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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Licence: Public Domain Mark

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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    o we have of designating at least two most dissimilar diseases by one name. We call the excitement which attends an inflammation, fever. We call the prostration of all the bodily powers, which arises from a polluted atmo- sphere, or from contagion, fever also; and yet, were ever two diseases more widely different? We have seen that as regards the pathology of the blood they differ entirely; and 1 am sure we have but to look at the symptoms of each to see an equal difference. Indu- ration and softening, anemia and ple- thora, atrophy and hypertrophy, are, in fact, not more distinct from each other than are the two states, whicli I would call inflammatory excitement, and true fever. T am sure that the distinction I here indicate is required; it would prevent many grievous mistakes; and, a strict regard for scientific accuracy seems to me imperatively to demand its being made. There are one or two other matters with reference to fever,—of course I mean true fever, typhus—which I cannot let escape. And, first, I would observe on the custom of giving large quantities of saline medicines, and especially of ni- trate of potass, in true fever. On theoretical grounds, it is evident that nothing can be more prejudicial than such treatment. The plastic ele- ment of the blood in such cases is al- ready deficient in consistency, and, as some salines, like mercury, are known to have the effect of diminishing the con- sistency of this element, they should surely be as much avoided as mercury is avoided in such cases. And so also, for the same reasons, there is an objec- tion to the profuse use of alcoholic and watery drinks. And, what theory thus suggests, is, as far as my observations go, fully borne out at the bedside. The number of cases of fever which I have seen has been by no means few, nor have I been inattentive in watching them ; and this I can say, that while I liaveseen muchhann done by salines and alcoholic drinks, I have never yet seen a sinking patient from fever permanently rallied by the administration of any prepara- tion of alcohol. T have spoken of the free use of watery drinks in fever; and these carried very far, as is often done, are likewise highly injurious. There seems to oome on a state, indeed, when such drinks are not received into the circulation at all; when the specific gravity of the blood would appear to be reduced to that of the fluids given, in which state there is consequently no absorption; and the results are, a highly diluted state of blood, with an accumu- lation of fluid in the stomach and in- testines, giving rise to tympanitis, un- easiness, weight, and other distressing symptoms.* At the same time, I am bound to admit that the view I here take con- cerning the effects of saline substances in reducing the consistency of the fibrinous element of the blood, does not coincide with the views which certain very eminent continental physiologists take on the same subject Thus I find Lehman, in the last edi- tion of his work on Physiological Che- mistry, directly combating this view, and urging, in support of his argument, some experiments by Scherer, in which that experimentalist tries to prove that inflammatory fibrine is not soluble in solutions of nitrate of potash. “ How, then (asks Lehman), can a solution of nitre prevent the augmentation of fibrine, through a solvent power which in this instance it actually does not possess ?” Now, unfortunately for this reasoning of Lehman, it is not only in opposition to the experiments of Zim- merman, who asserts that inflammatory fibrine is soluble in a solution of nitrate of potash, but it is actually in opposi- tion to his own conclusions; since he, in a previous page, writes in contradic- tion to Sherer, by stating that, in all his own experiments on the blood of man, he has found the fibrinous ele- ment soluble in solutions of nitre, whether it be from venous blood, from arterial, or from that drawn during in flanimation (at least, with two excep- tions). Other contrary arguments, having reference to the amount of nitre necessary to dissolve the fibrine, and to the inadequacy of other alkaline salts in effecting such a solution, are also named by this chemist; but, as these * Adair, in his Thesis on Purpura (Edin. 1781), records a case in which that disease was self- induced in a fanner, by living on bread and water. And it is well known how much the same impoverished diet tends to bring on fever, an al'.ied disease. It has also been shown by Albert, a German physician, that the water cure tends to induce symptoms similar to purpura.