266 OF THE BLOOD: 



diminution in the proportion of Fibrin is a tendency to the occurrence of 

 Haemorrhage or Congestion, either in the pareuchyraatous tissue or on the 

 surface of membranes ; and these conditions are well known? to constitute 

 common complications, not only of febrile diseases, but also of Apoplexy 

 and Purpura hsemorrhagica, in both of which there is a marked deficiency 

 of Fibrin. It has been asserted that the proportion of Fibrin is diminished 

 in Scurvy; but this, from the analyses of MM. Becquerel and Rodier, Chatiu 

 and Bouvier, 1 and Mr. G. Busk, 2 appears not to be the case, the proportion 

 of fibrin being rather above than below the normal average. In Cholera, 

 however, a reduction in the coagulable element of the blood seems to be an 

 almost constant occurrence; and in some instances the blood, although 

 loaded with solid matter, has scarcely coagulated at all. Of the blood drawn 

 during life, it has been observed that the clot is loose and grumous, often 

 not shrinking and expelling serum ; and that this change presents itself in 

 a degree corresponding to the severity and advanced stage of the disease. 

 And when the blood has been removed from the body after death, the clots 

 have been found loose and fragile in texture, sometimes almost semifluid. 3 

 How far the so-called exudation found in an inflamed part is dependent 

 upon the accumulation of the white corpuscles on the exterior of the vessels, 

 as described by Waller and Cohnheim, cannot as yet be stated with cer- 

 tainty. 



201. The amount of Red Corpuscles seems to be subject to greater vari- 

 ation, within the limits of ordinary health, than is that of fibrin. It may 

 even form a racial characteristic, for Mr. Bakewell* states that he was able 

 to distinguish the Mohammedan from the Hindoo by the proportion of cor- 

 puscles contained in their blood, and both of these races readily from the 

 negro, the blood in the latter race being very highly corpusculated. In the 

 condition which is ordinarily termed a highly sanguineous temperament, or 

 Plethora, it is chiefly the entire mass of the blood that undergoes an increase; 

 but whatever excess there may be in the proportion of its solid constituents, 

 this affects the Corpuscles rather than the fibrin, the proportion of these, 

 according to Mantegazza, 5 rising from 5,000,000, which is the normal 

 amount, to 5,500,000 in a cubic centimetre. Plethoric persons are not more 

 prone to Inflammation than are those of weaker constitution; but they are 

 liable to Congestion, especially of the brain, and to apoplexy or other 

 haemorrhage. The effect of bleeding in diminishing this tendency is now 

 intelligible, since we know that loss of blood reduces the proportion of cor- 

 puscles. On the other hand, in that temperament 6 which, when exaggerated, 

 becomes Anamiia, there is a marked diminution of the Corpuscles, the 

 number contained in a cubic centimetre falling from 5,000,000, which is the 

 normal amount, to about 2,000,000. This temperament may lead, on the 

 one hand, to Chlorosis, in which the Red Corpuscles are diminished whilst 

 the Fibrin remains the same, a condition of the system which is singularly 

 improved by the remedial employment of Iron; 7 and, on the other, to Scrof- 



1 Journ. do Chirr.ie Medic-ale, Mars, 1848 



2 Library of Medicine, vol. v, p. 90. Sec also Chalvet, Union Medieale, 1871, 

 p. 52:',. 



" Sec Dr. Parkes's Researches into the Pathology and Treatment of the Asiatic or 

 Al.^ide Cholera, pp. I52, 73. 



4 Mud. Times mid Gazette, Nov. 1872, p. 514. Also a paper read before the An- 

 thropological Society. 



5 (iM/.. Me.l. It,d., 18G5, Nos. 23 and 25. 



6 The term ti/in/>/intic has been applied to tins temperament; by which term was 

 meant a predominance of lymph in the absorbent vessels. 



7 The records of Medicine scarcely furnish a more notable example of the perni- 

 cious influence of theories founded upon a shallow Empiricism, and of the superiority 



