206 OF THE BLOOD. 



according to the general condition of the patient. " The highest health is 

 marked by an exudation of the most perfect and unmixed fibrin j the lowest, 

 by the most abundant corpuscles, and by their nearest approach, even in their 

 early state, to the characters of pus-cells. The degrees of deviation from 

 general health are marked, either by increasing abundance of the corpuscles, 

 their gradual predominance over the fibrin, and their gradual approach to 

 the character of pus-cells, or else by the gradual deterioration of fibrin, 

 which from being tough, elastic, clear, uniform, and of filamentous appear- 

 ance, or filamentous structure, becomes less and less filamentous, softer, more 

 paste-like, turbid, nebulous, dotted, and mingled with minute oil-globules ." 

 " After some practice," adds Mr. Paget, "one might form a fair opinion of the 

 degree in which a patient was cachectic, and of the degree in which an inflam- 

 mation in him would tend to the adhesive or to the suppurative character by 

 the microscopic character of these exudations." 1 From such evidence we seem 

 forced to the conclusion that, whether or not the Colorless corpuscles are to be 

 regarded in any other light than as blood-cells not yet fully developed, their 

 multiplication is not (as has been maintained) the source of increase in the 

 fibrinous constituent of the liquor sanguinis. 3 Whether the arrest of develop- 

 ment of these corpuscles, in the abnormal conditions just referred to, is to be 



1 Op. cit., p. 1015. 



2 The Author is not ashamed thus to record his withdrawal of an opinion which he 

 formerly held, and for which he even strenuously contended. His belief was founded in 

 great part upon the assertions of Mr. Addison ("Experimental Researches on the Process 

 of Nutrition/' First and Second Series), and of Dr. C. J. B. Williams ("Principles of 

 Medicine," second edit. pp. 258 266), as to the uniform concurrence of an increased 

 production of Colorless corpuscles with the augmentation of Fibrin usually regarded as 

 characteristic of the inflammatory state ; and this having been disproved by the researches 

 of Mr. Paget and other trustworthy observers, he abandons the idea as one no longer tenable. 

 He has the satisfaction of finding, however, that Mr. Wharton Jones has, on his side, given 

 up the doctrine that the Red corpuscles dissolve into the fibrin of the blood ; against which 

 the Author had argued, whilst endeavoring to substantiate his own. Mr. Wharton Jones 

 appears to be now satisfied that " the inverse proportion in the quantity of red corpuscles 

 and fibrin, though frequent, has not always been found to obtain ; and when found, the 

 diminution in the red corpuscles has not been in any regular relation to the increase in the 

 quantity of fibrin; moreover, the quantity of red corpuscles which disappear is quite 

 disproportionate to the comparatively small addition to the quantity of fibrin." (See his 

 Prize Essay " On the State of the Blood and the Bloodvessels in Inflammation," in the 

 "Guy's Hospital Reports" for 1850, p. 68.) Still, the above observations of Mr. Paget 

 and others seem to indicate some relation of reciprocity between the Colorless corpuscles 

 and the fibrin ; while those of Mr. Newport (g 195) favor the belief that these corpuscles 

 may melt down into a substance adapted for the nutrition of the tissues. An observation 

 of Mr. Addison' s too, which the Author has himself confirmed, appears to sanction the 

 idea (although it by no means proves) that the colorless corpuscles emit a fibrillating material 

 in bursting. (See his "Experimental Researches," second series, p. 4.) The Author 

 cannot help still suspecting, therefore, that the Colorless corpuscles are not to be regarded 

 merely as red blood-cells in their earlier phase of development ; but that they have some 

 special connection with the elaboration of the plastic constituents of the blood. Warned, 

 however, by previous experience, of the danger of building conclusions upon observations 

 of a limited and imperfect character, he refrains at present from offering any hypothesis 

 as to the nature of that relation merely suggesting that it is far from certain that all the 

 bodies which pass under the designation of "white" or "colorless corpuscles," are of the 

 same kind, as is shown by the fact that cells are formed in exudations, which cannot be 

 distinguished from the colorless cells of the blood, and which yet can scarcely be supposed 

 to be rudimental red corpuscles ; and that if some of the "colorless corpuscles" of the 

 blood be looked upon as instrumental in elaborating its plastic components, whilst others 

 are on the march of development into red corpuscles, it seems very probable that the same 

 depressing influence which checks the latter process should also interfere with the former, 

 and that thus an accumulation of colorless corpuscles in cachectic subjects may coincide 

 with a diminution in the red, and at the same time with an imperfect elaboration of the 

 fibrin of their blood. 



