48 ABNORMAL CONDITIONS OF THE BLOOD. 



leucocytes, and by them are carried outside the blood-stream. The cells of the splenic pulp, 

 marrow of bone, and the liver also take up these particles (Siebcl). 



The salts remain very persistently in the blood. The withdrawal of common salt produces 

 albuminuria, and, if all salts be withheld, paralytic phenomena occur (Forster). Over-feeding 

 with salted food, such as salt meat, has caused death through fatty degeneration of the tissues, 

 especially of the glands. Withdrawal of lime and phosphoric acid produces atrophy and soften- 

 ing of the bones. In infectious diseases and dropsies the salts of the blood are often increased, 

 and diminished in inflammation and cholera. [NaCl is absent from the urine in certain stages 

 of pneumonia, and it is a good sign when the chlorides begin to return to the urine.] [In 

 scurvy the corpuscular elements are diminished in amount, but we have not precise information 

 as to the salts, although this disease is prevented, in persons forced to live upon preserved and 

 salted food, by a liberal use of the salts especially potash salts of the organic acids, as con- 

 tained in lime-juice. In gout the blood, during an acute attack, and also in chronic gout, 

 contains an excess of uric acid {Gairod).~\ 



The amount of fibrin is increased in inflammations of the lung and pleura [croupous 

 pneumonia, erysipelas], hence such blood forms a crusta phlogistica ( 27). In other diseases, 

 where decomposition of the blood-corpuscles occurs, the fibrin is increased, perhaps because the 

 dissolved red corpuscles yield material for the formation of fibrin. After repeated hemorrhages, 

 Sigm. Mayer found an increase of fibrin. Blood rich in fibrin is said to coagulate more slowly 

 than when less fibrin is present still there are many exceptions. 



(B) (I.) Diminution of the Quantity of Blood, or its Individual Constituents. (1) Oligemia 

 vera. Anaemia, or diminution of the quantity of blood as a whole, occurs whenever there is 

 hemorrhage. Life is endangered in newly-born children when they lose a few ounces of blood ; 

 in children a year old, on losing half a pound ; and in adults, when one-half of the total blood 

 is lost. Women bear loss of blood much better than men. The periodical formation of blood 

 after each menstruation seems to enable blood to be renewed more rapidly in their case. Stout 

 persons, old people, and children do not bear the loss of blood well. The more rapidly blood 

 is lost, the more dangerous it is. [A moderate loss of blood is soon made up, but the fluid part 

 is more quickly restored than are the corpuscles.] 



Symptoms of Loss of Blood. Great loss of blood is accompanied by general paleness and 

 coldness of the cutaneous surface, increased oppression, twitching of the eyeballs, noises in the 

 ears and vertigo, loss of voice, great breathlessness, stoppage of secretions, coma ; dilatation of 

 the pupils, involuntary evacuations of urine and faeces, and lastly, general convulsions, are sure 

 signs of death by haemorrhage. In the gravest cases recovery is only possible by means of 

 transfusion. Animals can bear the loss of one-fourth of their entire blood without the blood- 

 pressure in the arteries permanently falling, because the blood-vessels contract and accommodate 

 themselves to the smaller quantity of blood (in consequence of the stimulation of the vasomotor 

 centre in the medulla). The loss of one-third of the total blood diminishes the blood-pressure 

 considerably (one-fourth in the carotid of the dog). If the haemorrhage is not such as to cause 

 death, the fluid part of the blood and the dissolved salts are restored by absorption from the 

 tissues, the blood-pressure gradually rises, and then the albumin is restored, though a longer 

 time is required for the formation of red corpuscles. At first, therefore, the blood is abnormally 

 rich in water (hydremia), and at last abnormally poor in corpuscles (oligocythemia, hypoglo- 

 bulie). With the increased lymph-stream which pours into the blood, the colourless corpuscles 

 are considerably increased above normal, and during the period of restitution fewer red corpuscles 

 seem to be used up (e.g., for bile). 



After moderate bleeding from an artery in animals, Buntzen observed that the volume of the 

 blood was restored in several hours ; after more severe haemorrhage in 24 to 48 hours. The red 

 blood-corpuscles, after a loss of blood equal to 1*1 to 4 '4 per cent, of the body- weight, are 

 restored only after 7 to 34 days. The regeneration begins after 24 hours. During the period 

 of regeneration the number of the blood-corpuscles in aii early stage of development is increased. 

 The newly-formed corpuscles contain less Hb than normal (Joe. G. Ott). Even in man the 

 duration of the period of regeneration depends upon the amount of blood lost {Lyon). The 

 amount of haemoglobin is diminished nearly in proportion to the amount of the hemorrhage 

 (Bizzozero and Saivioli). 



Metabolism in Anemia. -^The condition of tlve metabolism within the bodies of anaemic 

 persons is important. The decomposition of proteids is increased (the same is the case in 

 hunger), hence the excretion of urea is increased {Bauer). The decomposition of fats, on the 

 contrary, is diminished, which stands in relation with the diminution of C0 2 given ott. 

 Anemic and chlorotic persons put on fat easily. The fattening of cattle is aided by occasional 

 bleedings and by intercurrent periods of hunger {Aristotle). 



(2) An excessive thickening of the blood through loss of water is called Oligemia sicca. 

 This occurs in man after copious watery evacuations, as in cholera, so that the thick tarry 

 blood stagnates in the vessels. Perhaps a similar condition though to a less degree may 

 exist after very copious perspiration. 



(3) If the proteids in blood be abnormally diminished the condition is called Oligemia 

 nypalbuminosa ; they may be diminished about one-half. They are usually replaced by an 



