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
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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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    Dr. A. E. Boycott, speaking from the point of view of the histology of the blood alone, considered that the condition described was a clinical entity. Apart from the increase in the haemoglobin and in the number of cells he had found marked variation in size between individual red-blood corpuscles, their staining reactions were altered, and a small number of nucleated red-celis were constantly present. Polymorphonuclear neutro- phile leucocytes were increased; this also indicated an increase in the activity of the bone-marrow. [By permission of the President the two following letters, in the unavoidable absence of the writers, were admitted as contributions to the discussion.] May 8th, 1905. Dear Dr. Parkes Weber,—Let me thank you very warmly for your kindness in sending me the proof of the paper you are about to read to-morrow on “ ‘ Splenomegalic ’ or ‘ Myelopathic ’ Polycythiemia.” When the subject first emerged, a few years ago, it seemed to me that it might be simply a form of cyanosis due to disturbance of the circidation l)y one of the many mechanical factors which may disturb the ecpiilibrium. The consideration, however, of certain of the more recently published cases, the careful examination of an instance of the disease under the care of one of my friends here, which he recently published in the ‘Edinburgh Medical Journal,’^ and, above all, the study of your own work upon the subject, liave led me to the conclu- sion that a purely mecliauical hypothesis will not account for the phenomena. Your last paper has convinced me that increased i)lood-formation is the real cause of the disease, and I have no hesitation in accepting your suggestion of increased erythro- lilastic activity of the bone-marrow. Your conception of the order of development of the main symptoms appears to me to be perfectly correct, as increased viscosity of the blood must lead to increased strain on the circulation and to real plethora as an attempt to compensate for the viscosity. G. A. Gibson. Dear Dr. Parkes Weber,—A year and a half ago I had under my care at Westminster Hospital a case of splenomegalic poly- cytluBinia, which presented many points of similarity with the case described in your paper. The patient was a woman, aged 53, who had apparently been in good health until the time of the menopause, five years pre- viously. At that time she had an attack similar to the one for which she was admitted to hospital, consisting of headache, vomiting, and giddiness, with marked weakness of all four limbs, lasting about a week; there was no loss of consciousness. In ' Konaldson, ‘ Edin. Med. Journ.,’ vol. xvi, 1904, p. 244.