CLINICAL MORPHOLOGY versus BACTERIOLOGY, 
WITH SOME THERAPEUTIC DEDUCTIONS. 
By John Ashburton Cutter, M.D., B.Sc., of New York; City. 
Read before the Mississippi Valley Medical Association at its Fifteenth Annual Meeting September uth, 1889, 
and illustrated by lantern slides of microphotographs taken with the \-Afh, 1-10th 
\-\6th, 1-50th and 1-75th inch objectives of Tolies. 
Published in “The Medical Bulletin,” “The Weekly Medical Review,” “The Doctor,” et aliis. 
The following is an abstract:— 
What is Clinical Morphology? Morphology is the science 
of form. Clinical Morphology covers the form elements that the 
clinician sees in his daily work with his patients ; the position 
in bed ; the lines of the face; the attitudes assumed in walking 
and sitting; all come under the term Clinical Morphology; but 
for our purpose to-day, we will consider Clinical Morphology 
to be the description of the form elements found in the blood, 
the urine, the sputum, the skin, the feces and foods. 
What is Bacteriology? The science of Bacteria. What 
are Bacteria? Very small bodies which are hard to place. 
They have been classified under the heading of schizomycetes 
of the confervoid algae. A good definition of algae is, that 
they are plants that produce oxygen, and of fungi, that they 
are plants that produce carbonic acid gas. 
********* 
We now proceed to the concrete side of our subject, and 
will consider briefly the much advertised infants’ foods, asthma, 
rheumatism and tuberculosis. 
Inputs’ Foods. It will go without saying that bacteriology 
has little field of work in the artificial infants’ foods. Yet the 
opportunities offered for clinical morphological investigations 
are great and of much importance. 
Take for instance, “ Imperial Granum; ” the author of the 
Clinical Morphologies, showed years ago that, though the claims 
of the manufacturers were that this preparation was ‘ ‘amorphous, 
a solid extract, the salvator of the human race,” &c. &c., it was 
decidedly morphological, containing starch grains, to say no 
more, and the Connecticut Agricultural Experiment Station has 
backed up the statement of the morphologist by chemical ex- 
aminations which show that “Imperial Granum ” is common 
flour. 
Any physician who has an infant food sent him for an exami- 
nation should place the food under the microscope, study for 
gluten cells, starch cells, cellulose and the connective tissues of 
the various grains; see if it is an amorphous, homogeneous mass 
or made up of decidedly morphological elements. A food may 
be a first-class one chemically yet contain so much cellulose, 
that it is unfit for the stomach. The paper published in 1882 
in Gaillard’s Medical Journal, on Cereal Foods, by E. Cutter 
illustrated by cuts of micrographical drawings, created much 
attention as being the first to enter a new field as to foods, to 
wit: the morphological; chemistry and clinical morphology 
should go together. 
********* 
The therapeutic deduction is: feed the mothers during gesta- 
tion and lactation on such foods that they will have milk enough 
to nurse their children, summer or winter. Our plan is, two- 
thirds animal and one-third vegetable, with one meat and one 
vegetable at a meal. 
MORPHOLOGY OF THE SPUTUM IN ASTHMA. 
The following in quotations is from the work, entitled “The 
Clinical Morphologies,” by Ephraim Cutter, M.D., LL.D. 
Published by the author, New York. 
“ Cholesterin ; ” “Cystin;” “Oxalate of Lime;” “Phos- 
phate of Lime;” “Triple phosphates;” “Uric acid and urates;” 
“Calculi made up of these salts;” Contents of giant cells es- 
caped outside of walls;” “Crystals with two or more terminals;” 
“Foreign substances inhaled;” “Fusiform crystals;” “Gravel 
crystalline, Gravel granular, Gravel massive;” “Mucous corpu- 
scles distended with albumenoids; with crystalline and other 
bodies ; with cystin ; with giant cells; with melanotic matters ; 
with oxalate of lime; with triple phosphates; with uric acid and 
urates.” “ Other crystals whose names have not been made 
out;” “Spirilina splendens, Salisbury, 1865.” 
