
 
 Acdoptosis 
 
 157 
 
 Aerifluxus 
 
 104 
 
 Aesthetica 
 
 149 
 
 Agenesia , . , 
 
 . 156 
 
 Ageustia 
 
 ... 114 
 
 Agheustia 
 
 . . .98 
 
 Agrypnia 
 
 . 102, 153 
 
 Algor . , . . 
 
 100 
 
 Alibert's System 
 
 165 
 
 Alopecia 
 
 82, 106 
 
 Alphosis 
 
 164 
 
 Alusia . . • . 
 
 148 
 
 Alvifluxus, 
 
 . . . 103 
 
 Amaurosis 
 
 98, 113, 150 
 
 Amblyopia 
 
 98 
 
 Amenorrhoea 
 
 115 
 
Amentia . . . , 
 
 
 
 102, 112 
 
 American Med. Assoc, discussion c 
 
 )n the adoption 
 
 of a system of nomenclature, 
 
 
 
 i76> 
 
 Ammoniaemia 
 
 . 
 
 
 46, 264 
 
 Amnesia 
 
 
 
 lOZ 
 
 Amphimerina 
 
 , . 
 
 
 95 
 
 Amputatura 
 
 
 
 94 
 
 Anacatharsis 
 
 , 
 
 
 105 
 
 Anaesthesia 
 
 
 
 98, 114 
 
 Anaphrodisia, 
 
 , , 
 
 
 99,114 
 
 Anasarca 
 
 
 
 82, 104, 112 
 
 Anatomy . . . . 
 
 . 
 
 
 31 
 
 Anchylosis 
 
 
 
 82 
 
 Anepithymiae 
 
 . 
 
 
 99. 127 
 
 Anetus . . . 
 
 
 
 139 
 
 Aneurysma . . . . 
 
 • * 
 
 
 92, 115, 147 
 
 Angina .... 
 
 
 
 98 
 
 Angioma . . 
 
 . 
 
 
 49 
 
 Angioses 
 
 
 
 . 16S 
 
 Anhelatio . . . . 
 
 . 
 
 
 97, 117, 125 
 
 Anorexia 
 
 
 
 99. 114 
 
 Anosmia . . , . 
 
 • 
 
 
 98. 114 
 
 Antipathia 
 
 
 
 102, 153. 
 
 Anthracia 
 
 I • 
 
 
 I4S 
 
 Anthrax . . . 
 
 
 
 92, 141 
 
 Anthroponosography 
 
 . 
 
 
 34 
 
 Anthropophysiography 
 
 
 
 31 
 
 Anxietas 
 
 . 
 
 
 . 100, 153 
 
 Aphelxia . • 
 
 
 
 14^ 
 
 Aphonia 
 
 . 
 
 
 99, 114, 136 
 
 Aphoria 
 
 
 
 157 
 
 Aphorisms of Linnaeus 
 
 . 
 
 
 1 8a 
 
 Aphtha 
 
 
 83. 
 
 95, no. 144 
 
INDEX. 
 
 385 
 
 Apocenosis .... 
 
 . 115. 125 
 
 Apolepsis 
 
 83 
 
 Apomyttosis 
 
 97 
 
 Apoplexia 
 
 83, 99, III, 154 
 
 Apparatus — definition of 
 
 64 
 
 Apparatus — circulatory, disturbances 
 
 in . .47 
 
 Ardor . . . . 
 
 100 
 
 Aridura 
 
 104 
 
 Arthritis . . . , 
 
 100, 124 
 
 Arthrocace 
 
 94 
 
 Arthrodynia 
 
 no 
 
 Arthropuosis ., 
 
 • .110 
 
 Arlhrosia . . » • 
 
 144 
 
 Ascarides . . 
 
 83 
 
 Ascites . . 
 
 . 105. 113 
 
 Asphyxia 
 
 99 
 
 Asthenia . . . . 
 
 99 
 
 Asthma 
 
 . 83,98,111,125,138 
 
 Athroisaemia 
 
 . 47. 324 
 
 Atrophy 
 
 . 47,52.55.104,112 
 
 Auante . . . . 
 
 83 
 
 Aurigo . . 
 
 106, 127, 164 
 
 Auxesis . . . . 
 
 47, 52, 326 
 
 Azoteneses , 
 
 . 119 
 
 Bacteria . • . . 
 
 . 298-323 
 
 Ballismus 
 
 . 153 
 
 Barber-surgeon . 
 
 41 
 
 Basis of classification 
 
 . 214 
 
 Baumes' system 
 
 118 
 
 Beriberia 
 
 97. 153 
 
 Bex . , . . . 
 
 137 
 
 Bezoardus , , , 
 
 . 133 
 
 Bibliography, nosographical 
 
 , , 200-211 
 
30O INDEX. 
 
 
 
 Biothalmy » . » . ; 
 
 
 37 
 
 Blastomata , . . 
 
 , 
 
 49. 373 
 
 Blennoses 
 
 
 . 166 
 
 Blennorrhoea . , . -. 
 
 . 
 
 155 
 
 Blepharoptosis ..... 
 
 
 93 
 
 Blood, alterations in composition of 
 
 , 
 
 45. 254 
 
 Bronchitis . ^ , . . 
 
 
 142 
 
 Bronchocele ,. 
 
 , 
 
 92 
 
 Bubo ... . . . 83 
 
 92. 
 
 115, 140 
 
 Bucnaemia ..... 
 
 . 
 
 143 
 
 Bulimia ...... 
 
 
 102, 114 
 
 Cachexiae . . . 83, 104, 108. 
 
 112, 
 
 117, 127 
 
 Caeliaca 
 
 
 . 103 
 
 Calculus . . ... 
 
 . 
 
 133 
 
 Caligo . , . ... 
 
 98, 
 
 ii3» 150 
 
 Callus . ,. . 
 
 • 
 
 163 
 
 Calorineses ...... 
 
 
 . 119 
 
 Cancer . „, . , 83, 
 
 92, 
 
 115. 336 
 
 Carbuncle ... . . 
 
 
 . 83 
 
 Carcinoma . . 
 
 , 
 
 49, 105 
 
 Carcinus . 
 
 
 146 
 
 Cardialgia , . , , . , , ' 
 
 
 loi, 132 
 
 Cardiogmus . . 
 
 
 100 
 
 Carditis . , . . 96, 
 
 109, 
 
 123, 142 
 
 Caries . , , . , . 
 
 94. 
 
