450 OF NUTRITION. 



the patient was much exhausted; a case of Aneurismal dilatation of the Heart inducing 

 Dropsy; and in several cases of Cachexia Saturnina. 



d. The chief class of cases, in which any marked change has been observed in the 

 amount of solid matter in the Serum, is that of Albuminuria, or Bright's disease of the 

 Kidney. The diminished Specific Gravity of the Serum was long ago pointed out by Dr. 

 Christison; but Andral remarks that this is not an accurate criterion. since, if there be a 

 diminished amount of Globules (as is not unfrequenlly the case in this disease), the pro- 

 portion of water in the whole will be increased, and the specific gravity of the serum 

 thus lowered, without any alteration in its proper quantity of solid matter. According to 

 Andral, the diminution in the amount of Albumen in the Serum is exactly proportional 

 to the quantity contained in the urine. A case is related by him, under this head, which 

 affords an interesting exemplification of the general facts, that have been already attained 

 by his investigations. A woman who had been suffering from Erysipelas of the face, 

 and who had lost blood both by venesection and by leeches, became the subject of Albu- 

 minuria. The blood drawn at this time exhibited a considerable diminution in the pro- 

 portion of Globules, as well as of Albumen, a fact which the previous loss of blood 

 fully accounted for. After a short period, during which she had been allowed a fuller 

 diet, another experimental bleeding exhibited an increase in the proportion of Globules. 

 Some time afterwards, when the Albumen had disappeared from the Urine, some more 

 blood was drawn ; and it was then observed that the Albumen of the Serum had returned 

 to its due proportion, but that the Globules had again diminished, whilst there was a 

 marked increase in the quantity of Fibrin. This alteration was fully accounted for by 

 the fact, that, in the interval, several Lymphatic ganglia in the neck had been inflamed 

 and had suppurated; and that the patent had been again placed on very low diet. 

 "Thus," observes Andral, "we were enabled to give a complete explanation of the 

 remarkable oscillations which were presented, in the proportion of the different elements 

 of the blood drawn at three different times from the same 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 apparent 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." 



592. That the Blood is subject to a great variety of other morbid alterations, 

 which are sometimes the causes, and sometimes the results, of Disease, cannot 

 be for a moment doubted. But our knowledge of the nature of these changes 

 is as yet very insufficient. The great amount of attention which is being 

 directed by Chemical Pathologists to the subject, however, will doubtless ere 

 long produce some important results. Among the most frequent causes of 

 depravation in the character of this fluid, we must undoubtedly rank the re- 

 tention, in the Circulating current of matters which ought to be removed by 

 the Excreting processes. We have already seen, that a total interruption to 

 the excretion of Carbonic Acid by the lungs, will occasion death in the course 

 of a very few minutes ( 546) ; and even when only a slight impediment is 

 offered it, so that the quantity of Carbonic Acid always contained in arterial 

 blood is augmented to but a small degree, a feeling of discomfort and oppres- 

 sion, increasing with the duration of the interruption, is speedily produced. 

 The results of the retention of the materials of the Biliary and Urinary excre- 

 tions will be hereafter considered ( 661 and 670) ; and at present it will be 

 only remarked that such retention is a most fertile source of slight disorders 

 of the system, that it is largely concerned in producing many severe diseases, 

 and that if complete^ it will most certainly and rapidly produce a fatal result. 

 The most remarkable cases of depravation of the Blood, by the introduction of 

 matters from without, are those in which these substances act as ferments, 

 exciting such Chemical changes in the constitution of the fluid, that its whole 

 character is speedily changed, and its vital properties are altogether destroyed. 

 Of such an occurrence, we have characteristic examples in the severe forms 

 of Typhoid fever, commonly termed malignant; in Plague, Glanders, Pustule 

 Maligne, and several other diseases ; in some of which we can trace the direct 

 introduction of the poison into the blood, whilst in others we must infer (from 



