Observations on the treatment of pernicious anaemia based on a study of its causation : with notes of a case / by William Hunter.

  • Hunter, William, 1861-1937.
Date:
[1890]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the treatment of pernicious anaemia based on a study of its causation : with notes of a case / by William Hunter. 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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    The pallor was still extreme, mixed with a slightly lemon hue, but there was a slight return of colour to the mucous membranes and finger nails. He felt considerably stronger, and was now able to sit up for half an hour daily. He was still troubled with occa- sional looseness of the bowels, especially at night, accompanied by sweating. The improvement evident in his general condition was most'manifest in the urine. The latter was of more natural colour than at any time observed throughout the latter period of his illness, and presented nothing abnormal on microscopic exami- nation. The improvement which had thus set in, slight though it was, had not, however, been an uninterrupted one. He was subject from time to time to peculiar exacerbations of weakness, usually more or less sudden in onset, and of comparatively short duration, which always left him in a more exhausted condition than before. They occurred without any recognisable exciting cause, and were marked by certain highly characteristic features well fitted to arrest attention. The first of these attacks I had occasion to note, occurred on March 22nd. For two days previously he had presented a much more lemon tint than usual, and the urine at the same time had become still more highly coloured. The night of the 21st had been disturbed by perspiration, but on the morning of the 22nd he felt comparatively well, and took breakfast as usual. Shortly after- wards he was seized with a feeling of intense weakness, ushered in by drowsiness so marked in character that at the time of my visit the patient lay in a dreamy soporific state, as if under the infiuence of a slight narcotic, answering questions slowly and languidly, and taking no interest in his surroundings. This was all the more marked, as his natural disposition at all times was lively and excitable. While the attack lasted the patient presented a ghastly hue, the lemon tint becoming so pronounced that the medical attendant at one time feared an attack of jaundice. The pulse was slightly increased in rapidity, and more compressible; tempera- ture 994°; pupils contracted. The drowsiness continued till late in the afternoon, gradually passing off. During the night there v/ere several free motions of the bowels, the stools being much darker in colour than usual. The urine passed at the same time was of remarkably high colour, clear, very acid in reaction, specific gravity 1016, quantity