Anemias

Deficiencies in the number of red blood cells and in the hemoglobin content of the blood, which constitute a complex of symptoms, such as pallor, cardiovascular disturbances characteristic of oxygen deprivation, exertion dyspnea and palpitation, tachycardia, arrhythmia, low blood pressure, nervous symptoms, digestive symptoms, menstrual disturbances, loss of libido and albuminuria. The principal types are (1) normocytic (orthochromic) anemias (2) microcytic (hypochronic) anemias and (3) macrocytic (hyperchromic) anemias.

In the normocytic type the number of erythrocytes and the hemoglobin concentration are reduced in strict proportion. It is characteristic of hemorrhage, hemolyses due to poisoning and most infections or it may be "aplastic anemia" due to exhaustion of bone marrow. Blood transfusion is used as emergency treatment. Microcytic anemias are characterized by a reduction of corpuscular hemoglobin below 30% and a decrease of the mean volume of erythrocytes with a color index below one. This is usually caused by iron deficiency, inadequate digestion, exhaustion. The treatment is dietary.

Macrocytic anemias, including "pernicious anemia," have a high color index, with a mean corpuscular hemoglobin content above 30% and a high volume. They are caused by a lack of antianemic principle of the liver or the "intrinsic factor" secreted by the stomach. There is often failure of the stomach to secrete free hydrochloric acid. The missing factors have to be supplied as well as hydrochloric acid.