PROGRESSIVE PERNICIOUS ANEMIA. IDIOPATHIC 



ANEMIA. 



Definition. Causes, obscure, faulty diet, hygiene, microbes, glycerine, 

 pyrogallic acid, haemoglobin, deranged sanguification, parasitisms. Symp- 

 toms, of anaemia of obscure origin. Treatment as for anemia, special 

 measures for intestinal fermentations, dietetic. 



Definition. Anaemia which is without any pre-existing appre- 

 ciable cause. 



Causes. As in the corresponding disease in man the real start- 

 ing point of pernicious anaemia is unknown. Faults in diet and 

 in general hygiene have been adduced, and while in Berne this 

 appears to be sustained, in Ireland, in the poorest classes, the 

 disease is little known, and in Montreal, it finds its victims largely 

 in a class of well to do artisans (Osier). In the domestic animal 

 it is described on all soils, and on the most varied dietary (Bouley 

 and Rejmal). Zschokke and Friedberger and Frohner in cases 

 •occurring enzootically in stables, found a minute baccillus in the 

 patient, which would remove these cases into the list of sympto- 

 matic anaemia. The same is true of Texas fever and of Surra, 

 nagana, etc. of horses and mules, in which the trypanosoma de- 

 jstroys the red globules. Other forms that are apparently purely 

 idiopathic have been attributed to a failure in the cytogenic pro- 

 cesses in the bone marrow especially. Back of this we know 

 only of the various debilitating causes in food, hygiene, building, 

 location, work, etc., operating on a specially susceptible system, 

 in which, once started, the morbid process tends to perpetuate 

 itself and increase. 



Ponfick induced a,naemia experimentally by the intravenous in- 

 jection of glycerine, pyrogallic acid, solutions of haemoglobin, 

 etc., which dissolve the blood globules. This suggests the 

 probable pathogenesis by the production of unidentified blood 

 solvents in cases of deranged sanguification, but it still leaves us 

 in the dark as to the exact seat of such derangements (liver, 

 blood glands, bone marrow, etc. ) and as to the cause, parasitic 

 ■or otherwise, which determines such disorder. Pathological in- 

 vestigation has enabled us to differentiate, according to their 



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