CHANGE IN PLASMA VOLUME DURING RECOVERY FROM CONGESTIVE HEART FAILURE

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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

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