Clinical History
On November 7, 1829, Dr. Collineau treated a 39-year-old hat merchant of strong constitution but mobile and very irritable character, who presented with symptoms of dizziness and a heavy aching head from which he had been suffering for approximately an hour and a half. The patient had been walking quickly for twenty minutes prior to his arrival and had half a glass of wine an hour earlier, but had not been out of diet for a long time. Collineau bled the patient, and describes the blood as cloudy and light red in color as it came out of the vein, and it became mottled, whitish-red as it coalesced. Several drops which fell on the tile floor whitened within a few moments and took on the appearance of milk chocolate. An hour and a half later, it had formed a small lump swimming in a large quantity of white, opaque fluid similar to that of milk.
Dr. Collineau and his colleague Dr. Gendrin visited the patient that same evening and found that the patient’s blood remained in the same condition. They examined the patient several days later, who was a little better, but still experienced a heavy head and dizziness. Collineau notes that the patient was a small man with a rather pallid and very oily complexion, and that he admitted to having been ill from June through August but was not bedridden. He had been treated with leeches applied to the right side of his chest, and developed a bubo-like tumor in the left groin which opened and produced a small fistulous wound which was suppurating again. The patient said he had not exposed himself to any cause of syphilis. Furthermore, the patient reported that since childhood, he has coughed in the morning and felt oppression when climbing [French: “ressent de l’oppression lorsqu’il monte”], although breathing is easy when at rest. The right side of his chest gives less sound than the left.
Collineau states that he and Gendrin concluded that the patient suffers from chronic pleurisy, from which he has not yet recovered. They could not find any lesions or bodily dysfunction that would explain the changes to the blood that they had observed. They conclude that the change to the blood is an accident, and that in the following 8 days, after the patient’s dizziness had become as bad as it had been on the first visit, they applied leeches and bled the same arm; the blood from the leeches, the bleeding, and a nosebleed presented nothing more extraordinary.
Blood Analysis
A day after it was collected, Dr. Gendrin examined the blood taken from the patient on the initial visit. The clot, which was less than 1/5 of the blood mass, was floating in serum. It was covered with a thin, white, inconsistent, coarse layer. The layer was diaphanous and gelatinous. The serum appeared the same as when Gendrin had visited the patient on the previous evening. It was a slightly yellow milky white, matte and opaque, and tasted like normal serum. He sent a 6 oz sample to Monsieur Caventou to examine.
Caventou observed that the blood was white and milky, with a few globules of red matter swimming in it but not enough to alter its white color. The blood had no smell or flavor and appeared neutral.
Caventou attempted to filter the blood in order to separate the white material which caused its opacity, but all the liquid passed through the filter. He heated some of it, which coagulated in a single mass like pure albumin. He initially concluded that the white blood owed its color and properties to albumin in a certain state of coagulation, but the white liquid did not behave like albumin when subjected to chemical tests, although it was precipitated by a tincture of gall nuts, a character common also to fibrin, gelatin, and mucus. When he applied muriatic acid, a chemical reagent he discovered that turns the albumin of an egg blue, he saw no blue color.
He concludes that the white substance is not fibrin because fibrin does not dissolve in water and does not coagulate by heat, and it turns blue when dissolved in hydrochloric acid. It is not albumin, and it only had distant similarities to gelatin and mucus. Like gelatin, it did not produce a blue color in hydrochloric acid, but gelatin melts in heat while this substance coagulated.
Caventou was unable to identify the substance, but concluded that it would was a curious and important observation.
Source
Collineau M, Gendrin J, Caventou JB. Observation sur une altération particulière du sang. Journal général de médecine, de chirurgie et de pharmacie françaises et étrangères. 1829;106:67-71.
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