ALTERATIONS OF ITS COMPOSITION IN DISEASE. 267 



ula, in which a diminution of Corpuscles coexists with a deficiency in the 

 amount or in the degree of elaboration of the Fibrin. A similar deficiency 

 in the proportion of Red Corpuscles has been observed by Audral in other 

 cachectic states induced by disease, as in Diabetes Mellitus, Aneurismal 

 dilatation of the Heart producing Dropsy, and in Cachexia Saturnina. It 

 occurs also in Scurvy, and in the advanced stages of Albumiuuria, and Dr. 

 AVilliams 1 has observed a similar total destruction of the blood-disks in a 

 case of malignant scarlatina with purpura ; and has met with indications of 

 a partial destruction of them in acute purpura connected with jaundice, and 

 in cases of functional derangement of the liver. 



202. A marked increase in the proportion of the Colorless Corpuscles has 

 been frequently observed in the blood of Inflammatory subjects ; this in- 

 crease is not, however, so characteristic of the Inflammatory state as some 

 have supposed; for it is by no means constant in that condition, and is fre- 

 quently seen in very different states of the system. 2 Attention has recently 

 been drawn by Prof. J. H. Bennett 3 to a condition of the. Blood which is 

 especially characterized by a marked excess of these bodies, and which he 

 has designated by the term Leucocylhcemia (white-cell blood). This con- 

 dition has been detected in the blood of a considerable number of individ- 

 uals suffering under diseases (most commonly enlargement) of the Spleen, 

 Liver, and Lymphatic glands, either separately or in conjunction ; but it 

 has not yet been determined how 7 far it is constantly associated with any of 

 these abnormal conditions. In all cases in which such blood has been an- 

 alyzed, its specific gravity has been found very low, and the total amount 

 of corpuscles small ; but the fibrin is almost invariably above the average, 

 having in one instance risen to 7.08. 



203. The quantity of Albumen in the blood seems to vary less than that 

 of most of its other constituents. The proportion which it bears to the 

 water of the serum, is of course elevated by anything which diminishes the 

 latter ; and thus we find it high in cholera after profuse discharges of fluid 

 from the intestinal canal, and in other cases in which there has been an un- 

 usual drain upon the liquid part of the blood, provided that the albumen 

 do not pass off' with it, as sometimes happens. Where some special cause 

 is in operation, which favors the escape of the albumen from the circulat- 



ofaEational practice, based on u knowledge of the real facts of the case, than is afforded 

 by the contrast between the former and the present treatment of Chlorosis. Whilst the 

 notion prevailed that the " buffy coat" is a sign of Inflammation, and that the most 

 potent remedy for Inflammation is loss of blood, patients already reduced to a state of 

 ansemia, who complained of pain in the left hypochondrium, palpitations, etc., were 

 bled over and over again, every withdrawal of blood of course seriously increasing 

 the mischief, bj 7 producing a further reduction in the proportion of red corpuscles 

 (g 187). The Author well remembers that, when a pupil in the Bristol Infirmary in 

 the years 1833-4, he was repeatedly directed by the estimable Senior Physician (long 

 since dead) to draw eight, ten, or twelve ounces of blood from patients in this con- 

 dition ; and that the crassamentum, after coagulation, often resembled a small 

 island floating in an ocean of serum. Yet, because this minute clot exhibited the 

 buffy coat, the bleeding was considered to be " orthodox " practice, and the obstinacy 

 of the symptoms was attributed to the severity of the disease. If M. Andral had 

 made no" other contribution to Medical Science than the demonstration of the real 

 nature of this condition of the blood, and of the influence of further depletion in 

 promoting it, he would have rendered a most essential service to the multitude of 

 females who are unfortunate enough to suffer from this kind of deterioration of their 

 vital fluid. 



1 Principles of Medicine, 2d edit., p. 115. 



2 As in Scurvy. See Laboulbene, La Revue Scient., ser. ii, an. 1, p. 43, 1871. 



3 See his successive Papers in the Edinb. Monthly Journal for 1851, bis Treatise 

 On Leucocythaemia, and his Clin. Lectures On the Principles and Practice of Med., 

 4th edit., 1865, p. 867 et seq. 



