HEMOPHILIA. 



Definition. Causes, lack of plasticity of the blood, thin walls, blood 

 tension, cardiac erethism, hypertrophy and neurosis. Sex. Heredity 

 through the female. Treatment, depletive, styptic, astringent. Transfusion. 



This is a constitutional infirmit}'^, usually hereditary and char- 

 acterized by the occurrence of profuse and continuous bleeding as 

 the result of otherwi.se insignificant in j uries or even apart from 

 any recognizable lesion. It has been attributed to a slow coagu- 

 lation of the blood, but at the start of a haemorrhage the blood is 

 rich in corpuscles and coagulates firmly. It has also been as- 

 cribed to extreme tenuity of the vascular walls, but this has only 

 been met with in a certain proportion of the cases. Another po- 

 tent factor is a permanent over- filling of the blood-vessels (Immer- 

 mann, Delafield, Pruddeu). The same writers attach importance 

 to cardiac erethism, cardiac hypertrophy, and certain neurotic in- 

 fluences which temporarily increase the habitually congestive di- 

 athesis. In man the majority of victims have been males, per- 

 haps because most subject to traumatisms. On the contrary the 

 hereditary transmission is mainly through the female members of 

 the family. The families are very prolific, a condition counter- 

 balanced by the death of the majority of the victims at an- early 

 age. Among the lower animals it has been observed . in horses 

 consequent on castration (Siedamgrotzky, Kohne, Friedberger 

 andFrohner), setoning (Kohne, DieckerhofE), and an ulcer of the 

 leg (Kohne). 



Treatment consists in combating plethora and constipation by 

 saline purgatives. The subject should be carefully protected from 

 injuries. Locally use styptics such as matico, muriate of iron, 

 tannin, alum with pressure. Internally ergot, lead acetate, iron 

 chloride, tannin, alum, or muriate acids. Transfusion is a denier 

 resort. 



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