chains of spherical spores or conidia. FIG. 18.-FROM A SECTION THROUGH THE KIDNEY OF A F. Fat droplets. T. Tyrosin crystals. In the upper part of the figure is a metastatic focus composed of Aspergillus spores and mycelium. In the lower half of the figure the urinary tubules and two Malpighian corpuscles are seen. (After Grawitz.) Grohe was the first to show that the introduction of the spores of some species of aspergillus into the vascular system of rabbits sometimes produces death, with symptoms of Besides this mode of spore-formation metastasis into the various organs due to (asexual), there is another (sexual) which ac- localised foci, where these spores grow into cording to De Bary consists in this: some mycelial filaments. Lichtheim showed that terminal branch of the mycelium becomes such mycoses in rabbits cannot be produced twisted like a spiral, this is considered the by the spores of Aspergillus glaucus, but by those of Aspergillus flavescens and fumigatus. into the mycelium. Besides this asexual mode Grawitz studied this process more minutely, there is a second or sexual mode of fructificaand found that no matter whether the spores tion consisting in this: At the end of a mycelial are injected into the vascular system or into thread a cell grows up into a spherical large the peritoneal cavity, there are established in ball, the oogonium. From the same thread thin the kidneys, liver, intestines, lungs, muscles, threads-antheridia-grow towards the oogoand occasionally in the spleen, marrowbones, nium, with the protoplasm of which they merge. lymphatic glands, nervous system, and skin, This latter then differentiates into a number of minute metastatic foci, due to the growth of spherical masses, the oospores, which become the spores into mycelial filaments with im- invested with a membrane. These become free perfect organs of fructification, but no spore- and then germinate and grow into a mycelium. formation. Grawitz thought that the spores of Saprolegnia grows on the skin of living fish, ordinary moulds (penicillium and aspergillus) and there causes severe illness often terminating are capable of assuming these pathogenic in death. Thus the salmon disease, as Prof. properties if cultivated at higher temperatures Huxley has shown, is caused by this parasite. (39°-40° C.), and in alkaline media. These fungi, as is well known, grow well at ordinary temperatures and in acid media, and are then innocuous when introduced into the animal body; but by gradual acclimatisation they can also be made to grow at higher temperatures and in alkaline media, when they assume pathogenic properties, becoming capable of resisting the action of living tissues and of growing in them. This view has been proved to be incorrect by Gaffky, Koch, and Leber. Those spores that do exert such pathogenic properties are not at all dependent on such acclimatisation, and are not ordinary moulds, but a distinct species of aspergillus (Lichtheim), which grows well at higher temperatures (38° -48° C.), and the spores of which under all conditions of growth are capable of producing in rabbits the mycosis in question. (c) Penicillium. In this fungus hyphae which are not septate grow out from the mycelium; from the end of each of these arise like the fingers of the hand a number of short branched cylindrical ceils, which give origin to chains of spherical spores. The following two fungi belong to the order of fungi called Phycomycetes. (d) Mucor is characterised by this, that from the mycelium hyphæ grow out which are not septate, and at the end of these a large spherical cell originates, the sporangium, in which by endogenous formation a large number of spherical spores are developed; the wall of the sporangium giving way, the spores become free. (e) Saprolegnia; colourless tubular threads, forming gelatinous masses on living and dead animal and vegetable matter in fresh water. The cylindrical or flask-shaped ends of the threads-zoosporangia-form in their interior numbers of spherical or oval spores, zoospores, which are possessed of locomotion (one flagellum at each pole) and finally escape from the threads. These zoospores after some time become resting spores, surround themselves with a membrane and finally germinate into a cylindrical mass which becomes transformed FIG. 19. SAPRolegnia of Salmon disease. A sporangium filled with zoospores; in connexion with them several young mycelial threads. The zoospores of this salmon saprolegnia are however, as Huxley has shown, as a rule nonmotile. The hyphae of the fungus traverse the epidermis in the diseased patches of the salmon, and they bore through the superficial layer of the derma, a stem-part being situated in the epidermis, and a root-part in the derma; each of these elongates and branches out. "The free ends of the stem-hyphæ rise above the surface of the epidermis and become converted into