80 ON SPONTANEOUS GANGRENE FROM ARTERITIS AND 
have a sure, though imperfect glimpse, of the operation of mysterious but 
potent forces, peculiar to the tissues of living beings, and capable of reversing 
the natural order of chemical affinities ; forces which I suspect will never be 
fully comprehended by man in the present state of his existence, and the study 
of which should always be approached with humility and reverence. 
Having thus obtained evidence of the active operation of the living tissues 
upon the blood, it occurred to me that the walls of the vessels might probably 
act to greater advantage upon their contents when of small than of large calibre, 
and that, in that case, the blood might be found fluid in the small vessels of 
the human body after death, although coagulated in the heart and large vessels. 
Accordingly, I have examined three human bodies with regard to this point, 
and in every case have found my idea confirmed. One of these was a woman, 
aged seventy, who had been a patient under Dr. Gillespie’s care at the Infirmary, 
with senile gangrene. The right cavities of the heart were full of blood, and 
contained large clots buffed on their upper surface, and the large vessels also 
contained abundant soft coagula, but a small vein from one of the thighs yielded 
fluid blood, which coagulated slowly in a saucer. The body was examined 
about thirty-six hours after death. The other two had been patients under 
Dr. Gairdner’s care, also in the Royal Infirmary. One of these was a man 
about thirty, who had died of meningitis. The heart had been removed before 
I saw the body, but the large vessels, such as the external iliac vein, contained 
coagula, whereas all the small veins which I observed contained perfectly fluid 
blood, which, however, had lost the power of coagulation. The third case 
was that of a young man, aged twenty-one, who died of a complication of medical 
and surgical complaints, nearly forty-eight hours before the body was examined. 
The corneae were perfectly clear, and there was no appearance of any incipient 
decomposition. This case was investigated very carefully ; and as the subject 
is novel, it may be well to give the results in detail:—I was not present 
later I again examined the foot, and on reflecting the skin from the opposite aspect of the limb, found 
there a large subcutaneous vein distended with a mixture of blood and air; the latter, which had 
evidently passed through an anastomosing channel, being present in the form of very numerous large 
and small bubbles. Having secured the ends of a long piece of this vein, I dissected it out and shed 
its blood into a saucer. Not a particle of clot existed in the vein, and complete coagulation took place 
within a quarter of an hour. The vein which had been exposed, in order to inject the air, contained 
here and there portions of clot in the exposed part, the vitality of the vessel having doubtless been 
mpaired by the mechanical violence to which it was subjected in the dissection, or by the drying 
nfluence of the atmosphere. 
In order to illustrate the effect of mechanical violence applied to a vessel in promoting the coagula- 
tion of the blood within it, I pinched a vein of the same foot severely with dissecting forceps in about 
an inch of its length, at the same time that I injected the air into the other vein. On examining the 
foot, seven hours later, the vein which had been pinched contained coagulum in the part which had 
been so treated, but fluid blood in the rest of its extent, both above and below the injured portion.—J. L., 
March 19, 1858. 
