Polycythaemia in diseases of the heart and lungs and during residence at high altitudes / by F. Parkes Weber.

  • Weber, Frederick Parkes, 1863-1962.
Date:
[1908]
Catalogue details

Licence: In copyright

Credit: Polycythaemia in diseases of the heart and lungs and during residence at high altitudes / by F. Parkes Weber. 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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    cases in which the presence of absolute polycythemia is evidenced by the persistence of a relative polycythemia discovered on making a blood-count in the ordinary way. The possibility of cases of absolute polycythemia being regarded as cases of mere relative polycythemia (i.e., mere blood-concentration) is unlikely for the following reasons :— (1) The absence of the recognised causes (diarrhoea, excessive sweating, etc.) of diminution in the total quantity of blood. (2) The plethoric (full-blooded) or congested appearance of the patient. (3) The persistence of the polycythaemia (merely relative polycythaemia, as already stated, is almost always only temporary). (4) In some cases, moreover, as we shall subsequently point out, the total quantity of blood in the body can be estimated and proved to be in excess of the average. Cases of absolute polycythaemia may be divided into the following classes:— A. —Those due to imperfect oxygenation of the blood and tissues owing to circulatory disturbance in chronic cardiac and pulmonary diseases. To this class we might add the polycythaemia occasionally following carbon monoxide poisoning and other toxic conditions interfering with the proper oxygenation of the blood. B. —Those connected with living at high altitudes and diminished oxygen-tension in the inspired air. C. —Those classed under the heading “ Splenomegalic Poly- cythaemia,’' or, as I have termed them, “ Myelopathic Polycythaemia.” In all these classes of absolute polycythaemia, but especially in Class C., the increase in the number of red cells is sometimes very remarkable. In cases of congenital heart disease, with more or less chronic cyanosis, blood-counts of seven to eight million red cells to the cubic millimetre are not at all unusual, as in the case of a girl, aged 17 years, whom I showed at the Clinical Society of London in 1907,1 and whose red corpuscles had varied from 6,375,000 to 7,352,000 in the cubic millimetre. 1 Clinical Society’s Transactions, Vol. XL., p. 251.