Hemoglobin

“ It is a rare condition, and must be distinguished from hematuria, or blood in the urine, which is common. In both conditions chemic tests will show hemoglobin, but in the latter the microscope will reveal the presence of red corpuscles. Urines which contain notable amounts of hemoglobin have a reddish or brown color, and may deposit a sediment of brown, granular pigment.
Hemoglobinuria occurs when there is such extensive destruction of red blood-cells within the body that the liver cannot transform all the hemoglobin set free into bile-pigment. ”

“ In mild cases a slight decrease of hemoglobin is the only blood change noted. In very severe cases, especially in repeated hemorrhages, malignant disease, and infection by the worms uncinaria and bothriocephalus latus, hemoglobin may fall to 15 per cent. Hemoglobin is always diminished, and usually very greatly, in chlorosis, pernicious anemia, and leukemia. ”

“ They couldn’t do their job. The body had to quit making hemoglobin, because hemoglobin needs iron. So, since there was no hemoglobin in the bloodstream, the patient developed sudden pernicious anemia and died of oxygen starvation.”
Colonel Fennister looked suddenly at Dr. Smathers. “I thought you said the blood looked normal.”
“It did,” said the physician. “The colorimeter showed extra hemoglobin, in fact. But the chelating agent in the fruit turns red when it’s connected up with iron—in fact, it’s even redder than blood hemoglobin. ”

“ Hemoglobin Reduced by Pyrogallol, Merck.—Reddish-brown powd. containing iron in condition for easy assimilation.—Hematinic, Constructive, Tonic.—Uses: Anemia, chlorosis, chronic nephritis, diabetes, and in convalescence; readily transformed into blood coloring-matter in debilitated people, and uniformly well borne; much superior to inorganic preparations of iron.—Dose: 4—8 grn., 3 t. daily, 1/2 hour before meals, in powd. with sugar, or in pills or chocolate tablets. ”

“ The red matter consists of an albuminous crystalline substance called hemoglobin, which forms about 90 per cent. of the total solid matter 260of the dried corpuscle. Each red cell offers a certain absorbing surface for oxygen. As the blood circulates through the delicate walls of the lungs and the air-sacs, it takes up oxygen; the blood at the same time delivers to the air carbon dioxid which has been brought from the tissues where active cell metabolism has been going on. ”

“ But, you may say, suppose there is more than only one possible hemoglobin combination. It is true, after all, that the hemoglobin of various species of animals are distinct in their properties from one another. Well, let's be unfailingly generous. Let's suppose that every hemoglobin molecule that ever possibly existed on Earth is just a little different from every other. It would then be only necessary for our giant computing machine to find any one of 1050 possibilities. ”

“ I believe that in time we shall be able to refine this test to tell the exact individual, too.
"What is this principle? It is that the hemoglobin or red colouring-matter of the blood forms crystals. That has long been known, but working on this fact Dr. Reichert and Professor Brown of the University of Pennsylvania have made some wonderful discoveries.
"We could distinguish human from animal blood before, it is true. But the discovery of these two scientists takes us much further. ”

“ In us, the oxygen is carried to the tissues, and the carbon dioxide carried away by an iron compound, hemoglobin, but in many animals of Earth, the same function is performed by a copper compound, hemocyanin, which is an intense blue. ”

“ Increase of hemoglobin, or hyperchromemia, is uncommon, and is probably more apparent than real. It accompanies an increase in number of erythrocytes, and may be noted in change of residence from a lower to a higher altitude; in poorly compensated heart disease with cyanosis; in concentration of the blood from any cause, as the severe diarrhea of cholera ”

“ There is no single conspicuous material for carrying carbon dioxide like the hemoglobin which transports the oxygen. There are, however, a number of compounds in the blood which are able to combine with carbon dioxide, among them the blood proteins of which much was made in Chapter XIII. The carbon dioxide distributes itself among these various substances and so is transported. It should be noted that the blood does not become saturated with carbon dioxide as it does with oxygen. Arterial blood ordinarily carries practically all the oxygen it is able to take up ”