 -116, 147 
 
 Carphologia . . , , , 
 
 . , 
 
 97 
 
 Carpotica 
 
 
 . 157 
 
 Caruncula ..... 
 
 , 
 
 163 
 
 Carus . . . . , 
 
 
 83.99 
 
 Catacausis 
 
 , 
 
 146 
 
 Catalepsia 
 
 
 . 154 
 
 Catalepsis ,. . ,. . 
 
 . 
 
 99 
 
 Cataphora 
 
 
 83.99 
 
INDEX. 
 
 387 
 
 Catarracta . . 
 
 98, 150 
 
 Catarrhus . . . 
 
 loo, no, 124, 143 
 
 Catoche . ... 
 
 . 83 
 
 Catochus . . , 
 
 ... . 97 
 
 Catotica . ... 
 
 . 160 
 
 Cenotica . . . 
 
 .... 154 
 
 Cephalaea . . 
 
 . • 100, 154 
 
 Cephalalgia . . . \ 
 
 100 
 
 Cephalitis . . . 
 
 96, 142 
 
 Chancroid ulcer 
 
 49 
 
 Chirurgery, master in 
 
 41 
 
 Chlorosis . . . 
 
 106, III, 156 
 
 Cholaemia . 
 
 46, 266 
 
 Cholera . _ , 
 
 . . 84, 103, III, 133 
 
 Cholesteraemia . . . 
 
 ... 266 
 
 Chololithus . , 
 
 135 
 
 Choloses 
 
 . . 165 
 
 Chondroma 
 
 48 
 
 Chorea . . . . 
 
 . III. 153 
 
 Cibaria 
 
 132 
 
 Cinetica 
 
 152 
 
 Clasis .... 
 
 128 
 
 Classification of medicine . 
 
 • • 31 
 
 Classification . , 
 
 212 
 
 Classification, basis of 
 
 214 
 
 " , method of 
 
 .237 
 
 " , need of 
 
 . , • 213 
 
 Claudicatio 
 
 97 
 
 Clavus 
 
 . 115,163 
 
 Clonici generates 
 
 ., . .97 
 
 Clonici partiales . . • 
 
 97 
 
 Clonos .... 
 
 • • 126 
 
 Clonus . . . ^ • 
 
 152 
 
388 
 
 INDEX. 
 
 Coeliaca .... 
 
 124, 130 
 
 Colica .... 
 
 loi, III, 132 
 
 Coma ..... 
 
 84, 126 
 
 Comata .... 
 
 99. Ill 
 
 Condyloma .... 
 
 92 
 
 Congestion .... 
 
 47. 324 
 
 Constrictoria .... 
 
 125 
 
 Contractura . , , 
 
 96, 114, 126 
 
 Contusio .... 
 
 94 
 
 Convulsio .... 
 
 97. Ill 
 
 Cophosis . , , . 
 
 98 
 
 Coprostasis , , , 
 
 132 
 
 Coryza . . , . . 
 
 . 84, 103, 136 
 
 Crampus .... 
 
 96 
 
 Cretinismus .... 
 
 159 
 
 Crichton's system 
 
 122 
 
 Critici . . . . , 
 
 107 
 
 Cullen's rules . . 
 
 180 
 
 Cullen's synopsis . . 
 
 109 
 
 Cynanche .... 
 
 96, 109, 123 
 
 Cyrtosis .... 
 
 . 159 
 
 Cystides .... 
 
 92 
 
 Cystirrhoea .... 
 
 124 
 
 Cystis .... 
 
 128 
 
 Cysts ..... 
 
 50. 376 
 
 Cystitis .... 
 
 96, no, 123, 142 
 
 Cystocele . . . . 
 
 93 
 
 I>arwm'§ §y8tem 
 
 118 
 
 Debilitates . . . . 
 
 98,117 
 
 Decrease . . , , 
 
 48, 54 
 
 Definition of medicine 
 
 29 
 
 Definitions of terms of classification 
 
 247 
 
 Defluxion ♦ , • , 
 
 . 84 
 
INDNX. 
 
 
 389 
 
 Deformes 
 
 • • * 
 
 108 
 
 Deformitates 
 
 . 
 
 108 
 
 Degeneration 
 
 . 
 
 48, 327 
 
 Deliria .... 
 
 . 
 
 102 
 
 Demens 
 
 . 
 
 149 
 
 Demonomania 
 
 . 
 
 102 
 
 Description and definition 
 
 • • • 
 
 226 
 
 Desmoneoplasmata 
 
 . 
 
 48, 371 
 
 Diabetes 
 
 103, 
 
 in, 125 
 
 Dialysis .... 
 
 . 
 
 . 128 
 
 Diarrhoea, 
 
 84, 103, 
 
 in, 132 
 
 Diastasis .... 
 
 . 
 
 94, 129 
 
 Dilatation 
 
 . 
 
 48,57 
 
 Diplopia .... 
 
 • 
 
 . lOI 
 
 Dipsosis 
 
 . 
 
 131 
 
 Discalorineses 
 
 . 
 
 . n9 
 
 Disease, definition of . 
 
 . 
 
 43 
 
 , etymology " 
 
 . 
 
 • 43 
 
 , facies " 
 
 • 
 
 32 
 
 Disorder . . . . 
 
 . 
 
 . 58 
 
 functional 
 
 • 
 
 51 
 
 Disoxygeneses 
 
 • 
 
 . n9 
 
 Diuresis 
 
 • 
 
 125 
 
 Dolores . . . • 
 
 100, 
 
 108, n/ 
 
 Dolorosi 
 
 . 
 
 107 
 
 Dyalyses . . . . 
 
 . 
 
 . n6 
 
 Dysaesthesiae 
 
 
 98. 113 
 
 Dyscinesiae 
 
 • • 
 
 99, n4 
 
 Dysecoea 
 
 . 
 
 98, 113 
 
 Dysenteria 
 
 84, 103, no, 
 
 124, 143 
 
 Dysodia 
 
 . 
 
 104 
 
 Dysopia . . . . 
 
 . • 
 
 . 113 
 
 Dysorexiae 
 
 • 
 
 n4 
 
390 
 
 INDEX. 
 
 Dyspepsia 
 
 Dyspermatismus 
 
 Dyspermia 
 
 Dysphagia 
 
 Dysphonia 
 
 Dysphoria 
 
 Dyspnoea 
 
 Dysthetica 
 
 Dystocia 
 
 Dysuria 
 
 ficchymoma 
 
 Ecchymosis 
 
 Eccritica 
 
 Eccyesis 
 
 Echmasis . 
 
