Definition. Causes, obscure, faulty diet, hygiene, microbes,
glycerine, pyrogallic acid, hæmoglobin, deranged sanguification,
parasitisms. Symptoms, of anæmia of obscure origin. Treatment as for
anæmia, special measures, for intestinal fermentations, dietetic.
_Definition._ Anæmia which is without any pre-existing appreciable
cause.
_Causes._ As in the corresponding disease in man the real starting point
of pernicious anæmia is unknown. Faults in diet and in general hygiene
have been adduced, and while in Berne this appears to be sustained, in
Ireland, in the poorest classes, the disease is little known, and in
Montreal, it find its victims largely in a class of well to do artisans
(Osler.) In the domestic animal it is described on all soils, and on the
most varied dietary (Bouley and Reynal). Zschokke and Friedberger and
Fröhner in cases occurring enzootically in stables, found a minute
bacillus in the patients, which would remove these cases into the list
of symptomatic anæmia. The same is true of the anæmia (Surra) of horses
and mules in India and Siberia, in which Evans, Burke, Steele and
Ignatovsky, found a motile spirilloid organism which destroys the red
globules. Other forms that are apparently purely idiopathic have been
attributed to a failure in the cytogenic processes in the bone marrow
especially. Back of this we know only of the various debilitating causes
in food, hygiene, building, location, work, etc., operating on a
specially susceptible system, in which, once started, the morbid process
tends to perpetuate itself and increase.
Ponfick induced anæmia experimentally by the intravenous injection of
glycerine, pyrogallic acid, solutions of hæmoglobin, etc., which
dissolve the blood globules. This suggests the probable pathogenesis by
the production of unidentified blood solvents in cases of deranged
sanguification, but it still leaves us in the dark as to the exact seat
of such derangements (liver, blood glands, bone marrow, etc.) and as to
the cause, parasitic or otherwise, which determines such disorder.
Pathological investigation has enabled us to differentiate, according to
their respective causes, a number of diseases (distomatosis, lung worms,
ankylostomiasis, internal acariasis, chronic trichinosis, strongyliasis,
etc.,) which were formerly classed as anæmias, and it seems altogether
probable that the onward progress of medicine will enable us to go
farther in the same direction and to allot the remaining unclassed
anæmias to their proper etiological places. Some may be unrecognized
helminthiasis, others microbian disorders, and still others, disorders
in nutrition and sanguification from different causes.
The _Symptoms_ are those of other forms of anæmia, but being more
obscure in origin and therefore less open to corrective treatment, it is
more likely to grow to an extreme development and fatal issue. The weak
pulse, irritable heart, debility, unsteady walk with the hind limbs,
hurried breathing and sweating under exercise, watery, puffy eyes,
dropsies in limbs and dependent parts of the body, progressive
emaciation, and weakness are even more marked than in symptomatic
anæmia.
The _treatment_ is in the main as for the other form alike in its
hygienic and medicinal bearing. In man recoveries have taken place under
arsenic combined with the iron. Arseniate of potash and ferrum redactum
in pill form, or tincture of chloride of iron, and Fowler’s solution in
food or water, continued for a length of time. Phosphated pepsin, and
peroxide of hydrogen have seemed to do well in some instances, and
phosphorated oil is another resort. W. Hunter attributes idiopathic
anæmia to toxins derived from microbes in the alimentary canal, as Sir
Andrew Clark ascribes chlorosis to a similar cause. He prescribes
beta-naphthol as the least soluble and best antiseptic, in a dose of 5
grains daily in mucilage for man (1 drachm for horse or ox). Hunter
further found that a farinaceous diet protected the globules against
destruction while a nitrogenous diet favored this. It may be noted that
long ago Delafond attributed anæmia in animals to the extension of the
use of artificial fodders of the natural order leguminosæ which are rich
in nitrogen.