320 CIRCULATING FLUIDS : 



Ancelli remarks, tliat in the first stage of the endemic yellow 

 fever of tlie West Indies the blood is of a brighter red, contains 

 more salts, and is hotter than in a state of health. As the 

 disease progresses, its characters become changed, and towards 

 the tei'mination of the malady it loses its saline and animal 

 principles, and becomes black and thin ; in which state sangui- 

 neous effusions occur from the different outlets and tissues. 



Balard and Rochet^ have made some observations on the 

 properties of the blood in the plague. 



Balard is of opinion that the lymphatic system is first disor- 

 dered, and that inflammation, degeneration, and suppuration of 

 the lymphatic ganglia and vessels follow. It is not until sup- 

 puration in these structures has fairly set in that the venous 

 system begins to sufier, and a change in the composition of the 

 blood to ensue. 



The blood, when the disease is fully established, exhibits in- 

 variably the same properties, whether it is obtained by bleeding, 

 or taken from the vessels after death. The arterial and venous 

 blood have both the same dark colour; the blood generally 

 appears in a peculiar state of solution, and oily drops are fre- 

 quently seen on its surface. It frequently has a peculiar smell, 

 but never the buffy coat. 



In three patients, aged 19, 23, and 27 years respectively, and 

 in whom the blood was drawn between the third and fifth days, 

 it was of a dark-brown colour, and in the course of two hours 

 a good clot was formed. This, however, is frequently not the 

 case, especially when the oily globules appear. The serum was 

 reddish, and developed a gas which soon browned sugar of lead 

 test-paper, and which therefore contained sulphuretted hydrogen. 

 The clot constituted about 40~, and contained 33'5 of water, 

 •6 of fibrin, 3*8 of cruor, -25 osmazome, "9 of chlorides of sodium 

 and potassium, and "2 of carbonate of soda and fat. 



Lacheze,3 who observed the plague in Egypt, states that the 

 blood never coagulates, that it is greasy, and of a black colour. 



' Course of Lectures on tlie Physiology and Pathology of the Blood. The Lancet, 

 1840, p. 837. 



2 Casper's Wochenschrift, 1838, No. 12. 



^ Magendic, Lemons sur le Sang. Bruxelles, 1839, p. 200. 



