Microscopic Examinations 
of 
blood; 
AND 
VEGETATIONS FOUND IN VARIOLA, 
VACCINA, AND TYPHOID FEVER. 
BY J. H . SALISBURY, M . D . 
•X' e vo $) o r k : 
MOORHEAD, BOND & CO., PRINTERS. 
1868. Entered according to Act of Congress, in the year 1868, by J. H. Salisbury, M.D., 
in the Clerk’s Office of the District Court of the United States for 
the Southern District of New York. CONTENTS. 
I. 
MICROSCOPIC EXAMINATION OF THE BLOOD. 
What to look for in Blood Examinations. Proportion 
and Condition of the Cell Elements of the Blood, and 
the Knowledge to be gained by observing careiullx i he 
Manner in which they arrange and comport themselves 
BETWEEN THE SLIDES OF THE MICROSCOPE. ABNORMAL BODIES 
and Forms in the Blood that act as Specific Causes of 
Grave Pathological Derangements and Lesions. Con- 
dition, Appearance, and Arrangement of the Fibrin 
Filaments of the Blood in Health and Disease. Valua- 
ble Means of Diagnosticating certain Pathological 
States of the System. The Fibrin in Health. The Fi- 
brin in Rheumatism. The Fibrin in Pulmonary Tuber- 
culosis. The Fibrin in Anjemia. The Appearance and 
Condition of the Fibrin and other Blood Elements 
where there is a Tendency to the Formation of Thrombi 
and Emboli . • • • • • • Pp. 7 to 24 IV 
Contents. 
II. 
THE BLOOD DISC. 
A Vehicle for Transmitting Nerve Food. Cholesterine and 
other Crystalline Matters in the Healthy Blood Disc, 
AND IN AND OUT OF IT IN CERTAIN FORMS OF DlSEASE. READY* 
Means for Diagnosticating Conditions. 
Cryptogamic Vegetations that are in both Healthy and 
Diseased Blood ; with a brief Description of the Crypta 
Carbunculata, and Zymotosis Escularis . Pp. 25 to 43 
III. 
VEGETATION OF VARIOLA. 
Description of a New Vegetation, having Fungoid and Algoid 
Phases of Growth, found in the Blood and Eruptions 
of Variola and Vaccina ; and which appears to be the 
Specific Cause of these Diseases. Ios Variolosa Vacciola. 
Ios Vacciola. Leptothrix Buccalis. Persi- 
ca. Milk Fungus. Description of Plate . . Pp. 45 to 58 
IV. 
VEGETATION IN TYPHOID FEVER, 
Which appears to be the Specific Cause of the Disease ; with 
some General Remarks on the Treatment of Typhoid, 
Intermittent, and Remittent Fevers. Description of 
Illustrations Pp, 59 to 67 Microscopic Examination 
OF 
The Blood. MICROSCOPIC EXAMINATION 
O F 
THE BLOOD. 
What to look for in Blood Examinations. Proportion and Con- 
dition of the Cell Elements of the Blood, and the knowl- 
edge TO BE GAINED BY OBSERVING CAREFULLY THE MANNER IN 
WHICH THEY ARRANGE AND COMPORT THEMSELVES BETWEEN THE 
Slides of the Microscope. 
Abnormal Bodies and Forms in the Blood that act as Specific 
Causes of Grave Pathological Derangements and Lesions. 
Condition, Appearance, and Arrangement of the Fibrin Fila- 
ments of the Blood, in Health and Disease. Valuable means 
of Diagnosticating certain Pathological States of the Sys- 
tem. The Fibrin in Health. The Fibrin in Rheumatism. 
The Fibrin in Pulmonary Tuberculosis. The Fibrin in An- 
xMia. The Appearance and Condition of the Fibrin, and 
other Blood Elements, where there is a tendency to the 
Formation of Thrombi and Emboli. 
It has now been over eight years since I commenced 
the microscopic examination of blood, with the view of 
arriving at positive pathological conditions, etc., in this 
fluid in disease. These examinations have been con- 
ducted with great care and patience; being often repeat- 
ed at short intervals in the same case, in order to watch 
the successive changes brought about by treatment, and 
to confirm previous observations. 8 
What to Look for 
In this work of labor, I have already made over 
thirty-five thousand individual examinations. In all 
the more important of these, I have made careful draw- 
ings of the abnormal appearances and bodies present; 
and noted minutely the pathological conditions, and 
the attendant symptoms and lesions. 
This paper is a brief summary of a portion of this 
labor. It is with much hesitation that it is presented 
in this incomplete condition. It was my intention, be- 
fore saying publicly anything, to work quietly on, and 
spend much more time in labors so interesting to me, 
and that have aided me so much in treating disease; but 
a few learned gentlemen, who have taken great interest 
in the inquiries, have earnestly requested that they be 
published, so that others might commence and extend, 
investigations in the same direction. 
To obtain the blood, a clean puncture or cut is made, 
in any part of the body desired, the surface being pre- 
viously carefully cleaned. The wound should be large 
enough to allow the free and immediate escape of a drop 
on slight pressure. The blood at once is transferred 
to the slide, then quickly covered with thin glass, and 
placed under the microscope. By a little experience, it 
may be under observation in one second from the time 
it leaves the blood stream. 
WHAT TO LOOK FOR -IN BLOOD EXAMINATIONS. 
Blood examinations, to be of value in diagnosis, must 
be made with great care. There is not one microscope 
in fifty, of those in present use, that is suited for this 
kind of study. They lack in definition, and often in 
not being sufficiently achromatic. in Blood Examinations. 
9 
A drop of blood may frequently be explored for an 
hour or more with profit. If the case is obscure, and 
the first drop examined fails to throw light, explore an- 
other carefully. If you still fail, continue the search 
till you are perfectly satisfied that the cause is to be 
sought for somewhere else. Often much may be learned 
by allowing the blood to stand for from a few hours to 
two or three days between the slides, watching from 
time to time the successive changes taking place during 
the process of drying. These changes, compared with 
those taking place, under similar circumstances, in 
healthy blood, often throw valuable light upon certain 
peculiarities of the case. 
The following is a list in detail of some of the con- 
ditions, states, and pathological products to be sought, 
for in blood : 
1. Color of blood to the unaided eye and under the microscope. 
2. Consistence of the blood. 
3. Rapidity of clotting. 
4. Serum in normal proportion. 
5. Colored corpuscles in normal proportion. 
6. Colorless corpuscles in normal proportion. 
7. Fibrin in normal proportion. 
8. Serum in too small quantity. 
9. Colored corpuscles in too small quantity. 
10. Colorless corpuscles in too small quantity. 
11. Fibrin in too small quantity. 
12. Serum in too large proportion. 
13. Colored corpuscles in too large proportion. 
14. Colorless corpuscles in too large proportion. 
1 5. Fibrin in too large proportion. 
16. Colored corpuscles of normal consistence. 
17. Colored corpuscles too soft, plastic and sticky, adhering together 
and being drawn out into thread-like prolongations as they separate. 
18. Colorless corpuscles, normal in quantity, but so sticky and plas- 10 
JVhat to Look for 
tic that they adhere together in masses, endangering the formation of 
thrombi and emboli. 
19. Fibrin meshes normal in size and arrangement, allowing blood 
cells to freely circulate through them. 
20. Fibrin meshes too small to allow blood cells to freely flow 
through them, on account of which the blood cells arrange themselves 
in ropy rows, or ridges and masses, being held in the meshes of the 
partially clotted or contracted fibrin. In such cases the individual fib- 
rin filaments are increased in diameter and opacity. 
zi. Colored corpuscles arrange themselves in nummulated piles. 
22. Colored corpuscles have little or no tendency to arrange them- 
selves in nummulated piles. 
23. Colorless corpuscles, many of them ragged, partially broken 
down, and more or less curled and twisted and wrinkled. 
24. No tendency of the blood discs to arrange themselves in num- 
mulated piles; but remaining evenly and loosely scattered over the field. 
25. The blood discs may exhibit a slight tendency to group them- 
selves, having empty spaces between them. 
26. The blood discs may arrange themselves in irregular compact 
masses, occupying but a small portion of the field. 
27. The blood discs may arrange themselves in ridges, exhibiting a 
sticky stringiness and ropiness. 
28. The blood discs may hold firmly the coloring matter, and be 
soft and plastic. 
29. The blood discs may be high colored, smooth and even in out- 
line, hard and rigid, and hold firmly and completely the coloring matter. 
