NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
108
of 20 or 30. In the spaces between the clumps were many large somewhat polychro -
matic cells. The centre of the clumps were mainly composed of small dark cells,
and there were frequently seen leucocytes which had formed it would seem a nucleus
of agglutination.
Ghosts are seen of all sizes, some being slightly larger than red. cells, but
they are mainly smaller and often evidently composed of portions of cells only.
Polymorphonuclears containing red cells are frequent. Cells are as follows :—
Polymorphonuclears
.. ..
...
. .
..
..
60%
Small mononuclears
..
..
. .
..
..
17%
Transitional
..
..
.. ..
. .
. .
..
4%
Large mononuclears, many with included red cells
. .
. .
. .
11%
Macrophages
. . ..
..
. .
..
..
...
6%
Heart blood.—Shows groups of red cells massed about leucocytes. Between
these groups and to a large extent free are large and polychromatic cells. The
groups, however, are smaller and less conspicuous than in the hepatic blood. Very
few examples of red cell engulfment are met with in heart blood.
Splenic Vein.—Large crowded macrophages very conspicuous. Most of the
included cells are evidently the small round type. A large proportion of the
total cells are leucocytes or splenic cells.
Spleen—1,000 cells counted gave the following :—
Small phagocytes . .
..
..
..
unaltered cells . ..
. 7 %
altered cells
.. Nil.
Large macrophages with red cells
...
..
..
..
.. .6%
Polymorphonuclear leucocytes with included red cells ..
..
..
1.7%
Occasionally polymorphonuclear leucocytes contain 2 or even 3 red cells. In
thicker portions of films large masses of fused red cells are seen, and many of the
macrophages almost consist of this material held together with a minimal amount
of protoplasm.
Lung.—Red cells seen mainly of small dark type, large and polychromatic cells
not at all conspicuous. Mononuclear cells with green pigment very noticeable.
Bone Marrow.—Little evidence of cell engulfment. A few included cells
chiefly in large mononuclear leucocytes seen on searching.
corpuscles—.525 no hæmolysis
. 3 7 5 m a r k e d h æ m o l y s i s
accurate observation interfered
with by agglutination.
109
Kidney.—Substance resembling haemoglobin in various sized globules from
minute droplets to bodies half the diameter of a red cell scattered throughout films.
They are mainly derived from the ruptured epithelial cells of the kidney tubules
many of which are loaded with similar granules.
Dog X. Weight 4¼ lbs.
7th March 1908.—Isotonic point .475 per cent. salt.
5 p.m. 13th March 1908.,—Received 3 c.c. goat's serum.
10 a.m., 14th March 1908.—At site of injection but little reaction. No noticable
anæmia. Temperature 100. Polychromatic or
large cells about 1 per field. Many small darkcells.
I s o t o n i c p o i n t . 5 9 p e r c e n t . o r p o s s i b l y . 7 1 p e r c e n t . s a l t .
15th March 1908.—Isotonic point .9 per cent. salt. Dog not very ill b u t
there is marked pallor of the tongue and a consi-
derable amount of anæmia.
Temperature 101.8.
1 p.m., 15th March 1908.—Isotonic point .91 per cent. salt. No hæmoglobinuria.
9 p.m., 15th March 1908.—Isotonic point .83.
9 p.m., 16th March 1908.—Dog much better. Isotonic point .83.
9 p.m., 7th March 1908.—Blood received into 3 c.c. 1 per cent. salt to which one drop
of goat's serum was added ; left in incubator 15 minutes
no hæmolysis. It was then centrifugalised and.
isotonic point of
—
Placed in incubator in 1 per cent salt agglutinated corpuscles do not hæmolyse.
Dog XI.—Weight 3½ lbs.
5 p.m., 13th March 1908.—Received 6 c.c. goat's serum.
10 a.m., 14th March 1908.—Swelling at site of injection slight.
There is some pallor of tongue and some anæmia.
Temperature 101.2.
Isotonic point is .91. Polychromasia about 5 per
field, cells very irregular in shape, small badly dis-
played though film is a good one. Tendency to
form masses of 20 to 50 cells, the majority being the
small round variety.
227 H. D.
2F
110
1 p.m., 14th March 1908.—Passed h emoglobinous urine, Hæmoglobinæmia not
observable in 1/100 dilution, but seen on using larger
quantities of blood.
Isotonic point is .9 per cent. salt, but in place of
" h " it shewed only " tr."
