448 OF NUTRITION. 



severe, in which case the Fibrin and the solid matter of the Serum are also 

 reduced in amount. The extreme variations of each ingredient noticed by 

 Andral were, Fibrin, from 0-9 to 10-0 in every 1000 parts of Blood; the 

 Globules, from 21 to 185; the solid parts of the Serum, from 57 to 104: and 

 the Water from 725 to 915. The smallest proportion of Globules, and the 

 largest amount of Water, were presented in a case of severe uterine hemor- 

 rhage. 



a The most important fact substantiated by Andral is one that had been previously 

 suspected, the invariable increase in the quantity of Fibrin during acute Inflammatory 

 affections; the increase being strictly proportional to the intensity of the Inflammation, 

 and to the degree of symptomatic Fever accompanying it. " The augmentation of the 

 quantity of Fibrin is so certain a sign of Inflammation, that, if we find more than 5 parts 

 of fibrin in 1000, in the course of any disease, we may positively affirm that some local 

 inflammation exists." Several cases are mentioned, in which an increase to 7 or 7 

 parts took place, without any apparent cause; but in which it afterwards proved that 

 severe local inflammation was present: and thus we are furnished with a pathognomonic 

 sign of great importance. The average augmentation of Fibrin in inflammation may be 

 estimated at 7; the minimum at 5; the maximum at 10. It does not appear that in. 

 robust athletic persons, the proportion of Fibrin is greater than in those of feeble consti- 

 tution ; in the latter it is the Globules that are deficient ; and it is rather from this dispro- 

 portion, than from, an absolute excess of Fibrin, that their greater liability to Inflamma- 

 tory affections arises. Diseases which commence at the same time as the Inf 1 ammation, 

 or co-exist with it, do not prevent the characteristic increase of the Fibrin ; thus in 

 Chlorotic females, the proportion rises to 6 or 7, under this influence. The augmenta- 

 tion is observed at the very outset of the affection ; the quantity increases with its 

 progress; and a decrease shows itself when the disease begins to abate.* When the 

 disease presents alternations of increase and decline, these are marked by precisely cor- 

 responding changes in the quantity of Fibrin. It appears that the rise of the quantity of 

 Fibrin above the normal standard is not immediately checked by venesection ; this does 

 not prove, however, that bleeding is useless ; but only that it cannot arrest instanter the 

 tendency to the production of an increased quantity of Fibrin. It is a curious fact, that 

 an augmentation is commonly observable during the advanced stage of Phthisis, in spite 

 of the deterioration which the blood must then have undergone; this is probably depend- 

 ent upon the development of local inflammation around the tubercular deposits. Some 

 experiments performed by M. Andral on the blood of pregnant women seem to lead to 

 the conclusion that, during the first six months, the Fibrin is below the normal standard ; 

 and that it subsequently varies, usually undergoing an augmentation between the sixth 

 and seventh, and the eighth and ninth months. There is also a diminution in the Globules ; 

 and these circumstances combined favour the production of the buffy coat ( 589). 



b. It appears obvious, from what has been just stated, that the increase in the quantity 

 of Fibrin is not dependent upon the febrile condition, which is secondary to the local 

 inflammation, but upon the Inflammation itself. This conclusion is confirmed by the 

 interesting fact that, in idiopathic Fever, the proportion of Fibrin is diminished, instead 

 of undergoing an increase. This diminution was constantly observed by Andral in the 

 premonitory stage of Continued Fever; in some instances the amount was no more than 

 1-6 parts in 1000. The proportion of Globules was found to have usually, but not con- 

 stantly, undergone an increase; as had also thatttf the solid parts of the Serum. In 

 ordinary Continued Fever, in which there was no evident complication from local disease, 

 the quantity of Fibrin varied from 4-2 to 2-2; that of the Globules from 185-1 to 103 6 

 (excluding a case in which their amount was only 82-5, which was that of a Chlorotic 

 female); that of the solid matter of the Serum, from 98-7 to 90-9; and that of the Water 

 from 725-6 to 851-9. Hence the quantity of solid matter appears to be usually increased ; 

 but the peculiar condition of the disease may probably be stated to be, an increase in the 



* By experiments on animals, M. Andral has ascertained that no circumstance of pre- 

 vious debility or privation prevent this characteristic change. Having ascertained the 

 amount of fibrin in the blood of three dogs to be 2-3, 2-2, and 1-6 (the natural range for 

 these animals), he deprived them, completely or partially of food. On the fourteenth 

 day, the proportion of fibrin had risen, in the first, to 4-5: and in the second, to 4: these 

 animals had no food. In the third dog, which was supplied with a very small quantity 

 of food daily, the same condition developed itself at a later period; the blood on the four- 

 teenth day exhibiting only 1-8 parts of fibrin; but on the twenty-second day presenting 

 3-3 parts. In all these instances, the elevation in the proportion of fibrin was coincident 

 with Inflammatory changes in the stomach. 



