PATHOLOGICAL CHANGES IN THE BLOOD. 539 



contained in the urine. A case is related by him, under this head, which affords an interest- 

 ing exemplification of the general facts that have been already attained by his investigations. 

 A woman who had been suffering from Erysipelas of the face, and who had lost blood both 

 by venesection and by leeches, became the subject of Albuminuria. -The blood drawn at 

 this time exhibited a considerable diminution in the proportion of Corpuscles, as well as of 

 Albumen, a fact which the previous loss of blood fully accounted for. After a short period, 

 during which she had been allowed a fuller diet, another experimental bleeding exhibited 

 an increase in the proportion of Corpuscles. Some time afterwards, when the Albumen had 

 disappeared from the Urine, some more blood was drawn ; and it was then observed that 

 the Albumen of the Serum had returned to its due proportion, but that the Corpuscles had 

 again diminished, whilst there was a marked increase in the quantity of Fibrine. This altera- 

 tion was fully accounted for by the fact, that, in the interval, several Lymphatic ganglia in 

 the neck had been inflamed and had suppurated; and that the patient had been again placed 

 on very low diet. "Thus," observes Andral, "we were enabled to give a complete explana- 

 tion of the remarkable oscillations which were presented, in the proportion of the different 

 elements of the blood drawn at three different times from the same individual; and thus it 

 is that, the more extended are our inquiries, the more easy does it become to refer to gene'ral 

 principles the causes of all those changes in the composition of the blood, which, from the 

 frequency and rapidity with which they occur, seem at first sight to baffle all rules, and to 

 take place, as it were, at random. In the midst of this apparent disorder, there is but the 

 fulfilment of laws ; and in order to obtain these, it is only necessary to strip the phenomena 

 of their complications, and to reduce them to their simplest form." 



708. That the Blood is subject to a great variety of other morbid altera- 

 tions, which are sometimes the causes, and sometimes the results, of Disease, 

 cannot be for a moment doubted. But our knowledge of the nature of these 

 changes is as yet very insufficient. The great amount of attention which is 

 being directed by Chemical Pathologists to the subject, however, will doubt- 

 less ere long produce some important results. Among the most frequent 

 causes of depravation in the character of this fluid, we must undoubtedly rank 

 the retention, in the Circulating current, of matters which ought to be re- 

 moved by the Excreting processes. We shall presently see, that a total 

 interruption to the excretion of Carbonic Acid by the lungs, will occasion 

 death in the course of a very few minutes ; and even when only a slight im- 

 pediment is offered it, so that the quantity of Carbonic Acid always contained 

 in arterial blood is augmented to but a small degree, a feeling of discomfort 

 and oppression, increasing with the duration of the interruption, is speedily 

 produced. The results of the retention of the materials of the Biliary and 

 Urinary excretions will be hereafter considered (Chap, xv.) ; and at present 

 it will be only remarked, that such retention is a most fertile source of slight 

 disorders of the system, that it is largely concerned in producing many severe 

 diseases, and that if complete it will most certainly and rapidly produce a 

 fatal result. The most remarkable cases of depravation of the Blood, by the 

 introduction of matters from without, are those in which these substances act 

 as ferments, exciting such Chemical changes in the constitution of the fluid, 

 that its whole character is speedily changed, and its vital properties are alto- 

 gether destroyed. Of such an occurrence, we have characteristic examples in 

 the severe forms of Typhoid fever, commonly termed malignant; in Plague, 

 Glanders, Pustule Malignc, and several other diseases; in some of which we 

 can trace the direct introduction of the poison into the blood, whilst in others 

 we must infer from the similarity of result) that it has been introduced through 

 some obscure channel, probably the lungs. The final symptoms which are 

 common to all these diseases have been well described by Dr. Williams,* 

 under the title of Necroemia, or Death by depravation of the blood. " Almost 

 simultaneously, the heart loses its power, the pulse becomes very weak, 

 frequent, and unsteady : the vessels lose their tone, especially the capil- 

 laries of the most vascular organs, and congestions occur to a great amount; 



* Principles of Medicine, [Am. Ed. by Dr. Clyiner, p. 373.] 