4 p.m.,14th March 1908.—Isotonic point is .91, but shows trace only at both
.91 and .83. Some more urine passed, but con-
tains less hæmoglobin than last.
Autopsy—
Tissues pale.
Spleen.—10 grams. Blackish colour. Pulp tarry. Surface with tuberculations.
Liver.—Dark in colour. Weight 75 grams.
Contains blood much richer in red cells than that in the organ generally.
Portal and renal veins and inf. vena engorged.
Kidneys dark purple. Medulla pale.
Lungs.—Brick red.
A few hæmolymph glands seen, the largest not more than the size of a lentil.
Bladder contains dark urine not very hæmoglobinous.
Hæmoglobinæmia present in all situations. Most marked in renal and hepatic
veins, especially the former ; but only a trace visible in 10 dilutions.
Hepatic blood—
Red cells 2,904,000 per c.m.m.
. .
Only 2 per cent. large cells.
Ghosts 88,000 per c.m.m.
Renal blood—
Red cells 1,892, 000 per c.m.m.
...
... Very few large cells.
Ghosts 176,000 per c.m.m.
Portal blood—
Red cells 1,000,000 per c.m.m.
. .
.. Only 2 per cent, large cells.
Femoral blood—
Red cells 836,000 per c.m.m.
In 1,000 cells counted ghosts were encountered as follows :—
Portal
.. ..
..
..
. .
..
21 ghosts.
Hepatic ..
.. ..
. .
..
. . 26
, ,
S p lenic ..
..
..
..
..
..
7
, ,
Femoral .. .. ..
. .
. .
..
10
, ,
Renal from portions of kidney
. .
. .
.. 95
, ,
Pulmonary
..
..
. .
. .
..
15
, ,
Renal from renal vein
. .
. .
. . 70
, ,
111
(1) Washed blood corpuscles from portal vein + serum of normal dog = no hæmolysis
or agglutination.
(2) Washed corpuscles from portal, hepatic, and renal veins and from ventricles left
in sugar and salt solution at 37° c., no hæmolysis or agglutination.
(3) Washed portal blood corpuscles + crushed liver substance = marked agglutination,
no hæmolysis.
(4) Washed spleen pulp in sugar and salt solution at 37° c. no hæmolysis, doubtful
agglutination.
Hæmosozic value is about .938 per cent, salt.
Centrifugalised renal blood shows tendency to form agglutinated masses with
free polychromatic cell.
Centrifugalised portal blood showed a good deal of red cell phagocytosis.
Dog XII. —Weight 4½ lbs.
5 p. m., 13th March 1908.—Received 3 c.c. goat's serum 10 c.c. normal serum.
10 a.m., 14th March 1908.—Site of injection of 3 c.c. specific serum much swollen.
Site of injection of 10 c.c. normal serum not nearly so
markedly swollen.
No noticeable pallor of tongue. Anæmia swollen moder-
ate.
Isotonic point .59 per cent, salt.
Large and polychromatic cells about 1 per field, many
small round cells.
4 p .m., 14th March 1908.—Temperature 100.4. Extremities cold.
9 p. m., 14th March 1908.—Isotonic point .83 per cent, salt.
1 p.m., 15th March 1908.—Isotonic point .91 per cent, salt, slight hæmolysis at
.83 per cent, salt.
5 p.m .,15th March 1908.—Received 3 c.c. goat's serum.
16th March 1908.—Blood very anæmic. Dog very seedy.
Isotonic point .91 per cent. salt ; more marked
hæmolysis at .83 per cent, salt.
4
p
.
m
. ,
1 6
t h M a r c h1
9 0 8 . — B l o o d s h o w s m a r k e d h æ m o l y s i s i n . 9 1 p m c e n t , s a l t
and there is a trace of free hæmoglobin in the serum.
Shortly after dog passed hæmoglobinous urine.
Autopsy—
Urine in bladder lighter than that passed shortly before.
Spleen.—II grams, dark colour, not very tuberculated.
112
Engorgement of visceral veins, portal, renal, and inf. vena cava very
noticeable.
Blood from different sources diluted 5 times with 5 per cent. citrate solution
and. centrifugalised showed —
Splenic
..
. .
. .
..
tint.
Portal
. .
.,
. .
..
tint.
Hepatic ..
. .
. .
..
slightly darker tint.
Renal
. .
. .
..
... marked red tint.
The number of red cells in blood from different sources counted in the Thoma-
Zeiss apparatus gave :—
Splenic Vein—
Large cells
. .
. .
. .
. .
..
149.600
Small cells
. .
. .
. .
. .
. .
