Anaemia and some of the diseases of the blood-forming organs and ductless glands / by Byrom Bramwell.

  • Bramwell, Byrom, Sir, 1847-1931.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Anaemia and some of the diseases of the blood-forming organs and ductless glands / by Byrom Bramwell. Source: Wellcome Collection.

    16/468 (page 4)
    ness is due to functional disturbance or organic disease of the blood-forming organs (the marrow of the bones, the spleen, and the lymphatic glands). But I doubt whether in the present position of our knowledge it is advisable to classify these so-called cytogenetic forms of anaemia under a separate heading. They are in reality primary anaemias, and, if separately grouped under a special term (cytogenetic), should be merely regarded as a sub-group of the primary anaemias. (2.) In other cases of anaemia, the bloodlessness is obviously secondary—the result of such conditions as:—(a) loss of blood; (J?) the presence of a poison introduced into the blood from without; (c) defective nutrition ; or (a) well-defined disease in some of the tissues and organs of the body, other than the blood-forming organs strictly so-called, such for example as cancer of the stomach- These we term the secondary or symptomatic anaemias. This classification is clinical and practical rather than strictly pathological and scientific. It is probable that as our etiological and pathological knowledge advances some of the cases of anaemia which we at present consider primary—I refer more particularly to some cases of pernicious anaemia—will be found to be secondary. Further, it must be remembered that in the present position of our knowledge it is not always possible to differentiate during life (clinically) the different sub-varieties of primary anaemia, nor even (in some cases) to say with absolute certainty whether the anaemia is primary or secondary. There seems, for example, some reason to suppose that in rare cases the clinical condition to which the term pernicious anaemia is applied may be due to a primary disease of the marrow of the bones ; in other words, in some cases this form of primary anaemia, i.e., progressive pernicious anaemia (which, as I will afterwards point out, is usually the result of excessive blood destruction and not of imperfect blood formation), is perhaps the result of imperfect blood formation. Again, there is,. I think, some reason to suppose that an anaemia, which is at first merely secondary and symptomatic, may, if sufficiently severe and sufficiently prolonged, ultimately assume all the clinical features of the pernicious form. But I need not enter into details regarding these very difficult and debatable questions. I will refer to them again when I come to consider the pathology of pernicious anaemia in more detail. From what I have just stated it will be obvious that in the present position of our knowledge it is convenient to divide cases of anaemia into two great groups, viz., primary and secondary; but as soon as we have more accurate information as to the exact