Clinical notes from the babies' wards : haemophilia (bleeders) / service of Augustus Caillé.

  • Caillé, Augustus, 1854-1935
Date:
[1894?]
Catalogue details

Licence: Public Domain Mark

Credit: Clinical notes from the babies' wards : haemophilia (bleeders) / service of Augustus Caillé. 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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    At four years the boy had haematuria constantly for twenty-one days, urinating every two hours. At five years he hied profusely fromQ^rasion of lower lip for three weeks. At four years, when four upper temporary incisors dropped out, his gums bled con- stantly for four to five weeks, requiring six weeks’ treatment at St. Luke’s Hospital. Recently the boy has had another attack of haematuria of short duration. At the present time every fall or blow is followed by ecchymosis of joints, with inability to use limbs for three or four weeks. The right knee is markedly swollen, with blood clots in the po]?- liteal space. The limb is flexed, and very tender on motion or to the touch. AVhen walking the boy steps lightly on the toes, and does not rest upon the entire foot, the knees and ankles being principally affected. On account of susceptibihty to haemorrhages into joints, the boy has been unable to attend school. The child is otherwise thin, anaemic, irritable and has foetid breath, and swollen gums which bleed when he coughs or cries, or when eat- ing solid food, and so forth. His nose bleeds frequently and profusely, and he also has phymosis. Blood; 3,840,000 red cor- puscles in c. mm. seven per cent, oxyhaemoglobin. Ratio of leu- cocytes not altered. Second child, Harry, a boy five years old; breast for two years. Bled from gums on eruption of all temporary teeth, from fourteen to twenty-one days, with no tendency to clot; also bled on biting tongue or abi’aiding mucous membranes. At three years he fell down cellar from a swinging gate and lacerated the scalp over the occipital bone, one inch in length, requiring five and a half months’ treatment at St. Luke’s Hospital. Nine stitches were used in sewing wmund. Blood from wound soiled the bed clothes every night, and there was also epistaxis at regular intervals. Admitted to Babies’ Wards, Medical Division, for bleeding gums and malnutrition, January, 1893. The usual styptics and local pressure had no effect in stopping the bleeding. Swabbing with one-half per cent, of potassium permanganate solution controlled the bleeding considerably, and after two weeks of nom-ishing* liquid diet, with small doses of tincture ferri chloride and fruit juice, the boy was dischai’g’ed in an excellent condition. He A^as readmitted with recurrent stomatitis and bleeding a month latei, and treated as before, with the best result. The condition was