Polycythaemia in diseases of the heart and lungs and during residence at high altitudes / by F. Parkes Weber.

  • Weber, Frederick Parkes, 1863-1962.
Date:
[1908]
Catalogue details

Licence: In copyright

Credit: Polycythaemia in diseases of the heart and lungs and during residence at high altitudes / by F. Parkes Weber. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    The word “ erythrocytosis ” could then, as Hirschfield advises, be reserved for any “ reactive ” increase in the number of erythrocytes (such as the polycythaemia of cardiac in- sufficiency, and the polycythaemia of high altitudes) resulting from imperfect oxygenation of the blood and tissues of the body, just as the word “ leucocytosis ” is now limited to signify a “ reactive ” increase in the number of leucocytes, such as that resulting from (and as a reaction towards) streptococcal and other microbic invasions of the body. The Relation of Polycyihcemia to Blood-Viscosity.—The blood-viscosity is always raised when the number of red corpuscles per cubic millimetre of blood is much increased. This can be demonstrated, as I have myself found, in specimens of blood from patients with polycythaemia and chronic cyanosis of cardiac or pulmonary origin. So also in two cases of splenomegalic polycythaemia I found the viscosity of citrated specimens of the venesection-blood to be more than twice the normal. Supposing the viscosity of normal human blood to be about 5-3, that is to say, 5-3 times that of water (when the temperature of both is 38° C.), Lommel found the viscosity to be over 11 • 0 in one case of splenomegalic polycythaemia, whilst Bence in another case obtained figures varying from 15-9 to 20 • 9. I11 three cases of cyanosis in heart disease, and in one case of bronchitis with emphysema, Bence obtained viscosity-values of between 6-9 and 8’2. In some rough experiments made in 1904 with J. H. Watson on citrated horse’s blood, we showed that the variations in viscosity generally depended mainly, though of course not entirely, on the proportion of the blood- corpuscles to the volume of blood-plasma. It was found, for instance, that horse's blood-plasma, artificially mixed with two millions of red corpuscles to the cubic millimetre, took 84 seconds to pass through the bulb of the “ viscosity-tube,” whilst a sample containing four million red corpuscles to the cubic millimetre took no seconds to pass through the bulb of the same tube.1 There can be no doubt that blood-viscosity is of some importance in regard to the question of venesection in chronic diseases of the heart and lungs, since in cases of cyanosis with polycythaemia, increased blood-viscosity, and engorgement of the right side of the heart, venesection must not only temporarily relieve the right side of the heart, but 1 Clinical Society’s Transactions, London, 1904, Vol. 37, p. 130.