"The globules are less liable to decrease than in cachectic dropsy; they, nevertheless, fell in one case to 70, and in another to 72. In three cases they were above 120 per 1000; in three others between 100 and 120; and in five cases between 100 and 110.

The fibrin underwent a marked diminution in two cases only, viz., between 1 and 2 per 1000; in six cases it varied from 3 to 6, while in three others it rose above 3 per 1000.

The albumen of the serum was always diminished, and in some instances this diminution was considerable; it ranged from 60 to 66 in four cases, and from 55 to 60 in six others, while in one case it fell as low as 51.02.

It is almost needless to add, that the specific gravity of both the blood and serum was always found to have fallen below the standard of health."

1 The above table is drawn up from eleven analyses of the blood; nine of the patients were males and two females. In all, the disease set in rapidly under the following circumstances: In one case, it followed a sudden suppression of the catamenia from violent emotion; in a second, it occurred at the fifth month of pregnancy, without any appreciable cause; in a third, it followed an attack of scarlatina; in four other cases, it followed prolonged exposure to cold; in another, it resulted from sleeping on the ground in the open air, during the month of June; lastly, in three cases, the cause was inappreciable. In two of these latter, the patients were suffering from a relapse of the disease. Of these eleven patients, none entered the hospital before the fourth, or after the eleventh, day of the disease. In six cases, dropsy was the only symptom; in two, it was accompanied by fever; in two others, there was slight fever; while in another, there was vomiting, coupled with a mild attack of jaundice.

From a careful historical analysis and examination of these cases, Becquerel and Rodier drew the conclusion that acute dropsy was the result of albuminuria following congestion of the kidney.

"Under the influence of some cause or other, congestion of the kidney is produced. The congestion is indicated, along with other symptomatic phenomena, by the escape of a certain amount of albumen with the urine; this, ere long, diminishes the natural proportion of the albumen of the blood, and the latter condition in its turn gives rise to a greater or less degree of dropsy. But the congestion of the kidney is generally of much shorter duration than the modification of the blood, and its consecutive dropsy; it disappears, therefore, long before these latter phenomena; and if the patients are not examined until a certain time after the onset of the disease, they alone are observed, the escape of albumen with the urine having altogether ceased."

Now, with reference to the diminution of the blood-corpuscles and albumen in malarial fever, we can state positively that it is not due to the escape of albumen through the kidneys. I have examined specimens of urine in all the various forms and stages of malarial fever in many cases; but never but once detected albumen in the urine, and that was in the case already reported of a seaman suffering with remittent and typhoid fevers combined. We know that albumen does appear in the urine of typhoid fever; so this case forms no exception to the previous statement.

The diminution of the blood-corpuscles and albumen in malarial fever appear to be due to one or both of two causes. Either the organs destined to elaborate and prepare the blood-corpuscles and albumen do not perform their office with sufficient energy to replace the constant destruction, or else the albumen and blood-corpuscles are destroyed during the chemical changes of fever, and by the catalytic action of the malarial poison.

A careful examination and comparison of these results, demonstrate that the destruction of the colored blood-corpuscles in the severest forms of malarial fever, and in the dropsical anemic condition called marsh cachexia, produced by the long-continued action of the malarial poison, is greater than in mechanical and acute dropsies, and equal to destruction of these important constituents. of the blood in cachectic dropsies, resulting from repeated losses of blood, exhausting discharges from the bowels, long-continued exposure and privations, hunger and thirst, and from that peculiar state of the system sometimes manifested in those suffering from cancers.

These investigations establish, without the shadow of a doubt, the fact that the malarial poison, or the peculiar train of chemical changes which it excites, destroys the gland-cells of the blood.

This fact is further sustained by the greater abundance of iron in the urine of malarial fever than in that of health. This increase of iron in the urine corresponds to the destruction of the colored blood-corpuscles, and the elimination of the products resulting from their physical and chemical changes.

3. Our researches show that the fixed saline constituents of the blood corpuscles are often diminished in malarial fever.

'Becquerel & Rodier's Pathological Chemistry, pp. 167-178.

