190 OF THE BLOOD. 



of fatty matter in the serum, and especially of the cholesterin, has been found 

 by MM. Becquerel and Rodier to undergo an increase at the commencement of 

 most acute diseases ; and they have also observed an increase of fat, and especially 

 of cholesterin, in chronic diseases of the liver, in Bright's disease of the kidney, 

 and in tuberculosis. The quantity of fat in the blood sometimes undergoes such 

 an augmentation as to give to the serum a constant " milkiness." This has been 

 observed by Marcet in a case of diabetes, by Traill in hepatitis, by Christison 

 in dropsy, icterus, and nephritis, by Zanarelli in pneumonia, and by Sion in 

 mammary abscess. In Dr. Traill' s case, the whole amount of solid matter in 

 the serum was 211 parts in 1000; as much as 157 parts being albumen, whilst 

 45 were fat. In Zanarelli' s case, the blood contained so small a proportion of 

 red corpuscles that it seemed milky when it first flowed ;* and it did not under- 

 go a regular coagulation, but merely separated into a thicker and a thinner por- 

 tion. This blood only contained 95 parts of solid constituents in 1000; and 10 

 parts of these consisted of fatty matter, and 9 parts of extractive and salines ; 

 so that the whole amount of fibrin, corpuscles, and albumen was only 76 parts. 

 In Dr. Sion's case, also, the blood itself was quite milky; it underwent no 

 coagulation ; and only a very small quantity of coloring matter was deposited 

 when it was allowed to stand. This blood was found by Lecanu to contain 206 

 parts of solid constituents in 1000; but of these no less than 117 parts were 

 fat, the remainder consisting of albumen (64 parts), and of extractive and 

 salines (25 parts). No fibrin could be found, and the quantity of haemato- 

 globulin was inappreciable. 1 Such a fluid must be considered rather as chyle 

 than as blood; and, in the entire absence of coagulating power, corresponds 

 rather with chyle when first absorbed, than with that which is usually delivered 

 by the thoracic duct (CHAP. vni.). Little is known with certainty regarding 

 the variations of the alkaline salts in the blood in different diseases. The 

 analyses which have been made, however, are considered by Prof. Lehmann 3 to 

 indicate that in very severe inflammations they are very much diminished ; 

 whilst they are much increased in the acute exanthemata and in typhus, in dysen- 

 tery, Bright's disease, and all forms of dropsy and hydrsemia; and are often 

 doubled in quantity in diseases depending upon malarious influences, such as 

 endemic dysentery, malignant forms of intermittent fever, &c. Although a 

 large quantity of saline matter usually passes off from the blood in Cholera, yet 

 the proportion of water discharged is so much greater, that, as appears from the 

 analyses of Dr. Garrod, the per-centage of salines in the blood is rather increased 

 than diminished. 3 



177. The proportion of Water in the blood will of course vary reciprocally 

 with that of the solid constituents ; and will be especially augmented when 

 there is a marked diminution in the amount of red corpuscles. When there is 

 an excessive and constant drain upon it, as in diabetes, there is at the same time 

 such a craving for liquids, as causes the quantity ingested to supply the deficiency 

 occasioned by its removal ; so that the mass of the blood is not thereby dimin- 

 ished. In Cholera, however, the case is different; for in that form of the dis- 

 ease attended with copious discharges, the reduction in the liquid constituent of 



individual ; and thus it is that, the more extended are our inquiries, the more easy does 

 it become to refer to general principles the causes of all those changes in the composition 

 of the blood, which, from the frequency and rapidity with which they occur, seem at first 

 sight to baffle all rules, and to take place, as it were, at random. In the midst of this appa- 

 rent disorder, there is but the fulfilment of laws; and in order to obtain these, it is only 

 necessary to strip the phenomena of their complications, and reduce them to their simplest 

 form." 



1 This remarkable case is cited in Simon's "Animal Chemistry," vol. i. p. 333, from 

 the "Lancette Francaise," 1835, No. 49. 



2 " Lehrbuch der physiologischen Chemie," band ii. p. 242. 



3 " London Journal of Medicine," May, 1849. 



