CHAP, xxvii.] MORBID BLOOD. 313 



In diseases of an inflammatory type, in which there is active 

 fever of a sthenic character, with proneness to the effusion of plastic 

 lymph, or to the formation of thick laudable pus, fibrine is said to be 

 increased in quantity to as much as five or six parts in one thou- 

 sand of blood; it is also said that there is an increase in the colour- 

 less corpuscles, and at first a slight increase in the coloured corpuscles, 

 though these latter afterwards undergo a diminution, which is the 

 more marked, in proportion to the extent of depletory measures em- 

 ployed. In no diseases are these changes in the blood more con- 

 spicuous than in rheumatic fever, pneumonia, and pleurisy. The 

 cupping and buffing of the blood is very marked, and the most 

 exquisite examples of that interesting phenomenon may be obtained 

 from patients labouring under these maladies. Sufficient allowance, 

 however, does not seem to have been made by observers generally 

 for the extent to which the apparent increase of fibrine may be 

 explained by the increase of the colourless corpuscles.* 



Diminution of the quantity of fibrine, accompanied with a de- 

 crease in the red particles, occurs chiefly in fevers arising from 

 the presence of a poison in the system. None shew these changes 

 more than those fevers which are caused by the paludal poison 

 namely, intermittent fevers. In rheumatic fever and in acute 

 general gout, there is a remarkable tendency to the diminution of 

 the colouring matter of the blood, even when these diseases have 

 been treated in the mildest manner. It would seem as if the 

 materies morbi acted as a blight upon the red corpuscles, and 

 prevented their development in the normal proportions. 



In some cases especially those connected with enlarged liver 



* Zimmerinann, and more recently Mr. John Simon, in his valuable lectures 

 on Pathology (Lancet, 1850, and since republished in 8vo) have advocated the 

 doctrine, novel indeed, but most worthy of attention, that the fibrine of the 

 blood must be regarded, not as an ingredient prepared for the nourishment of 

 certain tissues and ready to be appropriated by them, hut as " among those 

 elements which have arisen in the blood from its own decay, or have reverted 

 to it from the waste of the tissues." Mr. Simon has been led to adopt this 

 opinion chiefly from observing the unaltered or even increased quantity of the 

 fibrine under bleeding, starvation, amemia and other states of exhaustion and 

 increased waste, and also from the fact that in these respects the fibrine is in 

 direct contrast with the red particles which are rapidly reduced by these 

 means. This view is also favoured by the fact noticed by Andral and 

 Gavarret, that an improvement in the breed of an animal tended always 

 (cseteris paribus) to increase the proportion of the red particles, but to 

 diminish that of the fibrine. The small quantity of fibrine in foetal blood, the 

 absence of fibrine from the egg, the chyme, and the smaller quantity of it in 

 the blood of carnivora (which feed on it) than in that of the herbivora, are 

 additional facts adduced by Mr. Simon in support of this view. 



VOL. II. Y 



