On epistaxis and the haemorrhoidal flux : their pathogenic unity and identity of cure / by Alexander Harkin.

  • Harkin, Alexander.
Date:
1892
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Licence: Public Domain Mark

Credit: On epistaxis and the haemorrhoidal flux : their pathogenic unity and identity of cure / by Alexander Harkin. 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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    disorder of nutrition, looked at broadly, depends on a disturbance of the mutual relations between the blood and the tissues, it neces- sarily follows that it may originate either in an abnormal state of the blood or the tissues. Hence the pathogeny of the general disorders of nutrition suggests the possibility of their arising in different ways, and regards any one-sided theory—e.g., that they are a blood disease, as, a priori, unjustifiable. For, since the blood, besides supplying the tissues with pabulum, also receives from them the products of cellular metamorphosis, it is always possible that owing to a morbid state of all, or a majority of the tissues a secondary heterotomy or dyscrasy of the blood may be induced, as in diabetes mellitus. The anaunic condition may possibly depend on a state of the tissue elements in which the desire for pabulum is relatively good, when accompanied with an inadequate energy of sanguification; the hyperaemic, on a weak acquisitive power in the tissues, while the power of renewal of the constituents of the blood is unimpaired. My contention, then, is that the starting-point in the constitu- tional disorder which takes the form of anamiia or hyperemia, and of which epistaxis is a frequent result, is as clearly due to hepatic disorder as diabetes mellitus itself—viz, to an abnormal condition of the tissue elements or cells in the liver, secondarily affecting the blood and general constitution. With this theory of causation, treatment would naturally proceed on the lines of improving the constituents of the blood, and of restoring the health of the liver, whether functionally or organically defective. In accordance with my recorded experience,8 the first indication would be most readily met by the free administration of chlorate of potassium alone, or in combination with iron; the second, by counter-irritation over the region of the liver, a large blister being practically the most convenient form; further, as chlorate of potassium is possessed of remarkable haemostatic properties, I am satisfied that it is not solely through its immediate action on the molecular elements of the blood, but also by its direct operation on the disordered condition of the liver, that it controls and limits the congestive and other lesions of this important organ. That potassium chlorate has the power of yielding some life-giving element to the blood in cachectic conditions, and that its presence in the blood acts as a powerful stimulant to cell-growth, cannot be ■ British Medical Journal, October 30, 1880. N.B.—I intentionally pass over topical treatment during an attack, as there cannot be any doubt of its necessity. 4