20 GENERAL EXAMINATION. 



or external hemorrhage or in slight but frequent hemorrhages in- 

 ternally; it may be due to decrease in the amount of haemoglobin 

 in the blood-corpuscles in diseases peculiar to the blood, as in 

 auEemia, chlorosis, leukfemia, pseudo-leuksemia; in all diseases 

 producing great loss of fluids, especially of a chronic nature, such 

 as diseases of the kidneys and bowels, and also slow pus-forma- 

 tions that are accompanied with or without fever; in defective 

 heart-actioD, as in collapse, where the heart's action is, to a cer- 

 tain extent, paralyzed for the time, as in many acute diseases or 

 violent poisoning from some depressing drugs; also in diseases of 

 the heart and its covering (pericardium). A blue (cyanotic) col- 

 oring is sometimes seen in cases where there is defective oxygena- 

 tion of the blood, and it is loaded with carbon dioxide. This 

 is seen where the blood in the lungs does not come in contact with 

 oxygen, as in some contraction of the trachea or larynx produced 

 by an inflammation or swelling in the parts, foreign bodies, inter- 

 nal or external tumors pressing on the air-passages; also in acute 

 bronchitis; in the various forms of pneumonia; in large pleuritic 

 exudates; in hydrothorax; in severe ascites where the diaphragm 

 is pressed on; in rigidity of the muscles, as in eclampsia in bitches; 

 in strychnine-poisoning, and in some heart-affections; in cases 

 of defective blood-circulation in the capillaries from disease 

 of the heart, especially if there is fatty degeneration; from de- 

 fective valvular action, from deposits on them, from pericardiac 

 exudates, from the action of a poison acting directly on the heart, 

 or from some injury or pressure on the jugular; in diseases where 

 there is great accumulation of blood in the head, as in acute hyper- 

 semia of the brain and inflammation of the brain; in the latter 

 case the redness of the mucous membrane is lighter in color or 

 more of an arterial tint. A yellow color (icteric) generally de- 

 notes some disorder of the liver, such as gastro-duodenal catarrh, 

 causing a swelling and obstruction of the ductus choledochus; 

 occasionally from calcareous deposits in the bile-ducts or the pres- 

 ence of tumors that press on the biliary ducts. This colorino- 

 may be due to a decompositiou of the blood as a result of certain 

 poisons in the system, such as phosphorus. 



It is seen as a result of the effects of certain infectious diseases. 

 The reddening of the mucous membrane may be due in some in- 

 stances to phosphorus-poisoning (Miiller), to true scurvy (Siedam- 



