66 one by Dr. C. E. Fisher of Austin, Tex., on "Gunshot Wounds of the Spine," and two by Dr. Jos. E. Jones, of San Antonio, Tex., one on Lacerations of the Perinæum and their Primary and Secondary Surgical Treatment," and the other on "Infant Feeding;' one by Dr. E. A. Murphy, of New Orleans, La., on "Nephorraphy," and one by Dr. W. E. Green, of Little Rock, Ark., on Excision of the Mammary Gland for Sarcomatous Neoplasms.' All these papers were followed by general discussion. A resolution was adopted, condemning the indiscriminate. and reckless use of alcohol and opiates in medical practice. On the evening of the third day of the session addresses were delivered by Dr. Monroe, of Louisville, Ky., President of the Association, and by Dr. J. P. Dake, of Nashville, Tenn. The former address was upon "Homoeopathy, its Claims to Public Sympathy and Support,,' and the latter upon "The Relation of the State to the Medical Profession." The following officers were elected to serve for the ensuing year: President, Joseph Jones, M. D., of San Antonio, Texas; First Vice President, Walter M. Dake, M. D., of Nashville, Tenn.; Second Vice President, E. A. Murphy, M. D., of New Orleans, La.; Recording Secretary, C. G. Fellows, M. D., of New Orleans; Corresponding Secretary, C. R. Mayer, M. D., of St. Martinsville, La. ; Treasurer, J. G. Belden, M. D., of New Orleans, La. The next session will be held in New Orleans, beginning on the second Wednesday in December, 1887. Obituary. DR. JAMES A. GWALTNEY died at his home in Baltimore, December 18, 1886. At a special meeting of the Maryland State Institute of Homoeopathy, held December 20, 1886, the following resolutions were passed : Whereas, Under the dispensation of an all-wise Providence, our confrere, James A. Gwaltney, M. D., has been removed from our midst, and Whereas, We, the members of the Maryland State Institute of Homœopathy, recognizing in Dr. Gwaltney a conscientious physician, an earnest member of the Institute, and a devoted adherent to Homœopathy, do appreciate the loss his death has occasioned; Therefore, Resolved, That we tender to the bereaved family our sincere sympathy, and that a copy of these resolutions be sent to them, and also be published in the medical press. O. EDW. JANNEY, Secretary. PROFESSOR CARL THEODORE LIEBOLD, M. D., died suddenly of appoplexy, on November 29, 1886, at his residence, 1271 Broadway, New York, at the age of fifty years. He was born in Schlesein, Germany, and emigrated to this country in 1859. During our civil war, he served as an army-surgeon, and at its close resumed practice as an ophthalmic specialist, in New York city. From that time until his death, he was identified with the Ophthalmic Hospital, as a member of its staff and of its corps of teachers. For the past fifteen years he served as a member of the Faculty of the New York Homœopathic Medical College, and filled the chair of Ophthalmology with rare fidelity and acceptance. His broad and thorough acquirements, his skill as a teacher, and his geniality of manner, made him a favorite alike with students and professors. While Professor Liebold will be sadly missed, and his departure greatly regretted, it is gratifying to know that largely by his teachings and labors, our profession has been supplied with ophthalmic specialists, many of whom have risen to distinction in their chosen department. Thus his memory will live, and his works follow him. Funeral services were held at the rooms of the Ophthalmic Hospital-a most appropriate arrangement - and hundreds of professional and lay friends and bereaved patients assembled to pay their loving tribute to his memory. The College Faculty, and the Class of '87, have adopted suitable resolutions of respect for the deceased. PROFESSOR ALVAN E. SMALL, M. D.— As we go to press we learn of the death of the venerable Professsor A. E. Small, M. D., of the Hahnemann Medical College, of Chicago, Ill. A notice of the deceased will appear in our next issue. ☛☛The Editors are responsible for the maintenance of the dignity and courtesy of the journal, in both its literary and advertising departments, but not for the opinions expressed by contributors. Original Department. DO THE WHITE GLOBULES OF THE BLOOD MIGRATE DURING INFLAM MATION. BY WM. A. HAMAN, M. D., READING, PA. Inflammation, although more frequently observed than any other pathological process, has, for centuries, had its true nature hidden from the observations of man. Since the introduction of the microscope into pathological researches, great advances have been made towards the elucidation of its mysteries. Before the aid of this instrument was employed various theories were entertained by different factions of medical theorists, but since that time the vast majority proclaim adherence to the views of the celebrated German pathologist, Cohnheim. This gentleman's observations were the first to accurately acquaint us with the changes undergone by the vessels and their contents during the inflammatory process. The first mention of the observation of the escape of white cells from the vessels was made in 1842, by Dr. W. Addison. In 1846, Dr. Augustus Waller described the phenomenon more fully. This alleged discovery now passed into oblivion until 1867, when Cohnheim made it anew. The migration of leucocytes was a novelty and speedily became the almost universal VOL. XXI.