Hemophilia. 901 



of the vascular system was found (hypoplasia cordis et 

 arteriarum), with which the tendency to hemorrhages is sup- 

 posed to be inherited. In opposition to this Sahli pointed out 

 the insufficient formation of thrombin in the walls of the vessel. 

 As a matter of fact Morawitz & Lessen found a deficiency of 

 thrombin in a hereditary bleeder, probably as the result of 

 a change of the chemical constitution of the cellular elements 

 in the blood, which are to produce the thrombokinasis. In 

 animals inbreeding appears also to have an influence on the 

 development of a hemorrhagic diathesis in the progeny. 



As incidental causes of the hemorrhages, rapid galloping, 

 castration, rope pulling and other injuries of the skin or the 

 mucous membranes, or even parturition may come into con- 

 sideration (Stahn). 



Symptoms. The hemorrhage is usually external, sometimes 

 however it may be into a body cavity. The bleeding resulting 

 from external wounds is usually parenchymatous, and can be 

 stopped by the ordinary methods only with difficulty after 

 several hours, or not at all, so that the animal may even bleed 

 to death. Frequently the loss of blood is so great that it may 

 result in acute anemia from which the animals recuperate only 

 after several weeks. (Meyer observed in one case a diminution 

 in the number of red blood corpuscles to 3,000,000 in one cmm. 

 blood.) In other cases the bleeding may cease after a time, 

 but may appear again later, and after frequent recurrences may 

 produce death. In man hemorrhages are also frequent into 

 the joint cavities and give rise to painful swellings of the joints. 



Diagnosis. Before establishing the diagnosis of hemophilia 

 all diseases which according to experience may cause hemor- 

 rhages must be excluded (acute infectious diseases, affection of 

 the heart, aneurysms, kidney disease, new-formations). 



Treatment. After the appearance of the hemorrhage the 

 customary hemostatic remedies should be applied, likewise the 

 borders of the wound, if present, should be united, compression 

 should be applied on the bleeding place, and absolute rest of 

 the body is required. If the hemorrhage continues in spite of 

 these measures the blood must be coagulated by the use of 

 concentrated chloride of iron solution, fuming nitric acid, or 

 by the actual cautery on the bleeding surface. Internally ergot 

 preparations may be administered. According to recent ex- 

 periences in human medicine the subcutaneous injection of blood 

 serum from other species might also be utilized to advantage. 

 A resulting anemia should also be given appropriate treatment 

 (see p. 848). 



Zschotke succeeded in preventing the recurrence of hemorrhages in a horse 

 in two weeks by the administration of 30 gm. of phosphoric acid daily. 



Literature. Meier, Z. f. Tm., 1906. X. 1. — Stahn, Z. f. Vk., 1906. 214, — 

 Villemin, Ann., 1905. 154. — Zschokke, 0. M., 1904. 433, 



