188 OF THE BLOOD. 



is chiefly the entire mass of the blood that undergoes an increase ; but whatever 

 excess there may be in the proportion of its solid constituents, this affects the 

 Corpuscles rather than the fibrin. Plethoric persons are not more prone to In- 

 flammation, than are those of weaker constitution ; bul, they are liable to Con- 

 gestion, especially of the brain, and to Apoplexy or other Hemorrhage. The 

 effect of Bleeding in diminishing this tendency is now intelligible ; since we 

 know that loss of blood reduces the proportion of Corpuscles. On the other 

 hand, in that temperament, 1 which, when exaggerated, becomes Anaemia, there is 

 a marked diminution of the Corpuscles ; this temperament may lead to two 

 different conditions of the system. In Chlorosis, the Red Corpuscles are dimin- 

 ished, whilst the Fibrin remains the same ; so that the clot, though small, is 

 firm, and not unfrequently exhibits the buffy coat; in some extreme cases "of 

 this disease, the Corpuscles have been found as low as 27. The influence of 

 the remedial administration of iron in increasing the quantity of Corpuscles 

 was rendered extremely perceptible by Andral's analyses; in one instance, 

 after iron had been taken for a short time, the proportion of Corpuscles was 

 found to have risen from 49.7 to 64.3 ; whilst in another, in which it had been 

 longer continued, it had risen from 46.6 to 95.7. On the other hand, Bleeding 

 reduced still lower the proportion of Corpuscles ; thus, in one instance, their 

 amount was found, on a second bleeding, to have sunk from 62.8 to 49. The 

 full proportion of fibrin in the blood of Chlorotic patients seems to account for 

 the infrequency of Hemorrhage in them ; whilst it also leads us to perceive that 

 they may be, equally with others, the subjects of acute Inflammation, which we 

 know'te- be the fact. A diminution of Corpuscles may also co-exist with a dimi- 

 nution in the amount, or in the degree of elaboration, of the fibrin ; and this 

 condition seems to be characteristic of scrofula. Andral has noticed a diminu- 

 tion in the proportion of Red Corpuscles in other Cachectic states, resulting 

 from the influence of various depressing causes on the nutritive powers ; as in a 

 ease of Diabetes Mellitus, in which the patient was much exhausted; a case of 

 Aneurismal dilatation of the Heart, inducing Dropsy ; and in several cases of 

 Cachexia Saturnina. The proportion of Red Corpuscles seems constantly to 

 undergo a marked diminution in Scurvy : and has been found, in some cases of 

 this disease, as low as in intense Anaemia. The same may be said of the advanced 

 stage of Bright' s disease of the Kidney, and of "Leucocythaemia." A very rapid 

 disintegration of the Red Corpuscles appears sometimes to take place when a 

 morbid poison is present in the blood, or when its composition has been seriously 

 affected by the loss of its other constituents. Thus Dr. C. J. B. Williams 3 men- 

 tions a case of Albuminuria proving fatal in six days, with effusion of pus into 

 the joints the day before death, in which the coloring matter was found to be 

 dissolved in the liquor sanguinis, scarcely any perfect corpuscles being left. 

 He has also observed a similar total destruction of the blood-disks in a case of 

 malignant scarlatina with purpura ; and has met with indications of a partial 

 destruction of them in acute purpura connected with jaundice, and in cases of 

 functional derangement of the liver. 



175. A marked increase in the proportion of the Colorless Corpuscles has been 

 frequently observed in the blood of persons suffering under inflammatory diseases; 

 and has been supposed by some Pathologists to be an essential condition of the 

 inflammatory state. More extended observation has proved, however, that such 

 an increase is by no means constant, and that it shows itself especially in the 

 blood of cachectic subjects, in whom (particularly those of the tuberculous dia- 

 thesis) it seems to take place independently of Inflammation. Attention has 



1 The term lymphatic has been applied to this temperament ; by which term was meant 

 a predominance of lymph in the absorbent vessels. 



2 "Principles of Medicine," 3d Am. Ed. p. 50. 



