Licence: Public Domain Mark
Credit: The practice of medicine / by Thomas Hawkes Tanner. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![sists of an increase in the whole mass of the blood, to an extent very variable in different cases. There is always a superabundance of the red corpuscles. The proportion of fibrin is probably unaltered, or it may be slightly increased [hyperinosis, from 'Yxkp = in excess -f fe, Ivdq = the fibre of flesh]. The albumen of the serum is unchanged; the quantity of water being rather diminished. When the blood merely exists in too great abundance in one or more particular organs or tissues we say that there is local hyperemia, or par- tial plethora, or congestion, or determination of blood. There is no in- crease in the total amount of blood, nor in any of its constituents. In- deed partial plethora not uncommonly occurs in cases where the blood, taken as a whole, has been much diminished in quantity or quality by disease. Thus I have seen a woman lose a large quantity of blood by flooding directly after parturition, and yet the breasts have become greatly congested at the end of forty-eight hours, just prior to the secre- tion of milk. Again, if an organ be irritated mechanically, we cause an increased flow of blood to it through the arteries, thus giving rise to ac- tive congestion ; a condition which, after a time, either decreases insen- sibly, or ends in hemorrhage, or passes into inflammation. When the return of blood to the heart through the veins is impeded, as by the com- pression of one or more venous trunks, we have what is called mechanical congestion. Or again, the circulation of the blood through a part may be sluggish owing to want of tone in the walls of the veins and capilla- ries, as is often seen in persons debilitated by age or disease. We then have passive congestion. The blood being directly fed by the chyle, it is evident that too free living must be one of the most common causes of hyperemia. The nor- mal waste of tissue, and consequent expenditure of blood, is also impeded by a sedentary mode of life. Sometimes this condition is hereditary; and not unfrequently I have found it occur in women after the change of life. So again, plethora may result from the loss of an important part of the body. Thus, a spare man some months after amputation at the hip-joint became strong and robust and red-faced; for since he took as much food as he was accustomed to consume before the disease set in which rendered removal of his limb necessary, so of course he made as much blood as appeared needed for the nourishment of his body prior to nearby one-fourth part of it being removed. The existence of general Irypersemia is marked by symptoms which cannot be overlooked. The face appears full and turgid, with a purplish tinge. The eyes seem rather small, and the conjunctivae more moist than usual. There is distension of the capillaries, as can be observed on the lips and mucous surfaces. The pulse is large, somewhat hard, and insis- tent. There is also a turgid appearance of the veins. Obesity is some- times an accompaniment, though by no means an infallible sign of pleth- ora. Indeed, as will be mentioned in a subsequent section, many fat persons suffer from a deficiency, rather than from an excess, of blood; and consequently they bear lowering measures during the progress of disease very badly. Hypersemia produces lassitude and indolence; a desire for sleep, which](https://iiif.wellcomecollection.org/image/b21079961_0037.jp2/full/800%2C/0/default.jpg)
