LITMIR.BIZ

      Published by Good Press, 2019

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      EAN 4057664611000

Table of Contents

       INTRODUCTION.

       DEFINITION OF ANÆMIA. CLINICAL METHODS OF INVESTIGATION OF THE BLOOD.

       THE MORPHOLOGY OF THE BLOOD.

       A. METHODS OF INVESTIGATION.

       α Preparation of the dry specimen.

       β. Fixation of the dry specimen.

       γ. Staining of the dry specimen.

       1. Recognition of glycogen in blood.

       B. NORMAL AND PATHOLOGICAL HISTOLOGY OF THE BLOOD.

       A. Anæmic or polychromatophil degeneration.

       B. A second change that we find in the red blood corpuscles of the anæmias, is poikilocytosis .

       C. A third morphological variation which anæmic blood may shew in the more severe degrees of the disease, is the appearance of nucleated red blood corpuscles .

       THE WHITE BLOOD CORPUSCLES.

       I. NORMAL AND PATHOLOGICAL HISTOLOGY OF THE WHITE BLOOD CORPUSCLES.

       II. ON THE PLACES OF ORIGIN OF THE WHITE BLOOD CORPUSCLES.

       α. The Spleen.

       I. Cells bearing granules.

       II. Cells free from granules.

       TABLE I.

       (β) The Lymphatic Glands.

       (γ) The Bone-marrow.

       III. ON THE DEMONSTRATION OF THE CELL-GRANULES, AND THEIR SIGNIFICANCE.

       IV. LEUCOCYTOSIS.

       Leukæmia.

       V. DIMINUTION OF THE WHITE BLOOD CORPUSCLES (LEUKOPENIA) .

       LITERATURE [37] .

       INDEX.

INTRODUCTION.

       Table of Contents

DEFINITION OF ANÆMIA. CLINICAL METHODS OF INVESTIGATION OF THE BLOOD.

       Table of Contents

      In practical medicine the term "anæmia" has not quite the restricted sense that scientific investigation gives it. The former regards certain striking symptoms as characteristic of the anæmic condition; pallor of the skin, a diminution of the normal redness of the mucous membranes of the eyes, lips, mouth, and pharynx. From the presence of these phenomena anæmia is diagnosed, and according to their greater or less intensity, conclusions are also drawn as to the degree of the poverty of the blood.

      It is evident from the first that a definition based on such a frequent and elementary chain of symptoms will bring into line much that is unconnected, and will perhaps omit what it should logically include. Indeed a number of obscurities and contradictions is to be ascribed to this circumstance.

      The first task therefore of a scientific treatment of the anæmic condition is carefully to define its extent. For this purpose the symptoms above mentioned are little suited, however great, in their proper place, their practical importance may be.

      Etymologically the word "anæmia" signifies a want of the normal quantity of blood. This may be "general" and affect the whole organism; or "local" and limited to a particular region or a single organ. The local anæmias we can at once exclude from our consideration.

      A priori, the amount of blood may be subnormal in two senses, quantitative and qualitative. We may have a diminution of the amount of blood—"Oligæmia." Deterioration of the quality of the blood may be quite independent of the amount of blood, and must primarily express itself in a diminution of the physiologically important constituents. Hence we distinguish the following chief types of alteration of the blood; (1) diminution of the amount of Hæmoglobin (Oligochromæmia), and (2) diminution of the number of red blood corpuscles (Oligocythæmia).

      We regard as anæmic all conditions of the blood where a diminution of the amount of hæmoglobin can be recognised; in by far the greater number of cases, if not in all, Oligæmia and Oligocythæmia to a greater or less extent occur simultaneously.

      The most important methods of clinical hæmatology bear directly or indirectly on the recognition of these conditions.

      There is at present no method of estimation of the total quantity of the blood which can be used clinically. We rely to a certain extent on the observation of the already mentioned symptoms of redness or pallor of the skin and mucous membranes. To a large degree these depend upon the composition of the blood, and not upon the fulness of the peripheral vessels. If we take the latter as a measure of the total amount of blood, isolated vessels, visible to the naked eye, e.g. those of the sclerotic, may be observed. Most suitable is the ophthalmoscopic examination of the width of the vessels at the back of the eye. Ræhlmann has shewn that in 60% of the cases of chronic anæmia, in which the skin and mucous

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