156 THE BLOOD IN SCURVY, GOUT, RHEUMATISM, &c. [BOOK I. 



biconcave coloured corpuscles, seem to shew that, not unfrequently, 

 nucleated coloured corpuscles are present. In these cases it is to be 

 assumed that an affection of the marrow of the bones existed similar 

 to that which occurs in cases of myelogenic leukaemia. Professor 

 Grainger Stewart 1 failed to observe Eichhorst's corpuscles in two fatal 

 cases of pernicious anaemia. There can be no doubt moreover that 

 cases of pernicious anaemia do occur which terminate in recovery. 

 On the other hand, these corpuscles have been observed in large 

 numbers in the blood of a case of leucocythaemia 2 . 



Scurvy. 



Very little reliable information is possessed in reference to the 

 alterations of the blood in this disease. When humoral doctrines pre- 

 vailed, scurvy was looked upon as preeminently a disease due to 

 marked changes within the blood, and attempts were made to explain 

 the hemorrhagic tendency by ascribing it to a definite change in 

 the composition of the blood, notably to a great diminution of 

 fibrin (Andral 3 .) 



At the present time we are naturally more inclined to consider 

 the hemorrhages which occur in this disease as due to a morbid 

 change of the walls of the blood-vessels, and we are therefore not 

 surprised to find that in many cases where the blood of patients 

 affected with scurvy has been analysed the results have been purely 

 negative. 



Becquerel and Rodier had the opportunity of analysing the 

 blood of five patients affected with scurvy. They found it to be 

 poor in solid constituents and to be decidedly poor in corpuscles. 

 In these five cases the proportion of haemoglobin (which we have 

 calculated from the iron which they determined) was respectively 

 121-33; 64-41; 90'9 ; 99'3; 67'4 grammes per 1000 of blood. 

 The amount of fibrin was found in no case to be below the normal, 

 whilst in three of the five it was above the normal. 



Mr Busk analysed the blood in three cases of scurvy which 

 occurred in the Dreadnought Hospital Ship, and he found a great 

 diminution in the solid constituents of the blood as a whole, a 

 marked increase in the proportion of fibrin, albumin, and salts, with 

 a very great diminution in the proportion of blood-corpuscles 4 . 



From the evidence which has been accumulated, it would therefore 

 appear, that in scurvy a condition of anaemia is a constant antecedent, 

 using that term to designate a diminution in the total corpuscular 

 richness of the blood. The increase in the quantity of fibrin which 

 sometimes, though by no means always is observed, probably depends 



1 Grainger Stewart, "Note upon Professor Eichhorst's new pathognomonic symptom 

 of progressive pernicious Anaemia." British Medical Journal, July 8th, 1876, p. 40. 



2 Heuck, Zwei Fdlle von Leukdmie mit eigenthiimlichem Blut- resp. Knochen- 

 marksbefund. Virchow's Archiv, Dec. 1879, p. 475. 



3 Andral, Essai d' Hematoloyie pathologiqtie, Paris, 1843, p. 128. 



4 The Author has failed in 'his attempts to discover the medium through which Mr 

 Busk's results on this subject were published. They are, therefore, quoted at second hand. 



