Some clinical aspects of pernicious anaemia / by Herbert French.

  • French, Herbert Stanley, 1875-1951.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Some clinical aspects of pernicious anaemia / by Herbert French. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    He was the typical colour. There had only been slight loss of bulk, and he weighed 11 st. lib. without clothes. His temperature was always at least 99° F. at night, often it was 100° F., and sometimes 101° F. There were well marked retinal hemorrhages and hemic bruits. There had been oedema of the ankles, but this disappeared when he lay in bed. Appetite was poor, but there was no vomiting. The spleen was not palpable at first, but ultimately it became quite large. The liver was felt down to the level of the umbilicus, or lower. The urine had a specific gravity of 1010 : it was constantly pale; it deposited uric acid crystals spontaneously ; it was free from albumen except on one occasion, and from blood ; it gave no urobilin band to the ordinary spectroscopic test. Epistaxis occurred spontaneously more than once, and at one time there were subcutaneous petechise upon the arms and diffuse purpuric blotches on the legs. After the administration of arsenic there were one or two diarrhoeic attacks, but there had Ijecn none before arsenic was given. Itching of the skin was at one period a very troublesome symptom, though jaundice was entirely absent. During the final relapse the patient became oerlematous, and serous exudations occurred. Finally there was increased pyrexia with rigors, due to a terminal infective endocarditis, which was the immediate cause of death. The post-martein examination showed a well-nourished body, pro- foundly ansemic, but with very bright yellow-coloured fat. There was some oedema of the nether limbs. Each pleural cavity contained about three pints of serous fluid, the pericardium about 18 ozs. of a similar fluid, and the peritoneum 41 ozs. The lungs were very pale, and extremely cedematous. The alimentary canal looked normal. The heart was pallid, and the mitral and pulmonary valves cedematous, the former being incompetent and the latter bearing small recent granulations all along it near its free edge. The spleen weighed 19 ozs., and was dark and tough. The kidneys weighed 13 ozs., and the liver 80 ozs. Liver, spleen, and kidneys all con- tained a large excess of iron, and gave a well marked Prussian blue reaction.