zoosporangia, more or fewer of the spores of which attach themselves to the surrounding epidermis and repeat the process of penetration." In saprolegnia associated with salmondisease Prof. Huxley observed only the asexual mode of fructification. ACTINOMYCES. In cattle there occurs a fatal Осса disease, which is characterised by the forma- capsule, with spindle-shaped cells. tion of firm nodules of various sizes, due to a sionally the tumours are to be seen also in the growth of small cells. In the centre of the skin and in the lung; in the latter organ they nodules lie dense groups of peculiar club- appear as whitish nodules, easily mistaken for shaped corpuscles-actinomyces-corpuscles-tubercles. Bollinger first described the disease radiating from a firm homogeneous centre, and in cattle. Israel was the first to point out a joined to this by longer or shorter, single or branched, filamentous stalks. Each of these actinomyces-corpuscles appears homogeneous, and of a bright slightly greenish lustre. These FIG. 20.-FROM A SECTION THROUGH THE TONGUE OF A Cow DEAD OF ACTINOMYCES. A nodule is shown composed of round cells, in the centre is the clump of actinomyces surrounded by large transparent cells. (Magnifying power 350.) masses consist of what is called Actinomyces (Bollinger), and the disease is termed actinomycosis. In cattle the disease manifests itself by firm tumours in the jaw, in the alveoli of the teeth, and particularly by a great enlargement and induration of the tongue-"wooden tongue." On making sections through this latter organ there are found present in all parts microscopic tumours of small-cell growth. In disease in man, characterised by metastatic abscesses (spreading it seems from a primary abscess of the jaw) in various internal organs, due to the presence of a fungus, which afterwards was identified as actinomyces, and Ponfick has clearly established that in man it is not a rare disease. According to careful observations, Johne succeeded in transmitting the disease from cattle to cattle by inoculation, but not by feeding. He also found, in 20 out of 21 healthy pigs examined, the actinomyces present in the crypts of the tonsils. Israel succeeded in transmitting the disease to a rabbit by inserting into the peritoneal cavity a piece of a human antinomyces-tumour. R. Virchow quite recently, in conjunction with O. Israel and Duncker, ascertained that pork occasionally contained whitish chalky nodules, larger than those due to trichinæ, and containing in their interior the antinomyces. O. Israel claims to have succeeded in artificially cultivating the actinomyces on solid oxserum; in fluid media the growth does not succeed, owing to the swelling up and death of the actinomyces-corpuscles. ON THE RELATIONS OF SEPTIC TO PATHOGENIC ORGANISMS. There is hardly any question which to the pathologist and sanitary officer can be of greater importance than the relation of septic to pathogenic organisms. To the pathologist the life history of a microorganism, outside and within the animal body, must ever remain an important field of inquiry; to the sanitary officer all conditions affecting the life and death of those organisms which produce, or at least are intimately bound up with, infectious diseases, such as the distribution and growth of these micro-organisms outside the animal body, the agencies which affect it in a favourable and unfavourable sense, are the points which he has particularly to consider in dealing with the spread and prevention of infectious maladies. Now, it is known of many micro-organisms, both those that are associated with putrefactive processes as well as those that are bound up with infectious disease, that temperature, the medium in which they grow, presence and absence of certain chemical compounds are capable of materially affecting them. I need not for this purpose enumerate all that is known already by direct experiment, but will only limit myself to reference to the researches of Schröter, Cohn, and Wernich on that group of micro-organisms, known as pigment bacteria, i.e. bacteria which only under certain conditions, notably temperature and soil, produce definite pigments (Cohn's Beiträge zur Biologie d. Pflanzen); to those of Hansen (Carlsberg Laboratory) on yeast; to these of Neelsen on the bacilli producing the blue colour of milk, the bacillus syncyanus (Beitr, zur Biol. d. Pflanzen, iii. 2, p. 187); to the works of Toussaint, Pasteur, Chauveau, Koch, and others on the bacillus anthracis; Arloing, Thomas and Cornevin on the bacillus of symptomatic charbon; of Koch, on the bacillus of tuberculosis; of Israel on actinomyces, and many others; and particularly would I refer to the many valuable suggestions and considerations given by v. Nägeli on these points in his book, Die niederen Pilze, München, 1877 and 1882. While from these observations it would appear that both septic and pathogenic