"August, 1841.

"Miss N, whom I requested to announce to you the death of our poor suffering C., would probably tell you how very rapid and unlooked for her decline was at the last. Before going to Leamington she had been for a month at Bolton Bridge in Yorkshire, a beautiful sheltered spot. It was the first attempt we had been able to make, to break in upon our invalid habits, and the change it produced was quite astonishing. She came down to breakfast at nine o'clock every morning, took a large quantity of food, and was able to bear two drives a day with the carriage open. The weather became so cold that we were obliged to return home at the end of a month, and before a week had passed, she had relapsed into all her former habits, which so distressed my father, that he determined, as the last resource, to send her to Leamington. Before she left home both Mr. D. and Mr. G. tried the chest with the stethoscope, and said there was at that time no decided disease of the lungs, though there might be cause for apprehension hereafter. Three days after, Dr. J. saw her at Leamington. He evidently considered her at first a decidedly consumptive patient, but declined giving any opinion, and would not allow us to tell him any thing of her former symptoms nor any account of the local complaint. I returned home to my father, and the report made of poor C.'s state by our friend Miss N., continued to be encouraging for about three weeks. Dr. J. had made her walk up and down

stairs, which she had not done since she left Malvern; her appetite was good, and though her cough continued, she was going out in a Bath-chair when the day was not too cold; the only unfavourable circumstance appeared to be that she was getting thinner, which certainly startled us very much, because Dr. J. said she was improving-though her state was precarious. My father had been very ill, but as soon as he was able to bear the journey we set off, and on arriving at Leamington found my poor sister in the last stage of a consumption. She died a fortnight after our arrival. In consideration of the doubt and difficulty which had always been connected with my poor sister's long-continued illness, I felt it right that there should be an examination; and having signified my wishes to that effect to Dr. J. it took place in his presence. I copy for your inspection the written statement which he gave me.

"The right lung entirely gone; the left lung a mass of disease; the liver three times its proper size, and the right kidney much enlarged. In the small intestines extensive ulceration."

With regard to the kidney, Dr. J. said that in the whole of his practice he had never seen anything like it."

These cases embrace a general outline of the symptoms observed, or complained of, by those affected with consumption;-they pourtray the constitutional nature of the malady; the wide extent of its sympathies; together with its anatomical and other relations.

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CHAPTER II.

ETIOLOGY.

"Every new discovery in science brings into view whole classes of facts which would never otherwise have fallen under our notice at all, and establishes relations which afford to the philosophic mind a constantly extending field of thought, in ranging over which it is next to impossible that he should not encounter new and unexpected principles."-HERSCHEL.

"WE anticipate," says a very recent medical writer, "but little fruit from that refinement of post mortem or microscopical research, which seeks to discover visual evidence of the origin and nature of tubercles. We would not discourage nor ridicule such modes of investigation, nor would we undervalue the high talent and sagacity which have been displayed in the pursuit ; but we cannot help expressing our little confidence in the results, and we are not conscious that science has hitherto materially widened the extent of our mental apprehension of the real nature of disease." *

The question of the utility of microscopical analysis in

* Report of the Reading Dispensary, in the Provincial Medical and Surgical Transactions, 1846.

physiology and morbid anatomy, must be decided on general grounds. If it could have been shown, in chemistry, astronomy, or mineralogy, that no advantages had been gained by analytical proceedings; or that our mental apprehensions had not been extended by such means; we should have been prepared, with reason, to distrust the refinement of microscopical research directed to discover visual evidence of the origin and nature of tubercles. But in the absence of any such proof, analogy leads us to believe that the labour of the minutest investigation will in due time have its full reward. For it is the universal rule in all other departments of natural science, that the more extended our analysis of complex phenomena, the nearer our approach to ultimate facts. And why should anatomy and physiology form the exceptions? "How infinitely greater are the mere chances of discovery in chemistry," says Sir J. Herschel, in continuation of the paragraph heading our present chapter; among the innumerable combinations with which the modern chemist is familiar, than at a period when two or three imaginary elements, and some ten or twenty substances whose properties were known with an approach to distinctness, formed the narrow circle within which his ideas had to revolve?"

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Incautious or inconsiderate expectations have probably been entertained, that new elements could be brought into view ;-unexpected discoveries made,and difficulties which the discovery raises, in relation

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to established doctrine and teaching, could all be got over at the same time;—an expectation that has never been realized in any science or art. In twenty years, modern microscopical analysis appears to have shaken the whole fabric of medical science; and it ought to satisfy even the most impatient, that now,-when the doctrines of pathology, one after another, are tottering to their inevitable fall,-the cultivators of the "refined investigation," are prepared with better, because more general principles.

We have adopted the quotation to which these remarks are appended, as a text for comment, because we consider them as expressing the feeling not merely of the individual but of a class,-to whom we may appropriately address a paraphrase of the concluding pages of Herschel's Preliminary Discourse.

Anatomical researches in relation to physiology still remain boundless; and after centuries of labour, microscopical analysis shows us to be in the situation in which Newton figured himself,-standing on the shore of a wide ocean from whose beach we may have culled some of those innumerable and beautiful productions it casts up with lavish prodigality, but whose acquisition can be regarded as no diminution of the treasures that remain. The discovery of a general law, or the inclusion of what is already known in generalizations of a still higher order, is a new acquisition; and so far as our experience has hitherto gone, every advance towards generality has at the same time been a step towards