A practical treatise on disease in children.

  • Smith, Eustace, 1835-1914.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on disease in children. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    fresh air and exercise, is one of the commonest causes of anaemia in later childhood. The causes which induce impoverishment of the blood are no doubt often complex ; but of such as act alone imperfect digestion from catarrh of the stomach is perhaps to be blamed more often than any other injurious condition. These attacks tend to be repeated, and, as is else- where explained, recurring gastric catarrh may induce a degree of pallor and wasting which excites the greatest alarm in the minds of the parents, and often requires very careful treatment for its prevention and cure (see Gastric Catarrh). Again, the diathetic diseases—tuberculosis, scrofula, and syphilis— often induce a degree of anaemia, even before any local manifestations of the constitutional disposition are discoverable. In syphilis, also, the dis- ease, after apparent recovery, is apt to leave behind it a state of profound anaemia, which in many cases is to be attributed, not to the malady, but to the medication to which the patient has been subjected; for a prolonged course of mercury is an unfailing cause of impoverishment of the blood. In rickets, the beginning of the disease is announced, and its progress accompanied, by a marked degree of anaemia, which indicates the unfit- ness of the blood in such a case to fulfil all the requirements of healthy nutrition. Of other special general diseases which may lead to diminution in the amount of haemoglobin and so set up anaemia may be mentioned rheumatism, scurvy, and the cachectic condition induced by malaria. Disease of special organs concerned in sanguification—the spleen, the lymphatic system, etc.—is, of course, followed by great alteration in the quality of the blood. In extensive amyloid degeneration of these organs, the marked pallor of the patient is one of the most striking symptoms of the disease ; and in lymphadenoma the patient is jmculiarly paie aiui bloodless. The causes which increase the consumption of the blood are : Profuse haemorrhages, as in melaena neonatorum, haemophilia and hemorrhagic purpura ; severe diarrhoea ; chronic purulent discharges, as in cases of chronic empyema with a fistulous opening in the chest-wall; cirrhosis of lung with dilatation of bronchi; albuminuria ; onanism ; etc. In this class, too, must be included rapid growth, which is a very frequent source of languor and anaemia. It must be remembered, however, that at the age when growth is apt to be most rajrid the child is often exposed to other influences which may also tend to set up impoverishment of the blood, such as confinement to close rooms and want of exercise. Idiopathic anaemia (which is sometimes seen in young people) may re- sult from bad and insufficient food or other depressing cause acting upon the general system ; sometimes it is the consequence of mental shock, as in the case of a boy who was under the care of Sir William Gull, in Guy's Hospital. The lad began to suffer shortly after being attacked by a num- ber of sheep in a field. Morbid Anatomy.—In anaemia the blood may be merely deficient in amount (oligiemia), but it is usually found that there is also a deficiency in the haemoglobin (agiobulosis). It is not often that actual diminution in the number of the red corpuscles occurs in ordinary symptomatic anaemia im- less, iudeed, the impoverishment result from severe haemorrhage ; but these bodies are said to be considerably reduced in size, and in certain forms of amemia it is common to find many corpuscles with a diameter greatly below the average. The blood is paler than natural, for in con- sequence of the decrease in the hemoglobin it is deficient in iron. Its specific gravity is also lower, and it coagulates slowly into a loose clot.