BLOOD, MORBID CONDITIONS OF THE. 



alkaline salts were found diminished in the fol- 

 lowing proportions : 

 In healthy serum, according to Lecanu, 



salts 8-10 



In the serum of a male, aged 31, first day 



of fever, salts 4 



Ditto ditto aged 34, first day 



of fever, salts 5 



Ditto female, aged 14, fourth 



day of fever, salts 4'2 



Average of three other cases 4'4 



Scurvy. It seems to be the universal opi- 

 nion of those who have seen and written on 

 scurvy, that it owes its origin to a morbid 

 change in the fluids, and especially in the 

 blood ; and even those who have been the most 

 strenuous opposers of the humoral pathology 

 in general, among the most celebrated of whom 

 we may reckon Willis, Hoffmann, Boerhaave, 

 Cullen, and Sir John Pringle, have made an 

 exception in favour of this disease. Notwith- 

 standing this general belief there has been no 

 attempt up to the present time at any chemical 

 examination of the properties of scorbutic 

 blood, and we have only the general obser- 

 vation made by the surgeons of Lord Anson's 

 expedition, (Messrs. Ettrick and Allen,) that in 

 the beginning of the disease it flows from the 

 arm in different shades of light and dark 

 streaks ; that as this advances, it runs thin and 

 black, and after standing turns thick and of a 

 dark muddy colour, the surface in many places 

 being of a greenish hue, without any regular 

 separation of its parts ; that in the third de- 

 gree of the disease it is as black as ink, and 

 though kept stirring in the vessel for many 

 hours, its fibrous parts have only the appear- 

 ance of wool or hair floating in a muddy sub- 

 stance ; and that in dissected bodies the blood 

 in the veins is so fluid that by cutting any con- 

 siderable branch, the part to which it belongs 

 may be emptied of its black and yellow liquor, 

 the extravasated blood being precisely of the 

 same kind. The prevalence of scurvy where 

 there has been a long-continued use of salted 

 provisions has given rise to the supposition* 

 that the salt itself actually finds its way into 

 the circulation, and acts as it is known to act 

 on blood out of the body by preventing its 

 coagulation. This, however, is very evidently 

 not the case, first, because salt provisions are 

 not necessary to its production, since scurvy 

 has often made its appearance where no salt 

 provisions were used; as, for instance, in the 

 Milbank Penitentiary in 1819, where the diet 

 consisted of pease, barley soup, and brown 

 bread ; and, secondly, because the appearance 

 of the blood, especially as the disease ad- 

 vances, is exactly the reverse of what it would 

 be on the addition of salt, which, instead of 

 making it black, and causing it on standing 

 to become thick, muddy, and of a greenish 

 hue, would impart to it a fine scarlet tint that 

 would remain permanent until it began to 

 putrefy. Since the modern advances in ani- 

 mal chemistry, opportunities for examining the 

 blood in true scurvy have been very rare ; and 



* Jennins's Report. 



425 



it is therefore the more to be regretted that 

 Drs. Latham and Roget, philosophers every way 

 so competent to determine the precise morbid 

 changes which it undergoes, did not, when they 

 had it in their power, make a particular ex- 

 amination of it. Venesection, it seems, was 

 practised at the Penitentiary in a few cases, 

 but nothing is stated respecting the appearance 

 which the blood assumed.* The description 

 of Lord Anson's surgeons does not by any 

 means apply to the blood which is found in 

 purpura haemorrhagica, a complaint that was, 

 prior to the appearance of Dr. Bateman's work 

 on diseases of the skin, generally considered 

 closely allied to scurvy. In two cases of pur- 

 pura related by Dr. Parry ,f of Bath, blood 

 drawn from the arm exhibited a tenacious 

 contracted coagulum covered with a thick coat 

 of lymph ; and in one instance which occurred 

 under my care, where the patient, a man of 

 forty-five years of age, had most of the sym- 

 ptoms of sea-scurvy, such as general cachexia ? 

 with anasarca of the lower limbs, great depres- 

 sion of spirits and prostration of strength, ex- 

 tensive ecchymosis on the trunk and the ex- 

 tremities, fetid breath and extravasations of 

 blood from the gums, the stomach, and the 

 bowels, as well as from a large foul ulcer on 

 the leg; a copious venesection demonstrated 

 that the blood had not in any degree lost its 

 crasis, the crassamentum being covered with a 

 thick buffy coat, and having as much firmness 

 as is usual under the existence of such a state. 

 It is proper to observe that Lind's description 

 of the blood in scurvy differs from that of Lord 

 Anson's surgeons, as he found it generally either 

 natural or buffed.J 



Jaundice. In jaundice the blood, both 

 arterial and venous, is tinged with bile, and 

 this is apparent not only in the serum, 

 but still more strikingly in the crassamentum, 

 provided it be covered with a buffed surface. 

 If this be removed and dried in a state 

 of tension, it exhibits a deep yellow hue, 

 particularly when viewed by transmitted light. 

 Although the bile is thus rendered very 

 visible in jaundiced blood, yet, owing to its 

 combination with albumen, which defends it 

 from the action of acids, it is difficult of de- 

 tection by chemical re-agents, so that many 

 chemists of eminence have sought in vain to 

 ascertain its presence. Lassaigne, however, 

 succeeded in demonstrating that the colouring 

 matter of the bile is really to be found in the 

 circulation, and Berzelius tells us that Collard 

 and Martigny pretend to have discovered even 

 the resin of bile in jaundiced blood. M. Le- 

 canu has more recently confirmed these facts, 

 and Mr. Kane has verified his results. To 

 the medical inquirer who does not follow the 

 "minutiae of animal chemistry, the identity of 

 the colouring matter in the serum of jaundiced 



* Account of the Disease lately prevalent at the 

 General Penitentiary, by P.M. Latham,M.D. 1823, 

 p. 39. 



t Edinburgh Medical and Surgical Journal, 

 vol. v. p. 7. 



| Lind on Scurvy, page 512. 



Dublin Journal, vol. ii. p. 346. 