'Numerous examinations of the urine in different stages of malarial fever, have convinced me that the proportion of phosphates are increased after an attack of malarial fever. If the urine excreted during convalescence be set aside for a few hours, it will rapidly change from the acid to the alkaline reaction, and a heavy deposit of prismatic (most generally) and stellate crystals of triple phosphate, and light-yellow granules, and acicular crystals of urate of ammonia, will be thrown down. So abundant are the crystals of the phosphates in the urine of convalescence, that if, after standing until the reaction is decidedly alkaline, it be held in the sunshine, thousands of these crystals of the triple phosphate will be seen, like small spangles of silver. It is probable that a portion of these phosphates, at least, has been derived from the dead, disintegrated, chemically altered, colored blood-corpuscles.

The bearing of these facts upon pathological and therapeutical science, is placed in a clear light by a consideration of the phenomena and offices of the colored blood-corpuscles.

The specific gravity of the colored blood-corpuscle varies with the quantity of hæmatin which they contain, and with the state of concentration or dilution of its contents. The density of the fluid contents will depend upon the character and rapidity of the mutual interchanges of the cellular fluid of the blood-corpuscles and the surrounding liquor sanguinis. Constant action and reaction are kept up between these two great elements of the blood. Each corpuscle is a cell, resembling in its nutrition, growth, and general structure the active agents in the formation, elaboration, and separation of all secretions and excretions. Their cell-walls possess the property of separating from the surrounding medium certain organic and mineral compounds. If a blood-corpuscle be placed in water, it swells up and finally bursts. If it be placed in a solution denser than its internal contents, they pass out more rapidly than the exterior solution passes in, and the cell-wall swells up. The same physical laws of endosmose are at work in the animal economy. A mutual action and reaction is incessantly carried on between the interior contents of the blood-corpuscles and the exterior liquor sanguinis. Whenever water or liquids of low specific gravity are introduced into the circulatory system they dilute the serum, and immediately there is an endosmose of the less dense fluid into the denser contents of the corpuscles. Whenever water is withheld, the liquor sanguinis continually loses this element by evaporation from the surface of the lungs and skin, and by the action of the

kidneys becomes denser than the contents of the corpuscles, and exosmose takes place into the surrounding medium. The cell-wall modifies the physical and chemical properties of every molecule of liquor sanguinis that passes through its structure.

In pathological conditions the cell-wall may be altered in chemical and physical condition. This alteration will necessarily be attended by disturbance of the physical and chemical relations of the exterior liquor sanguinis to the interior cellular fluid.

In pathological conditions (as we have just demonstrated in malarial fever) any one or all the mineral and organic constituents of the blood-corpuscles may be altered physically and chemically. These alterations will be attended by corresponding alterations in the minute actions and reactions of the liquor sanguinis and cellular fluid.

In pathological conditions, any one or all the constituents of the liquor sanguinis may be altered, physically and chemically, and exist either in deficiency or excess; or some new constituent may be introduced.

These alterations may interfere with the physical and chemical alterations of the blood-corpuscles; and may even prevent the development and nutrition of the blood-corpuscles; may be attended by a perversion of all the chemical and physical actions, and final death of the blood-corpuscles.

These views are borne out by the fact, that whilst in healthy human blood the density of the blood-corpuscles varies in man from 1088.5 to 1088.9, and in woman from 1088.0 to 1088.6, in diseases the density is not confined to these limits; for in cholera Schmidt found that the specific gravity of the blood-corpuscles was increased to 1102.5, or even to 1102.7; whilst in dysentery it was diminished to 1085.5, in albuminuria to 1085.5, and in dropsies to 1081.9.

Any alteration in the constituents of the blood corpuscles must alone, independently of any actual destruction, produce disturbances in the muscular and nervous systems. The truth of this assertion is evident, when we reflect that one of the most important results demonstrated by the researches which we recorded in a former chapter, was that the development of the muscular and nervous systems was always attended by an increase of colored corpuscles in the animal kingdom.

The researches of C. Schmidt have shown that the fluid contents of the blood-corpuscles contain, in addition to peculiar organic