127,600
Ghosts
..
. .
. .
. .
. .
..
13,200
Renal Vein—
Large cells
. .
. .
. .
. .
. .
40.000
Small cells
. .
. .
. .
. .
. .
61,600
Ghosts
..
. .
. .
. .
. .
. .
127,600
Portal Vein—
Large cells
. .
. .
. .
. .
528,000
Small cells
. .
. .
. .
..
..
13,200
Ghosts
..
. .
. .
. .
. .
..
4,400
Hepatic Vein—
Large cells
. .
..
. .
. .
. .
448,800
Small cells
. .
. .
..
..
. .
136,400
Ghosts ..
..
..
..
..
. .
8,800
Difference between large and small cells very striking.
The significance of these experiments will be discussed in the following chapter.
113
CHAPTER III.
GENERAL CONSIDERATION OF BLOOD DESTRUCTION IN RELATION TO
HÆMOGLOBINURIA.
Levaditi (76), studying the result of the injection of specific h aemolytic sera,
concludes that the principal cause of the anæmia in animals so treated
is an intense phagocytosis of the red cells in the spleen. The fact that such
an intense phagocytosis takes place will be evident from a study of our experi-
ments upon dogs. It is even more important in our present connection to note
that hæmoglobinæia was not necessarily associated with this form of blood
destruction.
As soon, however, as hæmoglobinæmia came about hæmoglobinuria fo
l - l o w e d . I n t h e s e e x p e r i m e n t s t h e n t h e h æ m o g l o b i n u r i a w a s n o m e r e m e a s u r e
oft he amount of hæmoglobinæmia, but an indication that such a condition
had supervened.
This conclusion is supported by our observations upon Black-water Fever, for
in this disease hæmoglobin is excreted in the urine even when hæmoglo-
binæmia is scarcely to be detected by the spectroscope. Hunter (68) also comes to
the conclusion that hæmoglobinæmia in the peripheral circulation however
small in amount leads to hæmoglobinuria. On these grounds it appears reason-
able to conclude that hæmoglobinuria and hæmoglobinæmia are concomitant
phenomena, the former necessarily following the appearance of the latter.
Against this view there are the observations of Ponfick (69) who found
that on injecting laked horses blood into dogs no hæmoglobin was ex-
creted until the amount free in the circulation reached one-sixtieth of the
total hæmoglobin of the body. But that these experimental data do not apply in
Black-water Fever is certain, since hæmoglobinuria commonly occurs as we
have seen with an amount of hæmoglobinæmia much less than would be caused
by the presence of one-sixtieth of the total hæmoglobin, and may be present
when the amount of hæmoglobin in the plasma is so small as to escape detection.
Again in many conditions hæmoglobinæmia has been described as present
without the occurrence of hæmoglobinuria ; but these observations seem all to refer
not to the recognition of hæmoglobin in solution in the plasma, i. e., true
hæmoglobinæmia, but to the presence of hæmoglobin in the serum exuded from
the blood after this has clotted.
Such observations as we have previously pointed out are open to grave error.
They may relate, indeed, to quite a distinct condition, the recognition of
227 H. D .
2F
114
which is in itself of great importance, namely, that, on clotting of the blood,
solution of a certain number of red cells has occurred. Murri and Justus allowed
blood obtained by venesection from thirty syphilitic patients to clot at a high
and a low temperature. In the former twenty-eight out of the thirty showed a
reddish serum, but in all the latter a clear serum exuded. Here then the reddish
serum was not an indication of the existence of true hæmoglobinæmia.
Other examples are given in the case of dogs 1 and 2 (vide experiments).
Until therefore we have observations specifically noting the presence of
hæmoglobinæmia in the plasma as against its presence in the serum after clotting,
we are unable to judge whether in such cases true hæmoglobinæmia unassociated
with hæmoglobinuria is present.
Another very important point emphasized by these experiments is that
until hæmoglobinuria supervened, the most severe blood destruction was
unassociated with the presence of hæmoglobinæmia. Even very large doses of the
hæmolytic serum though they produced a correspondingly more rapid and intense
anæmia did not on this account give rise to hæmoglobinæmia, and the anæmia
seemed due almost entirely to removal from the circulation of damaged corpuscles
and their eventual engulfment by macrophages. Since hæmoglobinæmia does
not necessarily result from the most intense blood destruction its appearance
must depend upon some new factor or super-added condition. This new condition
seems to us to be the solution of the red cells in the plasma, in contra-distinc-
tion to their retention in the organs, and their ultimate phagocytosis and intra-
cellular digestion. Therefore we have two forms of blood destruction to consider.
