PATHOLOGICAL ANATOMY: 
THE NECESSITY FOR ITS STUDY, AND ITS 
INFLUENCE UPON MEDICINE AS A 
POSITIVE SCIENCE. 
ANNIVERSARY ADDRESS DELIVERED BEFORE THE MEDICAL SOCIETY 
OF THE STATE OF NEW YORK, AT ITS SIXTY-SIXTH 
ANNUAL MEETING, 
BY 
S. OAKLEY VANDERPOEL, A. M., M. D., 
PRESIDENT OF THE SOCIETY. 
[Reprinted from the American Journal of Insanity, for July, 1871.] 
UTICA, N. Y. : 
ROBERTS, STEAM BOOK AND JOB PRINTER, 60 GENESEE STREET. 
1871. PATHOLOGICAL ANATOMY. 
Gentlemen of the Society: 
In addressing you this evening, I make no apology 
for stepping somewhat aside from the beaten track, in 
the selection of my theme. From the fact that the 
audience is not wholly composed of medical men, it has 
been customary to select a subject somewhat popular in 
its character and general in its application. I confess, 
however, that neither my reading, nor tastes fit me for 
such an effort, and I shall rather ask your attention to 
a subject bearing in an intimate manner upon our every- 
day duties; influencing, in just so much as it is care- 
fully studied, our train of professional thought, and 
consequently our action with reference to the character 
and treatment of disease. Not that I shall be indiffer- 
ent to the interest, and even attention of those whose 
studies are not strictly such as pertain to medicine; for 
in all the natural sciences there is a close bond of union, 
an intermingling of sympathies in thought, which ren- 
ders any arbitrary line of demarcation impossible; and 
though I speak to night of a theme, at first mention 4 
wholly unattractive, perhaps repulsive, to all save those 
whose interest has been instructed, still it will be found 
to involve practical considerations, and demand the aid 
of scientific formulae as intricate perhaps as any other 
branch of physical science. 
Your attention then is invited to considerations upon 
the necessity of the culture of Pathological Anatomy; 
its relations to the daily workings of the physician; the 
influence its cultivation has exercised upon the progress 
of medicine, and how far its present knowledge ad- 
vances our appreciation of the intimate workings of 
disease in the economy. 
I am led to this topic from the fact that the general 
profession are far too indifferent to its practical study. 
Content to received the ipse dixit c>i general text-books, 
or special treatises upon particular organs, or recalling 
the necessarily imperfect demonstrations made during 
the students’ curriculum, they pass through life indiffer- 
ent to, or unmindful of, the rich stores of practical inform- 
ation constantly thrown within their reach. Ever 
studying disease patiently and assiduously during its 
active processes, they stop short of verifying the third, 
and most important, element of the syllogism, the proof 
of the correctness of their labors. 
Shall I speak what I know to be true, that there are 
scores of able, laborious physicians; men whose acute 
perception, careful observation, and intimate knowledge 
of disease entitle them to worthy confidence; who yet 
pass their lives in this almost empiric course, rarely 
witnessing or making a post mortem for the purpose of 
verifying a diagnosis, and roused only from this indiff- 
erence when some startling occasion calls for the verifica- 
tion of doubts and suppositions ? 
Daily will they listen to the taunts of the want of 
positivism in medicine as a science; daily will the un- 5 
certainties of their own practice evoke the self-re- 
proaches of conscience; and yet the golden opportunities 
of solving a doubt, confirming a fear, or establishing a 
truth pass indifferently from their grasp. If each did 
but labor for himself in this field, if nature were but 
systematically and carefully interpreted, too many a 
boasted diagnosis would prove fallacious, and many 
hidden ailments be revealed, which imperfect examin- 
ation, or blind prejudice in preconceived ideas, had 
clouded from the mental vision. These thing's are said 
in no uncharitable spirit. For while recognizing -what 
are conceived to be the deficiencies of the profession at 
large in this respect, I am by no means unmindful of 
the obstacles and difficulties which apparently surround 
the practical workings of this branch of study. I say 
apparent, for I so conceive them chiefly to be, and that 
the earnest spirit, the faithful interpreter, can dissipate 
them all, and in the end really be aided by what at 
first seemed his chief hindrances. 
In the larger centres of population, the stimulus 
arising from the contact of inquiring minds has of late 
years given a vast impetus to the study of pathological 
anatomy. Special organizations are created for this 
purpose, and the interchange of observations, the exhi- 
bition of specimens add to the general fund of knowl- 
edge. The facilities, too, of gaining autopsies are far 
greater than in sparsely settled districts. Indeed, I 
know the remark now rises instinctively to the lips of 
every physician engaged in country practice, that he has 
neither the time nor the opportunity to pursue this 
study. 
I know full well the difficulties and prejudices which 
surround him, since earliest memories recall the fatigues, 
anxieties, and wearisome journeyings which are the 
heritage of the country doctor. Though years have 6 
sped, the untiring labors of a venerated father, who for 
over thirty years responded to every call of sickness 
and distress, is, though softened, still vivid to the recol- 
lection. Our boyhood was initiated into the mysteries 
of compounding drugs, of venesection, and dentistry; 
and our introduction to professional labor, with the ex- 
hilaration and beauties of a country life, realized also 
the long pilgrimages by night, the buffetings with 
winds and storms, the slow progress through the deep- 
ening mud or drifted snow. 
I too have sat by the bright blaze of the large old 
fire-place, and listened with childish wonder to the sim- 
ple legends, mingled with much of superstition and 
awe, which pass from the old to the young, and know 
the dread and innate antipathy existing towards every- 
thing which seems to desecrate the remains of the dead. 
And yet with the difficulties arising from exhausting 
labor on the one hand and superstition on the other, 
we contend the country practitioner allows to pass too 
easily from his grasp the opportunities for pathological 
research. The rich fields which present themselves to 
his experience lie too often ungarnered and neglected. 
Fatigue should be forgotten in the zest for research, and 
prejudice overcome in the earnest claim that death, to 
the true student in his profession, but opens the portals 
to those mysterious labyrinths where disease with its 
protean workings is ever weaving deadly meshes, but 
where too, by reflected light, he may learn either how 
calamity may be averted, or at least, procrastinated to 
the future. 
