Just as there is a general and a special anatomy, physiology, pathology, so there must in like manner be a general and a special pathological anatomy. The former treats of general anomalies of organization, the latter of the special anomalies of individual textures and organs.

All anomalies of organization involving any anatomical change manifest themselves as deviations in the quantity or quality of organic creation, or else as a mechanical separation of continuity. They are reducible to irregular number [deficient or excessive formation], irregular size, form, position, connection, color, consistence, continuity, texture, and contents. They relate to the physical properties of the animal body and of its organs. The chemical properties, although not strictly pertaining to the field of anatomy, are too intimately connected with the physical, to be suffered to remain in the background at the present day. The animal fluids bear a similar relation to anatomy. Their anomalies will be taken into account, so far as it may appear needful, under the appropriate heads. Those of the sanguineous fluid will, however, demand a separate chapter. This will come in at the conclusion of the general anatomy, in which a frequent reference to them will have previously demonstrated the indispensable nature of the inquiry, as a sort of connecting link between general and special anatomy. "We shall thus have to discuss, in ten separate chapters, the anomalies of organization. There are, however, a few general points which require some previous explanation.

I. The Said Anomalies

The Said Anomalies, being simple alterations of the normal being and of its parts, appear as abnormal conditions, excluding the idea of an independent parasitic organism of disease.

II. No Formation Is Incapable Of Becoming Diseased

No Formation Is Incapable Of Becoming Diseased in one or more ways. Several anomalies coexisting in an organ commonly stand to each other in the relation of cause and effect. Thus, deviations in texture very frequently determine deviations in size, in form, - and these again deviations in position. Deviations in position give rise to anomalies of volume and of texture.

III. Pathological Anatomy

Pathological Anatomy, proximately concerned with anomalies of individual organs and systems - with local anomalies - has often reserved for it the task of revealing by experiment and deduction the existence of general disease, as also of establishing the mutual relations which exist between the two. The seat of general diseases may now be referred, almost without exception, to the blood [the fluids]. They appear, therefore, as anomalies of admixture or crasis, either primary or secondary.

IV. This Demonstration Of General Disease

This Demonstration Of General Disease is indeed a step in advance for pathological anatomy. It threatens, however, to mislead us into the error of exclusive, transcendental, all-pervading humoralism - into the error of denying all local disease, by deducing the latter in every instance from a corresponding general affection, - not but that many diseases really are but the localization of a pre-existent general disease.

V. The Existence Of Purely Local

The Existence Of Purely Local - independent of general - disease, from the simplest inflammation - from blennorrhea, to tubercle and cancer, we look upon as grounded -

(a.) In the self-vitality of organs, and their independent relations to the external world.

(b.) In the local influence of direct or reflected stimulation. Either directly, or through the medium of the nervous system, stimuli effect a local modification in the vital processes of absorption and secretion - in the interchange of matter, - an anomalous reciprocity between bloodvessels and their contents on the one side, and the parenchyma-engendering products, abnormal both in quantity and in kind, on the other.

Normal nutrition and secretion are no doubt mainly dependent upon a normal crasis; but they are also based upon the perfection of the specific vital action proper to individual parenchymata. Anomalous secretions often arise out of influences which modify the vital action of the parenchyma, and consequently its reciprocity with the unchanged gross material, the blood: as, for example, augmented or otherwise altered secretion of milk, produced by local irritation or by anomalous innervation, the effect of mental operations. In like manner, local diseases are but a consequence of qualitative and quantitative alienation of the textures and organs, - the formative material (the blood), notwithstanding its reciprocity with the latter, not becoming sensibly contaminated.

Influences, especially of a mechanical kind, are often so strictly local, that it would be far-fetched to derive all local disorder from a general causal disease. Even the latter would be but secondary, - a mere transfer of the alienation locally produced.

The existence of local diseases is further shown -

(c.) By direct evidence, where local disease is established, of the absence of any disease of the blood crasis.

(d.) In the curableness by topical remedies - extirpation, isolation, etc. - of local diseases, without their recurrence either on the same spot or elsewhere. The cure may even involve the simultaneous removal of a general disease consequent upon the local one, this having possibly acted as an anomalous instrument for the elimination of certain elements from the blood, exhausting it of certain essential constituents.

VI. Local Disease

Local Disease extends beyond its original seat in various ways:

1. By Contiguity

The affection spreads to the immediate vicinity of its original seat. This extension is favored -

(a.) By uniformity of structure.

(b.) By intensity of disease.

(c.) By the nature of the malady. Certain diseases, such as tuberculosis and cancer, in their extension, spare no texture, whilst the typhous process upon the intestinal mucous membrane always finds an arresting formation in the sub-mucous areolar tissue.