The therapeutical indication from the morphology in asthma 
is to feed the cases so that there will be the minimum of fer- 
mentation and thus stop the paralyzing action of the carbonic 
acid &c. on the eliminative glands; give tonic and liquifying 
medicines and if the case is watched closely and will follow the 
orders to the letter, a cure may be expected in time. It hardly 
needs to be said that Bacteriology is far behind Clinical Mor- 
phology because it can only treat of Bacteria, yet Clinical Mor- 
phology is able to show physical causes of asthma and hay 
fever. 
MORPHOLOGY OF THE BLOOD.* 
Mode of Study: “It is necessary to have the patient, the 
microscope, the light, the means of withdrawal of the blood— 
a lancet, spring lancet, the scarificator of the writer or a needle, 
which is not the best thing—all together.” 
“There is no such thing as taking the blood home to exam- 
ine. The changes are so rapid that most of the important ones 
disappear in ten minutes time. Still, after these are gone, 
many valuable points remain to be looked for. 
“Kind of blood.—The capillary—not the venous or arterial. 
“Site of withdrawal.—On the radial or ulnar side of the 
forearm near the wrist. The skin should be clean and free 
from hair. If dirty, wash with soapsuds or ammonia water. (It 
is well that the beginner should study the skin surface, dirt, 
and epithelium, before looking at the blood). Take the 
patient’s forearm in hand, and make the skin tense in the in- 
terval between the thumb and fore-finger. Puncture the skin 
one-eighth inch. The tension of the grip will squeeze out a 
drop of blood. The size of the drop should bear a direct rela- 
tion to the size of the cover. Very much depends on handling 
the drop of blood rightly. When the drop evenly diffuses 
itself it is to be presumed that the film is about uniform in 
thickness, so that one can judge somewhat as to the compara- 
tive number of corpuscles in each specimen. The process of 
* See Clinical Morphologies, E. Cutter. transferring the blood should take only a few seconds of time, 
a fraction should be sufficient. 
“MORPHOLOGY OF THE BLOOD IN HEALTH.”* 
“Color; bright, fresh, clear, ruddy, strong. 
“Clotting; rapid and firm. 
“Red corpuscles arrange themselves in nummulations, 
or are scattered evenly over the field. Normal in size. Non- 
adhesive. Central depression well marked on both sides ; pe- 
riphery well rounded, clean cut. Hold coloring matter firmly. 
Pass readily to and fro through the fibrin filaments ; appear 
fresh and fair. 
White corpuscles.—Normal in size. Not enlarged by in- 
ternal collections of foreign bodies. Amoeboid movements, 
strong or not. Proportion, one to three hundred of red cor- 
puscles. Consistence good. Not sticky. Color a clean white. 
Freely moving at will. 
“Serum—clear and free at sight from any form. After 
five minutes, most delicate semi-transparent fibrin filaments 
appear forming a very light network in the field, which offers 
no obstacle to the passage of the corpuscles. 
“There should be no spores nor vegetation in healthy 
serum, though they may be found by very minute examination, 
or by letting the blood stand for several days in closely stopped 
phials at a temperature of from 60—75 degrees Fahrenheit. 
This is not saying that spores and filaments cannot be found 
in blood of persons calling themselves healthy—for some dis- 
eases exist in a latent condition, like rheumatism, syphilis, 
cystinaemia, and consumption. I have met with people who, 
on finding vegetations in their blood, have decided not to ac- 
cept the evidence because they deemed themselves healthy. 
Again, it is difficult to find a perfectly healthy person in the 
community; this was made public during the “ late unpleasant- 
ness,” when drafts were made for soldiers. The blood evidence 
must be taken in connection with that of other physical signs. 
MORPHOLOGY OF THE BLOOD IN RHEUMATISM. 
The red corpuscles are sticky, forming large masses ; this is 
due to the excessive development of the fibrin filaments which 
form a strong net-work across the field and render the blood 
molasses-like. The white corpuscles are distended more or 
less with the crystalline matters present. 
In the serum interspaces, besides the fibrin filaments in ex- 
cess, are found the following crystalline bodies : uric acid and 
urates; phosphates, specially the triple phosphates of lime 
and soda; oxalate of lime; cystin, quite common and easily 
detected ; carbonate of lime, rare ; stelline and stellurine, 
these occurring mostly in granular form, but in old cases where 
the system is saturated, they are crystalline ; black, brown, an- 
iline blue, bronze, red and yellow pigments in the form of 
flakes or small masses are common in rheumatic blood. 