microorganisms are capable of suffering some modifications in their morphological and physiological behaviour, it is nevertheless still an open question whether an organism which under ordinary conditions is only associated with putrefactive changes in dead organic material, and which cannot under these ordinary conditions grow and multiply within the living body, can, under certain extraordinary conditions, become endowed with the power of growing and multiplying within the body of a living animal, creating there a pathological condition, inducing there an infectious disease. Three distinct septic micro-organisms have, after numerous experiments and careful observations, been mentioned, as being capable when growing under certain extraordinary conditions of assuming pathogenic properties. These three organisms are: (A) the common bacillus of hay-infusion said by Buchner to be capable of transformation into bacillus anthracis; (B) a bacillus subtilis, present in the air, which, although quite harmless in itself, assumes distinct pathogenic properties when growing in an infusion of the seeds of Abrus precatorius, becoming thereby endowed with the power of causing severe ophthalmia (Sattler); (C) common mould, aspergillus, which, harmless in itself, when grown on neutral and alkaline material at about the body temperature (38° C.) assumes, according to Grawitz, very poisonous properties, producing in rabbits inoculated with it death, with metastasis of the aspergillus and its spores in the various internal organs. There are in the literature of micro-organisms other cases mentioned, in which such a transformation has been supposed, but without experimental proof. Let us now review seriatim the above three cases: (4) Dr. Hans Buchner published in the| Sitzungsberichte d. math. physik, Classe d. k. Bairischen, Akademie d. Wiss. 1880 heft iii., p. 369, that he succeeded in transforming the common bacillus of hay-infusion, the haybacillus, into the bacillus anthracis. The hay-bacillus and the bacillus anthracis rank together morphologically under that form which Cohn has named bacillus subtilis. The two are, however, not quite identical in morphological respects. The hay-bacillus is a minute rod or cylindrical-shaped bacillus, which by elongation and division produces chains and ultimately threads just like the bacillus anthracis, but in the latter (¿.e. bacillus anthracis) the bacilli and their threads are composed of cubical elements, as is shown in stained specimens and as has been mentioned in a former chapter, whereas in those of the hay-bacillus the elements are rods or cylinders. I have seen, however, many of the short haybacilli which being constricted, i.e. in the act of division, appear as two short more or less cubical elements placed end to end. It is generally assumed that in hay-bacillus the bacilli are always rounded at their ends, whereas the bacilli anthracis are as if straight cut at their ends; but this is not universally the case, since I have seen in cultures the bacilli anthracis with distinctly rounded ends. But, speaking generally, the hay-bacillus is a rod more distinctly rounded at its ends, the bacillus anthracis of the blood is not so. The bacillus anthracis is slightly thicker than the hay-bacillus. In artificial cultivations carried on in neutral broth the bacillus anthracis is about twice as thick as the haybacillus growing in the same fluid, and when both are growing in neutralised hay-infusion the two are very conspicuously different from one another, and can at a glance be distinguished from one another, the hay-bacillus being about half the thickness of the bacillus anthracis. In stained specimens, too, the latter is made up of a beautiful row of cubical cells, whereas the former consists of cylinders only. The hay-bacillus is motile, possessed of a flagellum and therefore capable of locomotion; the bacillus anthracis is not motile. I am quite aware that Cossar Ewart states that he has seen in a specimen kept artificially heated under microscopic observation, that the bacillus anthracis, at first non-motile, is capable of becoming motile. In no instance has the bacillus anthracis been observed to be motile. I have examined thousands of specimens of fresh bacillus anthracis in the blood and in artificial cultures, and I have never seen any. thing that in the least would lead me to dissent from this proposition. (To be continued.) DIPSOMANIA. BY PROFESSOR MAGNAN. (Translated for the MEDICAL ABSTRACT.) THE dominating influence in dipsomania is heredity. An occasional cause may have a certain action upon particular seizures, but the disturbance is secondary; it has to do only with the manifestation present at the time of attack. Upon the morbid centres of action it has not the importance often attributed to it. Some writers instead of seeing in the morbid impulse to drink, the manifestation of