EFFECTS ON THE BLOOD 24 1 



There is, however, much variation in the changes in mass and composition 

 of the blood, varying according to species, age, individual and type of inanition, 

 as will appear in the subsequent review of the literature. The changes in 

 physico-chemical constitution, which in general lie outside the scope of the pres- 

 ent work, are reviewed by Burckhardt ('93), Lackschewitz ('93), Weber ('02), 

 Lewinski ('03), Tria ('11), Schulz ('12), Robertson ('13), Gerpott ('13), Ash 

 ('14, '15), Nobecourt ('16), Trowbridge, Moulton and Haigh ('15, '18, '19), 

 Lusk ('17), Hatai ('18), Moulton ('20) and others. In general, excepting 

 extreme stages and variations in water content, it may be stated that the chem- 

 ical composition of the blood undergoes relatively little change during inanition, 

 its losses being largely compensated through absorption of materials stored in 

 the various tissues and organs. Accurate analyses, however, show certain 

 definite and characteristic changes during various types of inanition. 



Special mention may be made of the fat content of the blood, since the fat 

 granules (as hemokonia) are visible by the ultramicroscope. Schulz ('96, '97) 

 found the fat content of the blood markedly increased (sometimes doubled) 

 in fasting pigeons and rabbits. This was confirmed by Daddi ('98b) for dogs in 

 short fasting periods, although a progressive decrease occurs in longer fasts. 

 Further data are cited by Weber ('02), Rothschild ('15), and Greene and 

 Summers ('16). Bloor ('14) demonstrated that in dogs the result varies accord- 

 ing to the nutritional condition of the dog preceding the inanition. Aside from 

 the observations of Reicher ('09), Nobecourt and Maillet ('14) and Gage ('20, 

 '21), apparently no attempt has been made to correlate these chemical changes 

 with the morphological structure shown by the ultramicroscope. Some possible 

 relations between the lipemia during inanition and the deposition of lipoidal 

 fat in certain organs will be mentioned later. 



Changes in Human Adults. — The effects of total inanition (or water alone) 

 upon the blood have frequently been studied in man. Morgagni (1761) found 

 very little blood in the larger vessels of two men who died from chronic starva- 

 tion. This was confirmed by Haller (1771). Dutrochet (1816) stated that the 

 number of red blood corpuscles is increased by rich nutriment, and decreased 

 by fasting. Donovan ('48) observed marked anemia in the Irish famine vic- 

 tims. Brouardel ('76) found a high red cell count and a syrupy consistency of 

 the blood in a case of starvation from esophageal stricture. The blood changes 

 during Dr. Tanner's fast are given by Van der Weyde ('79-'8o). The digestive 

 leukocytosis was studied by Detoma ('80). Cadet ('81) found that a 24 hour 

 fast causes a slight increase in the number of red cells (per cu. mm.), and a 

 decrease in the white cells and platelets. Curtis ('81) observed during a 45 

 day fast great variations in the number (2,370,000-6,770,000), size and form of 

 the erythrocytes, probably due chiefly to imperfections of technique. 



Hayem ('82, '89) claimed that in chronic cachexias, the loss in the total mass 

 of blood is relatively greater than that of the whole body. The decrease in the 

 red cell count is at first slight; later it may be extreme. The leukocyte count 

 varies according to the cause of the cachexia. The number is usually increased; 

 but, as likewise for the platelets, it may decrease before death. The structure 

 of the leukocytes may also change, with cytoplasmic vacuolation and less 



