426 



BLOOD, MORBID CONDITIONS OF THE. 



blood with that of the bile itself will be ren- 

 dered sufficiently evident by adding to it an 

 equal quantity of sulphuric acid diluted with 

 twice its bulk of water. The serum will thus 

 change its yellow hue for the characteristic 

 green colour of acid bile. Experimentalists 

 have failed in producing this effect, being pro- 

 bably misled by having found that the small 

 proportion of acid which is required to strike 

 a green colour with urine charged with bile, 

 produces no such effect when added to jaun- 

 diced serum. 



Disease of the kidney. In those organic 

 diseases of the kidney which are characterized 

 by anasarca and the passing of urine coagu- 

 lable by heat and acids, the albumen of the 

 blood is more or less deficient in proportion; 

 and this is marked by a corresponding dimi- 

 nution in the specific gravity of the serum. 

 In a letter to Dr. Bright, published in the first 

 volume of that author's Reports of Medical 

 Cases, page 83, Dr. Bostock states, in re- 

 ference to the blood in these diseases, that 

 the crassamentum was for the most part co- 

 vered with a thick burly coat, and was gene- 

 rally of a firm consistence. The appearance 

 of the serum was more varied. It was occa- 

 sionally turbid, and upon standing for twenty- 

 four hours a white creamy substance rose to 

 the surface ; but no proper oily matter could 

 be detected in it. On exposing it to heat, it 

 coagulated in the ordinary manner, except that 

 the coagulum seemed to contain an unusual 

 number of cells, and that a greater quantity 

 of serosity separated from it. " I think I may 

 venture to say," adds the writer, " that the 

 serum generally in these cases contained less 

 albumen than in health, although I am not 

 able to state precisely the amount of this dif- 

 ference. The serosity which drained from the 

 coagulated albumen on being evaporated was 

 found to consist in part of an animal matter 

 possessing peculiar properties which seemed 

 to approach to those of urea ; it was partially 

 soluble in alcohol, and was acted upon in a 

 somewhat similar manner by nitric acid." 



The above remarks were made on specimens 

 of blood furnished from time to time by Dr. 

 Bright. The number is not stated, nor was the 

 specific gravity of the serum taken. Dr. Bos- 

 tock gives a case, however, (page 85,) where, 

 after stating that the crassamentum was re- 

 markably buffed and cupped, he adds, " The 

 serum was also worthy of attention, as taken 

 in connexion with the state of the other fluids. 

 Its specific gravity was almost exactly the same 

 with that of the urine, being no more than 

 1-013, which I believe to be lower than had 

 ever occurred to me in the numerous expe- 

 riments which I have made upon this sub- 

 stance. We have here, therefore, an example 

 of blood exhibiting a very great deficiency of 

 albumen, at the same time that we observe the 

 mode in which it passes off from the system 

 by means of the kidney, while this organ has 

 its appropriate office of secreting urea nearly 

 suspended. I regret that I did not attend 

 particularly to the specific gravity of the other 

 specimens of dropsical serum which you sent 



me. From some incidental remarks in my 

 notes, I suspect that its specific gravity would 

 have been found lower than ordinary ; but it 

 is a circumstance which I shall be anxious to 

 ascertain when any opportunity occurs." This 

 suspicion is completely confirmed by other 

 cases that have occurred to myself, in which 

 the fact was also established beyond doubt, 

 that the animal matter found by Dr. Bostock 

 in the serosity was not merely an approach to 

 urea, but that principle itself possessing all its 

 usual characters. The following may serve as 

 an example of light serum. 



William Squires, aged 54, labouring under or- 

 ganic disease of the kidneys and chronic bron- 

 chites with anasarca, had for many months 

 voided urine which coagulated on the appli- 

 cation of heat or the addition of nitric acid. 



The specific gravity of his blood at 



88 Fahr.was 1-041 



Do. Serum at 68 1-021 



healthy standard 1-030. 



This blood contained in 1000 parts, 

 3-845 fibrine : 



healthy standard 2*1 to 3'56 

 55-000 albumen : 



healthy standard 65 to 69 

 In this case 100 grains of urine contained 6'666 

 albumen. There was consequently nearly one 

 eighth as much albumen in the urine as in the 

 blood, and the patient lost as much of that con- 

 stituent daily, as if he had been bled to the 

 extent of four ounces. 



The following cases are from notes with which 

 I have been favoured by Dr. G. H. Barlow, 

 who has devoted much attention to the exami- 

 nation of the blood and urine in this disease. 



No. 1 . A patient affected with general ana- 

 sarca Urine copious, clear, pale, coagulable 

 by heat and nitric acid : specific gravity 1-011. 

 Blood cupped and buffed, serum milky : spe- 

 cific gravity 1-019. 



No. 2. Man aged 48, anasarcous Urine 

 dingy brown, natural in quantity, acid, coagula- 

 ble; specific gravity 1-017, contained 4* per 

 cent, of albumen. Serum of the blood, specific 

 gravity 1-Q13. 



No. 3. A man who was found on post-mor- 

 tem examination to have granulated kidneys. 

 Urine reddish brown, very scanty, coagulable ; 

 specific gravity 1-008. Blood cupped and buf- 

 fed ; specific gravity (of the whole blood) 1-037. 



In my paper on the blood in the Medico- 

 Chirurgical Transactions, vol. xvi. I have stated 

 the case of a woman forty-eight years of age, who 

 for ten weeks had complained of pains in her 

 loins, anasarcous swelling of her legs, and ge- 

 neral debility, and who passed urine which was 

 in a high degree coagulable. I examined her 

 blood, and found it to contain 0'43 per cent, of 

 fibrine, and only 1-61 per cent, of albumen. 

 The specific gravity of the serum was 1-020 

 at 60 Fahr. In that paper I have also 

 observed that in several cases marked by 

 coagulable urine, I have examined the specific 

 gravity of serum with which Dr. Bright has fur- 

 nished me, and have always found it much 

 below the healthy standard. 



It is not, however, in this complaint ex- 