 Eclampsia 
 
 Ecphlysis 
 
 Ecphronia 
 
 Ecphyma 
 
 Ecpyesis 
 
 Ecstasis 
 
 Ectasis 
 
 Ecthyma 
 
 Ectopiae 
 
 Eczema 
 
 Effera 
 
 Efflorescentiae 
 
 Elcosis 
 
 Elephantiasis 
 
 Emboh'smus 
 
 Emesis 
 
 Empathema ■ 
 
 Emphlysis 
 
 
 . 
 
 Ill, 132 
 
 . 
 
 104 
 
 , 115, 126 
 
 • 
 
 • 
 
 . 156 
 
 lOO, 
 
 114 
 
 125, 131 
 
 
 • 
 
 • 137 
 
 • 
 
 
 153 
 
 84. 98, 
 
 III, 
 
 125, 138 
 
 • 
 
 
 145 
 
 . lOI 
 
 84, 
 
 104, 
 
 115, 126 
 9h 115 
 
 • 
 
 
 85, 127 
 . 159 
 
 • 
 
 , 
 
 158 
 48,57 
 
 • 
 
 • 
 
 97 
 162 
 
 • 
 
 . 
 
 148 
 163 
 
 • 
 
 ^ 
 
 163 
 99. 154 
 
 • 
 
 . 
 
 48,57 
 163 
 
 93. 
 
 116, 
 
 128, 129 
 162 
 
 • 
 
 • 
 
 95 
 
 91. 125 
 
 106 
 
 105, ] 
 
 ti3. 146 
 
 . 
 
 
 47» 326 
 
 
 
 132 
 
 • 
 
 . 
 
 148 
 
 
 . 
 
 145 
 

 INDEX, 
 
 391 
 
 Emphyma 
 
 « • -• 
 
 • 159 
 
 Emphysema 
 
 • • < • 
 
 92, 128, 160, 142 
 
 Emprosthotonos 
 
 • • « 
 
 . 85 
 
 Empyema 
 
 • • • 
 
 85, 98, 109 
 
 Empyesis 
 
 t • • 
 
 . 145 
 
 Enanthesis 
 
 
 144 
 
 Encephalocele 
 
 • • • 
 
 93 
 
 Endothelioma 
 
 
 48 
 
 Enecia 
 
 • 
 
 140 
 
 Enlargement 
 
 
 47. 52 
 
 Entasia 
 
 « • • 
 
 . 152 
 
 Enterica 
 
 
 130 
 
 Enteritis . 
 
 . 
 
 96, 109, 123, 142 
 
 Enterocele 
 
 
 93 
 
 Enterolithus 
 
 
 . 133 
 
 Enteroses 
 
 
 165 
 
 Enuresis . 
 
 
 103, 115 
 
 Epanetus 
 
 
 139 
 
 Ephelis 
 
 
 91. 164 
 
 Ephemera 
 
 
 . 94. 139 
 
 Ephialtes . 
 
 
 97. 138 
 
 Ephidrosis 
 
 . 
 
 103, 115, 161 
 
 Epichrosis 
 
 
 164 
 
 Epilepsia 
 
 . 
 
 75. 97. Ill 
 
 Epinyctides 
 
 
 • 85 
 
 Epinj'ctis 
 
 1 • • 
 
 91 
 
 Epiphora . 
 
 • • • • 
 
 103, 115 
 
 Epiplocele 
 
 . 
 
 93 
 
 Epiploitis 
 
 » - • • • 
 
 . 96 
 
 Epischeses 
 
 • • • 
 
 57, 108, 115, 125 
 
 Epistaxis 
 
 • < • - 
 
 . no 
 
 Epithelioma 
 
 » 1 » 
 
 49 
 
 Equinia 
 
 • ' • • ' 
 
 . 49 
 
392 
 
 INDEX. 
 
 Erotomania 
 
 127 
 
 Erysipelas . , 
 
 85, 95, no, 144 
 
 Erythema 
 
 92, 124, 141 
 
 Eschara . . 
 
 . 94 
 
 Ethmoplecoses 
 
 165 
 
 Evacuatorii 
 
 . 108 
 
 Exangia 
 
 147 
 
 Exania . . . . 
 
 93. 134 
 
 Exanthemata . 
 
 no, n7, 125 
 
 Exanthematica 
 
 95, 107, 144 
 
 Exanthesis 
 
 162 
 
 Exarthrema 
 
 . 94 
 
 Excoriatio 
 
 94 
 
 Excrescentiae 
 
 . 92 
 
 Exocyste 
 
 . 93, 128 
 
 Exomphalus , 
 
 . 93 
 
 Exophthalmia . , 
 
 93 
 
 Exormia 
 
 . 162 
 
 Exostosis 
 
 92, n6, 124, 159 
 
 Extractives 
 
 . 294 
 
 Exulceratio 
 
 94 
 
 FacuUy, definition of 
 
 . 70 
 
 Farr's system . 
 
 174 
 
 Favi 
 
 . 85 
 
 Feb res 
 
 94, 108, 109, 117 
 
 Fibroma 
 
 48, 371 
 
 Fissura 
 
 94 
 
 Fistula 
 
 86,94 
 
 Flatus , . . . 
 
 132 
 
 Fluxus 
 
 102, 117 
 
 Foreign bodies 
 
 50 
 
 Fractura 
 
 94, 116 
 
 Framboesia 
 
 105, n3 
 
INDEX. 
 
 393 
 
 Function, definition of 
 
 . 66 
 
 Functional disorders 
 
 . 51. 59 
 
 Furor . . . . 
 
 156 
 
 Furunculus 
 
 92. 141 
 
 Oalaetia 
 
 155 
 
 Galactirrhoea . . . 
 
 104 
 
 Ganglion . . . . 
 
 115 
 
 Gangraena 
 
 86, 106,^09, 147 
 
 Gangrene, humid and dry . 
 
 . ' 48 
 
 Gasterocele 
 
 93 
 
 Gastritis . , . . 
 
 96, 109, 123, 142 
 
 Gastrodynia 
 
 V . .101 
 
 Gastroses . . . . 
 
 165 
 
 Generic characters 
 
 188 
 
 Generic names 
 
 191 
 
 Genetica 
 
 . 154 
 
 Genetic sense 
 
 26 
 
 Gibbositas . . 
 
 92 
 
 Glanders 
 
 49 
 
 Glaucoma , • 
 
 S6 
 
 Glaucosis 
 
 150 
 
 Glioma .... 
 
