TREATMENT 339 



hematology that diseases of the blood and of the nervous system present many 

 identical etiologie factors, and frequently show a certain parallelism in their 

 course. 



Finally, the fact must be borne in mind that in many cases chlorosis appears 

 as a hereditary condition, and we may assume that both the debility of the 

 nervous system, and the anatomical incompleteness in the structure of the 

 vascular system are inherited. But the view may be just as well maintained 

 that errors in Iringing up which favor the outbreak of chlorosis may be trans- 

 mitted from the mother to the daughter in consequence of the faulty manner 

 of life in some families just as a disease may be transmitted. 



PROGNOSIS 



The prognosis in general is that of other benign diseases which are readily 

 cured, and consequently it may in general be regarded as favorable from the 

 onset. It is especially so in the case of those girls in whom the symptoms have 

 appeared suddenly, and who previously neither were anemic nor showed other 

 pathological symptoms. Such cases occur in domestics who have grown up 

 in the country or in- a small town. More unfavorable are the conditions in 

 girls who from early youth have shown the signs of anemia, who are addicted 

 to all the previously mentioned errors of education and general hygiene, the 

 importance of which in the development of the disease has been indicated 

 above. Those cases are doubtless particularly unfavorable that are complicated 

 by the existence of anatomical anomalies of the heart and vascular system 

 such as were pointed out. These latter young girls, in consequence of their 

 generally lessened power of resistance, are in greater danger when acute dis- 

 eases such as pulmonary inflammations, influenza, enteric fever, etc., appear 

 intercurrently. 



TREATMENT 



Chlorosis is generally amenable to treatment, but from the onset we must 

 bear in mind the factors which favor the development of the disease, and as 

 every rational treatment must begin by an attempt to remove the cause of the 

 malady, or at least its predisposing elements, it becomes the duty of the physi- 

 cian to try to discover in the individual case what causes have favored the 

 development of chlorosis, a point that is of paramount importance in family 

 practice, where the error must be sought in the general mode of life of the 

 family and particularly in the bringing up of young girls. This is often a 

 difficult and delicate task, and requires great tact and judgment on the part 

 of the physician. 



Particularly for this reason, i. e., because the development of the disease 

 is favored by the injudicious manner of life and habits of the family, it is 

 wise in many cases to remove the patient from her usual surroundings and 

 place her in a suitable sanatorium, preferably in a suitable health resort; in 

 many cases the results will prove that stubborn cases of chlorosis that have 

 resisted all the therapeutic efforts of home practice are speedily cured on 

 removal from their former surroundings. It may be maintained with cer- 



