Remarks on the fibrinous element of the blood in relation to disease : read before the Medical Society of London, Nov. 15, 1851 / by Benjamin W. Richardson.

  • Richardson, Sir Benjamin Ward, (1828-1897)
Date:
1851
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Credit: Remarks on the fibrinous element of the blood in relation to disease : read before the Medical Society of London, Nov. 15, 1851 / by Benjamin W. Richardson. 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 organ to the light, with all their anastamoses. The vessels were firmly injected with blood, so that very firm ressure on each side of an artery, made y the thumb and finger, was required to compress it, and to produce an arrest in the motion of the blood through the ves- sel. The temperature of the body was 102° by a Fahrenheit thermometer. Here, then, were almost all the symp- toms which denote in the human subject an inflammatory fever—symptoms ap- pearing most distinctly to follow an in- crease of fibrine; for, by this time, blood drawn from a vessel in the ear showed a very large increase of fibrinous element. I have said above that the increase of fibrine is most probably dependent upon the inflammation. In this I have perhaps said more than may be con- sidered allowable ; since it may be sup- posed that in some forms of inflamma- tion the increase of fibrine may be dependent on the same cause as the in- flammation itself. Thus there is a decided increase of fibrine in erysipelas, a disease, as far as I can learn, depend- ing entirely on atmospheric causes. I merely take one example; but I think that the analogy may perhaps be carried out more or less to all others. I have before alluded to the fact, that there may be increase of the fibrinous element of the blood, not from any real increase in fibrine, but from a diminu tion in the other constituents, by which in health it is held in solution. This, I think, is shown in a very marked manner in phthisis pulmonalis, where the fibrine has been found increased to 6, 7, and even to 9. But, if we only consider how large a quantity of the watery portion of the blood passes off in this disease by the skin, and often by the bowels, and how at the same time the patient is disabled from taking muscular exercise, we need not feel much surprised at seeing the fibrinous element of the blood increased relatively to the other parts. In Bright’s disease of the kidneys, ajjpin, the fibrine often arises to aveiy high figure, but here there is an equal deficiency in some other constituents; for the blood does not lose its watery portion alone, but large quantities of its albumen also, in the discharges of pale urine, which characterize this disease in its progress. In these diseases, then, as in some others, the increase of fibrine may be relative, not real.* With reference to the question whe- ther venesection tends to increase the fibrinous element, I am in some doubt, since the analyses which have been conducted to settle the matter vary somewhat, and have not always been made on blood proper for the purpose. On the whole, however, I think the inference is pretty strong in favour of the supposition that it does lead to increase; but at most the increase is small, and by no means in proportion with the decided increase of water which follows the same cause. I need not go on to enumerate in detail the other diseases in which fibrine is increased, since the causes of its in- crease are probably the same in all. There is, however, one disease on which I must for a moment dwell, inasmuch as there is apparently something ano- malous about it: this disease is sea scurvy. In all the accounts which we have of scurvy, from persons well acquainted with it, we find that the causes which give rise to it, are, want of pure air and nutritious diet, insufficient clothing, great fatigue, and tbe like. Now, these are just the things which modern science declares, on the strength of careful experiment, to be most active in diminishing the quantity of fibrine in the body; while the symptoms of the disease also show a very marked degree of impoverishment and fluidity of the blood :f and yet, in the analyses of the blood of three patients suffering from decided survy on board the Dread- * In a case of albuminuria, with dropsy of a fortnight duration, Dr. Ayres found upwards of 11 parts of fibrine and tritoxide of proteine in 1000 parts of blood.—Lancet, Aug. 2d, 1845. The same increase of fibrine in the blood is sometimes found during menstruation, owing, it is probable, to the same relative cause. The blood is at the time losing by the menstrual flow, water, albumen, and other blood constituents, but no fibrine; temporarily, therefore, the fibrine of the systemic biood seems increased. For analysis of the menstrual fluid, see Letheby, in the Lancet for Aug. 2d, 1845. t Thus, in an excellent Essay on Scurvy, published in 1804, by Mr. W. Hunter, that author enumerates the following causes, as giving rise to a disease which he terms Cacotrophia, evidently scurvy with dropsy superadded (а) “ Food deficient in nourishment, or in stimulating power. (б) “ Respiring an atmosphere deficient in (c) “ Preceding disease. [oxygen. (rf) “ Intemperance. (e) “ Indolence, and want of exercise. (f) “ Excessive fatigue. (g) “ Suppressed perspiration.”