(1) The holding up and immediate, or ultimate, phagocytosis of red cells,
apparently unassociated with any extra-cellular solution.
This method of red cell destruction we propose to call for convenience of
description " ERYTHROKATALYSIS."
(2) That condition, in which the red cells undergo solution in the plasma,
and in which results true hæmoglobinæmia followed by hæmoglobinuria.
This condition we propose to call " LYSÆMIA,"
The condition met with where true hæmoglobinæmia is not present; but
where the blood after clotting shows the presence of hæmoglobin dissolved in the
serum may be appropriately named, " EXTRA-VASCULAR LYSÆMIA. "
I . — E R Y T H R O K A T A L Y S I S .
The condition seen in the spleen and other organs of animals inoculated
with specific hæmolytic serum resembled in a remarkable degree that which we
have already described in the spleen. and liver of Black-water Fever.
115
The cells in which ingested red blood corpuscles are seen have the same gen-
eral characters as those seen in Black-water Fever; they are :
( 1 ) C o m p a r a t i v e l y s m a l l c e l l s c o n t a i n i n g a s i n g l e r e d c o r p u s c l e , w h i c h
is generally either normal in appearance or only slightly altered.
These cells possess the same crescentic nuclei and scanty protoplasm,
just sufficient to surround the engulfed red cell, already noted in
those seen in Black-water Fever.
( 2 ) L a r g e c e l l s e v i d e n t l y o f t h e s a m e t y p e , b u t c o n t a i n i n g m a n y m o r e r e d
•
cells, exactly resembling those described in the spleen in Black-water
Fever.
Besides being present in the splenic pulp and liver capillaries, cells of this
nature were extremely abundant in the blood from the splenic and
hepatic veine, They appear to be actively engaged in transporting
engulfed red cells. As large numbers are present in the hepatic
blood, but are not seen in the peripheral circulation, it seems
probable that many of them are stopped in the capillary system of
the lungs.
Many cells of this type are found surrounding dense masses of red cell
substance. The nucleus is pushed to one side and the protoplasm
forms a scarcely perceptible envelope. They more nearly resemble
masses of hæmoglobin than cells.
(3) Endothelial plaques which often consist of several imperfectly differ-
entiated cells. They are almost certainly derived from the visceral
(splenic and hepatic) endothelium.
Like the last mentioned cells they are common in the splenic and hepatic
veins and occur occasionally in the peripheral blood.
They contain debris of various kinds, including altered and unaltered
red cells, vacuoles and fragmenting masses of nuclear matter or en-
gulfed leucocytes.
( 4 ) P o l y m o r p h o n u c l e a r c e l l s . — T h e s e a r e a c t i v e l y e n g a g e d i n e n g u l f i n g
red cells and may be seen with one, two, or even three included cells.
We have not seen this type of cell in active red cell phagocytosis
i n B l a c k - w a t e r F e v e r .
The included red cells are often at first sight quite normal in appearance.
But a closer inspection shows that many are a trifle paler than normal,
while others are smaller and darker. Most of the cells become eventually clear
vacuoles, which later become contracted to smaller and smaller dimensions.
116
But in some case the engulfed red cells takes on a greenish tinge, and gradu-
ally becomes converted into a dull greenish mass; this latter change is however
not very frequently seen.
Engulfment is most active in the spleen, it is somewhat less so in the liver
capillaries; and is but little in. evidence in the kidneys and bone marrow.
In the lung capillaries it was very conspicuous, and some of them were filled
with rows of macrophages and polymorphonuclear cells containing engulfed red
cells.
Erythrokatalysis in Black-water Fever is not then very noticeably different
from that seen in the experimental conditions we have described.
II.—LYSÆMIA.
We have previously drawn attention to the fact that once hæoglobinæmia
is established hæmoglobinuria follows. In order to ascertain the site of this
form of hæmolysis, observations were undertaken in regard to—
(1) The existence of stromata,
(2) The degree of hæmoglobinæmia,
in different parts of the circulation. A peculiar point at once became evident,
namely, that, whilst the peripheral blood was intensely anæmic, that in the liver
and kidneys and to a less extent the spleen was much richer in corpuscles. This
is very evident from the counts given for dogs (11 and 12).
