BLOOD, MORBID CONDITIONS OF THE. 



423 



condition of serum was observed. This was quite 

 opaque, and nearly as white as milk ; and on 

 standing for a few hours, a film of mattter re- 

 sembling cream covered the surface. The clot 

 could not be seen when it was scarcely a tenth 

 of an inch beneath the surface. It had a 

 firm, very thick, white coat of fibrine, and the 

 red particles were almost diffluent beneath. 

 The patient, a female, could not be called ple- 

 thoric, having been the subject of her emaci- 

 ating complaint more than a year and a half. 

 Milky serum, though of a far less marked cha- 

 racter, having occurred in persons who have 

 been bled shortly after making a hearty meal, 

 the notion has been entertained that it is owing 

 to the passage of liquid chyle into the circu- 

 lation. This was Haller's opinion, while others 

 have attributed its appearance to admixture of 

 fat. To the former notion it may be objected, 

 that whereas it is certain that the milky appear- 

 ance of serum is owing to the presence of oily 

 particles, it is very doubtful, from the discord- 

 ant opinions of eminent chemists, whether the 

 chyle contains more oily matter than the blood 

 itself. Berzelius, indeed, makes its solid part 

 to consist of more than twenty-one per cent, of 

 fat, and Raspail considers it as differing little 

 from milk. Prout, however, whose analysis is 

 adopted by Turner, only admits an unappre- 

 ciable trace of oily matter in chyle, and makes 

 its composition differ little from blood ex- 

 cept as respects the absence of red particles. 

 In milky serum the oil exists in superabun- 

 dance at the expense of the albumen, which, in 

 all the specimens I have examined, has been 

 remarkably deficient in proportion, its specific 

 gravity varying from 1'019 to 1-024. This cir- 

 cumstance naturally leads to a question whether 

 this oil may not owe its origin to some chemical 

 change in the albumen itself, of which it seems 

 to supply the place. The remarkable blood * 

 described by M. Caventou,* and alluded to by 

 M. Raspail, f which was evidently nothing 

 more than blood with milky serum, affords ad- 

 ditional ground for supposing that such a 

 change takes place. " This blood issuing from 

 the vein was turbid, of a pale dirty red colour, 

 and became marled and of a whitish red as it 

 cooled in the basin, and some drops which fell 

 on the floor assumed this colour in a few 

 seconds, and looked like drops of chocolate 

 made with milk. After half an hour a coagulum 

 of moderate size was formed in it, which floated 

 in a large quantity of a white opaque fluid ex- 

 actly like milk." Raspail, who had evidently 

 never seen a marked example of milky blood, 

 gives the following fanciful explanation of the 

 appearance. " Under the influence, or in the 

 absence of one of the causes which together 

 produce the circulation, an acid had been 

 formed, which, saturating the alkaline men- 

 struum of the albumen, had caused it to coagu- 

 late. Now this irregular coagulation could not 

 take place without disguising the colour of the 

 blood and rendering it rose-coloured, while it 

 would give the serum the appearance of milk." 

 If the albumen had really been coagulated by 



* Annalcs de Ohimie, vol. xxxix. p. 288. 

 t Sect. 941. 



an acid, a distinct clot would not have been 

 formed by it, but a curdled precipitate ; nor 

 would the serum have borne any resemblance 

 to milk. But what is important as confirming 

 my view respecting the conversion mentioned 

 above, M. Caventou, to his great astonishment, 

 could not find any albumen in the milky serum 

 here described. The probability of this change 

 is heightened by the consideration that some- 

 thing analogous must necessarily occur in the 

 formation of true milk, the oil of which, when 

 separated as butter and melted to clarify it 

 from curd, remarkably resembles the oil of 

 milky serum. 



The attention of pathologisls to the salts of 

 the blood, which, considering the visible effects 

 they produce on this fluid, had been strangely 

 neglected, has of late years been roused by the 

 observations of Dr. Stevens, who certainly may 

 claim the merit of having advanced our know- 

 ledge of facts on this subject. It appears that 

 in the last stages of tropical fevers the saline 

 ingredients of the blood are so much diminished 

 that they are no longer capable of giving a red 

 colour to the haematosine. The black blood 

 that is found in the heart after death from 

 either the climate fever or the African typhus, 

 remains black even in an atmosphere of pure 

 oxygen, but it instantly changes colour when we 

 add it to a clear fluid that contains even a small 

 portion of any neutral salt. Nor is it in fever 

 alone that this deficiency of salts is observed. 

 Dr. O'Shaughnessy has shewn that it likewise 

 exists in malignant cholera, and it is probable 

 that in sea-scurvy, and in those analogous dis- 

 eases produced by want and unwholesome 

 nourishment, a similar state occurs. 



The saline matters may be in excess as well 

 as in defect, and this is marked by excitement 

 of the circulating system, and either local de- 

 terminations or general febrile disturbance. The 

 stimulant effect of saline springs has been known 

 time out of mind, while the thirst and heat pro- 

 duced by the too copious use of common salt 

 is in every body's experience. If we couple 

 these facts with the certainty that the neutral 

 salts will pass unchanged through the circu- 

 lation so as to admit of detection in the urine, 

 we may infer that their superabundance in the 

 bood is not only a possible, but, in all proba- 

 bility, a frequent occurrence. They are occa- 

 sionally found after death deposited in a crys- 

 talized form, as was observed by Sir Everard 

 Home, who, in dissecting an aneurismal tumour, 

 found a mass of crystals, which were analyzed 

 by Mr. Faraday, and are stated to have been 

 salts usually met with in the blood. 



Having thus concluded such remarks as the 

 present state of our knowledge has enabled me 

 to offer respecting the morbid changes which 

 take place in the separate constituents of the 

 blood, I now proceed to notice some of the 

 more important diseases in which those changes 

 have been observed to occur. 



Inflammation. The usual appearances of 

 blood in inflammatory diseases have already 

 been described in treating of the buffed coat. 

 The crassamentum is commonly supposed to 

 be increased in bulk, but this is somewhat 

 doubtful; and indeed it so much depends upon 