30. The blood discs may allow the coloring matter to escape readi- 
ly, obscuring the individual outlines of the discs. 
31. The discs may be mainmellated. 
32. The colorless corpuscles may be in excess or in too small quan- 
tity, and be normal in consistence. 
33. The colorless corpuscles may be in excess, to a greater or less 
extent, and be sticky, plastic, and adhesive, having a tendency to stick 
together in groups and masses. These masses tend to hang in the 
meshes of the sticky fibrin. Under such circumstances there is great 
danger ahead from the liability to the formation of thrombi and emboli- 
34. The colorless corpuscles may be in excess, and ragged, and 
broken. 
33. The colorless corpuscles may be in excess, and smooth and even 
n outline. in Blood Examinations. 
11 
36. Minute grains and ragged masses of black, blue, brown, or yel- 
low pigmentary matter may occur disseminated through the blood. 
37. Globules and masses of fat may be present. 
38. Amyloid matter may be present. 
39. Masses of broken down and disintegrating parent cells may be 
present. 
40. Emboli of fibrin may be present in greater or less quantity. 
These emboli may or may not be filled with granular and crystalline 
matters. 
41. Emboli of algoid spores may be present. 
4.2. Emboli of algoid filaments and spores may be present. 
43. Algoid filaments and spores may be diffused or disseminated 
through the blood, without being aggregated in masses. 
44. Fungoid spores may be present. 
45. Fungoid spores and filaments may be present. 
46. Granules and crystals of oxalate of lime may be present. 
47. Granules and crystals of cystine may be present. 
48. Granules and crystals of phosphates may be present. 
49. Granules and crystals of stellin-e may be present. 
50. Granules and crystals of stellurine may be present. 
31. Granules and crystals of matters of a miscellaneous character 
may be present. 
52. Conchoidine may be present. 
53. Pigmentine may be present. 
54. Leucine may be present. 
35. Creatine may be present. 
56. The lithates or lithic acid may be present. 
37. Inosite may be present. 
58. Both the serum and blood discs may contain brain fat or choles- 
terine. 
59. The blood discs only may contain brain fat. 
60. The Zymotosis regularis is present in the spore state. 
61. The spores and filaments of Zymotosis regularis may be both 
present. 
62. The spores of the Entophyticus haemactus may be present. 
63. The spores and filaments of the Entophyticus haemactus may be 
both present. 
64. The Penicillium quadrifidum may be present, both in the spore 
and filamentous states of development. 
65. The spores and filaments of the Botrytis infestans may be present. 12 
What to Look for 
66. The colorless corpuscles may contain thin, bladder-like empty 
cells, of various sizes, that distend them. 
67. The colorless corpuscles may contain algoid or fungoid spores,, 
or both, which tend to destroy their normal contents and to distend the 
outside walls of the cells, so that they may be much larger than the 
healthy cell and appear like sporangia. 
There are many other things to be sought for in pa- 
thological blood, which will be spoken of hereafter. I 
have given the foregoing list, in order to convey to the 
minds of those who have not conducted examinations 
in this direction, an idea of what to look for. The 
general impression is, that there is nothing to be found 
in the blood-stream, but the blood elements; and it 
has been considered that these elements are scarcely 
ever, to any great extent, pathological, and if they are, 
the microscope fails to throw much light upon the sub- 
ject. This is a mistake. A good microscope and ex- 
perience, and a little more patience and time devoted to 
blood examinations, will satisfy any physician that there 
is much more to be learned in this direction, than he has 
ever dreamed of. The work, however, must be patient- 
ly, carefully and honestly performed, and be most tho- 
rough. The more extended the knowledge of micro- 
scopic forms, of every conceivable variety, the more 
readily abnormal bodies are given their proper place 
and importance, and the more valuable in diagnosis 
are such labors to the observer. 
Some pathological products and states are best studied 
immediately after the blood is drawn, while others are 
better made out after the blood has stood a longer or 
shorter time between the slides, and become stationary, 
uncovering crystalline and granular products that were in Blood Examinations. 
13 
at'first too much enveloped in blood cells to be discov- 
erable. Often after having worked over a drop of 
blood for half a day, I have discovered new forms on 
re-examination. 
In the nicer microscopic explorations, we are very apt 
to see only those objects and conditions we are in search 
of, overlooking many interesting forms and features 
that after they have been pointed out to us, we are per- 
fectly astonished, how, in the extreme care we have 
used, they could have been possibly overlooked. The 
truth of this remark will come home with peculiar force 
to those who have labored the most carefully in micro- 
scopic researches in new fields. The superficial observer 
cannot appreciate it, as he never studies out the nicer 
details of the individual features and forms under ob- 
servation. His mind receives simply a vague impres- 
sion of the general appearance, instead of grasping in 
detail well-defined pictures, which alone give positive 
and exact knowledge. 
The symptoms and pathological consequences of the 
presence of stelline, stellurine, pigmentine, and conch- 
oidine, are briefly set forth in my paper describing these 
substances, published in the New York Medical Record 
for February i, 1868. The symptoms and pathologi- 
cal states excited by the presence in the blood and tis- 
sues of cystine, oxalate of lime, phosphates, and lithic 
acid, are described in my paper on Rheumatism, pub- 
lished in the American Journal of Medical Science, for 
July and October, 1867. 
The symptoms and abnormal states excited by the 
presence of algoid and fungoid spores and filaments, 14 
Fibrin in the Blood 
have been briefly spoken of in several of my papers, and 
will be more fully set forth in a paper which is now 
nearly ready. 
The presence of cholesterine in the blood disc of 
healthy blood, and in it and the serum in certain forms 
of disease, is the subject of a paper now ready, and 
which will soon appear. 
Other pathological states produced by abnormal con- 
ditions of the blood cells, will constitute also the sub- 
ject for a separate paper. 
We will now present briefly some observations con- 
nected with the 
CONDITION, APPEARANCE AND ARRANGEMENT OF THE FIBRIN FILAMENTS 
IN THE FRESHLY DRAWN BLOOD OF HEALTH AND DISEASE. A VAL- 
UABLE MEANS OF DIAGNOSTICATING CERTAIN PATHOLOGICAL STATES 
OF THE SYSTEM. 
That the fibrin filaments exist ready formed in the 
blood stream, there is no possible doubt. By a little 
practice, the eye can begin to explore a drop of blood 
under the microscope, in one second after leaving the 
blood vessels. An experienced observer will imme- 
diately detect colorless corpuscles, masses of granules, 
and sporoid bodies, and sometimes crystals, that are 
fixed, or made almost stationary by some invisible 
means. If the eye watches these closely, while the 
balance of the blood is moving this way and that, and 
running in little currents in various directions, in a few 
moments will be noticed faintly delineated filaments, 
crossing and recrossing each other, forming a mesh- 
work which holds fast these fixed cells, granules and 
spores. These are the fibrin filaments, which make up of Health and Disease. 
15 
an almost invisible network in the freshly drawn blood. 
This network of organized fibrin gradually loses the 
almost perfect transparency it has in the blood stream, 
and becomes little by little more and more opaque and 
visible in outline, till in the course of five or ten 
minutes after it is drawn, the network of threads 
reaches its maximum opacity, the filaments being to the 
educated eye well defined. 
The fibrin filaments are developed from the fibrin 
cells that are organized in the arterial extremities of the 
spleen and lacteal and lymphatic glands. These cells 
are mostly developed into filaments before they leave 
the glandular capillaries. The nucleus, or “yolk” of 
the fibrin cell forms the blood disc, while the portion 
of the cell outside of the nucleus is “spun ” into a fine 
fibrin thread. This whole process is fully described in 
my paper on the “Histology and Functions of the 
Spleen and Lacteal and Lymphatic Glands,” published 
in the American Journal of Medical Sciences for April, 
1866. 
Upon the appearance and state of the filaments, and 
size of the meshes of this fibrin network, much de- 
pends. What might appear to be slight derangements 
in the parent cells that organize the fibrin cells, may 
result in grave pathological states. 
The trouble, no doubt, starts primarily with defect- 
ive or deranged alimentation, or with some disturbance 
of the digestive apparatus of the alimentary canal, by 
which improper, defective, irritating or poisonous food 
is transmitted to the parent fibrin cells of the spleen, 
lacteal and lymphatic glands. This imperfect food, 16 
Fibrin Filaments 
little by little, deranges the digesting, assimilating, and 
organizing functions of these organisms, so that the 
fibrin cells they manufacture are in one or more ways 
pathological. These diseased cells produce fibrin fila- 
ments that are more or less abnormal. Now the causes 
that produce disturbance in the blood may be so far 
removed from the pathological results at the time we 
detect them in the blood, that they are entirely lost in 
the consideration of the subject. We only recognize, 
perhaps, the pathological products and conditions we 
find present in this fluid at the time of the examination. 