-5. ly accepted theory of inflammation. Prior to the promulgation of Cohnheim's views regarding the vascular changes in inflammation, the pus corpuscles were regarded as originating in the increased activity and multiplication of the connective tissue cells. This discovery of the migration of leucocytes added a new and important source of the pus corpuscles and these cells were then regarded as originating in the two ways, and such was the teaching of our text books and colleges but three years ago. At present the believers in the migration theory assert that "all new cells formed in the tissues as a direct result of injuries are escaped white globules," and that no increased activity and multiplication of the tissue cells occur; the chief opponents to this view are Stricker and Böttcher who, however, admit the possibility of the migration of red and white cells. The method of investigation consists in the display of transparent membranes of animals such as the web, mesentery and tongue of the frog and toad and the mesentery of the rabbit and guinea-pig, the induction of inflammation artificially and the observation of the changes produced. The tongue and mesentery of the toad and frog are preferred. The following is an epitomized description of the inflammatory changes as given by Ziegler. "The exposure of the mesentery to atmospheric air quickly sets up inflammation. The earliest vascular change is a general dilation of the vessels, first of the arteries, then of the capillaries and veins.— The flow of blood through the widened channels at first becomes more rapid; but sooner or later the speed diminishes, and at length the flow becomes slower than the normal. The individual blood cells, which at first were indistinctly seen as they hurried past, become recognizable, especially in the veins and capillaries. In these latter the blood begins to accumulate more and more as the current slows. In the veins of the peripheral layer of the current, usually containing plasma only, begins to be filled with white blood cells. These have left the axial stream, and float slowly on with the slower peripheral current; or, fastening themselves to the wall, they remain immovable or oscillate to and fro. This is described as the marginal or peripheral disposition of the white blood cells. At this stage the red cells take the place of the white in the capillaries. Before long the peripheral disposition of the cells is associated with another appearance. Here and there white blood cells throw out processes which pass into the vessel wall. Soon the processes appear outside the vessel and thereupon the whole protoplasmic mass of the cell passes through the wall. 1. Green's Pathology and Morb. Anat., 6th ed., p. 240. The white cells in this way escape, migrate or extravasate from the ves- 1 Ziegler's Text Book of Pathological Anatomy, Vol. 1, p. 139. He they thus assume is more or less stellate, it need scarcely be added, therefore, that even if the white corpuscles still within living vessels did shoot out processes, the stellate form they thus acquired would effectually interfere with their escape by any boring motion." Although Henry Green, in his work on Pathology and Morbid Anatomy, says "amoeboid movements have never been seen in the white corpuscles whilst within the vessels," agreeing in this respect with Mr. Jones, while an ardent upholder of Cohnheim's views regarding inflammation, I am positive that both are in error. I have demonstrated the contrary to my own satisfaction at least. During last September I had a smaller vein in the mesentery of a frog under a inch objective (using a cover glass), with the draw tube out, giving me a power of at least 350 diameters; there were numerous white globules hugging the vessel wall while the axis of the contents of the vessel oscillated gently to and fro; the walls of the vessel were sharply outlined, the surrounding tissue being nearly free from stray globules, and the colorless corpuscles were clearly defined. I carefully and closely watched one white globule in the center of the tube; it was motionless but gradually changed its shape by shooting out processes and finally by imperceptible activity reached one side of the vessel and there changed from the circular shape to that of a square. I thought I was now going to witness migration, but in a short time it left the side of the vessel, resumed its circular shape, and returned to the center of the vessel where it let go its hold on the vessel wall and oscillated to and fro with the current, in company with the other red and white globules, thus showing it to be still within the vessel. I believe, the assertions of Messrs. Jones and Green to the contrary notwithstanding, that it was a bona fide instance of amoeboid change of shape and movement in a white corpuscle while still within a living vessel. I afterward observed the same phenomenon in the case of other colorless cells. To resume Mr. Jones' paper. "Many years before Prof. Cohnheim promulgated the doctrine that an essential part of the inflammatory process is the escape of blood corpuscles from the vessels which are the seat of the congestion, it had been, as mentioned above, alleged that white corpuscles may be seen in the act of boring through the walls of capillaries. In the course of my prolonged investigation of the mechanism of the circulation in extreme vessels, and on the state of the blood and the blood vessels in inflammation, made nearly forty years ago, my attention was constantly directed to see whether any escape of white corpuscles could be observed to take place from the interior of 1 Green's Pathology and Morbid Anatomy, 6th ed., p. 246. |