.IlLY 3, 1903.] 



SCIENCE. 



pathological conditious in man. That a 

 similar form of thrombosis plays an im- 

 portant part in experimental pathology 

 could be shown by studying the 'clots' 

 formed in the heart and great vessels in 

 poisoning by ether, alien serum and ricin 

 injections in rabbits, and has been proved 

 by the observations made by Fisher, work- 

 ing in Dr. Welch's laboratory, of the oc- 

 currence of such thrombi in experimental 

 infections with the tj-phoid bacillus, and 

 Boxmeyer, of Boston, of their existence in 

 relation with certain necrotic foci in the 

 liver in experimental hog-cholera bacillus 

 infectious. Heiiter and Klebs and Welch 

 had, many years ago, drawn attention to 

 the fact that certain of the so-called hyaline 

 .thrombi appeared to be composed of fused 

 and altered i-ed corpuscles, observations 

 which are confirmed and explained by these 

 later findings. 



It seems to me highly probable that ag- 

 glutinative thrombosis will, in the near 

 future, be recognized as an important 

 pathological condition in man, and that a 

 large number of the thrombi that arise in 

 the course of infectious disease and, doubt- 

 less, disea.ses of uncertain etiologj-, will be 

 discovered to have originated in agglutina- 

 tion. Not only will capillaiy hyaline 

 thrombi be explained upon this basis, but 

 the thrombi of larger vessels, such as those 

 of the femoral vein, may equally be shown 

 to have this mode of origin. I wish, in 

 this connection, to draw attention to the 

 unsatisfactory nature of the data relating 

 to the mycotic origin of thrombi with which 

 French writers especially have identified 

 themselves, and to suggest that in agglu- 

 tination a more adequate cause for throm- 

 bosis might come to be found. 



The experimental study of agglutination 

 seems capable of shedding much needed 

 light upon the subject of intravascular 

 clottintr in general. I have been able to 



show that the so-called cuagula which ap- 

 pear in the heart in experimental ether and 

 alien serum poisoning are not clots in a 

 true sense, but merely masses of fused red 

 corpuscles; and Ehrlieh many years ago 

 endeavored to explain the lesions of ex- 

 perimental ricin poisoning upon the basis 

 of his findings of capillary thrombi com- 

 posed of agglutinated corpuscles. Ehr- 

 lieh 's attention was called to this appear- 

 ance by the previous observations of Kobert 

 and Stillmark upon the precipitating and 

 coagulating effects of ricin upon red cor- 

 puscles in vitro; but the entire series of 

 pathological effects of ricin upon the organ- 

 ism can not, as I pointed out some years 

 ago, be explained by thrombosis. 



That relation exi.sts between extensive 

 blood destruction and agglutinative throm- 

 bosis, the mode of action of ether and alien 

 serum injections in producing rapid death 

 quickly proves; and the essential identity 

 of the agglutination prodiiced i)> vitro and 

 in the body by agglutinating and haemo- 

 lytie substances can be easily shown. If 

 a dog or a rabbit is injected with a fatal 

 quantity of hsemolytic serum and the gel- 

 atinized blood in the heart and great veins 

 be removed and subjected to immediate 

 examination in the fre.sh state, the cor- 

 puscles will be found fused together and, 

 under the influence of the pressure of 

 a cover-glass, to undergo extraordinary 

 changes in form and position. Any one 

 acquainted with the remarkable photo- 

 graphs of ^Mitchell and Reichert illus- 

 trating the eft'ects of venom upon red cor- 

 puscles will recognize the identity of the 

 two pictures. 



The description of agglutination of cor- 

 puscles by venom given by Jlitehell and 

 Reichert, and later by ^Mitchell and Stew- 

 art, in their papers on venom, and the 

 studies upon venom recently conducted by 

 Dr. Xoguehi and mvself. suggested a re- 