These we give the place of causes of the systemic dis- 
turbance. This may be to a great extent true, but the 
physician should be able to look back and beyond these 
specific excitants, to the primary or generic causes, 
which, perhaps, have been operating for years in de- 
ranging the functions of the mother cells. This knowl- 
edge he should have, that he may be able to impart 
such instructions to his patient, after specific or imme- 
diate causes are removed, as will enable him to live 
in such a way as to escape falling into the same patho- 
logical state again. Here is a field for much careful 
research and patient labor. It is in this direction that 
positive medicine may be greatly extended by close 
study, and honest, persevering investigation. 
APPEARANCE AND ARRANGEMENT OF FIBRIN FILAMENTS IN HEALTH. 
Where the system is in all respects healthy, where 
every part of the complicated machine is performing 
its functions normally, the colored and colorless cor- 
puscles are distributed evenly throughout the serum, in Health. 
17 
and the fibrin meshwork does not interfere with the 
free movement of the blood elements. As the natural 
process of clotting goes on, after the blood is removed 
from the system, the fibrin filaments contract, decreasing 
the size of the meshes of the network, so that the blood 
elements are to a considerable extent caught and held 
fast. If, however, the freshly drawn blood be stirred 
constantly with a rod, till the clotting process is over, 
the fibrin will be found adhering to the rod in white 
ropes and shreds, being almost perfectly free from 
the colored and colorless corpuscles. The reason of 
this is that the blood cells, by the motion kept up in 
the fibrin, are washed out from the network before the 
filaments have sufficiently contracted to hold the blood 
cells fast in the fibrin meshes. The filaments of fibrin 
Fig. i. 
in the healthy blood are much smaller and less strongly 
marked than in rheumatic and tubercular states: and 
the meshes of the network are larger, allowing the blood 
cells to pass freely through them in all directions. Fig. 
i represents the fibrin network of healthy blood as 18 
Fibrin Filaments 
it presents itself between the slides of the microscope, 
a few minutes after the blood leaves the blood stream, 
It will be seen that this network is free from spores, 
granules, colorless corpuscles, and crystals. There are 
no abnormal products adhering to the filaments, or 
fastened in the meshes. All the elements of the blood 
are normal. . 
APPEARANCE AND ARRANGMENT OF FIBRIN FILAMENTS IN RHEUMATISM. 
In rheumatic conditions the filaments of the fibrin 
network of the blood are in a tonic state of contrac- 
tion. This increases the size of the filaments, making 
them more plainly visible; and decreases the size of 
the meshes, so that the blood is in the premonitory 
stage of clotting; the meshes being so small that they 
interfere with the free passage of the blood elements,— 
they holding partially in their meshes the colored and 
colorless corpuscles. This makes the blood have a 
ropy, half clotted appearance between the slides. 
In a few minutes after rheumatic blood is placed be- 
tween the slides, the colorless and colored corpuscles 
arrange themselves in ropy rows and masses, leaving 
large, irregular, clear spaces, in which may be distinctly 
traced the meshwork of fibrin filaments. 
Frequently, for months before the patient has any 
idea that he is rheumatic, or in danger of being at any mo- 
ment taken suddenly down with rheumatism, this con- 
dition may be positively diagnosticated by the appear- 
ance and condition of the blood. By this mode of 
working, the causes of this dreaded disease may be 
discovered and removed before the patient is aware he in Rheumatism. 
19 
is in danger, thereby saving perhaps, severe suffering, 
and grave pathological disturbance. 
In rheumatism, there appears to be a tendency to a 
tonic contraction in all the fibrin elements of the body. 
The whole muscular system is more or less stiffened 
and rigid. That suppleness and elasticity of the perfect 
physiological state is gone, and a heavy, non-elastic, 
more or less lame feeling pervades the organism. This 
tonic muscular rigidity no doubt extends to the mus- 
cular fibres of organic life ; in the walls of all hollow 
vessels, as those of the blood apparatus and alimentary 
canal. 
This condition, together with the tendency in the 
connective tissue to contract under the influence of 
cold, renders a rheumatic patient extremely sensitive 
to cold and exposure. His system usually indicates 
Fig. 2. 
Fig. 2. 
Fig. 2. 
meteorological changes with as much sensitiveness as a 
barometer. 20 
Fibrin Filaments 
Fig. 2 represents the appearance and condition of 
:he fibrin network in the blood of rheumatism, as ex- 
hibited in the vacant spaces between the slides. It will 
he seen that the fibrin filaments are more contracted 
md larger, and the meshes of the network smaller than 
n healthy blood. This difference is really more strongly 
marked than is represented in the drawings. 
Spores, granules, colorless corpuscles, and crystals are 
seen fastened or caught in the meshwork. These 
bodies and conditions are pathological. They are never 
found present in healthy blood. 
APPEARANCE AND ARRANGEMENT OK FIBRIN FILAMENTS IN PULMONARY 
TUBERCULOSIS. 
In tubercular disease the blood has somewhat the ap- 
pearance presented in rheumatic affections, save that 
there is less tendency for the colored and colorless cor- 
puscles to become aggregated in ropy rows and masses; 
yet the resemblance in many cases is quite strong. In 
tubercular phthisis, there are almost always more or less 
flying rheumatic neuralgia pains. The fibrin filaments 
are sometimes almost as large and well defined, and the 
meshes as small, as in rheumatism. These pathological 
conditions are present, for the reason that this disease 
is almost always accompanied with more or less of the 
specific causes of rheumatism. This matter will be 
more fully presented in a paper now nearly ready on 
the primary and specific causes of pulmonary tubercu- 
losis. 
At Fig. 3 is represented the network of fibrin fila- in Pulmonary Tuberculosis 
21 
Fig. 3 
ments in pulmonary tuberculosis. The fibrin filaments 
are contracted and distinct, and the meshes much small- 
er than in health. In the meshes and sticking to the 
filaments are seen spores, granules, colorless corpuscles, 
etc. These bodies are fastened in the fibrin network, 
and the conditions present, that fix and hold them, are 
pathological. 
APPEARANCE AND ARRANGEMENT OF THE FIBRIN FILAMENTS IN THE 
BLOOD OF ANAEMIA. 
In pure cases of anaemia, that is, in states of the sys- 
tem where the organized histological elements of the 
blood are in the proper proportion, but where they are 
in by far too small quantity, the great mass of the 
blood being serum, the filaments of fibrin are small and 
faintly delineated, and the meshes of the network 
formed by them large, allowing the thinly scattered 
blood elements to float freely in all directions in the 22 
Fibrin Filaments in Anemic. 
serum, between the slides, without any distinct evi- 
dence of clotting. In such cases, the red and white 
corpuscles are evenly distributed throughout the serum, 
there being but slight tendency in the fibrin filaments 
to contract, hence the meshes remain so large that they 
do not entangle the blood elements. When, however, 
the rheumatic or tubercular diathesis accompany anae- 
mia, then the fibrin filaments assume all the characteris- 
tics peculiar to these pathological conditions. 
Fig. 4. 
At Fig. 4 is represented the network of fibrin in 
the blood of a pure case of anaemia. 
APPEARANCE AND CONDITION OF THE FIBRIN AND OTHER BLOOD ELE- 
MENTS WHERE THERE IS A TENDENCY TO THE FORMATION 
OF THROMBI AND EMBOLI. 
Whenever there exists in the blood abnormal bodies 
that are insoluble in the serum, more or less irrita- 
tion of the lining tissue of the blood apparatus, espe- 
cially in the heart and vicinity, is the result. Sooner 
or later, the organic muscular fibres lose a part of their Thrombi and Emboli. 
23 
tonicity, and there are frequently tired feelings, and wan- 
dering pains and aches, which are more likely to hang 
about the cardiac region than elsewhere. The insolu- 
ble matters floating in the blood, have a tendency to fix 
themselves in or near the heart, to the epithelial lining, 
the secretions from which assume a more or less plastic 
and sticky condition from the irritation excited. These 
fixed particles become centres for the gradual accretion 
of fibrin, which applies itself slowly, layer upon layer, 
and finally little by little we have formed thrombi. 
These from time to time break loose from their 
points of attachment, and float as emboli in the blood 
stream. 