(Readers of this abstract will find this morphology described 
to a much greater extent in the Clinical Morphologies, 
E. Cutter). 
“LATENT CONDITION OF THE CHARACTERISTICS OF 
RHEUMATIC BLOOD.” * 
“ Themorphology of rheumatic blood exists in a latent condi- 
tion in persons apparently well; but when they are exposed to 
cold, the blood-vessels contract, catch and detain these abnor- 
mal elements, and we have a stasis of the blood which may be 
active or passive and manifests itself in heat, fever, pain, swell- 
ing, inflammation or passive congestion, effusion, etc., and 
which make up what is known as an “attack of rheumatism.” 
“Fibraemia* is where the fibrin is in excess in filaments, 
skeins, curled massive fibres like strings—thrombi and emboli. 
These are in a more exagerated condition and form than in 
consumption or rheumatism, and are not necessarily asso- 
ciated with the crystalline matters or gravel. Sometimes the 
fibres look like a scalp that has been taken from the head of a 
women with long tresses of hair. 
“Thrombosis* is where masses of fibrin accrete and con- 
solidate together, including or not the red corpuscles, white 
corpuscles, crystalline and pigmentary bodies, spores and my- 
celial filaments or vegetations, one or all. 
“ Embolism * is where a thrombus has been caught or en- 
gaged a blood-vessel and acts as a plug disturbing the circula- 
tion. 
“Pre-embolic state.—As thrombi precede emboli, so they 
can be detected in the blood before the embolism, simply 
by the morphology of the blood. In this way, sudden deaths 
from embolism, specially in the puerperal state, can be averted.” 
Here again we have a subject which Bacteriology can not 
touch, as the morphology of the blood in rheumatism shows 
the causes of the inflammation, pain and deposits to be purely 
physical and chemical. Beef has had many sins that other 
foods should have borne the complaint of, laid at its door. 
Stop the Englishman from eating his puddings, pastry and 
sweets and feed him on beef rightly prepared and I think he 
will have less gout. The morphology of the blood in these 
old cases of gout is very interesting and beautiful. One case I 
examined several years ago, had a most remarkable display of 
crystals of cystine. 
To treat rheumatism, one must be patient; sometimes the 
cases have to go on very rigid diet; nothing but the beef sep- 
arated from its fibrin, and the resultant pulp broiled. I wish 
to say here, that we never prescribe beef raw, never did and 
never will. 
“MORPHOLOGY OF THE BLOOD IN TUBERCULOSIS.”* 
“First or Incubative Stage.—Red corpuscles are less in 
number, ropy and sticky, more or less, but not much changed 
otherwise. 
“Second Stage of Transmission.—Red corpuscles: color 
pale, non-lustrous; not clear cut, not ruddy. Consistence, 
sticky, adhesive. Coating of neurine removed. Not so num- 
erous as in normal blood. Owing to the increased size 
and strength of the fibrin filaments and the thickness, they form 
in ridges, rows, but not so marked as in rheumatic blood. 
They accumulate in aggregations of confused masses like droves 
of frightened sheep. They adhere to each other, and are rot- 
ton, as it were, in texture. 
“White corpuscles.—Enlarged and distended by the 
mycoderma aceti or spores of vinegar yeast, that are transmitted 
into the blood stream from the intestines. 
“Serum.—More or less filled with the spores of myco- 
derma aceti or vinegar yeast. These occur either singly or 
in masses of spores which is the common form in which they 
are found, wherever vinegar is produced. 
“The fibrin filaments are larger, stronger, more mas- 
sive than in health, and form under the microscope a thick 
network which is larger, stronger, and more marked in direct 
proportion to the severity of the disease or the amount of 
accumulation. 
“Besides, the serum is apt to be of a dirty ash color. 
“ The sticky white corpuscles, the massive fibrin filaments 
in skeins, and the yeast spores alone or combined, form aggre- 
gations, collects, thrombi and emboli which block up the 
blood-vessels of the lungs soonest, because exposed to air the 
most of any viscus ; the blood-vessels contract, and thus arrest the 
thrombi and form a heterologous deposit, which is called tubercle. 
