THE BLOOD 325 



hy a rapidly succeeding pallor. The appearance of erythematous areas upon 

 the trunk may also be grouped with these. 



^ Disturbances of the organs of special sense, particularly often that of 

 vision, manifesting itself by the fact that 'the patients soon tire in reading, 

 sewing, etc., in most cases are caused by weakness of the eye-muscles and of 

 the mechanism of accommodation. 



Besides this, in many instances, serous infiltrations of the retina are found, 

 which then appears strikingly pale, and, especially about the papilla, lacks 

 distinct contour, and looks as if loosened. 



Now and then attacks of transitory blindness or partial deficiencies in 

 vision are noticeable, which, although they greatly alarm the patient, offer a 

 good prognosis and disappear completely. 



Anomalies of taste have already been mentioned. We also find abnormal- 

 ities of smell, the same as in hysteria. 



THE BLOOD 



The blood of chloeotics has, for a very long time, been the subject of 

 thorough and extensive researches, and even with the naked eye the watery 

 appearance and the marked pallor of the blood, which flows freely from the 

 slightest puncture, is conspicuous. If blood of this kind is diluted with a 

 definite quantity of water, and this mixture is compared with a similar dilu- 

 tion of a like quantity of normal blood, the difference in color is very decided; 

 this is also shown by all the various instruments which are constructed for 

 the same purpose, i. e., for comparison, by means of transmitted light, of the 

 color of the blood with a standard color, the so-called hemoglobinometer, so 

 as to determine a decided reduction of the coloring matter of the blood. 



The exact estimation of the amount of hemoglobin from the amount of 

 iron contained in the blood also shows a considerable reduction of the iron 

 and hemoglobin values, so that there can be no doubt that in chlorosis there 

 is a considerable reduction of the hemoglobin percentage. 



In opposition to this, 'it is of special interest that the count of red blood 

 cells, which in the course of time has been made in many cases and from 

 different standpoints, shows in the majority of cases of uncomplicated chlorosis 

 no considerable reduction in the number of these cells, which are the carriers 

 of the hemoglobin, and it can be stated positively to-day that a reduction in 

 the number' of these cells, an " oligocythemia/' is not present in chlorosis. 

 The normal number of red corpuscles in a cubic millimeter of woman's blood 

 is about 4,500,000; in chlorotics we find an average of from 3,800,000 to 

 4,000,000, and in some cases even an almost normal number ; while a marked 

 reduction in the number of red blood cells is found only in such chlorotics 

 as are debilitated in consequence of a prolonged duration of the disease, insuffi- 

 cient nutrition and complications of some kind. 



These two important facts, that, on the one hand, the amount of hemo- 

 globin is always considerably reduced, sometimes to a third of the normal, 

 while the number of red blood cells is changed but very little, allow us to 

 conclude positively, that some individual red blood cells must be poorer in 