 48, 371 
 
 Gonorrhoea . 
 
 86, I04,jii5, 124 
 
 Good's system 
 
 . 130 
 
 Gout 
 
 . . . 86 
 
 Graviditas 
 
 104 
 
 Green sickness 
 
 86 
 
 Gutta rosea 
 
 91 
 
 Haeman gioma 
 
 . 49. 372 
 
 Haematemesis 
 
 103 
 
 Haematica . , » 
 
 139 
 
 Haematuria . 
 
 103, 125 
 
 Haemodiapedisis 
 
 . 47, 325 
 
394 
 
 INDEX. 
 
 Haemoptysis 
 
 t • • - * t 
 
 102, no 
 
 Haemorrhagia 
 
 .47, 86, 102, no, 
 
 125. 145. 325 
 
 Haemorrhois 
 
 • • - • - m -, • 
 
 86, 103, no 
 
 Hallucinatio . 
 
 • • • « 
 
 . loi, 127 
 
 Hectica 
 
 • • • • . 
 
 95, 109 
 
 Helminthia . , 
 
 • • ^ . . 
 
 133 
 
 Hemicrania 
 
 • • • • • 
 
 100 
 
 Hemiplegia 
 
 
 99 
 
 Hepatalgia 
 
 • ' • * 9 • • 
 
 lOI 
 
 Hepatirrhoea 
 
 »■- • • • 
 
 103 
 
 Hepatitis 
 
 96, 
 
 109, 123, 142 
 
 Hepatocele 
 
 
 93 
 
 Hernia 
 
 • • • •- • 
 
 116, 128 
 
 Herpes 
 
 86 
 
 , 91, 116, 162 
 
 Hidroa 
 
 • • • • • 
 
 91 
 
 Hippocrates, diseases upon which he has written 
 
 82-91 
 
 Hordeolum 
 
 
 92, 141 
 
 Hosack's system 
 
 » » »- • 
 
 i66 
 
 Hydatis 
 
 
 93. 1 16 
 
 Hydrarthrus . 
 
 • • ((N * - 
 
 93, n6, 144 
 
 Hydrocele , 
 
 
 ii3» 128 
 
 Hydrocephalus 
 
 
 . 105, n2 
 
 Hydrogeneses 
 
 
 . n9 
 
 Hydrometra . 
 
 
 . 105, n3 
 
 Hydrophobia 
 
 
 102, 112 
 
 Hydrops 
 
 
 160 
 
 Hydrorhachitis 
 
 
 105, n2 
 
 Hydrothorax 
 
 
 . 98, 113 
 
 Hygiene 
 
 
 . 35 
 
 Hyperaemia . 
 
 
 . 45. 254 
 
 Hyperaestheses 
 
 
 . 108 
 
 Hyperalonaemia 
 
 
 . 45. 259 
 
 Hypercholesteraemia » .. . . 
 
 46, 266 
 
INDEX. 
 
 395 
 
 Hyperchromataemia 
 
 Hypererythrocythaemia 
 
 Hyperglycaemia 
 
 Hyperinosaemia 
 
 Hyperhydraemia 
 
 Hyperleucocythaemia 
 
 Hyperleucontaemia 
 
 Hyperlipaemia 
 
 Hyperphysaemia 
 
 Hypersarcosis 
 
 Hypertrophy and Hypotrophy 
 
 Hyperuraemia 
 
 Hyperuricaemia 
 
 Hypoaemia 
 
 Hypoalonaemia 
 
 Hypocholesteraemia 
 
 Hypochondriasis 
 
 Hypochromataemia 
 
 Hypoerythrocythaemia 
 
 Hypoglycaemia 
 
 Hypohydraemia 
 
 Hypoinosaemia 
 
 Hypoleucocythaemia 
 
 Hypoleucontaemia 
 
 Hypolipaemia . 
 
 Hypophysaemia 
 
 Hypostophyle . 
 
 Hypouraemia 
 
 Hysteralgia 
 
 Hysteria . , 
 
 Hysteritis 
 
 Hysterocele 
 
 Hysteroloxia 
 
 • 45. 259 
 
 46, 261 
 
 . 46, 263 
 
 45. 257 
 . 45. 257 
 
 46, 260 
 . 45. 258 
 
 46, 262 
 
 . 46, 262 
 
 . S6 
 
 53. 55. 326 
 
 46, 265 
 
 . 46, 265 
 
 45. 255 
 . 45. 259 
 
 46, 266 
 
 lOI, III 
 
 46, 260 
 
 . 46, 261 
 
 46, 264 
 
 . 45.257 
 
 45, 258 
 
 . 46, 261 
 
 45. 259 
 . 46, 262 
 
 46, 262 
 
 93 
 46, 265 
 
 lOI 
 
 97, 112 
 10 124, 143 
 
 • 93 
 93 
 
390 
 
 INDEX. 
 
 
 Hysteroptosis 
 
 
 93 
 
 Icterus 
 
 . . • • 
 
 113' 134 
 
 Icthyiasis 
 
 
 162 
 
 Ileus 
 
 . 
 
 103, 132 
 
 Impetigines 
 
 
 105, 113 
 
 Impetigo 
 
 . 
 
 127, 163 
 
 Impotens 
 
 
 S7, 156 
 
 Infiltration 
 
 . . • • 
 
 48. 328 
 
 Inflammation 
 
 
 47, 51, 52, 123 
 
 Inoma 
 
 . • 
 
 48, 371 
 
 International Medical Congress, 
 
 
 questions s 
 
 uggested for discussion by 
 
 244 
 
 Intumescentiae 
 
 
 . 104, 112, 128 
 
 lonthus 
 
 
 141 
 
 Ischaemia 
 
 
 47, 323 
 
 Ischias 
 
 
 lOI 
 
 Ischuria . 
 
 
 105, 115, 125 
 
 Lagnesis . 
 
 
 156 
 
 Laryngismus 
 
 
 137 
 
 Laryngitis 
 
 
 142 
 
 Lassitudo 
 
 
 100 
 
 Laxarthrus 
 
 
 94 
 
 Leiomyoma 
 
 
 49» 372 
 
 Leipopsychiae 
 
 
 99 
 
 Leipothymia 
 
 
 99 
 
 Leontiasis 
 
 
 105 
 
 Lenticula 
 
 
 164 
 
 Lepidosis 
 
 
 162 
 
 Lepra 
 
 
 . 49,105,113 
 
 Lepriasis 
 
 
 162 
 
 Leprosy 
 
 
 . 87 
 
 Lethargus , 
 
 
 . 99» 154 
 
 Lethargy 
 
 
 . 87 
 
INDEX. 
 