“The third Stage, or Stage of Tubercular Deposit.— 
“These deposits increase so long as vitality subsists in the 
tubercle and surroundings. When vitality ceases, the tubercle 
softens and breaks down. Sometimes, if the process is very 
slow and life slightly inheres in it, the proximate tissue 
undergoes fatty infiltration, which preserves it from readily 
breaking down. 
“The morphology of the blood is the same for the second 
and third stages of consumption. 
“Fourth Stage, or Interstitial Death. — Morphology 
of the blood in this stage is the same as in the second and 
third, save that it becomes more impoverished. 
“The red corpuscles are thinner, paler, much lessened in 
number; increased in adhesiveness, stickiness, and poverty. 
Devoid, more or less of neurine. 
“ The white corpuscles are fewer in number, more en- 
larged ; often ragged and rough. Distended with spores ot 
mycoderma aceti; more adhesive and sticky. 
* See Clinical Morphologies, E. Cutter. Figures i and 2.—Crystals and crystalline bodies from the blood of rheumatic patients. (E. Cutter.) Figure 3.—Cystine in blood from a case of sciatica. (E. Cutter.) 
Figure 4.—Microphotograph, healthy blood, i-i6th inch Tolies’ objective, E. Cutler, 1883. 
Figure 5.—Microphotograph, fibrin filaments in unhealthy blood. i-5oth inch Tolies’ objective, E. Cutter, 1876. Taken with one form Cutter clinical microscope. 
Figure 6.—Massing and crowding of red blood corpuscles; unhealthy blood. Microphotograph, 1876, G. B. Harriman and E. Cutter. 
Figure 7.—Three white corpuscles enlarged with spores of vinegar yeast; the fourth ruptured; tuberculous blood. Microphotograph, i-75th inch Tolies’objective, 1876, G. B. Harriman and E. Cutter 
The first ever taken in the world. 
CLI1TICAL MORPHOLOGY veesus BACTERIOLOGY. 
by John Ashburton cutter, m. d., b. sc. 
Fig. 5. 
Fig. 7. 
(Copyrighted 1889, by Ephraim Cutter. All rights reservedl) 
Fig. 6. 
Fig. 4. 
Fig 2. 
Fig. 3. 
Fig. I. “The serum.—Fibrin filaments are thickened, stronger, 
more massive, and more skeins of them present. The collects 
of mycoderma aceti are very much larger and more numerous ; 
in moribund cases, I have seen them so large as almost to fill 
the field of the microscope. They present anfractuous edges 
and amoeboid prolongations, giving them a wierd, bizarre ap- 
pearance which, under the circumstances, have a portentous 
aspect, for the larger and more numerous the spore collects of 
mycoderma aceti are, the more dangerous the case.” 
THE MORPHOLOGY OF THE BLOOD IN FIBROUS CON- 
SUMPTION. 
“Here the mycoderma aceti or vinegar yeast does not get 
into the blood and change it as in tubercular consumption, 
since the pylorus keeps the vinegar yeast in the stomach. 
There is breaking down of living tissue to a less extent. This 
tissue has been thickened, hardened, and made stony from de- 
posit of gravel. The diagnosis is not so easy as that of tuber- 
cular consumption.” 
It is wonderful to see in these cases how soon the cough be- 
gins to lessen, due to the stopping of the production of the 
carbonic acid gas, which by its paralyzing action on the mucous 
membranes of the trachea and lungs, has caused that pouring 
out of mucous. I would that I had more time to go into the 
description of the rationale of the production of these diseased 
conditions in rheumatism, asthma and consumption, tubercu- 
lar and fibrous. 
•‘MORPHOLOGY OF THE SPUTUM IN TUBERCULOSIS.” f 
“Bacilli; bacteria, so-called; clots of blood; elastic lung 
fibers; epithelia, ciliate, non-ciliate, pavement and colum- 
nar; granular tubercular matter ; granular tuberculous matter, 
so-called, sometimes fetid in odor; inelastic lung fibres; lu- 
mina of blood-vessels ; mucous corpuscles, normal, deformed, 
distended with spores and gravelly matters ; mucous filaments 
and fibres; mycelial filaments; swarms of spores; yeast plants; 
and yeast sporangia, alcoholic and lactic acid.” 