Indifference manifested by the physician to the study 
of pathological anatomy operates most unfavorably 
upon the young men commencing the study of medi- 
cine. Much as is said of natural gifts and predilec- 
tions, I am of those who firmly believe most of our 7 
tastes and habits are acquired. Very few, I think, pur- 
sue the study of any department of natural science from 
mere intuitive impulse, but rather as the result of some 
direct attention to the special subject, by which the 
curiosity, or it may be the thirst for further knowledge 
is stimulated. Subjects which at first sight are repug- 
nant, may if properly approached, and the zeal awak- 
ened, become of special and absorbing interest. This 
is in a peculiar manner true of morbid anatomy. There 
is in the experience of every beginner in medicine an 
instinctive repugnance, which meets him at the very 
threshhold of his pathological studies. From early 
childhood he is taught to consider death, and the ever 
recurring mystery which the transition occasions, with 
awe. Fie looks at the body only in its decomposing 
elements; he feels that the necessary dissections are a 
violation of respect to the memory of the dead. Added 
to this is the natural disinclination to handle rapidly 
decomposing substances, or those from which arise foetid 
emanations; he has too the healthy fear impressed upon 
him to avoid the saeptic poisoning which arises from the 
absorption of decomposing fluids: and yet it is at this 
early stage of his studies that the taste for researches of 
this kind must be acquired, and the habits of exacti- 
tude and minute research established. Indeed, if the 
preceptor is to give special prominence to one branch of 
medical study rather than another, it should be that of 
pathological anatomy. In anatomy and physiology his 
admiration is ever active at the wonderful mechanism 
and harmony of parts, the ceaseless activity of function, 
the vital unity which pervades the whole. And even 
in sickness when function or harmony is interrupted, 
his attention is readily occupied by the restoring agen- 
cies which the skill of the physician applies. In path- 
ological anatomy, however, he has none of these stimuli. 8 
Like the study of the classics in the youthful curricu- 
lum, it is approached with a feeling of dread: like them, 
the subsequent love of their study is an acquired taste; 
and like too the classics, in being the foundation of 
solid and thorough education and discipline, so patho- 
logical anatomy, in the personal study of each physician, 
must be the basis from which . to explain the morbid 
phenomena each day’s experience presents. I throw 
then, primarily, the responsibility of acquiring the taste 
and knowledge of pathological anatomy upon the pre- 
ceptor. 
The great majority of young men commence the 
study of medicine away from the centres of medical ed- 
ucation. A primary discipline, thus acquired, need not 
be and is not time necessarily lost. The student ac- 
quires habits of patient toil and study; of self-reliance 
and personal observation. Even in the quiet walks of 
his country home he may from time to time have oppor- 
tunities of practical demonstration, far superior to those 
which can be offered in any medical school. 
I claim then that the study of pathological anatomy 
should begin with the commencement of the student’s 
medical course. Even though he is not familiar with 
the normal appearance and condition of organs and tis- 
sues, still the two are always found in juxta-position; 
for rarely is a whole organ or tissue diseased; and he 
insensibly acquires that first education of the senses of 
sight and touch, far more valuable and enduring than 
the most minute and elaborate description. What 
would be thought of one commencing the occupation 
of machinist, who contented himself with reading and 
studying all that pertained to the theoretical ideas of 
motion and force, and yet never made himself practic- 
ally acquainted with the construction of a machine, or 
the' repair of one which was disabled ? And yet we 9 
ask our young men to commence the study of the 
workings of the most delicate of all machinery, its har- 
monies and irregularities, without the slightest prac- 
tical experience of how the different parts look or feel, 
or are related the one to the other. Would you delay 
this study until the student attends the lectures of some 
medical school ? I answer, such delay is most unfortu- 
nate. With the best acknowledged facilities for its 
O 
study, pathological anatomy can be but imperfectly im- 
parted. How little definite impression is left upon the 
mind, when to a class of from one to four hundred a 
pathological specimen is presented, and it may be, care- 
fully described, yet how few are sufficiently near to profit 
materially ? No! Pathological anatomy, like normal, 
must be studied individually in the quiet of comparative 
retirement; and the student must make himself prac- 
tically familiar by sight, by touch, by microscopic re- 
search, with the metamorphosis of tissue or the destruc- 
tion of organs. Rather the study of pathological anat- 
omy at the medical school than none at all; but better 
far its study under the personal supervision of the in- 
structor. 
At this point it may be claimed my position is de- 
fective, for there should be a more definite expression 
as to what is considered the province and limit of this 
branch of study. Briefly then, pathological anatomy 
takes cognizance of all alterations in the economy, 
whether they are the cause or effect of disease. It 
should tell us which are the elements in organs, that 
are attacked, what transformations of form, volume, 
consistence, or composition they undergo. Even here 
its province does not cease. By comparing a large 
number of similar lesions of different degrees, we have 
presented the complete cycle of morbid transformations, 
in taking each organ in a condition of health and fol- 10 
lowing out all the alterations of which it is susceptible, 
even to the extreme phase, and. then the return to a 
normal state if such return be possible; at the same 
time it should indicate what changes are permanent 
after the cure. 
Under this aspect pathological anatomy is allied to 
pathological physiology by the same relations that 
anatomy is to physiology. As anatomy studies the dif- 
ferent parts of the body in a state of repose, and phys- 
iology the action of organs, so does pathological anat- 
omy study the cadaver or the resultant of disease, 
and pathological physiology the manner in which the 
diseased portions performed their functions: or in other 
words shows us how the lesions are allied to each other 
and how they trouble the normal functions of organs. 
With a province and duty so broad, it would seem 
that the necessity for its cultivation would be univer- 
sally recognized. Yet there always have been and still 
are ardent adversaries: minds which cannot bind them- 
selves to study realities, which cannot permit facts to 
present any obstacles to their speculative abstractions. 
As ultra vitalists, they see nothing but morbid func- 
tion, and take no cognizance of the suffering organ; or 
again they seek to depreciate it, in alleging that it es- 
tablishes only effects or results of disease. While this 
is often true, yet have not these very effects their im- 
portance ? And from these lesions carefully studied in 
their different states, may we not deduce the successive 
phases of the malady ? Sometimes, indeed, determine 
the origin and nature ? And does it not become often 
possible so to explain the symptoms, and draw from 
them practical deductions for diagnosis and treatment ? 
Yes: it is not too much to affirm, that a half century of 
studies in pathological anatomy has made greater 
progress in medicine, than ten, fifteen centuries of spec- 11 
ulation upon the nature of diseases, considered at one 
time as atonic, and at another as excess of action. I 
affirm that without its study there is no possible verifi- 
cation of opinion, no means of rectifying one which is 
erroneous. It constitutes the surest foundation of ex- 
perience, in confirming the physician in his apprecia- 
tions, if they are justified; or in correcting, if the results 
show him in the wrong. To-day, the most obscure 
affections are those in which the anatomical lesions are 
least known, or even completely ignored. 