Though stromata were occasionally seen in the peripheral blood and in the
spleen, they were more numerous in the portal and pulmonary veins ; they were most
numerous of all in the kidney and liver. It will be seen from the experiments
given in full at the beginning of this chapter, that the amount of hæmoglobinæmia
followed very closely this distribution, being greatest in the blood of the
hepatic and renal veins. The accumulation of shadows in the organs may occur,
however, without it necessarily following that they have been produced in this
situation, and the concentration of the blood in the liver and kidneys may also
account for the slightly greater amount of hæmoglobinæmia seen in the blood
from this portion of the circulation. The evidence of shadow corpuscles and the
amount of hæmoglobinæmia therefore suggests though it does not prove these
organs to be mainly concerned ; and the fact of greater concentration of the
blood in these situations is also significant.
The agglutination of corpuscles so noticeable in the blood from the hepatic
vein seems at any rate to show that it was chiefly in passing through this organ
117
that the blood was acted upon by agglutinins which were present in the speci-
fic serum employed.
III. —EFFECT OF THE INJECTION OF HÆMOLYTIC SERUM AND SNAKE
VENOM UPON THE ISOTONIC POINT.
To explain hæmolysis in certain diseases, reduced resistance of the red cells
has often been hypothecated ; and this reduced resisting power has been very
generally considered as bearing a more or less definite relation to their resistance
to laking by salt solutions ; or in other words to be associated with alterations
in their isotonic point.
Variations in the isotonic point have been described by Vicarelli, Limbeck
(80), Castellino, and others, and this point may reach in certain pathological
conditions .66% salt solution (normal .46%, vide page 128).
We are not aware that any observer has assigned a definite reason for these
changes, so that even apart from any relation the discovery may have to our
present studies, it is a matter of considerable importance and interest that in dogs
and rabbits a raising of the isotonic point to .7%, .8%, or even .9% salt solution
is observed as a result of the injection of specific hæmo-toxins.
227 H. D.
2G
—
Dog 4. 15 c.c. goat's serum injected 10 A.M., 2nd March 1908.
Percentage salt
..
..
1.00
.91
.83
.77
.71
.66
.59
.55
.525
. 5 0
475
. 45
.425
.4
....
27th February 1908
..
..
..
..
..
..
Nil
Nil
Nil
tr
h
inc H inc H
..
..
....
1 P.M., 2nd March 1908 .. Nil
Nil
Nil
tr
h
hh inc H inc H inc H
..
..
..
..
..
Dog very ill. Shivering.
2 P.M., 2nd March 1908 ..
Nil
Nil
tr
h
h
. .
. .
. .
..
..
..
..
..
..
Marked anæmia.
No hæmoglobinæmia.
Dog killed.
Dog 7. 1 c.c. goat's serum injected 10 A.M., 2nd March 1908.
Percentage salt
..
..
1.00
.91
.83
.77
.71
.66
.59
.55 .525
. 5 0 .475
. 4 5 .425
.4
. . . .
1-30 P.M., 5th March 1908 ..
Nil
Nil
hh
inc H inc H inc H
..
..
..
..
..
..
..
..
Dog ill.Marked anæmia
m N o h æ m o g l o b i n u r i a .
8 A.M., 6th March 1908 ..
Nil
Nil
hh
inc H inc H
..
..
..
..
..
..
..
..
..
Ditto.
7th March 1908 ..
Nil
tr
h
hh
hh
hh
hh
hh
inc H
..
..
..
..
..
Dog not so ill.
8th March 1908 ..
Nil
Nil
h
hh
hh
hh
hh
hh
hh
hh
inc H inc H
..
..
....
11 A.M., 9th March 1908 ..
Nil
Nil
Nil
Nil
Nil
Nil
Nil
tr
h
h
hh
inc H inc H
..
Corpuscles almost all
very large or poly-
chromatic.
NOTE.—tr = trace; h=slight hæmobysis ; hh = more marked hæmolysis ; inc H = Incomplete hæmolysis; H = complete hæmolysis.
118
Dog 8. 3 c.c. goat's serum injected 11 A. M., 5th March 1908.
Percentage salt ..
.. 1.00 .91
. 87 .71 .66
. 59
. 5 5
. . . .
. .
..
..
..
..
....
4-30 P.M., 5th March 1908 .. Nil Nil
tr
hh inc H inc H ..
..
..
..
..
..
..
..
. . . .
8 A. M., 6th March 1908 .. tr
h inc H inc H ..
..
..
..
..
. .
. .
. . ..
.. Hæmoglobinuria dur-
ing night of 5th
March 1908.
5 P.M., 6th March 1908 .. Nil tr
h inc H ..
..
..
. .
..
..
