86 ABNORMAL DIMINUTION IN THE AMOUNT OF BLOOD. 



tion, the skin and the bones become thin, while the nervous system resists the 

 longest. The crystalline lens becomes turbid in consequence of the presence of 

 sugar in the fluids of the eye, which abstract water from the lens. Wounds 

 heal badly on account of the abnormal constitution of the blood. If a drop 

 of blood be spread upon a glass slide, then treated with a solution of Bieberich's 

 scarlet or alkaline methylene-blue and heated for ten minutes at a temperature 

 of 35, it will not take the stain if derived from a case of diabetes, while normal 

 blood is stained. Instead of grape-sugar excessive accumulation of inosite or of 

 milk-sugar has also been found in the blood and in the urine. 



Lipemia. Increase in the amount of fat in the blood occurs normally 

 after the ingestion of food rich in fat, as, for instance, in nursing kittens, so 

 that the serum itself may acquire a milky turbidity. Pathologically, this is 

 observed in still more marked degree in drunkards and in obese individuals. In 

 conjunction with marked destruction of proteids in the body, therefore, in a large 

 number of wasting diseases, the amount of fat in the blood is increased; likewise 

 after abundant administration of easily digestible carbohydrates, together with 

 much fat, in the food. V. Jaksch found traces of fatty acids in the blood 

 of febrile and leukemic patients. After injuries to bones involving the marrow 

 large numbers of fat-globules often pass from the vessels of the marrow, in part 

 unprovided with walls, into the blood-stream, so that fat may even find its way 

 into the urine, and may give rise to dangerous fat-emboli in the lungs. 



The salts are usually preserved with great tenacity. If sodium chlorid 

 be withheld, albuminuria results; and if salts in general, paralytic phenomena. 

 Excessive administration of salty food, as in the form of pickled meat, has not 

 rarely been followed by death through fatty degeneration of the tissues, par- 

 ticularly of the glands. Withdrawal of calcium and phosphoric acid brings about 

 softening or atrophy of the bones. In the presence of infectious diseases and 

 of anasarca the amount of salts in the blood has often been found increased, 

 while in the presence of inflammation (sodium chlorid is wanting in the urine 

 in cases of pneumonia) and of cholera the amount is diminished. 



The amount of fibrin in the blood is increased in the presence of inflamma- 

 tion, particularly of the lungs or the pleura. Therefore venesection under such 

 circumstances is followed by the formation of the so-called buffy coat. The 

 fibrin may be increased also in other diseases attended with blood-destruction. 

 Sigm. Mayer observed an increase likewise after repeated venesection. Blood 

 rich in fibrin usually coagulates more slowly than blood deficient in fibrin, although 

 exceptions to this statement are not wanting. 



ABNORMAL DIMINUTION IN THE AMOUNT OF BLOOD OR OF ITS 

 INDIVIDUAL CONSTITUENTS. 



Reduction in the mass of the blood as a whole true oligemia occurs after 

 every direct loss of blood. In the newborn a hemorrhage of even a few cu. cm., 

 in children a year old a hemorrhage of 250 cu. cm., and in adults a loss of one- 

 half of their blood may prove dangerous. Women withstand better than men 

 even considerable loss of the blood. In them the regeneration of the blood 

 appears to take place more readily and more quickly in consequence of the periodic 

 restoration of the blood lost at each menstrual period. Obese persons, as well as 

 the aged and the debilitated, are less tolerant to loss of blood. The hemorrhage 

 is the more dangerous the more rapidly it takes place. General pallor and coldness 

 of the skin, a sense of fear and oppression, relaxation, the appearance of spots 

 before the eyes, roaring in the ears and vertigo, loss of voice and syncopal attacks 

 usually accompany profuse hemorrhage. Dyspnea ("and breathing rapidly he 

 exhales life in a purple stream:" Sophocles' Antigone), cessation of glandular 

 secretion, profound loss of consciousness, then dilatation of the pupils, involuntary 

 discharge of urine and feces, and finally general convulsions are the positive 

 premonitions of rapid death from hemorrhage. In the state of greatest danger 

 life can be saved only by transfusion. 



As much as one-quarter of the normal amount of blood can be withdrawn 

 from animals without permanently lowering the blood-pressure in the arteries, 

 because the latter by contraction adapt themselves to the smaller volume of blood 

 in consequence of the anemic irritation of the vasomotor center in the medulla 

 oblongata. Loss of blood up to one-third of the volume of blood causes marked 

 reduction in the blood-pressure. Dogs recover after loss of one-half of the volume 