Without the aid of morbid anatomy joined to clin- 
ical observation, what would be our diagnosis of a 
great number of diseases? Percussion and ausculta- 
tion would not be recognized, or at least the phenom- 
ena, obtained by these important aids of diagnosis, 
would be only doubtful signs; the same as oppression, 
pain, cough, &c. The simple recital of some of the 
principal lesions, the history of which has thus been es- 
tablished, may not be profitless. How, without it, could 
simple bronchitis be distinguished from tubercular ? It 
teaches to recognize cancer from chronic ulcer of the 
stomach, having, as they do, many analogies in symp- 
toms, the one of which is however, often curable, and the 
other always mortal. It teaches, also, how tubercles are 
curable in their first period, and in their ulterior phases. 
In revealing the alterations of the kidney in Bright’s 
disease, pathological anatomy has lighted up the causes 
of several forms of general dropsies, and conducted to 
more rational therapeutics. The knowledge of venous 
obstructions explains the mechanism of local dropsies. 
The discovery of blood-clots in the cavities of the heart 
reveals the cause of certain sudden deaths. Arterial 
emboli often explain local gangrene, as also venous 
emboli and thrombi in the pulmonary vessels, give the 
key to those sudden oppressions, often mortal, and until 
this discovery, not understood. 12 
Great as are the benefits it daily renders to the sci- 
ence of medicine, they are equally so to the practice of 
the art, constituting one of its most precious resources. 
A certain malady may, to the vitalist, seem only an en- 
teralgia with trouble of assimilation; but the practi- 
tioner who seeks to penetrate the cause, will recognize 
by the rectal touch, cancer of the intestine. Another, 
following the Hippocratic course, will diagnose a nerv- 
ous dyspnea, while the anatomo-pathologist readily dis- 
covers pleuritic effusion. Indeed, what are all our aids 
of examination, such as the ophthalmoscope, laryngo- 
scope, endoscope, but the study of pathological anatomy 
upon the living organism ? 
Again, how often do we suppose our remedies cured 
a patient, when some accident has demonstrated we 
were entirely wrong? The individual has perhaps died 
suddenly from some other cause, and on examination 
the effect we have attributed to our treatment has evi- 
dently resulted from natural causes. Or how frequently 
has it been shown that mere symptoms are deceptive, 
and that a supposed inflammation is in truth no inflam- 
mation at all ? Investigations carried out in this manner, 
with a true spirit, will lead us to criticize carefully our 
remedies; not, as some assert, induce timidity, but rather 
show the fallacy of violent measures to cut short or 
suppress disease, when its positive detection is liable to 
so many fallacies. 
Still, we cannot fail to recognize that pathological 
anatomy, considered either as a base of scientific inves- 
tigation, or as a resource in the practical application of 
the art of medicine, has its limits, and we should not 
demand of it what it cannot render. We cannot say 
there is lesion, whenever there is sickness, or suffering, 
or functional trouble; or that each morbid symptom 
has for its correlation an anatomical alteration. The 13 
material cause of a functional trouble, may, as in the 
case of impure air, be wholly without the organism. 
Restore pure air, and the disease is cured. 
It often happens, too, that when the most palpable 
material lesions are established, they do not reveal what 
may be really desirable to know of the disease; and 
though they may explain certain functional troubles 
observed during life, at other times we are left in un- 
certainty, or have at best but imperfect notions of the 
different acts in the pathological drama. Or, again, 
the lesion we find, may be, as in the ulceration of 
typhoid fever, but an effect of the disease. But has not 
this resultant of a morbid act in the organism any prac- 
tical value? Neglecting an effect, we may have the 
awakening of a new trouble, in perforation of the in- 
testine. Sometimes the organic trouble ceases, while 
the lesion, the effect of such trouble, remains. Yet it 
is none the less a disease. Fibroid tumors of the uterus 
are the morbid products of a physiological act which 
ceases at middle age. While the fibroid growth may 
not therefore increase, still, it is a foreign body, having 
its importance in the future working of the economy. 
A calculus forms in the bladder, as a result of an alter- 
ation in the constituent properties of the urine. The 
urine may become normal, still the calculus remains, 
and becomes thus the essential cause of disease. 
Still there are morbid states and pathological acts, of 
which corresponding organic modifications are inappre- 
ciable. Pathological anatomy cannot inform us what 
constitutes the herpetic, rheumatic or gouty diathesis; 
nor can it tell us by what mechanism or physical act, 
the fluxion which exists to-day in the knee, shall disap- 
pear, to re-appear to-morrow with the same characters 
in the shoulder or elbow. These and many other in- 
stances which might be multiplied, show us that there 14 
are living forces in the economy which escape the ap- 
preciation of the pathological anatomist. We are forced 
to admit the influence of the vital principle, with its 
intellectual and moral manifestations. This is not of 
the domain of physical science, but our researches must 
always reach this impassable limit. In the condition 
of disease as in that of health, there are troubles of the 
living economy of which the natural sciences can give 
no explanation. 
But granting the vital principle, with its modifica- 
tions from moral and mental conditions, and also 
troubles from functional causes independent of anatom- 
ical lesions, shall we not therefore study where such 
lesions are incontestable ? Besides, who shall say that 
in a number of diseases, where anatomical researches 
have not to this time established a lesion, we shall not 
yet find intimate modifications of structure, which may, 
owing to our imperfect methods of study, have thus 
far escaped our observation ? It is only necessary to 
mention in this connection the train of affections of the 
nervous system, which remain obscure in their changes 
and results, from the want of proper means of study 
of this most delicate of all the structures. 
Thus far the considerations adduced, have related to 
the necessity of the culture of pathological anatomy, 
and the addition it contributes to the sum of positive 
knowledge in the daily experiences of the physician. 
There is, however, in its historical aspect a broader field 
of view, wherein the changes it has wrought, and the 
influence it has exercised upon the other departments 
of medicine can be better appreciated. From a mere 
personal standpoint, one cannot comprehend the results 
it has accomplished, nor realize the vast progress its 
study has given towards placing medicine in the rank 
of a science. We who enjoy the benefits arising from 15 
its study, who receive as axioms the truths it has 
established, knowing of them no doubt nor wavering, 
cannot without this survey, realize the uncertainty and 
ohaos which till its study hung over the medical world. 
As in history, he who attempts to write of current 
events, or in biography of immediate actors, fails in the 
former to appreciate their true philosophy, or in the 
latter to realize the harmonious workings of character, 
from too immediate contact with such events and char- 
acters ; magnifying the one with undue importance, or 
belittling some trait which is allied to the inner springs 
of character: or again, as the dweller on the plain, 
knows not the grandeur and extent of the landscape, 
familiar to those upon the lofty height, being wholly 
absorbed with immediate objects; so must we in order 
to appreciate the scope and influence of pathological 
anatomy upon the progress of medicine, cast aside 
immediate impressions, and seek that time when medi- 
cine groped without its teachings, and when the inge- 
nuity of speculation, replaced the toil of observation. 
Fortunately the dividing line is marked and decided. 
