186 OF THE BLOOD. 



The augmentation is observed at the very outset of the affection ; the quantity 

 increases with its progress ; and a decrease shows itself when the disease begins 

 to abate. 1 When the disease presents alternations of increase and decline, 

 these are marked by precisely corresponding changes in the quantity of Fibrin. 

 An augmentation is commonly observable during the advanced stage of Phthisis, 

 in spite of the deterioration which the blood must then have undergone ; this 

 is probably dependent upon the development of local inflammation around the 

 tubercular deposits. In one of Popp's observations, the proportion of Fibrin 

 in the blood of a Phthisical patient was not less than 10.7. Some experiments 

 performed by M. Andral on the blood of pregnant women seem to lead to the 

 conclusion that, during the first six months, the Fibrin is below the normal 

 standard; and that it subsequently varies, usually undergoing an augmentation 

 between the sixth and seventh, and the eighth and ninth months. There is 

 also a diminution in the Corpuscles; and these circumstances combined favor 

 the production of the "buffy coat" ( 190). These observations are confirmed 

 by those of MM. Becquerel and Rodier. 



173. It appears obvious, from what has been just stated, that the increase in 

 the quantity of Fibrin is not dependent upon the febrile condition, which is 

 secondary to the local inflammation, but upon the Inflammation itself. This 

 conclusion is confirmed by the interesting fact that, in idiopathic Fever, the 

 proportion of Fibrin is diminished, instead of undergoing an increase. This 

 diminution was constantly observed by Andral in the premonitory stage of 

 Continued Fever; in some instances the amount was no more than 1.6 parts 

 in 1000. The proportion of Corpuscles was found to have usually, but not 

 constantly, undergone an increase; as had also that of the. solid parts of the 

 Serum. In ordinary Continued Fever, in which there was no evident compli- 

 cation from local disease, the quantity of Fibrin varied from 4.2 to 2.2; that 

 of the Corpuscles from 185.1 to 103.6 (excluding a case in which their amount 

 was only 82.5, which was that of a Chlorotic female); that of the solid matter 

 of the Serum, from 98.7 to 90.9; and that of the Water from 725.6 to 851.9. 

 Hence the quantity of solid matter appears to be usually increased; but the 

 peculiar condition of the blood in this disease may probably be stated to be (so 

 far as regards the proportions of its principal constituents) a diminution of the 

 Fibrin in proportion to the Red Corpuscles. When, however, a local Inflam- 

 matory affection develops itself during the course of the Fever, the amount of 

 Fibrin increases; but its augmentation seems to be kept down by the febrile 

 condition. In Typhoid Fever, 3 the decrease in the proportion of Fibrin is 

 much more decidedly marked ; this does not depend upon abstinence ; for it 

 ceases as soon as a favorable change occurs in the disease, long before the effect 

 of food could show itself. In the various cases examined by Andral, the blood 

 furnished a maximum of 3.7 of fibrin, and a minimum of 0.9 ; in this last case, 

 the typhoid condition existed in extreme intensity, yet the patient recovered. 

 The proportion of Corpuscles varies considerably ; in an early stage of the dis- 

 ease it is usually found to be absolutely high ; and it always remains high rela- 



1 By experiments on animals, M. Andral has ascertained that no circumstance of pre- 

 vious debility or privation prevents this characteristic change. Having ascertained the 

 amount of fibrin in the blood of three dogs to be 2.3, 2.2, and 1.6 (the natural range for 

 these animals), he deprived them, completely or partially, of food. On the fourteenth day, 

 the proportion of fibrin had risen, in the first to 4.5, and in the second to 4; these animals 

 had no food. In the third dog, which was supplied with a very small quantity of food 

 daily, the same condition developed itself at a later period ; the blood on the fourteenth 

 day exhibiting only 1.8 parts of fibrin; but on the twenty-second day presenting 3.3 

 parts. In all these instances, the elevation in the proportion of Fibrin was coincident with 

 Inflammatory changes in the stomach. 



2 M. Andral confines this term to the species characterized by ulceration of the mucous 

 follicles of the intestinal canal. 