COMPARISON CLINICAL MORPHOLOGY AND BACTE- 
RIOLOGY AS TO TUBERCULOSIS. 
Etiology: The bacteriologist claims that the tubercle bacil- 
lus as discovered by Koch is the cause of tuberculosis. The 
clinical morphologist asserts that the vinegar yeast spores in the 
blood is the cause of tuberculosis by their chemical and me- 
chanical action on lung tissues. 
The bacteriologist has strong evidence in the fact of inocula- 
tion. The clinical morphologist, in that by methods based on 
the morphology of blood containing vinegar yeast, many cases 
of tuberculosis have been cured. How can these two claims 
be reconciled ? For over thirty years botanists have been 
fighting about Koch’s bacillus; some claimed that it was 
part of the life growth of the vinegar yeast plant; others, that 
it was not. The former hold the stronger position, for Koch’s 
experiments have demonstrated that the bacillus will propagate 
as itself; now here comes in the link; the bacteriologist is 
hard at work to find out how that bacillus gets into the lungs, 
and is laying down rules of preventive treatment which are in 
some cases fantastic and ridiculous ; the clinical morphologist 
is able to diagnosticate the vinegar yeast in the blood before the 
lungs break down; he finds that the morphology of the blood 
improves as the case improves; moreover, not being limited 
to the study of bacteria as the bacteriologist is, (if he works on 
bacteriology alone,) the clinical morphologist can develop 
from the sputum the full fledged vegetation from bacillus 
through the spore stage to the mycelial. 
Now if what I say is true, tuberculosis is a disease induced 
by the excessive feeding of fermenting food or food that will 
ferment into alcohol and vinegar ? The villi of the intestines, 
paralyzed by this fermentation, absorb the spores of vinegar 
yeast which gradually increase in the blood, and if not detected 
in time, cause tubercle; often a cold, overwork or worry will 
be the blow that upsets the case. 
Now when the lung tissues begin to necrose and cough comes 
on, of coarse the sputum will contain the tubercle bacillus, also 
the spores of vinegar yeast. 
My father’s experience which runs back over thirty-three 
years shows that children of tuberculous parents will by feeding 
on proper food grow up instead of dying. 
sic******* 
Men say to me that they examine blood and can tell nothing 
about it. I answer that my father thought it necessary that I 
should spend eight years in the study of the sciences and medi- 
cine before he would teach me how to study clinical morph- 
ology. The same rule applies in his instruction to others for 
he will teach only medical graduates, among whom I may note 
Dr. R. J. Nunn, ex-President of the Medical Association of 
Georgia; Dr. Nunn traveled in Europe and could not find what 
he wanted till he returned to New York. 
Therapeutics. In 1881, a young man lay sick in bed, 
of emaciation so great that he was almost a skeleton ; of 
hemoptyses so frequent that counting them had ceased; of 
night sweats; of copious expectoration which contained 
elastic and inelastic lung fibers. The heart was enlarged, 
the pulse 120, respiration 20 and more times a minute. In 
both lungs there were cavities. The blood presented the 
tuberculosis morphology. Now, this case, desperate as it 
was, was undertaken by my father. The patient was fed on 
beef taken from the top of the round. The fibrous tissues 
were separated from it by a machine, and the resultant pulp 
was moulded carefully into cakes, and broiled. Great care 
was taken in all the steps of the process of preparing the 
beef. The hands touched it as little as possible, for, even after 
the pulp has been separated from the fibrous tissues, if touched 
by the hand, the human animal-heat will be apt to change the 
condition of the meat, so it is moulded carefully with knife and 
fork. The meat was then broiled and seasoned to taste, with 
pepper, butter, lemon juice, and salt, as wanted. Worcester- 
shire sauce allowed. The patient was fed this three times 
a day, was given gentle tonics, and an ammonia or acid 
sponge bath twice a day. The case was very carefully watched, 
for life was likely to slip away at any moment. He gradually 
improved and was cured ; i. e. the cough ceased, and the 
sweats were gone; he got up from his bed, went through college, 
was graduated with honors, was married, and last seen by 
us one year ago, calls himself a well man. Now, what is the 
rationale of this cure ? By feeding him this particular food, the 
vinegar yeast was starved out of the blood, and thus its work of 
necrosing lung tissues was stopped. The acidity of the blood 
was taken away bv stopping the acetic acid fermentation, the 
fibrin filaments lost their large size, the red blood-corpuscles 
regained their normal tone and color, and were no longer hud- 
dled together ; while the white corpuscles came down to normal 
size, because the blood had been deprived of the spores of vine- 
gar yeast which they had been trying to enclose. Now, nature 
is a spiral spring, and in this case had been overloaded with 
wrong feeding. We had given her a chance by feeding the 
patient on the food that best agreed with her, and she being 
furnished with good blood, her eliminative glands in good con- 
dition, took the normal blood, and with her wonderful physio- 
logical means healed over the sore and broken down places in 
the lungs, and in some cases where the cavities were not too 
large, built and bridged them over. I believe this to be true, 
for I have been with a case where I could hear the air bubbling 
through the mucus in a small cavity, and yet that all disap- 
peared. 
