Most iron preparations blacken the teeth, and they should therefore, be taken through a straw, or in pill or tabloid, and the mouth well rinsed afterwards.
Pernicious Anaemia (see Plate IV.) is a term applied to a form of anaemia distinguished by its progressive and very fatal character. The persons who suffer from it complain of great muscular weakness, of giddiness, palpita tion, breathlessness, loss of appetite, constipa tion. The patient's skin usually is intensely pale, and even death-like in advanced cases. There is also a degree of puffiness of the skin, and the patient does not lose, as in most ex hausting diseases, the layer of fat under the skin. Owing to the two last-mentioned facts, therefore, patients, specially young girls, have an appearance of being well-nourished, if not over-fat, which contrasts strangely with the pallor and the complaint of weakness and easy exhaustion. There is a constant tendency to rupture of the smaller blood-vessels, specially in tissues of loose texture where the vessels are ill-supported, such as the brain and other parts of the nervous system, and the retina of the eye.
The examination of the blood according to the method described in the introduction (p. 18) at once enables one to distinguish between this form of anemia and the simple kind, for the differences in the characters of the blood iu the two types of anaemia are very great. They are shown in Plate IV., and noted on P. 21.
The causes of the pernicious type are not yet certainly known, but there is some reason for believing that it is due to the action of a poison —toxin—produced by organisms, and that such toxins may be produced in the mouth by the rotting stumps of teeth, or in the stomach or bowels by certain ulcerative and other condi tions. The state of mouth, stomach, and bowels ought, therefore, always to be investigated, and specially should the possibility of tape-worm in the bowel be carefully considered.
In the treatment, when the state of mouth, stomach, &c., has been noted, and any disorders, errors in diet, &c., corrected, arsenic is the drug mainly relied on.
Plethora (Full-bloodednese) is the opposite condition to alumina. It is also called hyper mmia, from Greek. huger, signifying excess, and haima, the blood. The blood contains excess of red corpuscles, is, in short, over-rich.
Symptoms.—Full-blooded people are easily recognized by their florid colour and stoutness. They are usually troubled with giddiness, be cause of excessive quantity of blood in the bead. The pulse is full and strong. The veins of the surface of the body are visibly distended. The capillary blood-vesssla are in a similar condition, and there is, therefore, a tendency to bleeding, apoplexy, &c. There are laziness and listlessness, a sense of restriction, a dull condition of mind, and tendency to sleep. The liver is usually sluggish, and the results of that condition are apt to arise (see p. 270).
Plethoric people are commonly addicted to indulgence of the appetite in eating and drinking.
The treatment is clearly indicated. It con sists in plain and temperate living, and avoid ance of rich and fatty foods, of beer, wines, and spirits. Besides this, active measures should be employed to reduce the condition, vigorous exercise, and the frequent use of medicine to unload the liver and bowels. The best medi cines for this are saline purges, epsom and seidlitz salts taken early in the morning, or some of the mineral waters. It is in full blooded persons that, in threatened attacks of apoplexy or in feverish and inflammatory con ditions, congestion of lungs, &c., bleeding proves specially relieving.
LeueocythEeMia (Leekannia — 11 hits - celled Blood) is derived from Greek words, lentos, white, kutos, a cell, and haima, the blood, and literally means white-celled blood. This in dicates the chief feature of the disease, which is an excessive production of the white cor puscles of the blood. These should exist in the blood in the proportion of 1 to every 600 1200 red ones; but in this disease they may come to equal or exceed the red corpuscles in number. Accompanying the chief feature is enlargement of the spleen, which, from being as a rule less than half a pound in weight, may come to weigh many pounds. Enlarge ment of the lymphatic glands and affection of the marrow of bones are also common during the progress of the disorder. The excessive number of the white corpuscles, and the en largement of the spleen and lymphatic tissues, are associated, such tissues being supposed to have to do with the manufacture of the white corpuscles. The causes of the disease are not known, though in a considerable number of cases exposure to marsh poison has been con nected with it. Men are more liable to it than women, and between the ages of twenty and fifty. (See Plate V.) The chief symptom is the great increase in the number of white corpuscles, which can only be ascertained by microscopic examina tion of the blood. As one would naturally expect, the diminution of the coloured cor puscles affects the colour of the blood, so that the person becomes pale. The enlargement of the spleen reveals itself by fulness of the belly, and, when it is considerable, the person is himself able to detect the presence of a large solid heavy mass extending downwards on the left side from under the ribs towards the groin. It is unaccompanied with pain. In creasing weakness and shortness of breath are marked. Bleeding is not uncommon, especially from the nose, but it may cause death by oc curring in the brain, or it may be in the ner vous coat of the eye affecting sight. Feverish attacks, dropsy, and other symptoms may also be present. Death occurs within a year or two, either from weakness or because of bleed ing or other complication.