Yellow fever / by George M. Sternberg.

  • Sternberg, George Miller, 1838-1915.
Date:
[date of publication not identified]
Catalogue details

Licence: Public Domain Mark

Credit: Yellow fever / by George M. Sternberg. Source: Wellcome Collection.

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    sometimes found upon the surface or in the substance of the heart, as well as in other muscles of the body and the organs generally. The cavities of the right side of the heart usually contain soft coagula or dark coloured fluid blood, and the right ventricle some¬ times contains a more or less decolourised fibrinous clot. Blood.—The blood in yellow fever has been described by many observers as “ completely disorganised ” as to its histological elements. This is a mistake, as is shown by the numerous photo-micrographs made by the writer while in Havana, in 1879, from the blood of cases near a fatal termination. Both the red and the white corpuscles retain their normal appearance, and I have frequently seen the leucocytes undergoing their characteristic movements, even after twenty-four hours, in blood which had been preserved in culture-cells. In the days of bleeding, numerous observers mentioned the fact that the blood either does not coagulate readily, or forms a soft, loose coagulum from which the .serum does not separate. The same is true of the blood in the heart and large vessels after death; it is fluid and dark coloured. Although there is no general destruction of the red corpuscles, it is probable that a considerable number of these elements perish in severe cases, for the serum contains free haemoglobin, which gives it a yellow colour even as early as the third or fourth day. This yellow colour is seen in the serum obtained from the application of blisters to the surface, and in blood drawn for microscopical examination. This passing of the haemoglobin into the serum, which is no doubt the cause of the yellow discoloration of the tissues in yellow fever, has been ascribed to the presence of bile. This view is not sustained by the chemical researches of Cunisset, a recent French author, who has arrived at the following conclusions:— “ Yellow fever is not a poisoning by the bile; at the outset of the malady the biliary pigments are rarely found in the blood or in the urine. They appear generally only during the second period, and in a great number of cases they are not to be found at all. “ The biliary salts, of which the powerful action of ‘ deglobulation ’ admitted by certain authors might explain the disorders which the malady presents, do not exist in the matters vomited, or in the urine, or in the blood, except, in certain cases, in very feeble quantity. In view of the profound alterations of the liver, this absence of the biliary salts is easily understood, and the defective depuration of the blood is to be looked upon as a complication rather than a determining cause of the malady.” Stomach and Intestinal Ccincd.—The most important pathological changes in yellow fever are found in the organs contained in the