..
. .
. . ..
. . . .
8 A. M., 7th March 1908 .. Nil tr
h inc H inc H ..
..
..
..
..
. . ..
..
..
. . . .
In 5 per cent. salt, no trace of tint.
Dog 9. 6 c.c. goat's serum injected 11 A.M., 6th March 1908.
1.5 c.c. „ „ „ „ 10-30 A.M., 8th March 1908.
Percentage salt ..
. . 1.00
. 91
. 83
. 71 .66 .59
. 55 .525
. 50 .475 .45 .425 .4 .375
....
5 P.M., 6th March 1908 .. Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil
h inc H
. . . .
8 A.M., 7th March 1908 .. Nil Nil Nil h inc H inc H ..
..
..
..
..
..
..
..
....
10-30 A.M., 8th March 1908 .. .. tr h
hh inc H inc H inc H ..
..
..
..
..
..
..
. . . .
5 P.M., 8th March 1908.. tr h
h inc H inc H ..
..
.. ..
..
. .
. .
. . .. Hæmoglobinuria
Hæmoglobinæmia.
119
Dog 10. c. c goat's serum injected 5 P.M., 13th March 1908.
Percentage-salt . .
.. 1.00
.91
.83
.71
.59
.50 .475 .425
..
..
. .
. .
. .
. .
. . . .
7th March 1908
. .
Nil
Nil Nil
Nil
Nil Nil
h inc H ..
. .
. .
..
. .
. .
. . . .
10 A.M., 14th March 1908 .. Nil
Nil Nil
Nil
h
hh
. . ..
. .
. .
. .
. .
. .
..
Many spherocytes.
9 P.M., 14th March 1908 .. Nil
tr
h
hh ..
. .
. . ..
. .
. .
. .
. .
. .
. . No hæmoglobinuria.
1 P.M., 15th March 1908 .. Nil
tr
tr
hh inc H ..
. .
..
. .
..
..
..
..
..
Ditto.
9 P.M., 15th March 1908 .. Nil
Nil
tr
h ..
. .
. . ..
. .
. .
. .
. .
. .
. .
Ditto.
16th March 1908 .. Nil Nil
tr
h ..
. .
. .
..
. .
. .
. .
. .
. .
. .
Ditto.
Dog 11 6 c.c. goat's serum injected 5 P.M., 13th March 1908.
Percentage salt
. .
.. 1.00
. 9 1
. 8 3 .77
. 7 1 ..
..
. .
..
. .
. .
..
..
. .
. . . .
8 A.M., 14th March 1908
. .
Nil
h inc H inc H ..
..
. .
..
. .
. .
. .
. .
. .
. .
. . . .
—
1 P.M., 14th March 1908 ..
tr
h
h
inc H ..
. .
. .
. .
. .
. .
. .
. .
. .
. . Hæmoglobinuria.
—
4 P.M., 14th March 1908
. . tr
h
hh
H
..
..
. .
. .
. .
. .
. .
. .
. .
..
Hæmoglobinuria.
—
227 H D
2H
Dog 12. 3 c. c. goat's serum plus 10 c.c. normal goat's serum injected.
3cc goat's serum injected 5 P.M., 15th March 1908.
Percentage salt
..
.. 1.00
.91
.83
. 7 7 .71
.66
. 5 9
. 5 5 .50
..
..
..
..
..
....
8 A.M., 14th March 1908 ..
Nil
Nil Nil
Nil Nil
Nil
tr
h
hh
. .
. .
. .
..
..
....
4 P.M., 14th March 1908 .. Nil
Nil
tr
tr
h
h
h
..
..
..
..
..
. .
. .
No hæmoglobin in
urine.
9 P.M., 14th March 1908 .. Nil Nil
tr
..
h
. .
. .
. .
. .
. .
. .
. .
. .
..
Ditto.
4 P.M., 15th March 1908 . . ..
tr
h
inc H inc H ..
..
. .
. .
. .
. .
. .
..
..
Ditto.
5 P.M., 15th March 1908 .. Nil
Nil
tr
h
..
..
. .
. . ..
..
..
..
..
..
Ditto.
8 A.M., 15th March 1908 .. Nil
tr
hh inc H inc H ..
. .
. .
. .
. .
. .
..
..
..
Ditto.
4 P.M., 16th March 1908 .. tr*
hh inc H ..
. .
. .
..
. . ..
. .
..
..
..
..
Hæmoglobinuria and
hæmoglobinæmia.
* Trace also in 5 per cent. salt.
1 2 1