PRODUCTS, ADVENTITIOUS. 



115 



scope it is mainly composed of a finely granular 

 mass, and often contains large, irregular, flabby 

 particles, with globules of various sizes. But 

 these globules bear but a very small proportion 

 in number to those in pus ; and, on the addi- 

 tion of acetic acid, they soon disappear, except 

 a few which seem more compact, and require 

 a longer time for solution : they are probably 

 altered blood-corpuscles. 4. Softened fibrin 

 more readily becomes putrid than pus. Fibrin 

 removed from the body and subjected to a 

 blood-heat, begins to change into matter, such 

 as that now described, in forty hours. 



We have had numerous opportunities of 

 satisfying ourselves of the general accuracy of 

 these observations of Mr. Gulliver; but we 

 cannot accede to the notion that the yellow ish- 

 green, soft, sometimes almost diffluent co- 

 agula, frequently seen in veins (coagula which, 

 according to the spirit, if not the absolute 

 letter, of Mr. Gulliver's doctrine, should con- 

 sist merely of softened fibrin and accidentally- 

 imprisoned blood disks,), never contain, and 

 hence never consist, in part, of pus. We have 

 more than once discovered fully-formed and 

 well-conditioned pus-corpuscles in such co- 

 agula, which, upon mere naked-eye evidence, 

 we had regarded as wholly composed of 

 softened fibrin. We refer here to cases 

 where no signs of inflammatory (or other) 

 alteration exist in the coats of the vein, and 

 where those coats appear to have nothing to 

 do with the appearances referred to ; for the 

 corpuscles appear chiefly, or it may be alto- 

 gether, in the centre of the coagula. Now 

 such cases seem to prove one or other of the 

 following three propositions : That corpuscles 

 exist, having all the micro-chemical characters 

 of those of pus, yet in reality of a different 

 nature ; that stagnating liquor sanguinis is 

 capable of undergoing, in its own proper sub- 

 stance, inflammatory changes ; or that the 

 pus-corpuscle is capable of forming, in stag- 

 nating liquor sanguinis through some peculiar 

 influence of non-inflammatory nature. Reason, 

 collateral experience, and the general laws of 

 pathology, point to the second of these pro- 

 positions as the most probable of the three; 

 but it is wisest for the present, perhaps, to 

 refrain from adopting any one of them. 



(c.) Epithelial fluid. Broken or perfect 

 epithelial scales sometimes accumulate in 

 very considerable quantities in certain serous 

 fluids ; and the resulting mixture cannot with 

 the naked eye be positively distinguished, 

 either by colour, consistence, or odour, from 



Eus. In the Fallopian tube (somewhat di- 

 ited) of an anasarcous woman, who died 

 under our care at University College Hos- 

 pital some time since, we found fluid of this 

 kind, containing (as shown by the microscope, 

 the only test in such cases,) not a single pus- 

 corpuscle, but abundance of epithelium. We 

 have seen the same kind of fluid in the pelvis 

 of the kidney. 



The microscopical distinctions of the un- 

 altered red-corpuscle of the blood, and the 

 pus-corpuscle, are so numerous and obvious 

 that they need not be enumerated ; it is im- 



possible to confound the two objects. The 

 red blood-corpuscles, however, when acted 

 upon by various re-agents (serum, urine, pus, 

 artificially added saline solutions, &c.) acquire 

 a more or less accurate resemblance to those 

 of pus ; they in truth increase somewhat in 

 bulk, lose their regularity of outline, which 

 becomes ragged, and alternately notched and 

 studded with minute prominences, appear- 

 ances which have led to very remarkable 

 errors. Nevertheless, the resemblance is far, 

 even, from seemingly perfect ; the altered red- 

 corpuscle is smaller than the other, and is not 

 minutely granular on the surface : if there be 

 doubt, however, in the case, acetic acid, by 

 dissolving the body (if it be a red-corpuscle), 

 or producing the changes already described 

 (if it be one of pus), will settle the question. 



The colourless corpuscle of the blood in its 

 unaltered state is with difficulty distinguishable 

 from the pus-corpuscle ; the two bodies have, 

 by practised observers even, been confounded. 

 It has the same minutely granulated aspect ; 

 and acetic acid discloses, as in the pus-cor- 

 puscle, a nucleus in its interior. The colour- 

 less corpuscle is smaller than the other, how- 

 ever (the mean ratio of their sizes being as 

 22 to 27, nearly). The nucleus is either 

 single, bipartite, or tripartite. 



The process by which pus is formed in 

 other words, pyogenesis or suppuration 

 was long supposed to be one of disintegration 

 and solution of the natural tissues. We need 

 not devote space to the elaborate refutation 

 of this rude conception : suffice it to say, that 

 pus may be produced for years from mucous 

 membranes, without even abrasion of their 

 surfaces having occurred, and that the ele- 

 mentary textures (e. g. the cellular) may, at 

 the outset of the suppurative process, be 

 shown to have retained all their natural pro- 

 perties. 



We might, on the score of its obvious fal- 

 lacy, similarly pass by the notion that the 

 corpuscles of pus are simple modifications of 

 the red-corpuscles of the blood ; but as, even 

 recently, symptoms of a return to this pre- 

 viously-exploded idea have appeared on the 

 Continent, a few words on the subject seem 

 called for. M. Gendrin (Hist. Anat. de V In- 

 flammation, #c.) taught that in consequence 

 of the stagnation of the red-corpuscles in- 

 duced by inflammation, those bodies are first 

 converted into pus-corpuscles in the interior 

 of the capillary vessels, and, secondly, exude 

 thence into the intercapiliary texture. The 

 experiment upon which the first portion of 

 this doctrine was based has been repeated by 

 Dr. Wood*, Mr. Gulliver, and others ; and 

 either no appearance at all of the alleged 

 puriform matter discovered, or its characters 

 proved to be those of softened fibrin. As 

 respects the exudation of ready-formed pus- 

 corpuscles, the theory manifestly involves an 

 impossibility, as the structure of the walls of 

 the capillary vessels is too close to permit 

 the passage of bodies of such dimensions. 



* Op. Cit. p. 4. 



