ABNORMAL INCREASE IN THE AMOUNT OF BLOOD. 85 



the amount of urea persists often for a number of days as a sign of slow destruc- 

 tion of the red corpuscles. Marked plethora is attended, further, with loss of 

 appetite as well as a tendency to hemorrhages from the mucous membranes. 



Serous polyemia is the name given to that condition of the blood in which 

 the amount of serum or plasma is increased. The condition can be produced 

 artificially by injecting into the veins of animals serum from the same species. 

 Under such circumstances the water is soon excreted with the urine, while the 

 albumin is decomposed into urea, without passing over into the urine. An animal 

 forms more urea from a given amount of injected serum than from an equal 

 amount of blood an indication that the blood-corpuscles are capable of being 

 preserved for a longer time than the serum. If, however, an animal be injected 

 with the serum from another species, in which the blood-corpuscles of the recip- 

 ient undergo solution, as, for instance, if dogs' serum be injected into a rabbit, 

 the blood-cells of the recipient are dissolved and hemoglobinuria develops, and 

 even death may take place if the dissolution be extensive. 



Simple increase in the amount of water in the blood, aqueous polyemia, occurs 

 as a transitory phenomenon after copious ingestion of fluid, but increased diuresis 

 soon restores the normal conditions. Disease of the kidneys attended with de- 

 struction of the secreting parenchyma of the glands induces, together with aqueous 

 polyemia, often general anasarca through the leakage of water into all of the 

 tissues. Ligation of the ureter likewise gives rise to an increase in the watery 

 elements of the blood. Stint zing and Gumprecht found the dry residue of small 

 amounts of blood after evaporation of the water to be from 19.8 per cent, in 

 women to 21.6 per cent, in men, while in cases of anemia it falls to 8.5 per cent. 



An increase of the red blood-corpuscles beyond the normal mean polycy- 

 ihemic plethora or hyperglobulia has been thought to be present in robust individ- 

 uals when hemorrhages that have regularly taken place cease and in general all of 

 the symptoms of polyemia are present. The cessation of menstrual, hemorrhoidal, 

 and nasal hemorrhages is considered as a cause, as well as the omission 

 of venesection previously employed systematically. Nevertheless, the poly- 

 cythemia under such circumstances is only inferred and not established by enu- 

 meration. On the other hand, a condition of polycythemia has been positively 

 observed. Thus, after transfusion of blood from the same species a portion of the 

 blood-plasma is soon consumed, while the blood-corpuscles are preserved for a 

 longer time. An increase in the number of red blood-corpuscles up to 8,820,000 

 in a i cu. cm. in case of severe heart-disease, with marked stasis, in which more 

 water escapes from the vessels by transudation, is a remarkable fact. The num- 

 ber is for the same reason greater also in cases of hemiparesis upon the paralyzed 

 side presenting phenomena of stasis. 



After attacks of diarrhea that cause a reduction in the amount of water in 

 the blood there is likewise an increase in the number of red corpuscles, and it is 

 probable that the same result is brought about by profuse sweating and by 

 polyuria. Agents that influence the caliber of the vessels, such as alcohol, chloral 

 hydrate, amyl nitrite, give rise to an increase in number when they cause con- 

 traction of the vessels and to a diminution when they cause relaxation. A 

 transitory increase in the ancestors of the red blood-corpuscles is encountered 

 as a reparative process after profuse hemorrhage or after acute disease. In 

 cachectic states the increase is permanent on account of interference with the 

 transformation into red corpuscles. In the last stages of cachectic states the 

 number progressively diminishes, as at this time the production of the ancestral 

 forms also ceases. 



The designation hyper albuminous plethora has been applied to an increase 

 of the albuminates in the plasma such as it may be inferred occurs after abundant 

 absorption from the digestive tract. The same condition may be induced experi- 

 mentally by injection of serum from the same species of animal, the elimination of 

 urea increasing at the same time. Injection of egg-albumin induces albu- 

 minuria. 



Melitemia or an excess of sugar in the blood. The sugar of the blood 

 is eliminated in part with the urine, in marked degree up to i kilo daily, and 

 the amount of urine may be increased to 25 kilos. To replace this loss an 

 abundance of nourishment and much fluid are necessary, and in this way the 

 amount of urea may at the same time be increased threefold. The marked pro- 

 duction of sugar also induces destruction of proteid tissue, so that the amount of 

 urea is increased, even if the supply of albumin be insufficient. The patients 

 emaciate, all of the glands, particularly the testicles, undergo atrophy or degenera- 