Pathological anatomy is the younger sister in the 
department of medicine. Scarce a century has elapsed 
since its claims were definitely established, and we could 
appropriately recognize on this occasion, the centennial 
of the death of its great founder. Not that medicine 
as a science did not exist before the study of pathologi- 
cal anatomy, since we presuppose its existence by estab- 
lishino; the influence which it has exercised. Theoreti- 
cally speaking, we can scarcely conceive, that the sci- 
ence could have been so called when it ignored the laws 
of organic development, vices of conformation, the 
reproduction of injured parts, the formation of tissues, 
analogous and heterologous to the natural, the existence 
of lacteal and lymphatic vessels, the mechanism of the 16 
•circulation, respiration, secretions, &c. Yet historically 
this is true. Without pathological anatomy, and even 
before its study, medicine existed and showed remarka- 
ble results. Its scientific relations, however, were wholly 
occupied with diseases in their external appearance, in 
the study of their physiognomy. It was the period of 
direct, visible observation, when the tableaux of symp- 
toms shone in all their brightness; a brightness with- 
out penetration, which would substitute the glare and 
glitter of the surface for hidden wealth, unsought and 
so unrevealed. The advent of a new period was an- 
nounced by the study of the concealed or internal phen- 
omena of disease. Such progress, however, does not 
prove the inutility of pathological anatomy, but rather 
that our science is not a dogma; that it was not born, 
grown and developed in a day; that, too, like the or- 
ganic being, the phases of which it studies, it admits 
of evolutions in its growth, even though the lapse be 
centuries. Still a review of the progress of medicine 
up to the middle of the last century, strikes us pain- 
fully to see what obstacles routine, prejudice, and espe- 
cially the pride of systems oppose; here it may be 1 >y 
inertia, there by active violence, the establishment of 
correct principles. Physiology scarcely makes a con- 
cpiest, ere it is turned into ridicule to be forgotten, or 
used it may be to serve as a rallying point around 
which to concentrate all pathology, without inquiring 
whether previous discoveries did not contradict the 
hastily drawn conclusions, or thinking if one point is 
illuminated, many others must still remain in obscurity. 
Thus at one time chemistry was invoked to explain all; 
at another mechanism, or possibly vitalism. Or again 
it was irritability, or it may be stimulation, and even at 
a comparatively recent period, through Broussais, the 
dogma of irritation. It was only when the pure and 17 
solid experimental method, which seeking after truth, 
did not hasten to enunciate law’s, but was content to 
record facts, drawing later from them established prin- 
ciples, was accepted as the basis of scientific research, 
that pathological anatomy took its inception. This 
change was by no means instantaneous. The mind 
like the body requires cycles for its evolution, and the 
germs of a principle are traced far back of its full 
development. In reviewing then, the philosophical 
spirit of the earlier and middle parts of the last century 
we find it markedly skeptical and materialistic; elements, 
both of which are absolutely essential for scientific 
growth. The human mind was heartily sick of the 
vague and profitless speculation upon generalities. 
Though, through the labors of Morgagni, this branch 
of study took at one step its scientific relations, still 
the student can see a slow, but sure shaping for this 
method of study. Bacon and Descartes, each in their 
respective spheres had revolutionized the world of 
thought. The former taking for guide in the study of 
natural science, observation, experimentation, and induc- 
tion, traced the method which assured immense pro- 
gress to the natural sciences, conducting Harvey, Gal- 
vani and Newton to their splendid discoveries: while 
the latter, in the domain of philosophy and abstract 
science, no less effectually broke the shackles which the 
force of ages had riveted on the mind, by admitting noth- 
ing except what was demonstrated by reason and ex- 
perience. 
To Morgagni, of Italy, then, belongs the credit, but 
little more than a century since, of laying the founda- 
tion of scientific pathological anatomy. While in the 
writings of his immediate predecessors and teachers, 
Malpighii, Albertini, and Valsalva, we notice the glim- 
merings of the truth soon to be established by him, yet 18 
lie it was, who by patient toil demonstrated the clinical 
relations of disease with their precise appearances after 
death. His life is a remarkable example of brilliant 
genius and untiring perseverance which ripened in the 
wisdom of maturity. What a lesson to the sunshine 
workers of our profession ! 
While yet a youth he excites the admiration of the 
illustrious savans who were his teachers. A doctor in 
medicine and philosophy at nineteen, he became prosec- 
tor to Valsalva, and filled the chair during the absence 
of his principal. When twenty-four years of age, he 
published his work, “Adversaria Anatomica,” and so 
placed himself in the front rank among anatomists. 
Far from being elated with his precocious success, he 
did not cease to instruct himself. Though occupied 
ardently with comparative anatomy and chemistry, he 
did not in the mean time neglect the practice of medi- 
cine. When too, we consider the enormous amount of 
material disposed of by Morgagni, we cannot but ad- 
mire the wisdom he showed in burying those treasures 
during all his long career, in order not to give them to 
the public until he arrived at an advanced age, being 
almost an octogenarian. His immortal work written in 
the latter part of his life, “ On the Seat and Causes of 
Diseases,” is based upon the examination of more than 
six hundred cadaver; a number, considerable at all 
times, enormous for .the epoch in which he lived. He 
joined to his own materials those which had been com- 
municated to him by Valsalva, and those that he found 
in his manuscripts. But all the documents the works 
of his predecessors furnished, and even those of his 
master, lose in their importance, and disappear, before 
the extent of his own researches. For the first time is 
seen a man grave and severe, separating himself from 
the anatomo-pathologists of the times, who were always 19 
seekingfor the wonderful, and occupying himself with the 
most elementary questions. His anatomical descrip- 
tions are made with an exactitude unknown up to his 
time. As often as the documents he possesses permits, 
he confronts the symptoms observed during life with 
the results of post mortem examinations. He avoided, 
as far as possible, generalities, and confined himself to 
the recital of facts. And may we not wonder that the 
founder of scientific pathological anatomy did so much 
with so great impartiality. No higher compliment can 
be paid to his memory, than the words of Cruveilhier, 
applying to him the cognomen of his great cotempo- 
rary, “ Haller of pathological anatomy.” 
