Critical review : polycythaemia, erythrocytosis and erythraemia.

  • Frederick Parkes Weber
Date:
1908
Catalogue details

Licence: In copyright

Credit: Critical review : polycythaemia, erythrocytosis and erythraemia. 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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    PAGE Other possible theories of erythrae- mia:— (a) Increased durability of the red blood-cells . . .113 (b) Diminished oxygen-capacity of the haemoglobin . .113 (c) Possible toxic and infectious causes .... . 114 Subdivision of cases of erythraemia . 115 Polycythaemia hypertonica without splenomegaly . . . . .115 Congenital erythraemia and ery- thraemia commencing in early life . 116 PAGE Diagnosis of erythraemia . . 117 Prognosis and course . . 117 Treatment . . 117 Appendix A Necropsy findings in cases of ery- thraemia and cases clinically cha- racterized by polycythaemia with splenomegaly . . . . .119 Appendix B Specially remarkable or obscure cases with polycythaemia. . . .125 References ...... 128 PART I. POLYCYTHAEMIA. Definition, Polycythaemia or Polycythaemia rubra (French ‘ Poly- globulie ’) signifies a condition of the blood in which the number of the red corpuscles (erythrocytes) is decidedly above the average. Slight physiological variations are connected with age, sex, and normal discharges (prolonged sweating, &c.) and probably also with atmospheric tem- perature ; and greater physiological variations are connected with atmospheric pressure (living in high altitudes). In ordinary low altitudes the standard number of red cells in a cubic millimetre of human blood is taken as 5,000,000 for healthy males after the ‘ polycythaemia neonatorum * of the first few days of extra-uterine life has passed off. For women the average is slightly less than for men. The purpose of the present article is chiefly to consider the form of poly- cythaemia known as ‘ erythraemia but in order to limit and define the group of cases to which this term can be applied it will be necessary first of all to classify the other forms of polycythaemia and shortly to discuss the various conditions which are known (or may be supposed) to be capable of giving rise to polycythaemia. Relative and absolute (true) Polycythaemia. Polycythaemia may be [a) relative or (b) absolute (true). (a) Mere relative polycythaemia is due to concentration of the blood, such as may be caused by choleraic diarrhoea or other excessive fluid discharges from the body (copious sweating). It is doubtless almost always of only temporary occurrence (possible exceptions occur in some cases of recurring night-sweats, &c.), and the diminution in volume of the blood-plasma* which causes it, is quickly recovered from when the normal osmotic conditions are re-established. Some degree of local relative polycythaemia can be induced (experimentally, as Cohnheim long ago showed, or by disease) in one limb or in one part of the body by obstruction to the return of venous blood from the
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