an interior condition of profound disturbance, regard it as developing only after long periods of alcoholic excess. This opinion, together with that which would make of dipsomania a distinct malady, in an otherwise healthy individual, does not withstand careful investigation. Esquirol saw in dipsomania a distinct malady characterized by an unusual desire to drink, and paid no attention to antecedents. But in order to comprehend dipsomania, this inquiry must certainly be made. Nothing can be more certain than that dipsomaniacs, at various periods of their lives, and many years before the development of their disease, have presented eccentricities of character and serious intellectual difficulties which their after lives have amply accounted for. Other writers have confounded the symptoms of dipsomania with its causes. Dyspepsia, so often regarded as a cause of the drinking impulse, is only a consequence of the malady, though it afterward aids in giving rise to the drinking seizure. The same is true of certain curious conditions to which writers have too readily applied the term hysterical, and which constitute in reality the habitual condition of the physiological life of the dipsomaniac. So also with the periods of melancholy. Far from being the causes, they are the first manifestations of the disease. To menstruation and the menopause have also been attributed a large importance in the causes of dipsomania. Their influence is slight, how ever, and only at the time of the access, the return of which is sometimes hastened. But even if menstruation has a certain action upon the periodicity of the access, it would be a gross exaggeration to say that it had anything to do with the cause of the trouble. resistance, she obtains a supply of liquor and locks herself up for the sole purpose of secret and unrestricted drinking. The melancholy continues to increase and symptoms of alcoholic poisoning appear. Hallucinations take the place of sleep; she sees skulls with flaming eyes and hideous faces grinning at her; objects assume all colors by turns and dance around her bedside. Her skin is troubled with sensations which she ascribes to vermin. The symptoms disappear in a few days and the patient remains sober perhaps for three months, without even a desire to drink. The odor of liquor then becomes so disagreeable as to be almost nauseating. The patient denies that she has a liking for drink. She says that she proceeds wholly against her will. "This is not," she said to us, “a passion with me; it is in spite of myself that I drink." During the attack she becomes irritable and has rushes of blood to the head. In each succeeding seizure the impulse to drink is more imperative and the resistance less powerful. Of this particular case I am unable to speak with certainty concerning hereditary predisposition. Of 8 cases now with us, however, two receive the impulse from both parents and five from either the father or the mother. The term monomania, introduced into science to explain "a kind of mental alienation characterized by a partial obscuration of the intelligence, of the affections, or of the will," is daily losing its force. In a general way I reject monomanias absolutely, without denying that certain impulses may be the most striking features in certain forms of insanity. But they can have only a symptomatic value. Monomania is but a mental condition in the midst of which a particular tendency manifests itself. It is not the essential disease, though it sometimes so dominates and absorbs the patient's mind as to give his trouble a special appearance. Enough will be shown to prove that if the necessity of drinking is, in the dipsomaniac, the most striking act, it does not constitute the disease. It is an episodical syndrome of a more profound mental state which is governed by heredity. One of my patients had suicidal melancholia, followed in turn by religious mania, nymphomania and homicidal impulses. Observers should be able to understand from such a case that all of these manifestations, far from being monomanias, are different presentments of a single pathological state. Marie D-, 45, had been in bad spirits for 4 years since her husband's death. For 18 months she had been seized at intervals with a violent desire to drink. Then followed a period of deeper sadness and discouragement, which immediately preceded her first seizure. Dipsomania is essentially intermittent in She complains at the time of attack of a con- character. The alcoholic delirium which striction of the stomach and the throat. As becomes associated with its seizures after they the impulse increases she reproaches herself have become very frequent, is a complication, and tries desperately to surmount her desire to not a symptom. The attacks of dipsomania drink. Incapable, however, of a prolonged | leave behind them a cerebral restlessness which VOL. IV., No. 9. |