BLOOD. 275 



The quantity of blood-corpuscles only once exceeded the quan- 

 tity in normal blood, and this instance coincides with that in 

 which the solid constituents generally attained their maximum, 

 228-0 : in most instances it was considerably diminished, and 

 hence we find that the average displays the corpuscles 16 below 

 the ordinary proportion. In only four cases was the quantity of 

 fibrin lower than 5'0. Andral and Gavarret remark that the 

 acuteness of the pain seems to have a greater influence on the 

 increase of the fibrin than the stage or duration of the disease. 

 The blood will be found to contain as large a proportion of fibrin 

 at the commencement of a rheumatic attack which begins very 

 severely, as at a much later period in a case commencing mildly, 

 but in which acute pain gradually supervenes. This will be 

 seen bj' the following analyses : 



In the first case, the maximum of fibrin is found in the blood 

 taken at the second venesection, and as early as the fifth day of 

 the disease. In the second case, on the contrary, it did not 

 occur luitil the fourth venesection, upon the thirteenth day of 

 the disease, when nearly all the joints were reported to be in a 

 swollen and painful state. These symptoms began to diminish 

 after the next two bleedings ; the fever, hoAvever, still continued. 



The minimum of fibrin in the first case occurred at the period 

 of the fifth venesection, and is even less than the amount in 

 normal blood : the corpuscles are now considerably increased. 

 This venesection was performed on the eighteenth day of conva- 

 lescence, after all pain had entirely disappeared, and after the 

 patient had been put upon a nourishing diet. 



Andi'al and Gavarret show in the following table how the 

 remission of the fever influences the quantity of fibrin. 