There is also another condition of the blood ele- 
ments, where there is great danger of thromboses and 
embolism, and which may be readily diagnosticated by 
means of the microscope, in time to avert the serious 
results which may await the patient. This is stickiness 
and plasticity of the fibrin filaments and colorless cor- 
puscles. This stickiness often extends even to the 
blood discs. Whenever this state is present, the col- 
orless corpuscles are found,—instead of being scattered 
about singly,—sticking to each other in groups of two, 
three, four, or more. The fibrin filaments are also sticky 
and plastic, and impede the free flow of the blood cells 
through their network. The result is a marked ten- 
dency to the formation of thrombi and emboli. Em- 
boli, under such conditions, are produced frequently, 
simply by the sticking together of the colorless cor- 
puscles, forming masses of greater or less size. They 
are also formed by the breaking loose of thrombi. 24 
1Thrombi and Emboli. 
This sticky state of the blood is usually scorbutic, 
it arising mainly from deranged or defective alimenta- 
tion. 
In conclusion, I would say that this paper is but an 
imperfect brief of extended labors in this direction. The Blood Disc. THE BLOOD DISC, 
A 
VEHICLE FOR TRANSMITTING NERVE FOOD. 
Cholesterine and other Crystalline Matters in the Healthy 
Blood Disc, and in and out of it in Certain Forms of 
Disease.—Ready Means for Diagnosticating 
Conditions. — Cryptogamic Vegetations that are in both 
Healthy and Diseased Blood; with a brief Description of 
the Crypta carbunculata and Zymotosis escularis. 
For several years I have been satisfied, from a variety 
of experiments, that the blood disc performed an im- 
portant office in transmitting nerve food. In healthy 
blood, freshly drawn, the cholesterine or nerve fat is 
held by the blood disc, there not being enough in the 
serum to crystallize on drying between the slides of the 
microscope. If, however, the blood is allowed to stand 
in clean, well stoppered glass bottles for from one to 
three days, and then placed between the slides of the 
microscope and allowed to dry for a few hours, the 
cholesterine crystals make their appearance, it having 
escaped from the discs with the coloring matter and 
other crystalline products, and become dissolved in the 
serum. 
This cholesterine is the fat of nerve tissue, and is 
largely present, it making up one of the principal con- 28 
Cholesterine 
stituents of the medullary matter that surrounds and 
insulates the ultimate central nerve threads, through 
which impressions are received and responses trans- 
mitted. This nerve fat has to be supplied through 
the medium of the blood. The only element of the 
blood that normally carries it is the blood disc, hence 
this disc may be considered a vehicle for transmitting 
to its destination nerve fat, and probably other nutrient 
products designed for nerve support. It can readily 
be conceived how defective alimentation and a great 
variety of other causes might derange this insulating 
covering, and how this derangement might disturb the 
normal mental functions and the nervous system gen- 
erally, thereby producing a variety of distracting and 
strange results. 
Here is a field open that offers tempting induce- 
ments to the careful and patient explorer. 
In certain conditions of the system, when the freshly 
drawn blood is placed between the slides and allowed 
to dry for a few hours, cholesterine crystallizes around 
inside the edges of the thin glass. This is diagnostic 
of cholestenemic states, and is pathological, and an im- 
portant fact to determine. 
Other matters held normally by the blood discs crys- 
tallize with the cholesterine. These will be briefly re- 
ferred'to further on. 
CHOLESTERINE IN THE RED DISCS OF HEALTHY BLOOD, BUT NOT IN THE 
SERUM TILL AFTER THE BLOOD HAS BEEN STANDING 
FOR SEVERAL DAYS. 
The following are a few of a series of experiments in Blood. 
29 
recently performed on the blood of persons in perfect 
health. 
Experiment i, October 13, 1867.—Drew two drams 
of blood from the arm of Dr. C. by opening a vein. 
Placed it in a clean glass-stoppered bottle, and set aside 
at a temperature ranging from 6o° to 750 Fahrenheit. 
On placing a drop of the freshly drawn blood between 
the slides of the microscope and allowing it to stand for 
twenty-four hours, no cholesterine crystals made their 
appearance. 
Dr. C. is in perfect health. 
October 16.—Shook up the bottle of blood well, and 
placed a drop between the slides of the microscope at 
1 p. m. At 3 p. m., two hours after, cholesterine crys- 
tals had formed all around and just within the edges 
of the thin glass. These are represented at 12. 
Experiment 2, October 13, 1867.—Drew a dram of 
blood from the arm of Dr. H., and placed it in a 
clean glass-stoppered bottle, and set aside at a tempera- 
ture ranging from 6o° to 750 Fahrenheit. 
On placing a drop of the freshly drawn blood be- 
tween the slides and allowing it to stand for twenty-four 
hours, no signs of cholesterine crystals made their ap- 
pearance. 
Dr. H. is enjoying excellent health. Age 26. 
October 15.—Shook up the bottle well, and placed a 
drop of the blood between the slides of the microscope 
at 1 p. m. At 3 2 p. m. cholesterine crystals had formed 
entirely around and just inside the edges of the thin 
glass, similar to those represented at 12. 30 
Cholesterine 
Experiment 3, October 13, 1867.—Drew two drams 
of blood from the arm of Dr. D., who is in perfect 
health, and placed it in a clean glass-stoppered bottle, 
and set aside at a temperature ranging from 6o° to 750 
Fahrenheit. 
A drop of this blood, freshly drawn, placed between 
the slides of the microscope and allowed to stand for 
twenty-four hours, afforded no crystals of cholesterine. 
October 16.—At 112 p. m., shook up the bottle well, 
and placed a drop of the blood between the glass slides 
and allowed to stand till 3 p. m., when it was examined. 
Found beautiful cholesterine crystals all around, just 
inside the edges of the thin glass. 
Experiment 4, October 13, 1867.—Drew two drams 
of blood from the arm of Dr. S., who is in perfect 
health, and placed it in a clean glass-stoppered bottle, 
and set aside at a temperature ranging from 6o° to 750 
F ahrenheit. 
A drop ot this freshly drawn blood placed between 
the slides and allowed to stand for twenty-four hours, 
exhibited no signs of cholesterine crystals. 
October 16.—At 1 p. m., shook up the bottle well, 
and placed a drop of the blood between the slides of 
the microscope and allowed to stand till 3 p. m., when, 
on examination, a beautiful row of crystalline plates of 
cholesterine was found just inside the edges of the thin 
glass. 
Experiment 5, October 9, 1867.—Drew two drams 
of blood from the arm of Dr. G., who is laboring 
under severe rheumatic neuralgia in small of back and in Blood. 
31 
hips, with partial paralysis of lower extremities. Has 
had this trouble for the last three years. Pains at 
times very severe. Takes morphine hypodermically to 
relieve suffering. Has severe oxalasmia and cystinasmia. 
Placed the fresh blood in a clean glass-stoppered bottle, 
and set aside at a temperature ranging from 6o° to 75° 
Fahrenheit. 
Had a healthy appearance, save that it was rich in 
fibrin, and contained granules of cystine and oxalate of 
lime, also spores of the Zymotosis regularis. 
A drop freshly drawn and placed between the slides 
of the microscope and allowed to stand for twenty-four 
hours, afforded no cholesterine crystals. 
October 12.—The bottle of blood was well shaken, 
and a drop placed between the slides of the microscope. 
This was done at 1 p. m. At 4 p. m., three hours after, 
crystals of cholesterine had begun to appear all around 
inside the edges of the thin glass. The Z. regularis 
was rapidly developing into filaments. 
Blood in bottle, which, when first drawn, was of a 
beautiful, clear red color, now had a bluish purple tinge. 
Coloring matter of the discs partially escaped and dis- 
solved in the serum. 
The fact that no cholesterine crystallizes in the 
freshly drawn healthy blood, while it does crystallize 
under similar circumstances, in the same blood, after 
it has stood for two or three days in clean, tightly 
corked glass-stoppered bottles, and the coloring matter 
of the discs partially escaped and dissolved in the serum, 
is interesting, and demonstrates the fact that the choles- 
terine is held by the blood disc in the freshly drawn 32 
Cholester<emia. 
healthy blood, and that it escapes from the disc with 
the coloring matter. 
From the fact that the blood discs contain choleste- 
rine, or nerve-fat, it would seem that they act as vehicles 
for transmitting nerve-food to its destination. 
In all samples of healthy blood, the spores of the 
Entophyticus luemactus and those of the Zymotosis regula- 
rs are found in small quantity, immediately after the 
escape of the blood from the blood vessels. 