It is not proposed in the limits of a discourse, to re- 
cite the progress made in the study of pathological 
anatomy from Morgagni onward. Yet historically it 
has a great interest. How its study, passing from Italy 
beyond the Alps, found a ready acceptance in the med- 
ical mind from the experimental bias at the time given 
by Haller to physiological studies. Holland, then as 
celebrated for her scholars, as she had been for the nur- 
ture and the growth of the principles of civil and reli- 
gious liberty, cherished the infancy of the science during 
the stormy days of the French revolution, and the early 
wars of Napoleon. And when at length, after a series 
of wars running through a whole generation, France, 
though humbled, yet masculine from the hardihood of 
her efforts, again sought in the pursuits of peace an em- 
ulation for scientific studies, and employment for her 
genius, we find coming forth that wonderful school of 
pathologists, whose labors and writings have been the 
admiration and study of most of those before me; very 
household gods to the plodding worker in this field of 
research. The names of Desault, Bichat, Corvisart, 
Dupuytren, Cruveilhier, Andral, Louis, Ac., occur at 20 
once as examples of this untiring and persevering 
school. England, though later in the field, was not in 
different to the impulse, and her literature shows many 
noble proofs of pains-taking and careful research. 
While, however, it may not be permitted to follow 
out, step by step, the progress made in pathological re- 
searches, still, it is appropriate to study the influence 
which its active cultivation exercised upon the science of 
medicine, and also the impress, still distinct, with which 
previous systems in turn biased the direction and char- 
acter of investigations. 
The cultivation of pathological anatomy represents, 
in the history of medicine, its logical development as a 
science. Though its rise was, as we have said, by no 
means sudden and unpremeditated, but due to the spirit 
of experimentation which arose in the sixteenth cen- 
tury, still up to this period, observation was confined 
almost wholly to external phenomena, visible to the 
eye. Pathological anatomy opened the study of inner 
parts, and was thus enabled to give the brilliant symp- 
tomatology of Hippocrates a scientific basis, which the 
dogmatism and empiricism arising from partial systems 
had failed to contribute. Indeed, looking to the past 
with the light now afforded, it was these premature 
efforts to construct systems, which for so many centu- 
ries kept medicine debased in its scientific relations. If 
the reserve of Hippocrates had not been discarded by 
his successors; if for the rational and experimental ba- 
sis upon which he fixed the art of medicine, they had 
not substituted the premature attempts of a scientific 
organization, then impracticable, perhaps the destinies 
of medicine, better favored, would have been spared the 
immense detour, and the long parenthesis of twenty- 
two centuries before reaching Morgagni; floating, with- 
out cessation, during this long interval between in- 21 
complete and fallacious observation ; between the Hip- 
pocratic doctrine, continued by tradition but obscured 
by systems, good perhaps, but insufficient, and the at- 
tempts at scientific organization even worse, because of 
their arbitrary character. To the premature efforts at 
systemization, the most brilliant and useful discoveries 
were nugatory and profitless, since they failed to con- 
form to the reigning hypothesis. 
While the study of pathological anatomy contribu- 
ted much to the position of medicine as a science, its 
influence was no less marked in giving renewed im- 
pulse, and harmonizing previous labors in the different 
departments of medicine. Acting as a central study, 
around which grouped, irresistibly, facts from other de- 
partments, it served as a rallying point for observers. 
Previously each arm of medical science, isolated in 
its speciality, had, for others, only distant relations. 
Anatomy, for example, had scarcely any alliance with 
pathology and therapeutics. Physiology was, so to 
speak, a stranger to the other two. While they might 
be called pieces of a grand whole, their relation was 
that of juxtaposition rather than combination. 
Not less evident also was its effect upon the natural 
sciences; for as soon as some of the laws of abnormal 
development were discovered, it was recognized that 
these should be studied in the immense sphere of their 
activity. Such study alone, by an elevated generaliza- 
tion, could start from the quiet contemplation of phe- 
nomena, and extend the application to the utmost limit of 
creation, in discovering the laws which preside in all 
vital irregularities. This generalization of principles 
brought in closer alliance the different branches of sci- 
ence; and these, in turn, acquiring extent by researches, 
and unity by analogy, became animated by a new phil- 
osophic spirit. There seemed to have been something 22 
which acted as a germ to this common fusion and fruit- 
ful renovation. That germ was that it compelled the 
examination of nature herself for supposed facts; and 
we find the literature of the period, when these re- 
searches were the most active, almost exclusively occu- 
pied by such discoveries. Few works were published 
but were inspired by such researches, and few authors 
but were compelled to discuss and analyze them. Path- 
ological anatomy became thus another link in the 
fusion of the sciences; and if on the one hand it har- 
monized medical observations, it was at the same time 
the common union of all biological studies. 
So too, was its influence happy in harmonizing and 
establishing many isolated truths of the ancients: truths 
which long observation and experience had established, 
but which lacking a common bond of unity, had floated 
with the caprices of dominant systems, and lost to a 
great degree their significance and their force. Organic 
studies then, by establishing an alliance between tradi- 
tion and new discoveries, and making of modern medicine 
a science, which disregarded nothing in its past annals, 
which sought truth through all systems, but which, pro- 
gressive since it had experimentation for guide, served 
as an active principle to renew quietly all parts, with- 
out at the same time disturbing the unity; differing 
widely in this respect from all past systems, which 
from exclusive immobility could neither allow addition 
nor subtraction. 
Another result emanating from organic studies, was 
that it enlarged and is enlarging the field of experi- 
mentation. Previous to their cultivation this method 
of investigation had been confined almost wholly to the 
verification of normal acts in the economy. The first 
impulse was to increase studies of this nature, but we 
soon find the disposition apparent to imitate artificially 23 
phenomena, of which physiological acts gave no ex- 
planation. Art attempted to a certain point to group 
all the conditions and circumstances requisite to study 
a given fact; for to wait upon the manifestations of na- 
ture alone, would ill satisfy the impatience of eager 
investigation. Nature rarely arranges them in an order 
suited to the necessities of our mental capacities, and 
though she follows in her works a regular and deter- 
minate march, this path is oftentimes followed so slowly, 
and by so many circuits, that the observer does not 
seize the relations of phenomena so distant from each 
other; or it may be when the phenomena arrive with- 
out previous intimation to the observer, he is taken un- 
awares, or ill prepared for their examination; though 
the intelligence is competent when he can govern such 
conditions. Experimentation then, to a great degree 
suggested by pathological anatomy, has since been most 
assiduously cultivated, and we find in all the large 
centres of medical instruction special facilities for its 
encouragement, and the dissemination of its teachings. 
