A treatise on the principles and practice of medicine : designed for the use of practitioners and students of medicine / by Austin Flint.
- Austin Flint I
- Date:
- 1884
Licence: Public Domain Mark
Credit: A treatise on the principles and practice of medicine : designed for the use of practitioners and students of medicine / by Austin Flint. Source: Wellcome Collection.
Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.
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![Melansemia. Melanaemia is tliat condition of the blood in whicli granular pigment is present. The pigment is black or brown in color, and in the form either of small roundish or angular granules, or of larger irregular flakes or masses. It exists partly free, and i)artly inclosed in leucocytes. Tlu; granules are some- times surrounded by a little hyaline material, and they have been found occa- sionally in fusiform cells, such as exist normally in the spleen. Melana^mia IS observed in cases of malaria. It is met with chiefly in the pernicious forms of intermittent and of remittent fever, and sometimes in chronic malarial cachexia. In the milder grades of intermittent fever, it is present, if at all, in very slight degree. The pigment in melana;mia is present not only in the blood but in certain organs, more especially the si)leen, the liver, and the mar- row of the bones. Pigment, however, may be found in any vascular part. The cortical substance of the brain accpiires a dark, slate-like color from mela- noBmic pigmentation. In the spleen, liver, marrow of the bones, and lym- phatic glands, the pigment is not only within, but frequently outside of, the bloodvessels. In the latter situation it may be either free or inclosed in cells. In the brain and other parts, the pigment is mostly intravascular. Small vessels may be occluded by pigment and ])igment-cells. In melaiutmia the number of red blood-corpuscles is diminished, either with or without an increase of the wdiite corpuscles. It is generally agreed that the pigment of melanasmia is formed out of the coloring matter of red blood-corpuscles. There are diHerent views as to the situation in which the pigment is formed. Virchow and Frerichs maintain that it is formed in the spleen out of red corpuscles, which have either escaped from the bloodvessels, or are contained in venous thrombi; that it is conveyed by the portal vein to the liver, where it accumulates in considerable ([uantity and thence passes into the circulation. The spleen is enlarged, and more deeply pigmented than any other organ. 0[)posed to the view that the pigment is j)roduced in the spleen, is that advanced by Arnstein,^ namely, that the formation takes place in the circu- lating blood, from red corpuscles destroyed by the malarial poison, and that subsecpieutly there is an accumulation in those organs in which fine |)articles introduced artificially into the blood of animals are retained. If cinnabar or carmine, for instance, be injected into the blood, it accumulates in the spleen, marrow of the bones, and liver, and is thereby withdrawn gradually from the circulation. The accumulation of melanaemic pigment in preciseiy these organs, makes it probable that it is not formed in them, but is retained by them as in the case of foreign particles in general. According to Arnstein, the melanaemia gradually disappears after a malarial paroxysm, in consequence of the retention of the pigment in the organs named. He found pigment in other organs than the spleen, liver, marrow of bones, and certain lymphatic glands, only when death occurred, while pigment was present in the circulat- ing blood. Melana^mia is developed during a malarial febrile paroxysm, and may disapi)ear in the course of two or three days alter the attack. It may also continue for months after the cessation of malarial paroxysms, as has been observed by Hosier. Melaiuemia, in fact, seems to be an inconstant con- dition. It IS certainly not infrequently absent when well-marked melanosis of the spleen and liver is found after death. The attempt to discover pig- ment in the blood in cases of severe malarial infection, is often unsuccessful. Although the views of Arnstein have been in the main confirmed by the stu- dies of Kelsch who observed numerous cases of pernicious malarial fever in](https://iiif.wellcomecollection.org/image/b21198135_0092.jp2/full/800%2C/0/default.jpg)
