154 



THE BLOOD IN PERNICIOUS ANAEMIA. 



[BOOK i. 



Results of 



Leucocy- 

 thaemia. 



The following Table exhibits the results of six sys- 

 tematic analyses of the blood of leucocythaemia by 

 various observers 1 . 



Progressive Pernicious Anaemia. 



By the above term Biermer 2 has designated a remarkable form 

 of anaemia which had already been recognized and graphically 

 described by Drs Addison and Samuel Wilks 3 . 



Occurring more frequently in women than in men, in adult life 

 than in adolescence or old age, this disease seems frequently to 

 originate in pregnancy, or to have exhausting disease as a predisposing 

 cause. Cases, however, undoubtedly occur in which no predisposing 

 cause can be traced. 



Commencing insidiously as one of the more ordinary forms of 

 anaemia, this disease is distinguished by the rapidity with which 

 all the phenomena of the most intense anaemia are developed 

 such as intense pallor, dyspnoea, inability to undergo the slightest 

 exertion, tendency to syncope, dropsy. It differs from the ordinary 

 forms of anaemia by the occurrence of more or less pyrexia, by a 

 great proneness to retinal hemorrhages, but especially by the much 

 greater tendency towards a rapid fatal termination. 



The disease is not associated with any essential lesion of any 



1 This table is taken from Robin's Traiti des humeurs, 2nd edition, p. 272, to which we 

 were referred by Gautier, who also uses it. (Gautier, Chimie Appliquee, &c., Vol. n, p. 321). 



2 Biermer, "Vorlaufige Mittheilung iiber fettige Degeneration des Herzens und 

 der Gefasse in Folge von Anamie;" Tageblatt d. 42. Versamml. deutsch. Naturforscher 

 u. Aerzte in Dresden, 1868. Deutsches Archiv f. Min. Med. vol. xm., p. 209. 



3 Addison, On the constitutional and local effects of disease of the suprarenal 

 capsules. London, 1855. Collected Works, New Sydenham Soc. 1868, p. 211. 



Samuel Wilks, "Cases of idiopathic fatty degeneration. With remarks on arcus 

 senilis." Guy's Hospital Reports, 1857, p. 203. 



In reference to the claims of these two authors to the merit of having first 

 recognized the disease under discussion, the reader is referred to an interesting paper 

 by Dr Pye-Smith, entitled "Zwei Falle von Anaemia idiopathica perniciosa" (Virchow's 

 Archiv, Vol. LXV. (1875), p. 507). 