There is still another interesting feature connected 
with the development of pathological studies. How- 
ever much it materially aided the scientific status of 
medicine, may have stimulated research in other depart- 
ments, and enlarged the field of experimentation, it was 
itself fettered by traditions of the past, and must needs 
pass by turns, modified it is true by its own reflected 
light, through the different systems which had for so 
long a period governed medical thought. These sys- 
tems, no matter what for the moment was the accepted 
belief, were always based upon the primary notions 
either of solidism, humoralism or vitalism. Nor was 
it strange that in organic studies it should follow a sim- 
ilar cycle. For the attention of anatomo-pathologists 
was first naturally directed to those alterations, surgi- 24 
cal in character, because external, having reference to 
the changes of form, volume and relations of organs: 
when observation was directed internally, it was only 
to such lesions as were striking and extraordinary, as 
cancerous tumors, biliary or vesical calculi. Investi- 
gation was prompted to determine the seat of dis- 
ease. Solidism was then the first fruit of the study 
of pathological anatomy, and marked the period of 
Morgagni in pathology, and Haller in physiology; the 
latter carrying the idea to the extent, that he expected 
to find the cause of organic formations in the solids of 
the embryo. It continued through the century to 
Laennec and Dupuytren, forming as they did a nosolog- 
ical classification upon this theory. Bichat, it is true 
made an advanced step, in studying not the diseased or- 
gans, but rather their component tissues; and while he 
and later writers recognize to a degree the importance 
of the liquids, still the study of alterations of the solids, 
was more or less the principal end of science. We 
can then safely assert that pathological anatomy at its 
commencement was wholly solidist. 
Investigation could not long remain satisfied with 
such barren results. The cause of disease must also be 
determined and for this purpose the fluids as well as 
the solids were to be examined. Andral, in 1825, gave 
an undoubted impulse to this direction of study. His 
'‘'‘Clinique is a work of science and con- 
science, to which medicine is indebted for many new 
truths, and the revival of many forgotten precepts from 
classical antiquity. A few years later, another eminent 
pathologist wrote : “The more we study diseases, the 
more we attempt to determine their immediate seat,, 
the more we are forced to regard the liquids as the 
vehicle of many morbid causes.” The insufficiency of 
the solids, then led to the study of the liquids, as the 25 
insufficiency of the seat led to the study of the cause. 
The inarch of every science is the same. There is a pro- 
gressive law of doctrines, and morbid anatomy could 
only reach its position in pathology, by traversing the 
grand systematic ideas which had ever been upon the 
medical horizon. From humoralism, to complete the 
circle, the step was but short to vitalism. It was not, 
however, the vitalism of the ancients, which in its ex- 
clusiveness ignored all other causes; nor was it again 
the superstitious vitalism of Van-Helmont, or the theo- 
logical of Stahl; but a renewed vitalism, founded on 
bases which recognized not only the attendants of 
solids and liquids, but also the modifications of forces; 
and which recognizing the analogies with the general 
forces of nature, proclaimed also their differences. It 
was not a vitalism depending upon external influences, 
but of the organism itself, interwoven with every or- 
gan and tissue. Vitalism, thus understood, was the 
legitimate expression of that period of the study of 
morbid anatomy when unaided vision and chemical 
analysis had exhausted research, and when vast orders 
of morbid phenomena must be ascribed to vital force. 
“ It took cognizance of everything specific, peculiar, or 
proper to the living being ; of everything which not 
being discovered by the sight, nor the touch, nor any 
external sense, is not directly observable. It consisted 
in the study and acquaintance of the acts and condi- 
tions of the forces which work in the individual sleep- 
ing or waking ; which characterize his individuality in 
the thousand and one modifications of race, of consti- 
tution, of temperament, of idiosyncrasies; in the infi- 
nite variety of diseases, not less than in their period- 
icity, which it governs by a pre-established harmony.” 
In this connection it is interesting to notice by what 
a long and painful route anatomo-pathologists confirm 26 
the aphorism of Hipprocrates. “ That we must consider 
in man, not only the solids and liquids, but especially 
the active powers, or that which gave them movement.” 
Commencing then in solidism, organic science finished 
with vitalism, while Hipprocrates, commencing in vital- 
ism ended in the course of centuries by associating 
organic study, proving at once the failure of any indi- 
vidual theory, and the necessity of reciprocal influence. 
For a period of forty years from the commencement 
of the present century, France maintained a pre-emi- 
nence for labors and researches in pathological anatomy, 
and the literature of the subject during that whole period 
can be consulted best among writers of that country. 
All that patient toil, clinical observation, and chemical 
analysis could demonstrate, was chiefly elucidated by 
them. Who that has read the classic productions of 
Bichat, Laennec, Andral and Cruveilhier, but will 
cheerfully acknowledge the debt of gratitude which the 
profession owe to their works of toil and genius? With 
them pathological anatomy completed its first era. 
Vast as were the accumulation of facts, philosophical 
and accurate as were their deductions, still we are 
forced to admit that the study presented little more 
claims for scientific recognition, than did that of as- 
tronomy when Galileo made use of the telescope ; for in 
neither had the inner laws of force and motion been 
developed. Unaided vision had to this time wrought 
both in healthy and morbid tissue all that could be ac- 
complished. It was reserved for another people to 
bring to the aid of investigation, mechanical appli- 
ances, and a philosophic spirit of research, which to-day 
makes histological pathology rank high in the pyramid 
of science. The German mind was wonderfully adapted 
to the class of labor which devolved upon it. The bril- 
liancy and eclat of the subject, its precise clinical 27 
relations and large generalizations, had been nearly 
exhausted by the French. Minute and patient toil 
must replace striking clinical demonstration. Order, 
method, analysis, must come forth from the chaotic 
mass which artificial aid brought to bear upon its study. 
In a word, another era was opening. Previous to the 
cultivation of pathological anatomy, the theories of the 
laboratory explained the seat and causes of diseases; 
subsequent to Morgagni, and up to the period to which 
we refer, clinical observation had completed her almost 
perfect work. For who shall describe with greater ac- 
curacy and fidelity than Andral and Cruveilhier? Who 
more methodically than Louis ? How much advance 
upon the auscultation of Laennec, the percussion of 
Piorry, the cardiac murmurs of Bouilland ? Bichat had 
carried the analysis of tissue as far as the eye and 
analogy would permit. Modifications of situation, of 
dimension, of weight, of form, of color, consistences, in- 
ternal and external aspect, constituted under such con- 
ditions the limit of the study. Though such modifica- 
tions are of extreme importance, yet they cannot reveal 
the profound microscopic and chemical alterations, com- 
prised in the texture, structure, and composition of 
parts. Its study must again return to the laboratory; 
not however, as before, for profitless speculation, but to 
call the chemical and mechanical aids which would 
carry investigation to its last analysis. 
Not that our immediate predecessors did not vividly 
feel the importance of such ultimate research. They 
accomplished with their means all in their power. 
