For these methods various diluting fluids are used, such as
physiological saline solution, 2.5% of potassium bichromate and many
others. According to H. Koeppe they are not indifferent as far as the
volume of the red blood corpuscles is concerned; and a solution which
does not affect the cells must be previously ascertained for each
specimen of blood. For this reason attention may be called to the
proceeding of M. Herz, in which the clotting of the blood in the pipette
is prevented by rendering the walls absolutely smooth by the application
of cod-liver oil. Koeppe has slightly varied this method; he fills his
handily constructed pipette, very carefully cleaned, with cedar wood
oil, and sucks up the blood, as it comes from the fingerprick into the
filled pipette. The blood displaces the oil, and as it only comes into
contact with perfectly smooth surfaces, it remains fluid. By means of a
centrifugal machine, of which he has constructed a very convenient
variation, the oil as the lighter body is completely removed from the
blood; and the plasma is also separated from the corpuscles. Three
sharply defined layers are then visible, the layer of oil above, the
plasma layer, and the layer of the red blood corpuscles. In as much as
the apparatus is calibrated, the relation between the volumes of the
plasma and corpuscles can be read off. No microscopical alterations in
the corpuscles are to be observed.
Though this procedure seems very difficult of execution, it is
nevertheless the only one, which has really advanced clinical pathology.
The results of Koeppe--not as yet very numerous--give the total volume
of the red corpuscles as 51.1-54.8%, an average of 52.6%.
M. and L. Bleibtreu have endeavoured indirectly to ascertain the
relation of the volume of the corpuscles to that of the plasma.
Mixtures of blood with physiological saline solution in various
proportions are made, in each the amount of nitrogen in the fluid which
is left after the corpuscles have settled is estimated. With the aid of
quantities so obtained they calculate mathematically the volume of the
serum and corpuscles respectively. Apart from the fact that a dilution
with salt solution is also here involved, this method is too complicated
and requires amounts of blood too large for clinical purposes. Th.
Pfeiffer has tried to introduce it clinically in suitable cases, but has
not so far succeeded in obtaining definite results. That, however, the
relations between the relative volume of the red corpuscles and quantity
of haemoglobin are by no means constant, is well shewn by conditions (for
example the acute anaemias) in which an "acute swelling" of the
individual red discs occurs (M. Herz), but without a corresponding
increase in haemoglobin. The same conclusion results from recent
observations of v. Limbeck, that in catarrhal jaundice a considerable
increase of volume of the red blood corpuscles comes to pass under the
influence of the salts of the bile acids.
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