Hydrotsmia. Aticemia Oligcemia. 373 



Symptoms. These may be little marked at the outset in slowly 

 developing cases. Extra pallor of the mucous membranes, 

 fatigue and even breathlessness on slight exertion, a small, weak, 

 pulse, with a tendency to become rapid, with violent heart beats, 

 when excited. 



At a more advanced stage the mucosae, especially the buccal, 

 are pale and thin, the muscles are soft, flabby and weak, fatigue 

 and perspiration are easily induced, the feet are advanced more 

 nearly in the median line of the body, and the toes strike on any 

 obstacles, the pulse is weak, small and quick, and the heart easily 

 excited even to palpitation, and with an occasional anaemic mur- 

 mur with the first heart sound. Arterial and venous murmurs 

 may be present. The hairs are easily detached. Appetite 

 and digestion fail, there is costiveness, a full secretion of 

 urine of a clear aspect, the subcutaneous fat disappears and the 

 skin feels thin and limp (paper skin in sheep) , the hair dry and 

 lusterless, the wool flattened (clapped). The weakness and 

 emaciation go on increasing and dropsies appear in the limbs, un- 

 der the trunk and jaw and in the internal cavities. 



Pathology. Lesions. Apart from the causes, the morbid condi- 

 tions are mainly found in the blood. The watery state of the 

 blood, the lack of red globules (even to but 2,000,000 per cubic 

 millimeter), the absence of albumen (76 per 1000 in place of 83), 

 the loose coagulum with excess of bufly coat, and the excess of 

 serum are characteristic. The presence of large, nucleated 

 (myelogenous) red cells, of spherical bodies smaller than the 

 normal red cells (microcytes) , and of irregularly shaped red 

 calls (poikilocytes) is characteristic, the latter especially of 

 pernicious anaemia. As the disease advances fatty degene- 

 ration of heart, liver, kidneys, and other organs are compli- 

 cations and tend to aggravate the disease, by counteracting repair 

 of the globules — thus establishing a vicious circle. All the organs 

 are pale and flaccid, the arteries empty, the veins contain a little 

 blood, forming pale clots. In the cases considered, all the result 

 of another disease, the lack of blood and of the solid and vital 

 elements in that which remains, entails imperfect function in all 

 the vital processes, including sanguification itself, and in this way 

 an anaemia once established tends to perpetuate and aggravate 

 itself. 



