A case of 'splenomegalic' or 'myelopathic' polycythaemia, with true plethora and arterial hypertonia, without cyanosis / by F. Parkes Weber.

  • Weber, Frederick Parkes, 1863-1962.
Date:
1905
Catalogue details

Licence: In copyright

Credit: A case of 'splenomegalic' or 'myelopathic' polycythaemia, with true plethora and arterial hypertonia, without cyanosis / 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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    nature manufactured in the enlarged spleen or alimentary canal is absorbed into the circnlating blood in minute quantities, not sufficient to cause much hmmolysis, but in amounts just sufficient to excite reaction in the haimopoietic (erythroblastic) tissues. Metchnikotf (piotes Belonovsky,^ of St. Petersburg, as having increased both the number of corpuscles and the amount of lunmoglobin in the blood of anasmic persons by the injection of minute doses of haemolytic serum. I have just mentioned these possible alternatives in regard to the nature of the bone-marrow activity in splenomegalic polycythaomia, but they are merely theo- retical suggestions, and I do not think it will l)o profitable to discuss them further without additional evidence. The cause of the sflenic enlargement.—If one inclines to the view that the bone-marrow condition in splenomegalic polycytha3mia is the result of reaction to toxins circulating in the blood, it is natural to suggest that the enlargement of the spleen is due to the same toxins, whether they enter the circulation from the intestines or elsewhere, or else that there is a ])rimary disease of the spleen, such as tuber- culosis (as there actually Avas in the case of Pendu and WidaP and some other cases), Avhich gives rise to a con- dition of toxannia to Avhich the bone-marroAv reacts (ex- cessive reaction being explained by idiosyncrasy) by an erythroblastic reaction resulting in jiolycythnDmia. In favouT- of such a vieAv there is the fact that in Saundby and Russell’s case'^ of splenomegalic polycythannia Avith cyanosis. Dr. Russell suav the patient Avith an enlarged spleen several years before cyanosis (leA’eloped. To this I Avould ansAver that the polycythannia Avas pi'obably like- Avi.se present for years before the cyanosis developed, and that cyanosis, if the vieAvs I have brought fonvard are correct, is not an essential part of the symptom-complex. ' ‘Sur rinfluenco do I’lnjoction do Diversos Doses de Serum Hemo- lytiquo sur lo NoiiiLro des Elomonts diA Sung-/ St. Poterslmrg, 1902. - ‘ Bulletins de la Soc. Medicale des Hopitaux/ Paris, 1899, p. 528. •'* “ An Unexplained Condition of Chronic Cyanosis,” ‘ Lancet,’ 1902, Ami. i, p. 515.