CHANGE IN PLASMA VOLUME DURING RECOVERY FROM CONGESTIVE HEART FAILURE

Abstract

In a lecture delivered before the Royal College of Surgeons in February 1896, Starling¹ predicted on theoretic grounds that "hydraemic plethora" must accompany congestive heart failure. Thirteen years later he was able to confirm the prediction by direct observation of a dog suffering from chronic myocardial insufficiency.² By bleeding the ailing animal he recovered 500 cc. of blood, as compared with 300 cc. from a normal dog of the same size. In 1902 Smith,³ using the Haldane carbon monoxide inhalation method of determining the volume of the blood, demonstrated a state of plethora in a case of congestive heart failure due to an adherent pericardium. Although Bock⁴ reported finding a normal blood volume in a case of cardiac failure, more recent investigations with carbon monoxide inhalation and various dye methods⁵ have indicated abnormally high blood volumes for patients suffering from uncomplicated heart failure.⁶ In addition, these studies