“ As the oxygen is removed in the passage of the blood through the body, there results in venous blood reduced hemoglobin, which is of a purplish color. Upon exposure to the air, however, it absorbs oxygen once more and resumes its scarlet color. If carbon monoxide gets into the blood, as in cases of gas poisoning, it drives off the oxygen and forms a more stable compound with the hemoglobin, whence the difficulty in restoring a person so poisoned. ”

“ That wonderful power of adaptation to unusual conditions, however, of which the human body is so generously possessed, is here demonstrated in the fact that on reaching the unusual height the quantity of hemoglobin, which gives the red color to the blood and enables it to carry oxygen to our tissues, begins to increase, and a few days of life at the high altitude renders us capable of continuing to live there under the diminished oxygen pressure without further danger to life. ”

“ The blood, which was carefully studied weekly, steadily improved until, on September 18th, the hemoglobin stood 95 per cent, with 4,600,000 red blood corpuscles and 8,000 white, and on November 10th the hemoglobin reached 100, and the red corpuscles 4,700,000. The urine, which presented albumen and granular casts on admission, had lost these, and on November 10th she passed 1,000 cc., with a specific 236gravity of 1.025, and normal in every respect, except a faint trace of indican. ”

“ This simple method holds good for all counts of 1,000,000 or more. Thus, a count of 2,500,000 is 50 per cent. of the normal. If, then, the hemoglobin has been estimated at 40 per cent., divide 40 (the percentage of hemoglobin) by 50 (the percentage of corpuscles) . This gives 4/5, or 0.8, as the color index.
IV. ENUMERATION OF LEUKOCYTES
The normal number of leukocytes varies from 5000 to 10,000 per cubic millimeter of blood. The number is larger in robust individuals than in poorly nourished ones, and if disease be excluded, may be taken as an index of the individual's nutrition. ”

“ The rare and rapidly fatal anemia which has been described under the name of aplastic anemia is probably a variety of pernicious anemia. Absence of any attempt at blood regeneration explains the marked difference in the blood picture. Red corpuscles and hemoglobin are rapidly diminished to an extreme degree. The color index is normal or low. The leukocyte count is normal or low, with relative increase of lymphocytes. Stained smears show only slight variations in size, shape, and staining properties of the red cells. ”

“ Besides these globules, others exist in which the evolution of the microbe is more advanced; the clear spot has become larger, and is surrounded as if by a setting of fine black granulations; all around, the hemoglobine, plainly distinguishable by its greenish-yellow tint, forms a ring, which grows narrower as the parasite increases in volume. At last, nothing is left of it but a perfectly colorless, narrow marginal zone, the hemoglobine having entirely disappeared, and the substance of the red globule having been taken possession of by the microbe till it has been reduced to a shell. ”

“ The action of the liver is not, however, simply to assist the kidney; there are certain special substances which are taken care of by the liver and which are never gotten rid of through the kidneys. The first of these are the broken-down blood pigments. We have already seen that after the red corpuscles become worn out they are decomposed in the spleen and the hemoglobin carried to the liver where the iron and other usable parts are saved and the useless remainder is passed on into the bile to be conveyed out of the body. ”

“ Anaemia is often used as a generic term for all blood diseases, for in almost all of them the haemoglobin is diminished, either as a result of diminution in the number of the red corpuscles in which it is contained, or because the individual red corpuscles contain a smaller amount of haemoglobin Anaemia. than the normal. As haemoglobin is the medium of respiratory interchange, its diminution causes obvious symptoms, which are much more easily appreciated by the patient than those caused by alterations in the plasma or the leucocytes. ”

“ That the oxygen forms a definite compound with the haemoglobin is proved by the fact that haemoglobin thoroughly saturated with oxygen (oxyhaemoglobin) has a definite absorption spectrum showing two bands between the D and E lines, whilst haemoglobin from which the oxygen has been completely removed only gives one band between those lines. In association with this, oxyhaemoglobin has a typical bright red colour, whereas haemoglobin is dark purple. A further striking characteristic of haemoglobin is that it contains iron in its molecule. ”