These spores are detected with difficulty, in the fresh 
blood, on account of their extreme transparency, and 
of being generally obscured by blood discs. After 
healthy blood has stood for from one to three days, at 
a temperature ranging from 6o° to 75° Fah., the spores 
and embryonic filaments of the Z. regularise are tound 
in great numbers. The E. h<emactus is also always 
present in the filamentous and spore state of develop- 
ment, but in small quantity when compared with the 
large presence of the Z. regularis. 
These vegetations are described further on. 
CHOLF.STER-flEMIA. 
There are two forms of this disease, each of which is 
well defined and may be readily diagnosed. In one, the 
cholesterine may exceed, may equal, or may be less 
than the normal quantity. In the other, it is always in 
excess. In one the blood discs are soft, yielding, plas- 
tic, and often sticky, and hold with feeble affinity their 
coloring matter and other products. I he coloring and 
crystalline matters escape from the discs on the least 
provocation, and obscure their outlines and become Cholesteraemia. 
33 
mingled with and dissolved in the serum. In this path- 
ological condition, the discs are unable to take up and 
hold the normal quantity of cholesterine and other 
crystalline products and coloring matter, and even when 
they are, the least disturbance liberates them. 
In the other form, the blood discs are more firm and 
are able to hold their normal quantity of cholesterine 
and other products ; but the cholesterine is always in 
excess in the blood, so much so, that a portion of it 
remains dissolved in the serum, the discs not being able 
to take it up. 
In both forms of the disease, when the freshly drawn 
blood is placed between the slides of the microscope, 
and allowed to stand for a few hours, crystals of cho- 
lesterine and those of other bodies belonging normally 
to the discs, show themselves around inside the edges 
of the thin glass. If there is no cholesteraemia, the 
cholesterine crystals do not form between the slides, 
unless the blood has been previously allowed to stand 
for from one to three days, allowing the coloring mat- 
ter to separate more or less from the discs. 
By this simple means, cholesteraemia may be readily 
diagnosed. In all cases of cholesteraemia, or in all cases 
where there is more cholesterine in the blood than the 
discs can readily take up and firmly carry, there is a 
tendency to amyloid disease of some part of the blood 
apparatus. This takes place usually first, in some one 
of the following parts, to wit: the arterial extremities 
of the spleen, the arterial extremities of the lacteal and 
lymphatic glands, the liver, kidneys, or heart, and large 
vessels leading to it. Cryptogamic Vegetation 
34 
As soon as amyloid disease is ushered in, its exist- 
ence may be determined simply by testing the blood 
for amyloid matter. Here a simple chemical reaction, 
under the microscope, settles another important ques- 
tion in positive medicine. 
Whenever cholestersemic states of the blood are pres- 
ent, to any extent, there seems to be much lassitude 
and depression, which are increased at irregular inter- 
vals. These spells are attended often with great sen- 
sitiveness and irritability, accompanied by peculiar 
mental impressions, and sometimes with paroxysms of 
an epileptic character. 
The freshly-drawn blood of such patients is found to 
contain, in large quantity, the Z. regularise both in the 
spore and embryonic filament states of development. 
The E. htemactus is also present in both the spore and 
filamentous stages of growth. 
Whenever amyloid disease of any part of the blood 
apparatus, or any of the blood glands, is thoroughly 
established, these vegetations appear in increased quan- 
tity. 
Abundant crops of the crystalline matter, represented 
at 18, 14, and 15, are also formed between the slides, 
with the cholesterine plates. These crystalline forms 
have a strong affinity for the coloring matter of the 
blood. This matter is confined to the discs in freshly- 
drawn healthy blood. It is however found in the se- 
rum, in diseased blood where the discs do not hold 
firmly the coloring matter. It is also found in the 
serum of healthy blood, after it has stood for from one 
to three days after being drawn from the bodv. These in Blood. 
35 
are the crystalline matters, which have been studied and 
described by Funke, Kunde, Lehmann, Parkes, and 
Sieveking-. 
O 
CRYPTOGAMIC VEGETATIONS IN BOTH HEALTHY AND DISEASED BLOOD. 
There are two species of cryptogams, one fungoid 
and the other algoid, that are always present in both 
healthy and diseased blood. The spores, in an inactive 
state, exist in small quantity in healthy blood, when 
freshly drawn from the body. These are however few, 
and difficult always to demonstrate, on account of 
their great transparency, coupled with the fact that they 
are covered up and obscured by the blood elements. 
If the freshly drawn healthy blood however be placed 
in a clean, glass-stoppered bottle, and allowed to stand 
for from one to three days at a temperature ranging 
from 6o° to 750 Fahrenheit, and then examined carefully 
under the microscope, the spores and filaments of the 
algoid vegetation will invariably be found in abundance, 
and spores and filaments of the fungoid growth will 
occur more rarely, but will always be found present. 
In certain diseased states, where the vitality is de- 
pressed, and the machine in all its parts moving in a 
slow and labored manner, these vegetations in the fila- 
mentous and spore states are both found in the freshly- 
drawn blood. The algoid vegetation is always very 
much more abundant than the fungoid. That thev 
produce grave disturbance in debilitated conditions, 
there can be no doubt. 
The following are brief descriptions of these ento- 
phytic cryptogams. 36 
Crypt ogamic Vegetation 
Entophyticus h^emactus, (Salisbury.) 
This fungoid vegetation- I have not yet developed to 
the stage of fruiting, and hence I am unable to give it 
its proper place. It is however very characteristic in 
the appearance and structure of its filaments. For con- 
venience in designating it, until I am able to see it in 
fruit, I have given it the name Entophyticus Juemactus. 
The spores of this plant are represented at 16, and the 
filaments, as they usually appear in the blood, at 7 and 
8. The inside tube of the filaments is rather opaque, 
giving to it a dark shade, and has interruptions of 
greater or less length, at irregular intervals. The fila- 
ments are usually irregularly and quite profusely 
branched, as represented in the figures. 
These filaments are found often in freshly drawn 
diseased blood, and always in healthy blood after it has 
been standing in closely stoppered bottles for from one 
to three days, at a temperature ranging from 6o° to 750 
Fahrenheit. The spores always occur in an inactive 
state, sparsely scattered, in freshly drawn healthy blood. 
Zymotosis regularise (Salisbury.) 
This is a minute and most beautiful species of the 
genus Zymotosis. The spores are very minute, well 
defined in outline, and uniform in size and shape. 
They, under the proper conditions, multiply rapidly 
bv duplicative segmentation, and develop into filaments 
with great rapidity. A single drop of blood may con- 
tain thousands of spores and hundreds of embryonic 
filaments. The filaments are well defined, uniform in 
diameter, and have cross markings or interruptions in in Blood. 
37 
the inside tubular membrane, at regular intervals, from 
which characteristic it derives its specific name. 
At i, is represented the spores and young filaments 
of this entophyte ; at 2, are seen the embryonic fila- 
ments; and at 3, the mature filaments. These are all 
magnified about 350 diameters. 
One peculiarity in the arrangement of the mature 
filament is, that it often returns on itself, the two 
portions maintaining in all their meanderings a uniform 
distance from each other of about the diameter of the 
filament, giving the space intervening the appearance 
of the central cavity of a tubular filament of larger 
growth. A careful examination, however, will always 
discover the truth. The filaments sometimes are ar- 
ranged, several of them, side by side, forming regular 
ribbon-like bands, which cross and recross each other 
in various directions, producing a quite regular plaid 
appearance. At other times they are knotted, tangled, 
and irregularly woven together. This is a beautiful 
species, and is very characteristic in its appearance, so 
much so, that it need not be mistaken for any other 
vegetation. 
VEGETATION' THAT I HAVE UNIFORMLY MET WITH IN THOSE SUFFERING 
WITH CARBUNCLES, AND WHICH IS BELIEVED TO BE THE 
SPECIFIC CAUSE OF THIS DISEASE. 
Crypta carbunculata, (Salisbury.) 
There is also an algoid vegetation that occurs in the 
blood in certain debilitated states of the system. It is 
however only occasionally met with. This plant is 
figured at 4, 5, 6. The spores and embryonic filaments 38 
Cryptogamic Vegetation 
are represented at 4 and 5, and the maturer filaments 
at 6. 
I have given the specific name, Carbunculata, to this 
cryptogam. The uniform adaptation of the inside to 
the outside membrane of the filament is so character- 
istic in the mature plant, that there is scarcely ever a 
cross marking discoverable, unless the plants are par- 
tially dried. The embryonic filaments show usually a 
moniliform structure. 
