ITS PHYSICAL, CHEMICAL, AND STRUCTURAL CHARACTERS. 187 



tively to the amount of fibrin. In Typhoid Fever, then, the abnormal condition 

 of the blood, in regard to the disproportion between the corpuscles and the fibrin, 

 is more strongly marked than in ordinary continued fever ; yet the usual aug- 

 mentation of fibrin will take place, if a local inflammation develops itself. In 

 " putrid" or " malignant" fevers, there appears to be a very marked diminution, 

 not only in the fibrin, but in the other solid constituents of the blood \ and in 

 their advanced stages, the blood may entirely lose its power of coagulation. 

 Thus in a case of " typhus abdominalis," in which the blood was analyzed by 

 Simon, he found only 112.5 parts of solid matter, of which 54 parts were albu- 

 men, the corpuscles only constituting 47? parts, and the fibrin being altogether 

 deficient. In the Exanthematous Fevers, it does not appear that the proportion 

 between the fibrin and the corpuscles undergoes so striking a change as in ordi- 

 nary continued fever ; but the number of cases examined has been too small to 

 admit of decided conclusions. It is evident, however, that the specific Inflam- 

 mations proper to, and characteristic of, these Fevers, have not the same effect 

 in occasioning an increase of the Fibrin, as an intercurrent Inflammation of an 

 extraneous character. It has been asserted that the proportion of Fibrin is 

 diminished in Scurvy; but this, from the analyses of MM. Becquerel and 

 Rodier, Chatin, and Bouvier, 1 and Mr. Busk, 3 appears not to be the case, the 

 proportion of fibrin being rather above than below the normal average. In 

 Cholera, however, a reduction in the coagulable element of the blood seems to 

 be an almost constant occurrence ; and in some instances, the blood, although 

 loaded with solid matter, has scarcely coagulated at all. Of the blood drawn 

 during life, it has been observed that the clot is loose and grumous, often not 

 shrinking and expelling serum ; and that this change presents itself in a degree 

 corresponding to the severity and advanced stage of the disease. And when 

 the blood has been removed from the body after death, the clots have been found 

 loose and fragile in texture, sometimes almost semi-fluid. 3 It appears from the 

 experiments of Magendie, that one of the effects of a diminution in the propor- 

 tion of Fibrin is a tendency to the occurrence of Hemorrhage or of Congestion, 

 either in the parenchymatous tissue, or on the surface of membranes : and these 

 conditions are well known to be a frequent occurrence, as complications of many 

 of the above disorders. A marked diminution of Fibrin was noticed also, by 

 M. Andral, in many cases of Cerebral Congestion, which commences with head- 

 ache, vertigo, and tendency to epistaxis, and not unfrequently passes into coma 

 and apoplexy. In Apoplexy, the diminution of Fibrin was still more striking ; 

 and in general, there was found to be an increase of the Corpuscles. In one 

 instance, the quantity of Fibrin on the second day of the attack was found to 

 have fallen to 1.9, whilst that of the Corpuscles had risen to 176.5; but on the 

 third day, when the patient's consciousness began to return, the quantity of 

 Fibrin was 3.5, whilst that of the Corpuscles had fallen to 137.7. It would seem 

 from the great change in the character of the Blood, which was noticed in this 

 and in other instances, that the want of due proportion between the Fibrin and 

 the Corpuscles may have been the cause, rather than the effect, of the Apoplec- 

 tic attack. In a case of Purpura Haemorrhagica in which the blood was ana- 

 lyzed by Routier, 4 the proportion of corpuscles was normal (nearly 122 parts in 

 1000), whilst the fibrin only amounted to 0.9 parts in 1000. 



174. The amount of Red Corpuscles seems to be subject to greater variation 

 within the limits of ordinary health, than is that of fibrin. In the condition 

 which is ordinarily termed a highly sanguineous temperament, or Plethora, it 



1 " Journ. de Chimie Medicale," Mars, 1848. 



2 "Library of Medicine," vol. v. p. 90. 



3 See Dr. Parkes's "Researches into the Pathology and Treatment of the Asiatic or 

 Algide Cholera," pp. 32, 73. 



4 "Gazette des Hopitaux," torn. vi. No. 90. 