“ Everything leads us to believe that the formation of globules in the blood is the last touch given by nature to that magical provision begun in thevegetable, continued in the stomach, and finished in the veins, to which, in combination with carbon, hydrogen, oxygen, and nitrogen, we are indebted for the subsistence of every portion of our body. Thus the blood-globules may be considered as albumen which has finished its education, and is ready to go into the world; while the albumen of the serum is, like our young friends, the generations in reserve, who are still at school awaiting their turn. ”

“ Hurried to the tissues, the oxygen, at a comparatively high tension in the arterial blood, passes largely into the tissues, in which the oxygen tension is always kept at an exceedingly low pitch, by the fact that the tissues, in some way at present unknown to us, pack away, at every moment, into some stable combination each molecule of oxygen which they receive from the blood. With much, but not all, of its oxy-hæmoglobin reduced, the blood passes on as venous blood. How much hæmoglobin is reduced will depend on the activity of the tissue itself. ”

“ When freighted with oxygen it becomes oxyhaemoglobin and is red in color; when freed from its oxygen it takes a purple hue; hence the widely different appearance of arterial and venous blood, which so puzzled the early physiologists.
This proof of the vitally important role played by the red-blood corpuscles led, naturally, to renewed studies of these infinitesimal bodies. It was found that they may vary greatly in number at different periods in the life of the same individual, proving that they may be both developed and destroyed in the adult organism. ”

“ The only condition absolutely necessary to the purification of the blood is an organ having a delicate membrane, on one side of which is a thin sheet of blood, while the other side is in such contact with the air that an interchange of gases can readily take place. The demand for oxygen is, however, so incessant, and the accumulation of carbon dioxid is so rapid in every tissue of the human body, that an All-Wise Creator has provided a most perfect but complicated set of machinery to effect this wonderful purification of the blood. ”

“ Hydrogen is found in all the fluids and in all the solids of the body. It is derived from the food, as well as from water and other drinks. It exists in the greatest abundance in the impure, dark-colored blood of the system. It is removed by the agency of the kidneys, skin, lungs, and other excretory organs.
52. Carbon is an element in the oil, fat, albumen, fibrin, gelatin, bile, and mucus. This element likewise exists in the impure blood in the form of carbonic acid gas. Carbon is obtained from the food, and discharged from the system by the secretions and respiration. ”

“ The blood goes to the lungs dark in color from its load of waste. It is changed to a bright red by taking up oxygen. Each red blood-corpuscle takes a load of oxygen, carries it to its destination, and gives it to some tissue to be used up in the chemical process of oxidation, upon which depends our life and energy. During the hours of rest the tissues are busy in this process, and during exercise the energy stored up in the tissue-cells is liberated and waste created. ”

“ It coagulates at about 56°, and its specific rotation is −30·70°. “Lact-albumin” occurs in all kinds of milk. The globulins are insoluble in water and in dilute acids, but soluble in alkalies and in neutral salt solutions; these solutions are coagulated on boiling. “Serum-globulin,” also termed globulin or fibrino-plastic globulin, paraglobulin and paraglobin, occurs in blood serum; “cell-globulins” occur in many organs—liver, kidneys, pancreas and the thyroid gland, also in muscle-plasma; “crystalline,” a globulin occurring in two forms α and β, is found in the lens of the eye ”

“ Since the function of respiration is to free the system of superfluous carbon and hydrogen, by union with the oxygen of the air, it follows that the greater the amount of the products to be expelled, the larger the quantity of oxygen will be required to effect this purpose, as we find to be the case with those who consume large quantities of food.
The quantity of oxygen daily consumed through the lungs by an adult is about 32.5 oz., and the carbon in the food 13.9 oz. But in order to convert this whole amount of carbon into carbonic acid, which passes off through the lungs and skin, 37 oz. ”