The filaments of this vegetation are about one half 
greater in diameter than those of the Z. translucens, 
and they run a much more zigzag or tortuous course.* 
Whenever I have found this plant in the blood, the pa- 
tients have been afflicted more or less with carbuncles. 
I have in several instances, in depressed states of 
the system, found it accompanying the Z. regularis. 
The fact that it is not always present with the regu- 
laris, shows that it has its own peculiar significance, as 
well as special conditions, under which it alone develops, 
and is no doubt indicative of certain pathological states 
of the system and blood. 
The fact that wherever I have met with this plant, 
the patients have been afflicted with carbuncles ; and 
also that the car’buncular sloughs contain the same kind 
of filaments in large quantity, would seem to point to 
this entophyte as the specific cause of this peculiar 
disease. If this should be true, it will explain why it 
* Whenever the lilaments of the carbunculata are allowed to dry partially between 
the slides of the microscope, they often show interruptions in the inside tube, as repre- 
sented at 17. This figure is more highly magnified than those represented at 4, 5, 
and 6. in Blood. 
39 
is that this affection sometimes seems to be transmitted 
from one person to another. 
(_'HOLESTERi'EMIC STATE OF, AND ALGOID VEGETA'l ION IN 1HE FRESHLA 
DRAWN BLOOD OF THE HORSE, IN WHAT APPEARS TO BE A PECULIAR 
FATAL FORM OF REMITTENT FEVER IN THIS ANIMAL. 
Zymotosis escularis, (Salisbury.) 
This is a vegetation found in the freshly drawn blood 
of the horse, in a peculiar fatal disease, affecting them 
in Cleveland and vicinity during the months of August 
and September, 1867. This plant in its various stages 
of growth is represented at 9, 10, 11. 
The horses are taken suddenly with an uneasiness, 
which they manifest by pawing, lying down and getting 
up, and stepping about in a manner that indicates pain. 
Soon they break out in a profuse perspiration, which 
is followed by the appearance of very great shrinkage 
in bulk and condition. 1 he skin is hot and feverish , 
the pulse somewhat rapid and intermittent; the mucous 
membrane rather dry; the breathing short and hurried, 
and the bowels so terribly constipated that it is almost 
impossible to procure a movement. During the day 
they seem to be easier than during the night. The 
exacerbations appear to come on about 7 0 clock p. m., 
and leave early in the morning. The remissions occur 
during the day. I he disease rapidly prostrates, the 
breathing becomes more short and hurried, and death 
takes place usually from the second to the fourth 01 
fifth day. If they survive beyond this period, there is 
hope of recovery. The horses are sensible to the last, 
and endeavor in the later stages to maintain an erect 40 
Cryptogamic Vegetation 
position till they fall from exhaustion, when they quickly 
expire. 
Toward the last the extremities and nose become 
cold, the pulse slow and intermittent, and the breathing 
very short and hurried. The urine is scanty and high 
colored, and generally voided frequently. 
On post-mortem, the lungs and heart are found 
healthy, the spleen and liver somewhat engorged, and 
usually impacted food and fasces are found in stomach 
and bowels. Bowels and stomach sometimes congested 
and slightly inflamed, but no organic lesions that are 
sufficient to cause any grave trouble. 
Blood appears to be in much smaller quantity than 
normal. It contains the algoid vegetation represented 
at 9, 10, 11, to which I have given the name Zymotosis 
escularis. 
9 represents the spores, which are disseminated 
throughout the blood, singly and in groups. 
10 represents the embryonic filaments, which are 
often moniliform in structure. 
11 represents a filament further advanced in devel- 
opment. 
This vegetation occurs in the freshly drawn blood. 
The filaments, in their early stages of development, 
are mostly moniliform in structure, as represented at 
10. The more mature filaments have the outside tube 
continuous and uniform in diameter, while the inside 
membrane has not only interruptions at irregular in- 
tervals, but the interruptions are of variable length. 
Where the inside membrane occurs it affords a double 
wall to the tube and communicates greater opacity than in Blood. 
41 
have the intervening spaces. The filaments of this 
plant have about three times the diameter of the Z. 
regularise represented at 3. 
13 represents crystals of cholesterine, which form 
between the slides of the microscope, soon after the 
blood is drawn and placed between them. This shows 
the blood in this disease to be cholestersemic. Vegetation of Variola. DESCRIPTION OF A NEW VEGETATION, 
HAVING FUNGOID AND ALGOID PHASES OF GROWTH; FOUND IN 
THE BLOOD AND ERUPTIONS OF 
VARIOLA AND VACCINA, 
AND WHICH APPEARS TO EE THE SPECIFIC CAUSE OF THESE DISEASES. 
In 1862, I first commenced the study of the vegeta- 
tion which appears to be the specific cause of small 
pox. Since that time I have taken advantage of every 
opportunity offered by the disease, to work up the 
various forms and phases of this entophytal cryptogam. 
It presented such different appearances, under different 
conditions, that it was not till within the last twelve 
months that I began to see clearly the place and signifi- 
cance of its various forms and phases of development. 
This paper is a brief summary of the results arrived 
at in this tedious and interesting labor. 
Ios variolosa vacciola, (Salisbury.) 
This is the plant which appears to be the specific 
cause of small pox. It is met with largely in the erup- 
tion of this disease, both in its spore and filamentous 48 
Vegetation of 
stages of growth. The spores are also found in the 
blood. It belongs to the mucedinous fungi. The 
spores are of two kinds, spores and zoospores. The 
spores (i, 2) develop into filaments, (3, 5, 6, 7, 8,) 
which when mature, constitute the perfect plant, that 
bears both kinds of spores (9, 10). The zoospores do 
not develop into filaments, but gradually expand and 
become filled with granules, (14, 15,) and finally these 
granules grow to be about i or 5 the size of a perfect 
spore. 1 represents a perfect spore, and 11 the gran- 
ules from the mature zoospores. These granules from 
the zoospores we shall call algoid cells or spores, from 
the fact that they multiply by duplicative segmentation 
and develop into filaments under the proper conditions, 
precisely like the minute algae, (20, 21, 22, 23, 24, 25 ;) 
this plant having both fungoid and algoid phases of de- 
velopment. The zoospores, when mature, are from 
the same to six times the diameter of the perfect spore, 
(14, 15, 18, 19.) Each contains a great number of 
algoid cells, or cells that comport themselves precisely 
like the spores of the minute entophytal algae. When 
the zoospores are fully matured, they rupture, and the 
spores escape either en masse, or in a more or less 
gradual and scattered manner, (16, 17.) These minute 
cells occur in vast numbers in the eruption of small 
pox. Both the algoid sporules and the perfect spore 
multiply rapidly by duplicative segmentation. 
I have given to the entire plant in all its phases of 
growth the name Ios variolosa vacciola; to the fungoid 
phase, I. variolosa; and to the algoid phase, I. vacciola. 
I have given these names to the two different phases Variola and Vaccina. 
49 
of this vegetation, tor reasons which will hereafter 
appear. 
In small pox, this vegetation develops in all its 
phases. If the vegetation of a small pox pustule be 
inoculated into a person who has never had variola, 
the same contagious disease, in a modified form, and 
the same vegetation, is produced. This vegetation is 
the Jos variolosa vacciola. If, however, the matter of 
small pox be inoculated into the cow, a pustular dis- 
ease is produced resembling that of variola, but the 
eruption will only be found to contain the algoid stage 
of the vegetation, on which account we have given to this 
stage of its development the name Ios vacciola. The 
fungoid phase of the plant is not produced in the 
cow. 
If now we take the matter from the pustule of cow 
pox and inoculate it into the human subject, we pro- 
duce a pustule like that of vaccina and variola, but it 
contains the stage of the vegetation only that is found 
in the cow pox sore. 
Another interesting fact is noticed, namely, that the 
vaccine pustule does not transmit the disease from one 
person to another, except by inoculation. The vege- 
tation in this stage seems to have no, or at least but 
little, power to penetrate the epithelial envelope that 
invests the body inside and out. The other form of 
the vegetation, however, which is developed in small 
pox, acts as an active contagion, and when the spores fall 
upon epithelial surfaces that have not had the impress 
of immunity stamped upon them by a previous inva- 
sion, they penetrate to the deeper tissues, and pervade 50 
'Vegetation of 
the entire organism, the result of which is the pustular 
eruption called small pox. 
These facts are extremely interesting, throwing a hood 
of light upon some singular features of the disease. 