 397 
 
 Leucaemia 
 
 Leucasmus 
 
 Leucoma 
 
 Leucomnines 
 
 Leucophlegmatia 
 
 Leucorrhoea 
 
 Leucorrhois . 
 
 Leucoses 
 
 Lichen 
 
 Lienteria . 
 
 Limosis 
 
 Lipoma 
 
 Lissa . , 
 
 Lithia 
 
 Lordosis 
 
 Loxia 
 
 Lues 
 
 Lumbago . 
 
 Lupia . 
 
 Luxatio 
 
 Lymphangioma 
 
 Lymphexosmosis . 
 
 Lymphorrhagia 
 
 ]%Iacbride'§ system 
 
 Macies 
 
 Maculae 
 
 Madness 
 
 Malasicterus 
 
 Malis 
 
 Mania 
 
 Marasmus 
 
 Marcores 
 
 Marisca 
 
 260 
 164 
 
 91 
 
 286-296 
 
 87 
 
 104, 124, 155 
 
 124 
 
 . 165 
 
 162 
 
 87» 103. 133 
 
 131 
 
 48, 334 
 
 152 
 
 . 161 
 
 92 
 . 152 
 
 146 
 . loi 
 
 . 93» 115 
 
 87, 116, 128 
 
 • 49. 372 
 
 47, 325 
 
 . 47, 325 
 
 . 117 
 
 104 
 
 91, 127 
 
 87 
 
 . 106 
 
 105, 163 
 
 102, 112, 148 
 
 145 
 
 112 
 
 93, 134 
 
398 
 
 INDEX. 
 
 Mastodynia 
 
 • ■ • • 
 
 
 lOI 
 
 Means 
 
 • • • . 
 
 
 • 135 
 
 Medicine, definition of 
 
 
 29 
 
 , classification of 
 
 
 • 31 
 
 and surgery 
 
 
 39 
 
 Meiosis 
 
 
 
 . 48, 54. 327 
 
 Melaena 
 
 . ' . 
 
 
 103. 134 
 
 Melanaemia 
 
 
 
 46, 267 
 
 Melancholia 
 
 , , 
 
 . * S7, 
 
 102, 112, 148 
 
 Melasma 
 
 
 
 . 127 
 
 Membranaceae 
 
 • t 
 
 
 96 
 
 Menorrhagia 
 
 
 , , 
 
 103, no 
 
 Mentales 
 
 . , 
 
 
 107 
 
 Mesotica 
 
 
 
 . 159 
 
 Metamorphoses, 
 
 retrograde 
 
 
 48 
 
 Meteorismus 
 
 
 ^ J 
 
 105 
 
 Metritis . 
 
 » • 
 
 
 96 
 
 Miliaria 
 
 
 , 
 
 95, no, 144 
 
 Milium 
 
 • • ' 
 
 
 162 
 
 Monsters 
 
 
 
 50 
 
 Moria . 
 
 • • 
 
 
 149 
 
 Morbositas 
 
 
 
 127 
 
 Morositates 
 
 ° • ■ 
 
 
 102 
 
 Motorii 
 
 
 
 108 
 
 Mutitas 
 
 • '' • 
 
 
 . 99. 114 
 
 Myoma 
 
 
 • < 
 
 49. 372 
 
 Myxoma 
 
 . 
 
 
 48 
 
 ]Vau§ea 
 
 
 
 103 
 
 Necrosis 
 
 • ' • ■ 
 
 . ' 48, 
 
 106, 147, 327 
 
 Neoplasmata 
 
 
 . 48 
 
 49» 328-372 
 
 Nephralgia 
 
 • ' « 
 
 
 lOI 
 
 Nephritis , 
 
 
 . k 
 
 no, 123, 142 
 
 Neuralgia 
 
 • • 
 
 
 151 
 
INDEX 
 
 Neuroglioma 
 
 Neuroma 
 
 Neuroses 
 
 Neurotica 
 
 Nictitatio 
 
 Nomenclature, character of 
 
 Nosography, origin of 
 
 Nostalgia 
 
 Nyctalops 
 
 Nymphomania . , 
 
 Nystagmus 
 
 Obstipitas 
 
 Obstipatio 
 
 Obstruction , . 
 
 Odontalgia . 
 
 Odontia 
 
 Oedema , . 
 
 Oneirodynia 
 
 Ophthalmia 
 
 Opisthotonos 
 
 Oppressivae 
 
 Orchitis 
 
 Organ, definition of 
 
 Orgastica . , 
 
 Orthopnea 
 
 Oscedo 
 
 Oscheocele . , 
 
 Osteoma . . 
 
 Osthexia . . , - 
 
 Ostocopus ^ , o . 
 
 Otalgia . , 
 
 Otitis 
 
 Otorrhoea , , 
 
 399 
 
 
 48, 
 
 371 
 
 
 49. 
 
 372 
 
 III 
 148 
 152 
 
 227 
 
 
 . 
 
 74 
 
 
 102, 
 
 114 
 
 
 . 
 
 88 
 
 . I02, 
 
 114, 
 
 127 
 97 
 
 
 . 
 
 96 
 
 
 115. 
 
 125 
 
 
 . 49, 57 
 
 lOO, 
 
 no, 
 
 124 
 130 
 
 
 • 
 
 92 
 
 
 . 
 
 112 
 
 oo, 109, 
 
 123, 
 
 143 
 
 
 , 
 
 88 
 
 
 . 
 
 98 
 
 
 • 
 
 143 
 
 
 . 
 
 63 
 
 
 • 
 
 156 
 
 
 88,98 
 
 
 • 
 
 97 
 
 
 . 
 
 93 
 
 
 • 
 
 48 
 
 
 
 160 
 
 
 • 
 
 100 
 
 
 
 100 
 
 
 • 
 
 142 
 
 
 
 104 
 
400 
 
 INDEX. 
 
 Oxygenases 
 Pa I pita! io 
 
 Pandiculatio 
 
 Panophobia 
 
 Parabysma 
 
 Paracusis 
 
 Paracyesis 
 
 Parageusis . 
 
