ABNORMAL DIMINUTION IN THE AMOUNT OF BLOOD. 87 



of blood. If two-thirds be removed one-half of the animals die, while the remaining 

 half recover spontaneously. 



If the hemorrhage does not terminate fatally, the water of the blood, with 

 the dissolved salts, is first replaced through absorption from the tissues, with 

 gradual increase in the blood-pressure; and later the proteids. Considerable 

 time is required for the regeneration of the blood-corpuscles. The blood, there- 

 fore, contains for a time an abnormal amount of water hydremia; and finally it 

 exhibits an abnormal deficiency in cells oligocythemia, hypoglobulia. With the 

 increased lymph-stream toward the blood the leukocytes are soon considerably 

 increased above their normal number. Also fewer red blood-corpuscles appear to 

 be consumed during the period of restitution, as, for instance, in the formation 

 of bile. 



After moderate venesection in animals Buntzen observed the volume of blood 

 restored in a few hours, and after severe hemorrhage in the course from 24 to 48 

 hours. The red blood-corpuscles, however, were, after venesection of from i.i 

 to 4.4 per cent, of the body-weight, fully restored to the normal only after the 

 lapse of from 7 to 34 days. The commencement of the regenerative process could 

 be recognized in the course of 48 hours. During this period of reorganization the 

 number of the embryonal forms of the blood-corpuscles was increased. The 

 newly formed blood-corpuscles appear at first to contain less hemoglobin than 

 normal. Also in human beings the duration of the period of regeneration ap- 

 pears to be dependent upon the amount of hemorrhage. The reduction in the 

 amount of the hemoglobin of the blood after venesection is approximately pro- 

 portional to the amount of the blood removed. 



Of especial significance is the state of metabolism in the body of an anemic 

 patient. The decomposition of proteids is increased, and as a result the elimina- 

 tion of urea is increased. The combustion of fats in the body is, however, 

 correspondingly diminished, and the amount of carbon dioxid given off is cor- 

 respondingly reduced. Anemic as well as chlorotic patients therefore readily 

 put on fat. The same significance is to be attached to the lipomatosis of 

 anemic convalescents after acute diseases interfering with blood-formation. The 

 fattening of animals is, accordingly, favored by occasional venesection. The same 

 statement is applicable to intercurrent hunger. Aristotle had already pointed 

 out that swine and birds readily take on considerable fat after days of intercurrent 

 hunger. 



Anemia results also from failure on the part of the blood-forming organs. 

 The alarming anemia from the presence of the bothriocephalus, which may pursue 

 a course similar to pernicious anemia is remarkable. It is probably dependent 

 upon a toxic effect induced by the parasite, which impairs the vitality of the 

 blood-corpuscles. 



Excessive concentration of the blood through loss of water is designated dry 

 oligemia. This condition has been observed in human beings after copious, 

 watery diarrhea, particularly in cases of cholera, and the thick, tarry blood stag- 

 nates in the veins. Probably copious loss of water through the skin as a result 

 of diaphoretic treatment, particularly in association with restriction of fluids, may 

 give rise to dry oligemia, even though only in moderate degree. 



If the proteids of the blood are diminished in abnormal degree a condition of 

 hy palbuminous oligemia is present. The proteids may be diminished more than 

 half. In their place an excessive amount of water usually finds its way into the 

 blood, so that the salts of the plasma are likewise diminished. Loss of proteids 

 from the blood is due directly to albuminuria, which may furnish even 25 grams 

 of proteid daily; to long-continued suppuration, extensive weeping cutaneous sur- 

 faces, excessive loss of milk, albuminous diarrhea (dysentery). Frequent and 

 copious hemorrhage, also, induces at first hypalbuminous oligemia, as the loss 

 primarily is principally made good by the taking up of water into the vessels. 

 V. Jaksch found that the amount of proteids failed to decline in correspondence 

 with the reduction in the number of blood-corpuscles. 