That the plant in its perfect state does not develop 
in the cow, while the algoid phase of growth finds in 
this animal a fertile soil, is highly instructive and sig- 
nificant, and may lead to interesting and valuable results 
in obtaining matter in other contagious and infectious 
diseases, that may impart without danger an impress 
of immunity by inoculation. 
1 his whole field is one of the greatest possible inter- 
est, and is full or rich rewards for the patient and care- 
ful student. 
The spores and filaments of the Leptothrix buccalis 
that develop in and on the epithelium of the tongue, 
and in and on the bronchial epithelium, in lung diseases,, 
appear to be but the algoid phase of development of a 
species of fungus that finds a fertile nidus in the fer- 
menting and vitiated condition of these surfaces. The 
algoid stage only of the plant is clearly determinable 
till the proper conditions arise in the later stages of dis- 
ease, for the development of the fungoid phase, when 
the algoid spores are seen to grow and gradually take 
on the fungoid type, and finally to develop into branch- 
ing mycelium. 
The Spheerotheca persica, (Salisbury,) which causes the 
blister and curl in peach leaves and decay in the peach 
fruit, produces two kinds of spores and filaments. The 
perfect fungoid spore and filament are produced, in this 
climate, from about the ioth of May to the 15th of Variola and Vaccina. 
51 
June. During this period, the fungus is furnished 
abundant nourishment from the young, tender, and 
vigorously growing leaves and young twigs to which it 
is mainly confined, and the threads are mostly fertile, 
producing enormous numbers of sporidia. From the 
15th of June to the 1st of September, the fertile 
threads are constantly decreasing and the sterile threads 
appear, taking their place. These sterile threads or 
filaments are longer and much more slender than the 
fertile ones, and are not moniliform. They resemble 
algoid filaments, and represent the sterile or algoid 
phase of development in this plant. From the 15th 
of June to the 1st of September may be denominated 
the period of sterile development in this fungus. The 
sterile or algoid growth begins as soon as the tissues of 
the leaves and twigs become so firm, and scant in nutri- 
tious juices, as to afford but imperfect nourishment to 
this parasite. The sterile growth exhausts the peach 
plant very much less than the fertile, or period of re- 
productive growth, which precedes it. 
The fertile and sterile stages of development of the 
S. persica correspond to the fungoid and algoid phases 
of growth in the variola vegetation. Both the fertile 
and sterile (fungoid and algoid) phases, are produced 
in small pox; but in the cow, only the sterile vege- 
tation thrives, on account of the tissues and fluids of 
this animal affording but a poor or imperfect soil for 
this entophyte. 
All the mucedinous fungi, when developing under 
the proper conditions, seem to produce the two kinds 
of spores here described. These two forms may be 52 
Vegetation of 
beautifully studied in the yeast plant of fermenting 
milk. In this case the two kinds of spores are denom- 
inated spores and zoospores, or inactive and active 
spores. The inactive spores are those which develop 
into fungoid filaments, producing the perfect plant. 
1 he zoospores, during their organizing period, are 
moving in all directions. They have two motions, 
which go on at the same time, one a progressive zigzatr 
movement, and the other a rotary at right angles to the 
progressive. During this compound movement, they 
organize and void at their posterior extremity, minute 
oblong cells, which have the appearance of minute algoid 
spores, in the manner in which they afterward arrange 
and comport themselves. After the zoospore has com- 
pleted its organizing functions, it becomes quiet, shrinks 
gradually, dies, disintegrates, and disappears. 
The zoospores of the milk fungus correspond to the 
algoid stage of the variola vegetation which we find in 
cow pox and in the vaccine pustule, and which we have 
designated as the Ios vacciola. 
This peculiar variation or phase in the development 
of mucedinous cryptogams, may be denominated the 
algoid, to distinguish it from the fungoid phase or the 
perfect plant. It is very probable that under the proper 
conditions, most or all mucedinous growths have their 
algoid and fungoid phases. The algoid or minute 
spores develop into filaments (20, 21, 22, 23, 24, 25, 
26) which have the peculiarities of algoid filaments in 
their structure and mode of growth. If this be as true 
as it now appears, it is highly probable that very many 
of the minute entophvtal algae are but special phases of Variola and Vaccina. 
53 
development of parasitic mucedinous fungi. This is a 
field of labor where explorations have to be conducted 
with the greatest possible persistence and caution, or 
errors will everywhere creep in and links be lost in the 
chain of inquiry. 
The cow pox is no more contagious than the vaccine 
pustule on the human subject. Both are only trans- 
mitted by inoculation. It is very doubtful whether 
the disease could be transmitted to the milkman or 
milkmaid, unless there were some abrasions through 
which the virus could reach the red and white blood ap- 
paratus and connective tissue. This is very fortunate, 
for otherwise we should often take the disease from the 
cow, as it no doubt is contracted by this animal from 
some of the fermenting matters of the barnyard. 
It is also fortunate that when the matter of cow pox 
is transmitted to the human subject, it becomes a dis- 
ease that is not transmissible from one to another 
except by direct inoculation. 
The specific poison of vaccina does not seem to pos- 
sess the power of passing through the epithelial envel- 
ope of the human body. If, however, we should take 
the disease from the same fermenting matters that give 
it often to the cow, no doubt it would be genuine small 
pox, a highly contagious disease, and would be readily 
transmissible from one to another, as this vegetation 
finds a rich soil in the human body for producing it in 
all its various phases of growth. 
Quite a number of different figures are given of the 
fungoid and algoid filaments and zoospores, in order to 
give an idea of the various appearances they present in Variola Vegetation. 
54 
different cases and under different conditions. These 
figures will all be of service to those who are making 
microscopic examinations of the variola poison. These 
figures are briefly described in the following description 
of the plate. DESCRIPTION OF PLATE. 
1. Spores of the Ios variolosa. 
2. Spores of the Ios variolosa beginning to elongate. 
3. Embryonic filaments of same. 
4. Spores of the I. variolosa developing in pus cells. 
5. Filament of I. variolosa, in its early stage of growth, sending off a 
branch. 
6. A filament of same, with a branch, but presenting scarcely any 
appearance of cross markings. 
7. Filaments of same, sending off branches, and presenting in internal 
structure, a somewhat different appearance from 5 or 6. 
8. Filaments of I. variolosa, presenting a still different appearance 
from 5, 6, or 7. 
9 and 10. The Ios variolosa in fruit. This stage of the plant is sel- 
dom met with. This is the most perfect appearance of fruiting 
that I have yet seen in all my examinations. 
1 1. Spores of the Ios vacciola; or spores of the algoid phase of devel- 
opment of the small pox vegetation (Ios variolosa vacciola.) 
These are the spores of the vegetation of the cow pox and 
vaccine pustules. They occur in multitudes in the pustules of 
variola and vaccina. 
12. The spores 11, or those from which the algoid filaments (20, 21, 
22, 23, 24, 25) are developed. 
13. The spores of the I. variolosa (1) or those which develop the 
fungoid filaments 5, 6, 7, 8, 9. 
14. Zoospores, or those spores that grow into spore cases, inclosing 
the spores 11. 
15. Mature zoospores, filled with the algoid spores 11. The spores 
11 are also often found developing in epithelial and pus cells. 
16. Spores escaping from a mature zoospore. 
17. A group of algoid spores that have escaped en masse from a zoo- 
spore. Spores of the I. vacciola. 
18 and 19. Mature zoospores of different shapes, that occur in the 
pustules of small pox and vaccina. 
20. Algoid spores (11) multiplying by duplicative segmentation, and 
forming embryonic filaments. 
21. Embryonic filaments of the I. vacciola, that present a moniliform 
structure. 
22. Embryonic moniliform filaments of same, showing a tendency to 
run a spiral course, which is often seen. 
23. Embryonic filaments of the I. vacciola, presenting less of the 58 
Description of Plate. 
moniliform appearance than 21 and 22. This form of the fila- 
ment is frequently met with. 
24. Filaments of the same vegetation presenting a more homogeneous 
structure, with usually a hooked extremity. This form is occa- 
sionally met with in the eruptions of small pox and vaccina. 
25. This is the appearance of the filaments of the I. vacciola often in 
vaccine scabs, some little time after their removal. To have them 
show well the scabs should be dissolved in pure water and allowed 
to stand a short time, in order to allow the dried vegetation to 
expand by absorbing moisture. 
26. This form of filament is also met with in the scabs. 
27. Algoid spores (11) developing in pus cells. 
28. Peculiar branched cells, that are occasionally met with in the erup- 
tions of small pox and vaccina, and which resemble cancer cells. 