Even when the microscope was introduced as a recog- 
nized aid to study, there were physicians blinded, it 
may be by prejudice, or bewildered by the immense 
number of new details introduced into the study of 
pathological anatomy, who declared that such researches 28 
were almost wholly, if not entirely worthless. We 
blush to say that even at the present day, one may oc- 
casionally be heard to raise the voice of ridicule. And 
yet is it not closing one’s eyes to the light ? Is it not 
declaring one’s self deliberately unjust or notoriously 
ignorant ? Pathological histology has had and still has, 
the same as normal histology, its obscurities, its fluctua- 
tions, the necessity to retrace its steps. It is the his- 
tory of every difficult science during its period of 
evolution. But who can deny that many questions in 
pathological anatomy have been definitively illuminated 
by the intervention of the microscope ? Who can deny 
that this intervention has dissipated uncertainty upon 
many points, and contrary even to what was formerly 
its reproach, rendered more simple and easy the study 
of numerous lesions? Nor are they among the rarer 
forms, but those of daily occurrence. 
The microscopic impulse spread with wonderful ra- 
pidity. Investigators were found on every hand, claim- 
ing through its use to penetrate the utmost mysteries of 
nature; enunciating generalizations and laws which 
subsequent researches showed to be untenable. The 
reaction which followed, threw, for a season, discredit 
on this class of researches. In this, however, the new 
era presented no exception to what experience and daily 
observation point us in the world of business as well 
as that of science. The establishment of any successful 
enterprize draws to its labors all restless, fitful work- 
ers, who, for a season, give a false glamour and obscure 
the real progress of the earnest worker. While the 
history of microscopic research is cotemporary and fa- 
miliar to most of my auditors, still a concise review of 
its growth is necessary to the elaboration of the subject 
under discussion. The ardor for minute research was 
first noticed in the department of physiolgy, and the 29 
names of Schultze, Purkinje, Valentin, Wagner and 
Muller should he especially mentioned for their histo- 
logical labors at this period. In them, and particularly 
in the writings of Valentin, we find the first traces of 
cell doctrines, or the recognition of cells as the basis of 
all organic forms. He does not, however establish the 
nucleus as the fundamental expression. About 1838, 
Schleiden and Schwann were simultaneously engaged 
in studies, the former upon vegetable, the latter upon 
animal tissues. Schleiden first described in a clear 
and definite way the formation of cells in vegetable 
structure according to a single and uniform method. 
Schwann catching the unity of plan, applied it to ani- 
mal tissues, and by the adoption of the nucleated cell 
as the elementary form, gave an individuality and vital- 
ity to the anatomical details then collected. He caught 
the first glimpses of a truth, which, although it then 
needed verification, was soon to be recognized as the 
grandest in physiological science. Though this truth 
was speedily verified and accepted in the physiological 
world, and histology built upon it the sure founda- 
tions of a science, pathologists were comparatively slow 
in grouping about this genesis, the many and varied 
formations and fluids which constantly claimed their 
attention. Yet it seems self-evident that the growth of 
normal histology, and its relations to physiology, in- 
volved, as a necessary sequence, the same relations of 
pathological histology to pathological anatomy. This 
sequence now so natural, required years to ‘effect. The 
first efforts in pathological histology were directed to 
the study of certain secretions or exudations, and while 
for nearly fifteen years great industry and perseverance 
were shown, and many isolated facts collected, there was 
no central idea to guide or direct observation. It was 
still the principle of Bichat with reference to anatomy, 30 
■studying disease by tissues, only carrying investigation 
far more minute by the use of microscopic and chemi- 
kcal aids. The writings of Gluge, Hasse, Vogel, Wedl, 
though constantly mentioning the presence of the cell 
in the composition of morbid humors and tissues, fail to 
recognize the unity of plan which had found full ac- 
ceptance in physiology. Even the grand and almost 
incomparable work of Rokitansky, which, for faithful 
description and a generalization based upon the largest 
experience, must ever make it classic, enters but little 
into the minute structure of tissue, or the unity of the 
great law soon to absorb the pathological mind. 
We cannot of course in our restricted limits trace the 
collateral workings of this idea. While distinguished 
names are noticeable in England and France; in the 
former Bennett, Paget, Todd and Bowman, in the latter 
Donne, Robin and many others; still the German mind, 
then as now, led in all researches demanding patient 
toil and close analysis. 
Pathological histology had still to overcome world- 
long prejudices. Probably no barrier was more in- 
strumental in retarding the recognition of the cell as 
the initial point in pathology, than the thraldom and 
prejudices, which systems had so long wove around it. 
Much of the last century was passed in arranging and 
re-arranging the classification of diseases. Even dur- 
ing the present, many leading minds have found their 
chief glory in creating a system of pathology, passing 
from artificial to natural systems. None had, however, 
constructed one which could be termed scientific, and 
be accepted as a basis by all physicians. Before a new 
era could be fully developed, an emancipation must be 
attained from these systems, and classification in disease 
must not be deemed essential. Dogmas in every science 
are the same; when established they are the expression 31 
of general conviction, and become after a time chains' 
which hinder the ulterior development of thought. 
After years of toil and labor, Virchow comprehended 
this position. In renouncing all attempts to create a 
system, he was disembarrassed from the last chains of 
dogmatism. In reducing disease to its cell life, he could 
reject the principal theory which governed science, ren- 
dering classification necessary, viz.: the unity of diseases;' 
the idea that each malady, constituted, so to speak, a 
being apart, a particular form of existence, which pene- 
trated into the economy as a foreign body, and which 
should thus be maintained along with the sound parts.. 
Disease and life are now no longer regarded as twa 
things marching together; on the contrary, the true 
material existence is found in the cells, the elements of 
the body. 
Fifteen years have not elapsed since Virchow, in a 
series of lectures gave the results of his studies to the 
medical world, and now the doctrine of cellular pathol- 
ogy is universally regarded as the basis from which all 
morbid manifestations must be studied. Later investi- 
gations have modified some of the details of Virchow1® 
teachings. These relate chiefly to the genesis of the- 
cell proper, its physical and chemical characters, and. 
the many and varied vital phenomena which originate 
in it. Such differences of opinion in no way invalidate 
the fundamental principle of the doctrine. The dogma- 
is accepted that organic life, vegetable or animal, pre- 
sents as last analysis a particular element, possessing 
always common characters, viz., the cell, characterized 
by the nucleus, the nucleolus, the contents and envelop- 
ing membrane. The presence of each of these elements 
is necessary to constitute a living cell, and from it all- 
tissues of the organism are formed. Virchow following 
this accepted truth in relation to the normal condition 32 
of tissues, has shown that it is equally applicable to 
pathological productions. His words are, “ that every 
pathological production has its analogy in physiological 
formations. The elements of every pathological forma- 
tion resemble and may be compared to normal elements 
preexisting in the economy.” 
Discarding the idea of the specific character of cer- 
tain morbid products, he further says “we shall always 
find a physiological process resembling the march of 
pathological neoplasms, and admitting of similar classi- 
fication. Certain pathological productions are com- 
posed exclusively of cells, as epithelial tissue; or again, 
those analogous to conjunctive tissue, which besides the 
cell elements, contain also more or less conjunctive tissue; 
or there is a third group of morbid tissues, resembling 
the higher order of organizations, as blood, muscles, 
nerves, &c. Most morbid organizations belong to the 
first two classes.” 