There is so much said about the non-curability of consump- 
tion. My father was nearly ostracised when he came out, in 
1880, with seventy cases published in the transactions of the 
American Medical Association, where he simply claimed that 
consumption was a curable disease. His cases in this table 
were: seventeen non-arrests, twenty-six partial arrests, and twenty- 
seven permanent arrests. It is perhaps well to note that this 
was all before Koch promulgated the tubercle bacillus, and with 
this article were printed micro-photographs of tuberculous 
blood. 
Now, it is reported that, in the morgues of the great cities of 
the world like Paris and New York, bodies are cut into in which 
are evidences of lung necrosis which had been stayed, the lungs 
healed or scarred, and the individuals found dead from some 
other cause. Moreover, surgeons are talking of removing by 
pneumectomy, untold portions of the lungs, and in a journal 
f See Clinical Morphologies, E. Cutter. I recently saw that a man could live with but two lobes. Well, 
suppose the patient has survived the shock of slicing out a part 
or the whole of one lung, he will continue to live on the food 
that produces tubercle. These facts apply to tuberculosis of 
the joints and the peritoneum as well. In a case of tuberculosis 
of the knee joints, I found the morphology of the blood to be 
tuberculous and syphilitic. Gentlemen, the medical, the tro- 
phologic side of these questions must be examined as well as the 
surgical. 
In our work we never say we are going to cure a case for 
we recognize the fact that we are human—finite; but we do 
know that cases have been cured, and so we will not take away a 
sufferer’s hope. We never know how a case is going to turn 
out; some cases will not respond to treatment, for they are just 
full of the disease—both lungs; but others come along that 
appear quite as desperate, we give them a chance, and they 
pull up and get well. 
I had a case of a woman in Kentucky; we healed her lungs 
several times and would send her home and there she would 
get upset; once she had to go into the kitchen and cook; this 
brought on an attack of meningitis which shattered her nerv- 
ous system so that her character w'as changed from that of a 
bright, happy woman to one despondent nervous and irritable. 
Yet she lived for over a year after that meningitis, though I was 
constantly told that she would die. For seven months before 
her death she never coughed. I took her to her family physi- 
cian and he admitted that her lung was healed. She died two 
months later, incidentally, from malaria; generally, from adyn- 
amia. 
Gentlemen, it takes nerve force to live; it takes nerve force 
to get well. Each time this woman’s lung broke down she 
had to use up nerve force to recover; if she had not been shat- 
tered by the meningitis, humanly speaking, she would be 
alive now. 
(See “On the Death of a Cured Case of Tuberculosis Pul- 
monalis,”J. A. Cutter, Virginia Medical Monthly, Sept. 1889.) 
I might give you the details of many more cases of tubercle 
but time does not permit; suffice it that I say that the cured 
cases run back into the ’60s, that we consider tuberculosis 
curable and our hope is that as soon as the profession and the 
laity share this belief and practice to cure, then many more lives 
will be saved. 
This taking away of hope kills many. How can a man live 
if there is no hope offered him ? If he does live, it is by sheer 
pluck and fight. But the battle which my father started in 
upon years ago to prove that consumption is a curable disease 
seems to be about over. We are entering on a new era in 
medicine. Nutrition of tissues must be studied, the causes of 
tumors, the excessive development of the fibrous tissues, the 
causes of degeneration, all these must be studied from the side 
of nutrition. 
