ALTERATIONS OF ITS COMPOSITION IN DISEASE. 269 



indicate that in very severe inflammations they are greatly diminished ; 

 whilst they are much increased in the acute exanthemata and in typhus, in 

 dysentery, Bright's disease, and all forms of dropsy and hydnemia ; and 

 are often doubled in quantity in diseases depending upon malarious influ- 

 ences, such as endemic dysentery, malignant forms of intermittent fever, 

 etc. Although a large quantity of saline matter usually passes off from 

 the blood in Cholera, yet the proportion of water discharged is so much 

 greater, that, as appears from the analysis of Dr. Garrod, the percentage 

 of salines in the blood is rather increased than diminished. 1 The propor- 

 tion of Water in the blood will of course vary reciprocally with that of the 

 solid constituents; and will be specially augmented when there is a marked 

 diminution in the amount of red corpuscles. 



204. 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. 2 The great amount of attention which is 

 being directed by Chemists and Pathologists to the subject, however, will 

 doubtless ere long produce some important results. Among the most fre- 

 quent causes of depravation in the character of this fluid, we must undoubt- 

 edly rank the retention, in the Circulating current, of matters which ought 

 to be removed by the Excretory processes. We shall hereafter see, that a 

 total interruption to the excretion of Carbonic Acid by the lungs will occa- 

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

 impediment is offered to the elimination of the carbonic acid, so that the quan- 

 tity of it always contained in arterial blood is augmented to but a small 

 degree, a feeling of discomfort and oppression, increasing with the duration 



1 London Journal of Medicine. May, 1849. 



2 It seems not improbable that the phenomena of disease are sometimes caused by, 

 though perhaps in other instances they may be only associated with, the develop- 

 ment" of living organisms in the blood. Thus extremely fine, moving threadlike 

 bodies resembling spirillum, have been observed by Obermeier (Centralbiatt, 1873, p. 

 145) in the blood of patients suffering from recurrent fever, shortly before or during 

 the crisis, but their nature is unknown. Nedvetski (idem, 1872, p. 234) has seen 

 moving particles, apparently derived from the white corpuscles, and bacteridia in the 

 blood of choleraic patients' Nepveu (Gaz Med. de Paris, 1872, No. 3) has noticed 

 bacteria in cases of erysipelas. Lewis (Pamphlet, 1872, Lancet, 1873, 1,446) has 

 described a peculiar kind of Filaria, as being constantly present in large numbers in 

 the blood of patients (in India) suffering from chyluria ; Kiess (lieichert's Archiv, 

 1872, p 237), bright granules in scarlet fever ; Birsch-Hirschfeld (Archiv d. Heil- 

 kunde, xiii, 1872, p. 38), micrococci in pyasmia and puerperal fever; Huter (Central- 

 biatt, 1868, p. 177), similar forms in diphtheritis. See also Orth, Archiv d. Heil- 

 kunde, 1872, xiii, p. 2<5o, and Miller, Centralbiatt, 1874, p. 833. In the Biennial 

 Pietrospect of Physiology, of the New Syd. Soc. for 1875, several other references 

 will be found. Considerable interest attaches to a statement re<*ently made by Los- 

 torfer (Wien. Med. Jahrb., 1872, Heft i, p. 96), and confirmed by Strieker, though 

 vehemently denied by others, that the blood of syphilitic patients can be recognized 

 bv the presence of small bright bodies, which present Brunonian movements, and in 

 the course of a week after removal from the body, enlarge, sprout, become vacuo- 

 lated, and die. Lostorfer's statements have been partially corroborated by Biesia- 

 decki, who, however, regards tho bright particles as paraglobulin (Untersuch. aus 

 dem Path.-Anatom. Institute in Krakau, Vienna, 1872) precipitated by carbonic 

 acid developed during the decomposition of the blood Such particles are present in 

 small numbers in alf blood, but are uncommonly abundant in blood preparations 

 from syphilitic patients, either because their blood contains more paraglobulin or 

 less fibrinogenous substance than other blood. See article by Klein in Lond Med. 

 Kecord, April 9th, 1873. Halford, On the Condition of the Blood after Snakebite, 

 1867, has observed peculiar nucleated cells in the blood after snakebite, which he be- 

 lieves to be derived from germinal matter in the poison of the snake, and to have 

 grown at the expense of the blood. 



