BLOOD. '2i)3 



Water ..... 

 Solid residue .... 

 Blood-corpuscles 

 Residue of seruui 



Choniel docs not consider that the diminution of fibrin is a 

 specific character of the blood in typhoid fever, because he 

 found that in 6 out of 30 cases, the blood formed a solid clot, 

 covered Avith a bully coat, but differing in thickness and colour 

 from the inflammatory clot; while in 2 cases there was a 

 slight film, beneath which the clot was diffluent, in 2 the blood 

 remained perfectly fluid and slightly lumpy, and in 20 the blood 

 formed a firm clot, but no buffy coat. 



The blood in all these cases was taken during the first or 

 the commencement of the second stage, never in the third. 

 The peculiarities in Chomel's statement may be partly due to 

 the blood being taken at a period before the fever had reached 

 its height, partly to the association of some inflammatory symp- 

 tom, or to a more synochal type of the disease. 



According to Jennings, ^ the blood in the first stage of ty- 

 phoid fever (depression) is generally thick and dark ; it coa- 

 gulates rapidly and forms a soft, large, dark-coloiu'cd clot. 

 In the second stage (excitement) it flows readily, is of a scarlet 

 coloiu-, does not coagulate so quickly as, and forms a more 

 solid clot than the former. It is also occasionally covered with 

 a slight buffy coat. In the third stage (collapse) it flows very 

 readily, is thin, watery, and of a dark colour: the clot is loose 

 and flocculent, and occasionally appears more as a sediment 

 of colouring matter than as a clot. In thoroughly developed 

 typhus. Dr. Armstrong found the Iflood of the temporal artery 

 as dark as that of the vein. Dr. Clanny also states that the 

 watery portion of the blood increases with the intensity of the 

 disease, and that not merely the solid constituents generally, 

 but also the salts and carbonic acid are diminished. The water 

 begins to decrease, and the solid constituents to increase in 

 favorable cases after 12 or 18 days. According to Stevens, the 

 salts of the blood (especially the chloride of sodium) are di- 

 minished in all typhoid fevers. 



' Course of Lectures on the Physiology and Pathology of the Blood, by II. Aucell. 

 The Lancet, 1840, p. 338. 