A few words as to foods in tuberculosis; the yolks of eggs 
are not allowed in any form, because hard to digest and a 
promoter of rheumatism; if you do not believe it try them on 
a case and see the result. Milk is commonly called the best 
of foods, yet in the adult nine times out of ten it is not the 
best as it so often causes biliousness. This we see in studying 
our cases. Testing the urine with nitric acid helps very much 
to show the biliousness. Milk if given to patients must be 
taken warm from the cow and be carried to the patient speedily, 
so that the ever present germs may not get into and contamin- 
ate it. But be careful in its administration. I have seen cases 
that I thought could take milk be upset by it. 
Some cases are kept alive on the whites of eggs slightly cook- 
ed, beef tea and Johnston’s extract of beef. Sometimes the 
stomach is in such a condition that the patient has to be sus- 
tained by nourishment per rectum till the stomach comes 
around. But the aim in our cases is to get the stomach in 
such a condition that they can be fed beef prepared as before 
described. When the blood becomes normal, the urine flow- 
ing with a specific gravity of 1015 to 1020 with no bile and no 
sediment, then other foods can be brought in cautiously, and 
it is only necessary for me to say that if you are watching the 
case carefully, you will soon find out whether the food you are 
allowing is the best or not. Again, time is a great considera- 
tion with these cases. They must be treated by the month, 
pay their fee in advance, must go under your care for at least 
one year, or better two; the specimens of blood, urine, feces 
and sputum must be often examined. Have the patient put 
his hand in yours and trust you faithfully; make him stop in- 
trospection and watch to see that causes of worry are removed. 
Temperament needs consideration; some cases need much en- 
couragement, others holding back; some are fearful of every- 
body and everything and have no faith; others expect to get 
well right off and go at the treatment with a rush, and when 
they find that nature takes her own time in healing their sins, 
they may be disappointed. 
It is no easy thing to take a case chronically sick and lead 
him along to health. Again, while remembering that without 
proper feeding you cannot cure your case, do not forget that 
with judicious medication the case may be pushed along faster, 
for the machine needs oiling. Have the case drink hot water 
one hour before meals and on retiring; usually a pint is need- 
ed at each draught, the temperature not boiling but comforta- 
bly warm. (See “The Therapeutical Drinking of Hot Water,” 
by E. Cutter, New York, W. A. Kellogg.) Do not give them 
any medicine that is made up with syrup. I have been asked 
so many times, “Do you give syrup of hypophosphites?” The 
answer is, “No, because there is fermentable matter in it.” 
In closing, gentlemen, I call your earnest attention to the 
need that large bodies of medical men, who are deeply anxious 
for the truth, should investigate the original experiments of 
Salisbury which were made on men and animals thirty years 
ago. Our work has been more with microphotography and 
demonstrations of healthy and diseased morphologies. We 
have not had the time nor money to hire men to eat certain 
kinds of foods, singly, and study the effects on them; neither to 
buy hogs and feed them to death on distillery slop. But all this 
must be done, and if this association with its personnel of 
scientific men industrious and anxious for therapeutic achieve- 
ments, will appoint a commission and investigate these matters 
thoroughly, a great good will be conferred. 
We must know the truth ! These matters ought not to rest 
on the utterances of one or two men. While I am satisfied as 
far as I have gone in the matter, and while I believe my father 
to be on the right track in his efforts to save these things to the 
profession, still I am anxious that these experiments be re- 
peated. 
A commission to undertake this work must be composed of 
your most eminent members; it should contain a first-class chem- 
ist, a neurologist, a pathologist, a therapeutist, and last, but not 
least, a morphologist. The work of this commission must not 
be hampered by the appointment of a man to do its micro- 
scopical work who is trained only in bacteriology. I believe I 
have shown you that bacteriology is an extremely small portion 
of the micrological world, and that the profession will be handi- 
capped until the word ceases to exist, and the bacteriologists of 
to-day become morphologists in order that they may cover the 
whole field. 
The Ariston, Broadway and Fifty-fifth street.