PATHOLOGICAL CHANGES IN THE BLOOD. 537 



degree of symptomatic Fever accompanying it. "The augmentation of the quantity of 

 Fibrine is so certain a sign of Inflammation, that, if we find more than 5 parts of fibrine in 

 101 id, in tin- course of any disease, we may positively affirm that some local inflammation 

 exists." Several cases are mentioned, in which an increase to 7 or 7^ parts took place, 

 without any apparent cause; but in which it afterwards proved that severe local inflamma- 

 tion was present; and thus we are furnished with a pathogribmonic sign of great importance. 

 The average proportion of Fibrine in Inflammation may be estimated at 7; the minimum 

 at 5; the maximum at 13'3. The greatest augmentation is seen in Pneumonia and Acute 

 Rheumatism. It does not appear that in robust athletic persons, the proportion of Fibrine is 

 greater than in those of feeble constitution ; in the latter it is the Corpuscles that are deficient; 

 and it is rather from this disproportion, than from an absolute excess of Fibrine, that their 

 greater liability to Inflammatory affections arises. Diseases which commence at the same 

 time as the Inflammation, or co-exist with it, do not prevent the characteristic increase of the 

 Fibrine; thus in Chlorotic females, the proportion rises to 6 or 7, under this influence. The 

 augmentation is observed at the very outset of the affection; the quantity increases with its 

 progress; and a decrease shows itself when the disease begins to abate.* When the dis- 

 ease presents alternations of increase and decline, these are marked by precisely correspond- 

 ing changes in the quantity of Fibrine. It is a curious fact, that an augmentation is commonly 

 observable during the advanced stage of Phthisis, in spite of the deterioration which the 

 blood must then have undergone; this is probably dependent upon the development of local 

 inflammation around the tubercular deposits. In one of Popp's observations, the proportion 

 of Fibrine in the blood of a Phthisical patient was not less than 10-7. Some experiments 

 performed by M. Andral on the blood of pregnant women, seem to lead to the conclusion 

 that, during the first six months, the Fibrine is below the normal standard; and that it sub- 

 sequently varies, usually undergoing an augmentation between the sixth and seventh, and 

 the eighth and ninth months. There is also a diminution in the Corpuscles; and these circum- 

 stances combined favour the production of the buffy coat ( 704). These observations are 

 confirmed by those of MM. Becquerel and Rodier. 



b. It appears obvious, from what has been just stated, that the increase in the quantity of 

 Fibrine is not dependent upon the febrile condition, which is secondary to the local inflamma- 

 tion, but upon the Inflammation itself. This conclusion is confirmed by the interesting fact 

 that, in idiopathic Fever, the proportion of Fibrine is diminished, instead of undergoing an 

 increase. This diminution was constantly observed by Andral in the premonitory stage of 

 Continued Fever; .in some instances the amount was no more than 1-6 parts in 1000. The 

 proportion of Corpuscles was found to have usually, but not constantly, undergone an increase ; 

 as had also that of the solid parts of the Serum. In ordinary Continued Fever, in which 

 there was no evident complication from local disease, the quantity of Fibrin varied from 4-2 

 to 2-2; that of the Corpuscles from 185-1 to 103-6 (excluding a case in which their amount 

 was only 82-5, which was that of a Chlorotic female); that of the solid matter of the Serum, 

 from 98-7 to 909; and that of the Water from 725-6 to 851-9. Hence the quantity of solid 

 matter appears to be usually increased ; but the peculiar condition of the disease may proba- 

 bly be stated to be, an increase in the proportion of the Corpuscles to the Fibrine. When, 

 however, a local Inflammatory affection de.velopes itself during the course of the Fever, the 

 amount of Fibrine increases ; but its augmentation seems to be kept down by the febrile 

 condition. In Typhoid Fever,f the decrease in the proportion of Fibrine is much more de- 

 cidedly marked; this does not depend upon abstinence; for it ceases as soon as a favourable 

 change occurs in the disease, long before the effect of food could show itself. In the various 

 cases examined by Andral, the blood furnished a maximum of 3'7 of Fibrine, and a minimum 

 of 0-9 ; in this last case, the Typhoid condition existed in extreme intensity, yet the patient 

 recovered. The proportion of Corpuscles varies considerably; in an early stage of the disease 

 it is usually found to be absolutely high ; and it always remains high relatively to the amount 

 of Fibrine. In Typhoid fever, then, the abnormal condition of the Blood, in regard to the 



* By experiments on animals, M. Andral has ascertained that no circumstance of pre- 

 vious debility or privation prevents this characteristic change. Having ascertained the 

 amount of Fibrine in the blood of three dogs to be 2-3, 2-2, and 1-6 (the natural range for 

 these animals), he deprived them, completely or partially, of food. On the fourteenth day, 

 the proportion of fibrine had risen, in the first to 4-5-: and in the second, to 4: these animals 

 had no food. In the third dog, which was supplied with a very small quantity of food 

 daily, the same condition developed itself at a later period ; the blood 011 the fourteenth day 

 exhibiting only 1-8 parts of fibrine: but on the twenty-second day presenting 3'3 parts In 

 all these instances, the elevation in the proportion of Fibrine was coincident with Inflamma- 

 tory changes in the stomach. 



f M. Andral confines this term to the species characterized by ulceration of the mucous 

 follicles of the intestinal canal. 