 Paraglossa 
 
 Paralysis 
 
 Paramenia 
 
 Paramorphiae 
 
 Paraneurismi 
 
 Paranoiac 
 
 Paraphonia 
 
 Paraphrenitis 
 
 Paraph legia 
 
 Paraphrosyne 
 
 Parapsis 
 
 Parasites 
 
 Pareccrises 
 
 Parenchymatosae 
 
 Parhaemasiae 
 
 Paristhmitis 
 
 Parodynia 
 
 Paroniria 
 
 Paronychia 
 
 Paropsis 
 
 Parorchydium 
 
 Parosmis 
 
 Parostia 
 
 Parotis 
 
 Parotitis . 
 
 119 
 
 97, III, 152 
 
 97, 152 
 
 102 
 
 135 
 
 98, 113, 150 
 
 157 
 151 
 
 93 
 
 99, III, 154 
 
 154 
 129 
 129 
 108, 127 
 
 99, 114 
 96 
 
 99 
 
 102 
 . 151 
 50 
 129 
 96 
 129 
 142 
 . 158 
 149 
 92, 141 
 149 
 93 
 150 
 
 • 159 
 
 92 
 
 142 
 
INDE 
 
 X. 
 
 
 401 
 
 Parr's rules . 
 
 
 
 185 
 
 Parr's system 
 
 
 
 122 
 
 Paruria 
 
 
 
 161 
 
 Pathengenetic and pathogenetic 
 
 
 
 56, 326 
 
 Pathology 
 
 
 
 34 
 
 Pemphigus 
 
 
 95. 
 
 no, 144 
 
 Periostea 
 
 
 
 124 
 
 Peripneumonia 
 
 
 
 88,96 
 
 Peritonitis 
 
 
 
 109, 142 
 
 Pernio 
 
 
 
 142 
 
 Pertussis 
 
 
 
 in 
 
 Pestis 
 
 • • 
 
 95. 
 
 no, 145 
 
 Petechia 
 
 
 
 127 
 
 Phaenigmus 
 
 
 
 106, 127 
 
 Phallic worship 
 
 
 
 26 
 
 Phimosis 
 
 
 
 92 
 
 Phlegmasia . 
 
 
 
 47. 52 
 
 Phlegmasiae 
 
 87, 95. 
 
 109, 
 
 117. 123 
 
 Phlegmatia 
 
 
 
 104, 128 
 
 Phlegmon 
 
 
 
 123 
 
 Phlegmone 
 
 
 
 92, 140 
 
 Phlogistici 
 
 
 
 . 107 
 
 Phlogosis 
 
 
 
 109, 124 
 
 Phlogotica 
 
 
 
 140 
 
 Phlyctaenae . 
 
 
 
 88 
 
 Ph lysis . . . . 
 
 
 
 141 
 
 Phonica 
 
 
 
 136 
 
 Phosphoreneses 
 
 
 
 n9 
 
 Phrenica 
 
 
 
 148 
 
 Phrenitica 
 
 
 
 124 
 
 Phrenitis 
 
 . 88 
 
 , 96, 
 
 109, 123 
 
 Phthinasis 
 
 • 
 
 
 106 
 
 Phthisis 
 
 104, 
 
 no, 
 
 124, 146 
 
402 
 
 INDEX. 
 
 
 Phyma 
 
 
 92, 141 
 
 Physconia 
 
 
 . 104, 113 
 
 Physician, the ideal 
 
 
 42 
 
 Physocepiialus ^ 
 
 
 105 
 
 Physometra 
 
 
 105, 112 
 
 Pica . 
 
 
 102, 114, 132 
 
 Pinel's system 
 
 
 . 118 
 
 Pityriasis 
 
 
 162 
 
 Plagae 
 
 
 . 94, 117, 128 
 
 Plague 
 
 
 . . 88 
 
 Plethora . 
 
 
 145. 254 
 
 Pleuralgia 
 
 
 138 
 
 Pleurisy . 
 
 
 88 
 
 Pleuritis 
 
 
 96, 142 
 
 Pleurodyne 
 
 
 . 9» 
 
 Plica . 
 
 
 163 
 
 Pneumatica 
 
 
 136 
 
 Pneumatosis . 
 
 
 • . 104, 112 
 
 Pneumonia 
 
 
 109, 123 
 
 Pneumonica 
 
 
 . 124, 137 
 
 Pneumonitis 
 
 
 142 
 
 Pneumoses 
 
 
 165 
 
 Podagra . 
 
 
 no, 144 
 
 Poecilia 
 
 
 164 
 
 Polypus 
 
 
 . 88, 125, 136 
 
 Polydipsia 
 
 
 . 102, 114 
 
 Polysarcia 
 
 
 104, 112, 159 
 
 Pompholyx 
 
 
 162 
 
 Porphyra 
 
 . 
 
 . 147 
 
 Porrigo 
 
 
 163 
 
 Priapismus 
 
 
 . 96, 126, 152 
 
 Proctalgia 
 
 
 lOI 
 
 Proctica . 
 
 
 • 134 
 
INDEX. 
 
 405 
 
 Proeotica 
 
 
 156 
 
 Profluvia . . * • 
 
 
 108, 125 
 
 Profusio .... 
 
 
 "5 
 
 Prolapsus ', , . . 
 
 
 116, 128 
 
 Prophylaxy .... 
 
 
 35 
 
 Proptoma . . . . 
 
 
 93 
 
 Prurigo . . . • 
 
 
 162 
 
 Pruritus . , . . . 
 
 
 100 
 
 Psellismus . -. . . 
 
 99. 
 
 114, 137 
 
 Pseudoblepsis 
 
 
 • 113 
 
 Pseudocycsis 
 
 
 158 
 
 Psora . . . 
 
 
 . 116 
 
 Psoriasis .... 
 
 
 162 
 
 Psydracia ... 
 
 
 . 91 
 
 Pterygium 
 
 
 88, 92 
 
 Ptomaines 
 
 
 267-286 
 
 Ptyalismus . . . • 
 
 103. 
 
 115. 131 
 
 Pudendagra 
 
 
 . lOI 
 
 Puerperalis . , . • 
 
 
 124 
 
 Punctura . 
 
 
 . 94 
 
 Purpura , . , 
 
 
 95 
 
 Pyosapraemia 
 
 
 46, 297 
 
 Pyretica 
 
 
 139 
 
 Pyrexiae . . , . 
 
 
 109, 123 
 
 Pyrosis . . , 
 
 
 100, III 
 
 Pyuria 
 
 
 . 104 
 
 Qiiietale§ . 
 
 
 108 
 
 Quinsey . . . . 
 
 
 . 89 
 
 Rai^e-Delorme's system 
 
 
 i66 
 
 Raphania .... 
 