From considerations upon the structure of organiza- 
tions, he passes to that of function. “ Every living ele- 
ment of the human body responds to an excitation in 
manifesting its activity. This activity is awakened for 
three different reasons: for the performance of function, 
of nourishment, and of increase. Hence arise three 
sorts of irritation: that which augments the organic func- 
tion; that which accompanies an exaggeration of nu- 
trition ; and that which causes the formation of new 
parts.” 
On the other hand beside these inflammatory processes 
in which the cells are active, Virchow studies a series of 
alterations which he calls passive. In this latter form 
the elements may be completely destroyed, as in fatty 
and amyloid degenerations, or be deprived in a great 
degree of their activity. Even in these destructive 
forms he demonstrates physiological analogies. The 33 
normal types of these pathological evolutions, are found 
in the normal secretions of the sebaceous glands of the 
skin, in colostrum, and the corpora lutea of the ovary. 
Hereafter the studies of normal and pathological his- 
tology are indissolubly connected. Starting with the 
cell as a common initial element, pathology must study 
it, in its aberrations, based upon an intimate knowledge 
of its normal characters. Simple as it may seem in 
principle, yet these aberrations are as infinite and varied 
as are the forms and intermingling of normal structure. 
Nor are these revelations made to the indifferent or in- 
experienced observer. To discover them requires, in 
most instances, the most delicate manipulation and tact 
in the use of optical appliances, as well as the many 
chemical and physical accessories to prepare structures 
for careful examination. The stimulus for minute re- 
search has carried mechanical and optical refinements 
to the most elaborate scientific formulas. Within a 
comparatively recent period, the “ immersion” lens, by 
lessening very much the refractive power of light upon 
the polished surface of the lens, has aided much both in 
illumination, and penetrating power in the examination 
of objects. 
It is this special tact and education, together with the 
time requisite for the various manipulations, which have 
thus far acted as serious hindrances to the spread and 
general acceptance of cellular pathology. The want too 
of these has furnished the ready sneer for the cynics in 
medicine, that one could see whatever he pleased, 
since there was no way of verifying what was only 
cognizant to the individual observer. It created, so 
to speak, an aristocracy in this field of study ; and how- 
ever desirous one might feel to verify in his own re- 
searches the truth or falsity of certain descriptions, such 
verification was impossible, from the barriers which the 34 
subject itself presented. The student must, in most 
cases, be content with the imperfect representations 
which an observer’s drawings had furnished. The in- 
terests of science, however, cannot brook such an obsta- 
cle. She has too many resources, readily available, by 
which this exclusiveness can be overcome. The bonds 
of union between different departments of science are 
too intimate, and interlaced by too many affinities to 
allow any one to fail from want of support. Wherein 
the microscope cannot popularize, photography must 
come to its aid, and so perfectly has she already been 
taught, that the image produced is, in many respects, 
superior to that which direct microscopic observation 
reveals. Hereafter, tissue or structure shall be its own 
delineator. No imperfect description, no vivid imagin- 
ation, no overwrought theory shall affect the truth of 
representation. It is a wonderful triumph of art. Tis- 
sues, requiring the magnifying power of one thousand 
diameters, are printed of any size, with all the distinct- 
ness and vividness of outline, which the most skillful 
and delicate manifestations can give to the eye of the 
observer. 
This popularization, so to speak, of the most hidden 
and minute recesses of nature, is due to the labors of 
one of our own countrymen. Very properly, too, it orig- 
inated in that grand museum at Washington, formed and 
nurtured under the auspices of the Surgeon General of 
the army, becoming not only the depository of the 
large experience of our late war, but returning to the 
profession at large practical benefits, the value of which 
cannot be estimated. 
The experiments in photographing by artificial lights, 
either electric, magnesian, or oxy-calcium, of microscopic 
objects under great magnifying power, has first been 
performed by Dr. J. J. Woodward, of the United States 35 
army. His success has been all that the most ardent 1 
student could desire. Not only do his own observa- 
tions verify those of Cohnheim upon the histology of 
minute blood vessels, but by a series of photographs, 
are delineated, not only the epithelial cells of the capil- 
laries with their nuclei, but also the stomata between 
these cells, said to give exit to the white corpuscles. 
The bearing of these facts upon the theory of inflamma- 
tion, is familiar to those who have followed the discus- 
sions based upon these discoveries. I regard the practical 
exemplification which these photographs furnish as the 
most positive claim which pathological anatomy has thus 
far presented for scientific recognition. Our studies at 
once become more interesting and personal, for we know 
that we reason from the same premises, study the same 
tissue, which was once the exclusive favor of some skill- 
ful observer. The property of one has become the 
common property of all. Let us hope that the ingenu- 
ity of the gentleman who has so far perfected his me- 
chanical appliances, may be further encouraged in his 
large field of labor. We recognize that he has estab- 
lished an era in the study of pathological anatomy, 
equivalent to that which marked the application of the 
microscope as a means of research. 
It must not be understood from the tenor of the fore- 
going remarks, that histological pathology can or will 
replace studies in clinical medicine. The vast array of 
facts which this latter has already afforded to the pyra- 
mid of positive medicine are too valuable to be dis- 
carded or forgotten. Rather does pathological histology 
perfect the symmetry, fill in the many interstices, and 
give harmony and symmetry to the structure. 
I have thus hurriedly, and necessarily, imperfectly, re- 
viewed the past and the present of pathological anat- 
omy. No attempt has been made to consider its special 36 
relations to tissues, or the different forms of heterolo- 
gous growths, for the literature of these subjects is 
ample and accessible.* I have rather traced the growth 
of that idea which originating but a century since, 
when medicine had scarcely made any material advance 
in the twenty-two centuries which had elapsed since 
the wonderful symptomatology of Hippocrates, has 
since advanced with marvellous strides, and already 
lays a claim of exactitude among the sciences. Patho- 
logical anatomy can no longer remain a secondary 
chapter in the study of pathology, but calling to its 
aid all the resources of art and science it must take a 
first position. “ It must in studying alterations go back 
to their origin, determine the producing cause, the 
modes of termination, elucidate the methods of spon- 
taneous cure, signalize the resources of art. Interroga- 
ting morbid phenomena, it will not separate organs one 
from another, but comprehending all changes, in their 
connections and reciprocal influences, it will always 
have in view the entire organism, recognizing at the 
same time all the physical and moral conditions peculiar 
to the patient. Studied thus, it will become more and 
more a science full of interest, furnishing for the art of 
medicine most useful aid, and constituting a most pow- 
erful auxiliary to its practice.”