General pathology, as conducive to the establishment of rational principles for the diagnosis and treatment of disease : a course of lectures, delivered at St. Thomas's Hospital, during the summer session of 1850 / by John Simon.

  • John Simon
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: General pathology, as conducive to the establishment of rational principles for the diagnosis and treatment of disease : a course of lectures, delivered at St. Thomas's Hospital, during the summer session of 1850 / by John Simon. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    41/222
    dilution, making it more or less watery than it should be; and, in doing this, they alter its specific gravity. a. Inspissation of the blood, under such circumstances, is rare. You might at first think it would occur in diabetes, where the flux of water is so great; but when you remember the high specific gravity of the urine, and the vast quantity of solid matter running to waste in that excretion, you will be prepared to believe the contrary. And such is the case: the solids of the blood are relatively diminished in diabetes. Nothing can illustrate the waste of the economy in that disease, and the extreme degree in which nourishment is derived from its due course, more clearly than the fact that, despite the im- mense elimination of water, the specific gravity of the blood is below its standard. The only disease (so far as I know) in which the excretions gain on the fluidity of the blood, so as to inspissate it, is cholera. Lecanu made several experiments upon the constitution of the blood in this disease, and found the water always materially reduced, in one case even to less than half the total weight of the blood examined. The following are his numbers :— Case 1. Case 2. Case 3. Case 4. Solid constituents . . . 251 330 340 520 Water 749 670 660 480 and in a separate analysis of the serum in cholera, which O'Shaugh- nessy published, the solid ingredients are given as more than 17 per cent, of the serum, instead of being 9 or 10 per cent. This inspissation of the blood in cholera has, no doubt, much to do with the production of symptoms: the dulness and flaccidity of the cornea, the shrinking of the extremities, the imperfect aeration of the blood, and especially the stagnation of the blood-corpuscles in the Malpighian capillaries of the kidney, with the consequent suppression of urine, would all be probable physical results of so important a change in the fluidity and circulability of the blood. As regards the origin of that change in the blood, I need hardly tell you that the excretions, which pour by pailfuls from the intes- tinal canal with a rapidity unparalleled in disease, furnish a sufficient explanation. b. Attenuation of the 5?ooc?marks all other diseases which are attend- ed by exhaustive discharges, and is their almost immediate result. First among these may be counted hemorrhage. Ten of Cruveil- hier's patients were bled three times. The mean condition of their blood, after each bleeding, was as follows:— Density of defibrinated blood Quantity of water in 1000 parts Solid residue . Corpuscles . Albumen . Fibrin . 3 At 1st At 2,1 At 3d bleeding. bleeding. bleeding. . 1056 1053 1049 . 793 807.7 833.1 . 207 192.3 176.9 . ]29.2 116.3 99.2 65 63.7 64.6 3.5 3.8 3.4