290 OF THE BLOOD: ITS VITAL PROPERTIES, 



ruaut, until some appropriate part is rendered, by some such cause, pecu- 

 liarly susceptible to this malady. 1 But, in other cases, we find that the con- 

 tamination of the blood is such as primarily to produce more or less dis- 

 turbance in all the functions; as we especially witness in the severer forms 

 of fever, in poisoning by venomous serpents, etc. Even in this last class of 

 cases, however, a special determination to one organ or system is frequently 

 obvious ; and this may be so constant as to be characteristic of the disease, 

 as is the case with the skin affection in the Exanthemata generally, the 

 affection of the throat and the kidneys in Scarlatina, and that of the air- 

 passages in Measles. But in other instances, the local affections produced 

 in different individuals by the same specific* poison, vary in their relative 

 intensity, and even in their seat, according to the previous conditions which 

 their respective subjects afford ; and whilst in some instances, this variation 

 may be clearly traced to local peculiarities of nutrition, in others it seems 

 only capable of being accounted for by supposing that the blood of each 

 individual has some peculiar or personal character, which causes it to be 

 differently affected in each subject. Of the determining influence of local 

 deteriorations of nutrition, we occasionally meet with curious examples in 

 the Exanthemata : thus, the eruption of Measles has been seen to be deepest 

 and most diffused over a knee affected with chronic synovial inflammation 

 and general swelling; and in a patient who became affected with Small-Pox 

 soon after a fall on the nates, the pustules, though thinly scattered elsewhere, 

 were crowded together on the injured part as thickly as possible. 2 So, during 

 an epidemic Influenza, it is evident that the local affection often manifests 

 itself chiefly (if not solely) in what was previously regarded as the " weak 

 point "of each patient's system. 3 The local determination of a morbid 

 poison may frequently be regarded as one of the means whereby the blood 

 and the system at large are freed from its action. Of this, again, we have 

 a most characteristic example in the Exanthemata : for it is a matter of 

 constant observation, that the coustitional symptoms, especially fever and 

 delirium, are most severe before the cutaneous eruption comes out; that 

 there is much greater danger to life, when the eruption does not develop 



1 See Mr. Paget's Lectures on Surgical Pathology, vol. i, p. 492. 



2 Paget, op. cit., p. 444. 



3 Of those variations, on the other hand, which, as they cannot be thus attributed 

 to purely local causes, must be referred to peculiarities in the general state of the 

 system, and especially of the blood, of each individual, we have a highly character- 

 istic example in the following incident, which fell under the notice of Prof. Huxley, 

 when serving as Assistant-Surgeon on board H. M. S. Rattlesnake, which had been 

 engaged on a surveying voyage about New Guinea and Australia. The crew seem 

 to have acquired a predisposition to disease, by long confinement, exposure to trop- 

 ical sunshine, unwholesome food, and other unfavorable influences; but no decided 

 malady had shown itself among them, until one of them, after slightly wounding 

 his hand with a beef-bone, had suppuration of the axillary lymphatic glands, with 

 which typhoid symptoms and delirium were associated, and which proved fatal. A 

 few days alter hi* death, the sailor who washed his clothes had similar symptoms of 

 dUease in the axilla; and for four or five months he snU'ered with sloughing of por- 

 tions of the cellular tissue of the axilla, arm, and trunk of the same side. Near the 

 same time, a third sailor had diffuse inflammation and sloughing in the axilla; and 

 after this, UK- disease ran in various forms through the ship's company, between thirty 

 and forty of whom were sometimes on the sick-list at once. Some had diffuse cellu- 

 lar inflammation ; some had inflammation of the lymphatic glands of the head, axilla, 

 and lower extremities; one had severe idiopathic erysipelas of the head and neck ; 

 another had phh-gmonons erysipelas of the hand and arm after an accidental wound ; 

 others had low fever with or without enlargement of glands. Finally, tin- disease 

 took the form of mumps, which affected almost everybody on board. The epidemic 

 lasted from May to July (the winter in the southern hemisphere), the ship being at 

 sea during the whole time. 