 
 III, 153 
 
 Recamier's system . -■ , , 
 
 
 121 
 
 Rhabdomyoma 
 
 
 49» 372 
 
 Rhachia . . , 
 
 
 159 
 
404 
 
 INDEX. 
 
 Rhachialgia . . 
 
 Rhachitis .... 
 
 Rhagas .... 
 Rheum .... 
 
 Rheuma .... 
 Rheumatismus 
 Rhinoscleroma 
 
 Rhonchus . . , , 
 
 Rhypia .... 
 Richerand's system . . . 
 
 Rigor .... 
 
 Rosalia .... 
 
 Roseola .... 
 Royal Coll. of Phys. of London 
 Rubeola .... 
 Rubigo .... 
 
 Rubula .... 
 
 Rules for the guidance of the nosographe: 
 Ruptura .... 
 Sagar'8 §y§tein 
 Salacitas . . , , 
 
 Oaid-X • • • a • 
 
 Sanguifluxus 
 
 Sarcoma .... 
 
 Satyriasis .... 
 
 Sauvages, notice of . 
 
 Savignac's system 
 
 Scabies .... 
 
 Scarlatina .... 
 
 Scelotyrbe .... 
 
 Sciatica, .... 
 
 Scirrhus .... 
 
 Scorbutus .... 
 
 48, 
 
 
 loi, 132 
 
 
 105, 113 
 
 
 . 94 
 
 
 89 
 
 
 . 98 
 
 
 100, no 
 
 
 49. 374 
 
 
 136 
 
 
 . 162 
 
 
 129 
 
 
 . 97 
 
 
 144 
 
 
 162 
 
 
 175 
 
 95. 
 
 no, 144 
 
 
 127 
 
 
 145 
 
 
 180 
 
 
 94 
 
 
 116 
 
 
 156 
 
 
 149 
 
 
 102 
 
 92, 115. 
 
 159. 365 
 
 102, 
 
 114. 127 
 
 
 76 
 
 
 173 
 
 
 105, 163 
 
 
 95, no 
 
 
 97 
 
 
 89 
 
 . 
 
 92, us 
 
 105, 
 
 113. 127 
 

 INDEX. 
 
 
 
 40s 
 
 Scrophula 
 
 
 
 
 105, 113 
 
 Scurvy 
 
 
 . 
 
 
 . 89 
 
 Scybalum 
 
 
 
 
 133 
 
 Selle's system 
 
 
 • 
 
 
 117 
 
 Septicaemia . , 
 
 
 
 
 46, 267 
 
 Serifluxus . . 
 
 
 
 
 103 
 
 Singultus 
 
 
 
 
 98, 152 
 
 Sinus 
 
 
 
 
 94 
 
 Somnambulismus 
 
 
 
 
 lOI 
 
 Spasmi 
 
 
 '96, 
 
 108, 
 
 III, 117, 126 
 
 Spasmodicae 
 
 
 
 
 97 
 
 Specific differences 
 
 
 
 
 194 
 
 Spermorrhoea . . 
 
 
 
 
 155 
 
 Sphacelus 
 
 
 
 
 89, 109, 147 
 
 Spilus . 
 
 
 
 
 164 
 
 Splanchnica 
 
 
 
 
 134 
 
 Splenalgia 
 
 
 
 
 lOI 
 
 Splenitis 
 
 
 
 
 96, no, 142 
 
 Splenocele 
 
 
 
 
 93 
 
 Staphyloma 
 
 
 
 
 93. 150 
 
 Stark's system 
 
 
 
 
 173 
 
 Stenosis 
 
 
 
 
 48, 56 
 
 Sternalgia 
 
 
 
 
 . 138 
 
 Sternutatio 
 
 
 
 
 97, 152 
 
 Stertor 
 
 
 
 
 89,98. 136 
 
 Stomacace 
 
 
 
 
 103 
 
 Stones . , 
 
 
 
 
 50, 89 
 
 Strabismus 
 
 
 
 yu, 
 
 114, 126, 150 
 
 Strangury 
 
 
 
 
 . 89 
 
 Stricture 
 
 • • 
 
 • 
 
 
 48, 56 
 
 Strophulus 
 
 
 
 
 162 
 
 Struma 
 
 • 
 
 • 
 
 
 146 
 
 Stupor . , 
 
 
 
 
 , 100 
 
406 INDEX. 
 
 
 Suffusio 
 
 lOI 
 
 Supercalorineses 
 
 .119 
 
 Superoxygeneses 
 
 119 
 
 Suppressiones 
 
 .117 
 
 Suppressorii . 
 
 . . . 108, 125 
 
 Surditas .... 
 
 . . . 150 
 
 Swediaur's system 
 
 . . . 129 
 
 Sycosis .... 
 
 . 141 
 
 Synclonus 
 
 153 
 
 Syncope .... 
 
 99. Ill 
 
 Synocha 
 
 94. 109, 123 
 
 Synochus 
 
 94, 109, 123, 140 
 
 Synonyms . . . . 
 
 198 
 
 Synopsis of Cullen 
 
 .109 
 
 Synopsis, of morbid states, etc. 
 
 . ; 45 
 
 Syphilis . . 
 
 49, 105, 113, 127, 146 
 
 Syphilodes . . , , 
 
 146 
 
 Syrogmos • • 
 
 . lOI 
 
 Systatica . . . , 
 
 153 
 
 Systremma . , 
 
 . 152 
 
 Tabes • . . , 
 
 104, 112, 146 
 
 Tabes dorsales 
 
 ... 90 
 
 Tarantismus , . . . 
 
 102 
 
 Tenesmus 
 
 90, 103, 134 
 
 Teratology . . . . 
 
 34 
 
 Terminthi . 
 
 • 90 
 
 Tetanus . . . , 
 
 90,97, III, 126, 152 
 
 Tetartophya 
 
 . .95 
 
 Therapy . . . , 
 
 . . 36 
 
 Thrombosis . • 
 
 47.325 
 
 Tinea . . . 
 
 105, 116 
 
 Tonici generales . 
 
 . 97 
 
 Tonici partiales . , . 
 
 96 
 
] 
 
 [NDEX. 407 
 
 Tourdes' system , 
 
 .120 
 
 Tourtelle's system . 
 
 ....... 121 
 
 Tricoma 
 
 .106 
 
 Trichosis . • 
 
 . 90. 163 
 
 Tremor . , . 
 
