150 CHARACTERS OF THE BLOOD IN ANAEMIA. [BOOK I. 



By pursuing such methods of investigation Hayem has obtained 

 results which have led him to recognize four classes of cases of 

 anaemia, as determined by changes in the blood. 



Hayem's 1. Slight anaemia, characterized either by slight 



classification changes in the corpuscles or by none. Corpuscles 

 Anaemia f equivalent to between 4 and 3 millions of healthy cor- 

 puscles (the actual number may be actually as large 

 as in health). The individual value of the corpuscles varying 

 between 1 and 0*70 (1 expressing the normal as determined by 

 richness in colouring matter). 



2. Anaemia of medium intensity, characterized by marked 

 changes in the corpuscles, with a diminution in the size of the 

 corpuscles, the total of which may be equivalent to between 3 and 2 

 millions of corpuscles in the cubic millimetre, though the actual 

 number may vary between 5,500,000 and 3,000,000 ; the individual 

 value of the corpuscles may vary between 0*30 and 0'80. 



3. Intense anaemia, characterized by marked changes in the 

 corpuscles and especially by corpuscles of very unequal dimensions, 

 some being of very large size. The total number of corpuscles may 

 be equivalent to between 2 millions and 800,000 healthy corpuscles, 

 though the actual numbers may fluctuate between 2,800,000 and 

 1 million ; the individual value of the corpuscles may vary between 

 0'40 and 1. 



4. Extreme anaemia, characterized by altered corpuscles, of 

 unequal dimensions, whose mean size approaches the normal, and 

 may even exceed it. The total number of corpuscles may be equivalent 

 to between 800,000 and 450,000 healthy corpuscles, and the actual 

 number of corpuscles may be very small, even smaller than corre- 

 sponds to the number of corpuscles, so that in these cases the amount 

 of colouring matter in each corpuscle may actually be higher than 

 the normal. 



During the course of treatment of anaemia by preparations of iron 

 the progress of the case can be studied by comparative determinations 

 of the total number of corpuscles and their colorific intensity, and it 

 is sometimes found that as recovery advances the corpuscles actually 

 decrease in number whilst their richness in colouring matter augments. 



The Blood An attempt has been made to establish a distinction 



in cases of between the changes in the blood in chlorosis and other 

 Chlorosis. forms of anaemia. It appears to the Author however 



that such a distinction is of the most artificial and useless kind. 



Chlorosis may be defined as an intense form of anaemia occurring 

 in women (usually in adolescents), evidenced by a yellowish-green 

 tint of the pallid skin, often associated with marked nervous symptoms, 

 and usually, if not always, associated with disorder of the menstrual 

 function. It is, that is to say, a disorder of nutrition accompanied by 

 intense anaemia, which in some yet unintelligible manner is specially 

 connected with the menstrual function. 



