Congenital hemolytic jaundice : report of an interesting case / by Julius Friedenwald and W. Horsley Gantt.

  • Friedenwald, Julius, 1866-1941.
Date:
[1922?]
Catalogue details

Licence: In copyright

Credit: Congenital hemolytic jaundice : report of an interesting case / by Julius Friedenwald and W. Horsley Gantt. Source: Wellcome Collection.

    5/16 (page 97)
    Blood Wassermann reaction negative. Red blood corpuscles, 3,200,000. White corpuscles, 6000. Hemoglobin, 75 to 85 per cent. Differential count FIRST EXAMINA¬ TION SECOND EXAMINA¬ TION Small mononuclears.... 30 28.5 Large mononuclears.... Polynuclear neutro- 12 7.5 philes. 51 62.0 Eosinophiles. 1 0.8 An examination of the blood smears indicates slight secondary anemia; no poikilocytosis and but slight anisocytosis; moderate polychromatophilia; no myelo¬ cytes; no neucleated red blood corpuscles. Resistance of the erythrocytes to hypo¬ tonic salt solution. Maximum 0.48 first examination, minimum 0.30; maximum 0.45 second examination, minimum 0.25. The subcutaneous tuberculin test is negative. Gastric secretion Ewald test breakfast, 60 cc. of well digested clear secretion was obtained, total acidity 40, free HC1 32. Rehfuss fractional analysis HOURS FREE HC1 TOTAL ACIDITY 1 4 20 32 1 2 26 34 3 4 42 58 1 36 48 n 34 48 ii 28 40 if 16 24 2 12 22 21 6 20 21 20 32 2f 20 34 3 64 80 Duodenal contents The duodenal content is yellow turbid and contains much mucus. On stimula¬ tion with magnesium sulphate, there is a free flow of very dark and cloudy bile, containing an almost pure culture of streptococci. A fractional analysis of the duodenal contents according to the Einhorn method is as follows: ALKALINITY TRYPSIN AMYLOPSIN STEAPSIN Fasting stomach. 20 mm. 4 mm. 2 mm. 15 One-half hour after stim¬ ulation with bouillon.. 18 1 5 10 One hour after stimula¬ tion with bouillon. 20 6 2 10 One and one-fourth hours after stimulation with bouillon. 18 3 2 12 Two hours after stimula¬ tion with bouillon. 18 2 0 9 Stools The stools are normal in appearance, brownish in color, contain no blood, and but a slight trace of mucus. The exami¬ nation for parasites and ova is negative. A few undigested meat fibres are observed and urobilin is present. DISCUSSION It was in 1885 that Murchison pub¬ lished a report of an interesting condi¬ tion which he termed chronic acholuric jaundice, which was associated with anemia and splenomegaly, but did not present the usual manifestations of biliary intoxication. Subsequently LeGendre, Hayern, and Wilson re¬ ported similar observations, but it was not until 1900 that Minkowski clearly described the syndrome now recog¬ nized as congenital hemolytic jaundice occurring in certain individuals, mem¬ bers of the same family. Since then, numerous valuable contributions have appeared, regarding this affection. ANNALS OF CLINICAL MEDICINE, VOL. I, NO. 2