Some clinical aspects of pernicious anaemia / by Herbert French.

  • French, Herbert Stanley, 1875-1951.
Date:
1909
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Licence: In copyright

Credit: Some clinical aspects of pernicious anaemia / by Herbert French. 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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    more pernicious a complaint than is pernicious anaemia. I should like to see the older term, “ Addison’s anaemia ” used instead. It will be Sciid that I haive picked out a pairticularly favourable case when I give the following notes about Charles R. The allegation is true; but his story illustrates so well both the power some of these patients have of rallying, aind also the length of time they mtiy survive, and, further, the fact that their initial symptoms— lumbago in this case—may not seem to have any relation to a blood disease, that I beg leave to read this short account of him. (Charles R., aged 45, a bricklayer, was first admitted under Dr. Pavy in 1889 for mental irritability, weakness in the legs and pain in the back and loins. His colour at that time was not apparently abnormal, and the diagnosis made was “ Lumbago and 2Jaresis of the legs The pains in the back were very acute and the patient had had three or four attacks of it each year for the previous 15 years. There was no hjomaturia nor other indication that the pains might have been due to renal colic, and lumbago seemed to fit the case. In view, however, of the subsequent course it seems at least possible that the pains were similar to those which other pernicious ansemia cases often complain of in one part of the body or another; for, less than a year later, in January, 1890, the patient was readmitted for loss of physical strength, failure of appetite, diarrhoea, and night sweating, and the skin was now pale and waxy, and had been obviously so for more than two months. There were no retinal haemorrhages but occasional specks of blood Avere expectorated. There Avas no other bleeding. ' The urine Avas high coloured; it contained no albumen, blood, nor sugar. The blood count indicated pernicious anaemia. The patient AA^as treated Avith pilula colocynthi et hyoscyami and mistura ferri et ammonii citratis and improved in general condition, though the blood count remained much the same. By September, 1891, the patient Avas so Aveak, hoAvever, that he could not Avork, though he had worked betAveen his discharge and then. He was re-admitted under the late Dr. Washbourn, and Avas in hospital from September 4th, 1891, to November 30th, 1891. The attacks of pains in the loins still continued, and they Avere very bad. There Avere neither enlarged glands nor spleen, nor vomiting, nor diarrhoea. Treatment Avas noAv by means of liquor arsenicalis, which was increased up to 9 minims throe times a day, Avith material relief to the ansemia. The patient Avent out in November,