A system of surgery : pathological, diagnostic, therapeutic, and operative . scertain whether this tendency to the development of the buffycoat exists it is not necessary to make use of a spoliative bleeding, but simply todraw a few drops of blood, and to look atit with the microscope, which will at oncedetect the slightest deviation from thenormal standard. The red corpuscles willbe observed to run almost immediatelyinto clusters of piles or rouleaux, as repre-sented in fig. 1. In certain forms of inflammation andconditions of the system the blood is notonly buffed, but cupped ; that is, the
A system of surgery : pathological, diagnostic, therapeutic, and operative . scertain whether this tendency to the development of the buffycoat exists it is not necessary to make use of a spoliative bleeding, but simply todraw a few drops of blood, and to look atit with the microscope, which will at oncedetect the slightest deviation from thenormal standard. The red corpuscles willbe observed to run almost immediatelyinto clusters of piles or rouleaux, as repre-sented in fig. 1. In certain forms of inflammation andconditions of the system the blood is notonly buffed, but cupped ; that is, the uppersurface of the crassamentum exhibits ahollow appearance, as if it had beenscooped out with a knife. This occur-rence usually denotes a higher degree ofmorbid action than the mere presence ofnaked fibrin on the top of the clot, andyet it is not unfrequently witnessed undercircumstances which render it veryquestionable whether there is any in-flammation at all, as in anemia, in pro-fuse evacuations from the bowels, skin,and kidneys, in scurvy, and in chlorosis. Fig. Buffy and cupped blood, from a preparation in theauthors collection. 76 INFLAMMATION. chap. hi. It is generally not easy to account for such anomalies, but of their practical im-port every practitioner must be fully aware. In my private collection is a beau-tiful specimen, which I obtained many years ago from bleeding a young manlaboring under pleuro-pneumonia, in which both the buffed and cupped appear-ances exist in a marked degree on both surfaces of the crassamentum. Theadjoining sketch, fig. 2, affords a good illustration of the preparation. 4. INTIMATE NATURE OF INFLAMMATION. In the definition of inflammation, given in the early part of this chapter, noattempt was made to specify its true character or essential nature. To do sowould have been premature; but now that we have studied its various local phe-nomena and traced its constitutional effects, we are fully prepared to enter uponthe subject, and to
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