176 THE FLUIDS. 



and fibrine (/Stas), but a large amount of serum-caseine. Stas also 

 found urea in this blood. 



D. Zimmermann found the serum of the blood of the veins of the 

 lower extremities poorer in water than that of the upper extremities. 



E. The menstrual fluid is to be regarded, histologically, merely as 

 a hemorrhage 1 periodically recurring from the interior of the uterus, 

 and therefore as pure blood. It is, however, discharged per vaginam 

 in a state of admixture with the mucus of the cervix uteri and the 

 vagina, and therefore contains epithelial cells and cytoid corpuscles. 

 (Fig. 109.) Jul. Yogel states that menstrual blood contains no fibrine. 

 On the other hand, E. H. Weber found coagulated blood on the mu- 

 cous membrane of a young girl who had committed suicide during 

 the catamenial period. The fact that in ordinary circumstances the 

 menstrual fluid does not coagulate, has generally been attributed to 

 the action of the acid mucus of the vagina, and not to the absence 

 of fibrine, the former holding the latter in solution. Certain it is, 

 that where the menstrual flow is so increased as to constitute a pa- 

 thological condition (menorrhagia), there is no deficiency either of 

 fibrine or of coagula. 



Pathological States of the Blood in certain Diseases. 



1. Inflammation. The changes in the intercellular fluid in inflam- 

 mation are these : 1. In all inflammations accompanied by a febrile 

 reaction there is an increase of fibrine (hyperinosis), it ranging from 

 4.7 to 10.5 parts in 1,000 of the blood. The highest increase occurs 

 in acute rheumatism and pneumonitis. It may be considerable 

 when the inflammation is not extensive, as in erysipelas ; but in 

 each particular disease it is proportioned to the degree and duration 

 of the inflammation. It is independent of the strength of the pa- 

 tient, and of the increase or decrease of the other solid constituents 

 of the blood, occurring in the most decided anemia or hydraBmia, 

 and as abundantly in meningitis and other acute cerebral diseases as 

 in inflammation of other parts. 2. The albumen is somewhat dimi- 

 nished in inflammatory blood. The serum also frequently becomes 

 turbid from the presence of separated albumen. (/Scherer.) 3. There 

 is less chloride of sodium in inflammatory than in normal blood, but 

 the sulphate of soda and of potassa are increased. 



The red corpuscles are diminished in violent inflammation (rheu- 

 matism and pneumonitis), but not in any marked degree unless 

 other pathological conditions coexist to induce a simultaneous dimi- 



1 Those who maintain that this fluid is an exudation, or an effusion, overlook 

 the fact that the blood-corpuscles can leave the vessels only after a rupture of their 

 walls. See next chapter, on "Effusions" and "Exudations." 