29. Sporangia found occasionally in the fresh scabs of variola and vac- 
cina. These are believed to be spore cases of the Ios vacciola. 
The minute spores inside are usually in active motion. Vegetation in Typhoid Fever. VEGETATION IN TYPHOID FEVER, 
WHICH APPEARS TO BE THE SPECIFIC CAUSE OF THE DISEASE J WITH SOME 
GENERAL REMARKS ON THE TREATMENT OF 
TYPHOID, INTERMITTENT, AND REMITTENT FEVERS. 
In the course of the investigations connected with 
intermittent and remittent fevers, in 1863, I discovered 
a peculiar minute algoid vegetation, developing in and 
on the human body in typhoid fever. The first dis- 
covery was made in a highly malarious district, in a 
family all the members of which had, during the sum- 
mer months, been affected with intermittent fever. 
During the early part of September, the husband and 
father was taken down with typhoid fever. The wife, 
who was constantly over the patient, in about two 
weeks was taken down with the same disease. 
It was in these patients that I first discovered the 
vegetation. I found the spores developing in pro- 
fusion over the whole body, inside and out. 
Since that time I have seized upon every opportunity 
to work up the various stages in the growth of this 
plant. 
It develops upon all the epidermic and mucous 
surfaces, extending from cell to cell, reaching the deep- 
est part of the follicles and more complicated glands. 62 
Vegetation in 
It penetrates the basement membrane, and extends to 
all portions of the blood apparatus and blood glands, 
and especially flourishes with great luxuriance in the 
agminated and solitary glandules of Peyer. 
I have given to this vegetation the name Biolysis 
typhoides, (Salisbury.) It seems to grow only on and 
in animal matters. It so poisons the epithelial cells, 
in and on which it develops, that they eat, digest, 
assimilate, organize, and eliminate but imperfectly. In 
fact, these processes are so far checked, that the cells 
cease almost entirely to eliminate fluids, in consequence 
of which the surfaces become dry, hot, and parched, 
allowing nothing to escape save the gaseous products 
of decomposition. In this condition the system be- 
comes surcharged with disintegrating, fermenting, and 
decaying animal matters, which seem for a time at least 
to increase the fertility of a soil already producing a 
prolific crop of vegetation. This process goes on till 
the organism finally becomes so poisoned and vitiated, 
that it seems to be no longer able to propagate the 
vegetation that has been the specific cause of all the 
trouble. A change now takes place in the condition 
of the epithelial surfaces and glands which is favorable 
to’recovery, it the local lesions are not too great and 
the'powers of life too far spent. 
During the incubative stage, previous to the ushering 
in'of the disease by the algoid and febrile paroxysms, 
the skin and mucous membranes are found to be cov- 
ered [more or less with the spores of the B. typhoides 
(1, 2,3.) The algid paroxysm, terminating the incu- 
bative stage, is indicative of the vegetation having Typhoid Fever, 
63 
reached the more vital and highly animalized elements. 
During the period of high febrile excitement the vege- 
tation multiplies with great rapidity, penetrating to 
every tissue of the organism. 
The tendency to periodicity in all febrile diseases 
probably marks the periods of the successive crops of 
vegetation. 
The spores multiply by duplicative segmentation (3,) 
and develop rapidly on and in the cells of the epidermic 
and mucous surfaces (2.) The filaments (10, 11) and 
spores (1, 5) are found developing in the glands of the 
red and white blood apparatus, and the spores are fre- 
quently met with in the blood, developing in the color- 
less corpuscles, (4, 6, 8, 7) destroying their contents 
and dilating their walls, so that the cells are often from 
two to four times the size of a normal colorless cor- 
puscle (4, 6, 7, 8.) Especially is this vegetation found 
developing in Peyer’s glands. 
Since the discovery of the vegetations in febrile dis- 
eases, I have changed my treatment of these maladies 
materially and with marked benefit. 
In intermittent, remittent, and typhoid fevers, I 
order the patients bathed thoroughly, morning and 
evening, with either sulphuric acid, a solution of bisul- 
phites, chlorine water, or nitromuriatic acid. Of these 
I usually prefer the former. Sometimes a change from 
one to the other of these baths, from day to day, is 
tound beneficial. I usually add to the baths a portion 
of quinia, on account of its fine tonic effects upon the 
skin and its marked tendency to check cryptogamic 
development. 64 
Vegetation in 
For cheapness and convenience I have adopted the 
following formulas and plan of bathing. 
R. Acid sulphuric aromat., Siv ; Aquae, 3iv; quiniae 
sulphate, 5iij. S. Put a tablespoonful in half a pint 
of warm water, and wash the body and limbs all over 
thoroughly, morning and evening, and wipe dry after. 
Or 
R. Potass, chlorate, gr.xij ; Acid hydrochloric, 5j ; 
quiniae sulphate, 5j ; Aquae, 5xv. M., adding the 
water, ounce by ounce, to the other ingredients in a 
pint bottle, shaking after the addition of each ounce. 
S. Put four ounces of this mixture with four ounces 
of warm water, and wash the body and limbs all over 
thoroughly, morning and evening, and wipe dry. 
Or 
R. Nichols’s solution of bisulphite soda, 5viij ; qui- 
niae sulph., 5iss. M. S. Put two tablespoonfuls in 
half a pint of warm water, and bathe morning and 
evening as before mentioned. 
Or 
R. Acid nitromuriatic dil., 5hj ; quiniae sulph., 5ij. 
M. S. Put two teaspoonfuls in half a pint of warm 
water, and bathe thoroughly night and morning. 
The object of the baths is to destroy the vegetation 
developing in and on the surface epithelium. Just in 
the proportion as this vegetation is destroyed, the 
patient brightens up, and the skin becomes soft, moist, 
and natural in feel, and the disease abates. As the 
skin improves, the mucous membranes, under the in- 
fluence of similar internal remedies, take on a healthier Typhoid Fever. 
65 
and more natural appearance, the tongue becomes moist 
and clean, and the whole organism from hour to hour 
puts on more and more the vigor, glow, and supple- 
ness of the physiological state. 
The internal treatment is directed so as to check 
zymotic development as rapidly as possible. Quinite 
is invaluable. The bisulphites, chlorine water, tr. ferri 
chlorid., lactate ot iron, strychnine, and the mineral 
acids are all highly useful. 
A plenty ot beef tea, and milk warm from the cow, 
aid much in the treatment. The clothing and bedding 
should be changed morning and evening, and the room 
should be well and constantly ventilated. By following 
out this plan the dangers and lingering sufferings may 
be much lessened, and these febrile diseases materially 
shortened in their course. DESCRIPTIONS OF ILLUSTRATIONS. 
1. Spores of the Biolysis typhoides, as they appear upon and in the 
epithelial cells of the epidermic and mucous surfaces in typhoid 
fever. 
2. Epithelial cells filled with spores of the B. typhoides. These cells 
were scraped from the epidermis during the active stage of the 
disease. The cells of the epidermis and mucous surfaces are filled 
with these spores during the entire course of the fever. 
3. Spores of the B. typhoides multiplying by duplicative segmentation. 
At the right are represented embryonic filaments. 
4. Colorless corpuscles in the blood of typhoid fever expanded about 
four times their usual diameter, with their normal contents de- 
stroyed by the spores of the B. typhoides, which now fill the dis- 
tended cells. These spore sacs are frequently met with in the 
blood of this disease. 
5. Mass of spores of the B. typhoides from the blood of typhoid fever. 
6. Colorless corpuscles of the blood in typhoid fever, with their nor- 
mal contents destroyed and their place occupied by the spores of 
the B. typhoides. 
7. Distended colorless corpuscles that have been filled with the spores 
of the B. typhoides, and which spores have escaped, leaving almost 
empty sacs. These empty sacs are quite abundant in the blood 
of typhoid fever. 
8. Distended colorless corpuscles of typhoid fever .filled with the spores 
of the B. typhoides. 
9. Spore of the B. typhoides. 
10. Embryonic filaments of the B. typhoides in various stages of develop- 
ment, that occur in the secretions, excretions, and glands of typhoid 
fever patients. These filaments in their earlier stages of growth 
are mostly moniliform. 
11. One form of mature filaments of the B. typhoides which presents 
a quite homogeneous appearance throughout its entire length. 
Other filaments have cross markings at tolerably regular intervals. 
These are met with in the fa»cal and urinary discharges in the later 
stages, and in the blood and glands after death.