64 ABNORMAL CONDITIONS OF THE BLOOD. 



the blood is caused directly by albuminuria ('25 grammes of albumin may be given off 

 by the urine daily), persistent suppuration, great loss of milk, extensive cutaneous 

 ulceration, albuminous diarrhoea (dysentery). Frequent and copious haemorrhages, 

 however, by increasing the absorption of water into the vessels, at first produce 

 oligajmia hypalbuminosa. 



Mellitaemia. The suar in the blood is partly given off by the urine, and in 

 "diabetes mellitus " one kilo. ('2 - 2 Ibs.) may be given off daily, when the quantity 

 of urine may rise to 25 kilos. To replace this loss a large amount of food and 

 drink is required, whereby the urea may be increased threefold. The increased 

 production of sugar causes an increased decomposition of albuminous tissues; hence 

 the urea is always increased, even though the supply of albumin be insufficient. 

 The patient loses flesh ; all the glands, and even the testicles, atrophy or degenerate 

 (pulmonary phthisis is common); the skin and bones become thinner; the 

 nervous system holds out longest. The teeth become carious on account of the acid 

 saliva, the crystalline lens becomes turbid from the amount of sugar in the fluid 

 of the eye which extracts water from the lens (Kunde, Heubel), and wounds heal 

 badly because of the abnormal condition of the blood. Absence of all carbo- 

 hydrates in the food causes a diminution of the sugar in the blood, but does not 

 cause it to disappear entirely. An excessive amount of inosite has been found in the 

 blood and urine, constituting mellituria inoslta (Vohl). 



Lipseniia, or an Increase of the Fat in the Blood, occurs after every meal 



rich in fat, so that the serum may become turbid like milk. Pathologically, this 

 occurs in a high degree in drunkards and in corpulent individuals. When there is 

 great decomposition of albumin in the body (and therefore in very severe diseases), 

 the fat in the blood increases, and this also takes place after a liberal supply of 

 easily decomposable carbo-hydrates and much fat. 



The Salts remain very persistently in the blood. The withdrawal of common 

 salt produces albuminuria, and, if all salts be withheld, paralytic phenomena occur 

 (Forster). Over -feeding with salted food, such as salt meat, has caused death 

 through fatty degeneration of the tissues, especially of the glands. Withdrawal of 

 lime and phosphoric acid produces atrophy and softening of the bones. In infectious 

 diseases and dropsies the salts of the blood are often increased, and diminished in 

 inflammation and cholera. [NaCl is absent from the urine in certain stages of 

 pneumonia, and it is a good sign when the chlorides begin to return to the 

 urine]. 



The amount Of fibrin is increased in inflammations of the lung and pleura; 

 hence, such blood forms a crusta pldo'j'istica (p. 39). In other diseases, where 

 decomposition of the blood-corpuscles occurs, the fibrin is increased, perhaps 

 because the dissolved red corpuscles yield material for the formation of fibrin. 

 After repeated hpernorrhages, Signi. Mayer found an increase of fibrin. Blood rich 

 in fibrin is said to coagulate more tsloivly than when less fibrin is present still 

 there are many exceptions. 



For the abnormal changes of the red and white blood-corpuscles see p. 23. 