 97. III. 153 
 
 Trismus 
 
 96, III, 126, 152 
 
 Tritacophya . • 
 
 . 95 
 
 Trophopathies • 
 
 165 
 
 Tuber 
 
 . 128 
 
 Tubera • • 
 
 105 
 
 Tuberculosis 
 
 . 49 
 
 Tuffls 
 
 98 
 
 Tumors . . • 
 
 . 90 
 
 Tympanites 
 
 . 105, 112 
 
 Typhomania 
 
 99 
 
 Typhus, 
 
 95. 109. 123, 140 
 
 Ulceration 
 
 48 
 
 Ulcers 
 
 . ... 90 
 
 Ulcus 
 
 . 94,116,147 
 
 Ureses • 
 
 165 
 
 Urticaria . 
 
 no, 144 
 
 Taccinia 
 
 . . . 144 
 
 Vagi 
 
 , . . . . 100 
 
 Varicella 
 
 no, 144 
 
 Varieties . 
 
 . 198 
 
 Variola 
 
 95. no. H5 
 
 Varix • . 
 
 90,92, us, 147 
 
 Verruca 
 
 92.115.163 
 
 Vertigo 
 
 91. loi 
 
 Vesaniae , . 
 
 loi, n2, 117, 127 
 
 Vitet's system 
 
 .117 
 
 Vitia . 
 
 91] 108. 117 
 
 Vitiligo 
 
 91 
 
408 INDEX. 
 
 Vomica • • • • • 109, 140 
 
 Vomitus ••••••• 103 
 
 Vulnus • • • • • . 94, 116 
 
 Angell's Pnnting Office, 354 Fourth Ave., N. Y. 
 
409 
 
 WORKS BY THE SAME AUTHOR. 
 
 A CASE OF POLYPUS OF THE LARYNX. — Tracheotomy to 
 prevent impending suffocation ; laryngo-tracheotomy ; 
 recurrence of the disease ; operation repeated ; recovery. 
 New York Medical Journal, September 1867. 
 
 On external perineal urethrotomy, or an improved 
 method of external division of the urethra in perinaeo 
 for the relief of obstinate stricture, etc. Transactions of 
 the Medical Society of the State of Nev^ York, 1869. 
 New York Medical Journal, August 1S69. Reprinted 
 in pamphlet form, pp 32. 
 
 Instruments for exploration of the urethra, — 
 Difficult catheterism, etc. Medical Record, March 15th, 
 1870. 
 
 Treatment of intractable (urethral) strictures. 
 
 Divulsion and divulsors, etc. Medical Record. April ist, 
 1870. 
 
 On internal urethrotomy. Medical Record. April 
 I5lh, 1870, 
 
 Strictures at the meatus urinarius, and in the fossa 
 navicularis. Their nature, diagnosis and treatment. 
 Medical Record. May 2d, 1870. 
 
 On MODERN lithotripsy. Medical Record. October ist, 
 1870. 
 
4tO 
 
 Urethral fever from catheterism, its nature and treat- 
 ment. Medical Record. October ist, 1872. 
 
 Case of retention of urine caused by a single, diseased 
 kidney, situated in the pelvic cavity, for tiie relief of 
 which rectal puncture was done. The trocar passing to 
 the right of the bladder and entering the kidney. Death 
 on the fourth day after the operation. Autopsy. Re- 
 marks. Medical Record. October I5ih, 1872. 
 
 Rupture of the bladder from retention of urine due to 
 .stricture of the urethra. With cases and remarks. 
 Medical Record. November ist, 1872. 
 
 Diseases of the urinary organs, including stricture of 
 the urethra, affections of the prostate and stone in the 
 bladder. 1873. 8vo pp 368. 
 
 Perityphlitic ABSCESS due to perforation of the appendix 
 vermiformis, with remarks on the surgical treatment 
 thereof. Transactions of Medical Society of the State of 
 New York, 1875. Virginia Medical Monthly. March 
 1875. Pamphlet pp 9. 
 
 Treatment of chronic cystitis. Abstract of a paper 
 read on this subject to the Medical Society of King's 
 County, New York. Medical Record. October 30th, 
 1875. 
 
 Urethroplastic operations to remedy hypospadias, 
 epispadias and incurvation of the penis. Medical Record. 
 February 19th, 1876. Pamphlet pp 15. 
 
411 
 
 Stone in the bladder, its spontaneous expulsion and its 
 removal by lithotripsy, lithotomy and perineal lithotrity, 
 with an analysis of thirty-five cases. Abstract of paper 
 read to Medical Society of the State of New York, June 
 1876. Medical Record. July 8th, 1876. 
 
 Report of a case of sub-periosteal excision and dis- 
 articulation of the entire inferior maxillary bone for 
 phosphorous necrosis. Pamphlet pp 6. Extracted from 
 the Transactions of the International Medical Congress, 
 Philadelphia. September 1876. 
 
 Amputation of the penis. Cases illustrative of the man- 
 agement of the extremity of the urethra after amputation 
 of the penis close to the pubes. Louisville Medical 
 News. September 15th, 1877. 
 
 Retention of urine in elderly men. Acute retention 
 of urine. Medical Record. August 23rd, 1879. 
 
 Internal urethrotomy and lithotripsy at the same sit- 
 ting, etc. With remarks on rapid lithotripsy, and on the 
 evacuation of detritus from the bladder. Pamphlet pp 16. 
 Reprinted from the Medical Record. October i8th, 
 1879. 
 
 Note on CYSTORRHagia from retention of urine. Pamphlet, 
 pp 15. Reprinted from the Transactions of the Medical 
 Society of the State of New York for 1880. and published 
 in ihc Medical Record. February 21st, 1880, 
 
Chronic retention of urine in elderly men. Pro- 
 ceedings of the Medical Society of the County of 
 Kings. Vol, VI, January 1882. 
 
 A CLINICAL contribution to lithoclastic cystotomy, with 
 eleven illustrative cases. The Medical Gazette. Nev^r 
 York, June 2d, 1883. 
 
 Report of a case of ligature of the right prim- 
 itive ILIAC artery for diffuse aneurism of the external 
 iliac; death from pyaemia on the twenty-first day. 
 Transactions of the New York State Medical Association. 
 1884. 
 
 Some points in the surgery of the hypertrophied 
 prostate. Transactions of the American Surgical 
 Association. 1885. 
 
 Notes on contracture of the bladder consequent 
 upon cystitis. Transactions of the New York State 
 Medical Association. 1885. 
 
 Sacculation and perforation of the bladder as 
 consequences of chronic retention of urine. Pamphlet 
 pp 14. Reprinted from the Transactions of the New 
 York State Medical Association. 1 886. 
 
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