Definition

Anemia means a deficiency in the volume of the blood albumin or hemoglobin. Pronounced anemia follows excessive loss of blood. Anemia may be local or general.

Local Anemia

Local anemia of the brain causes fainting. When the sluices of one large district are too wide open, others are left anemic. It is said that when the mesenteric channels are opened from any cause, all the blood of the body will be sent to the abdominal cavity, leaving all other parts of the body fatally anemic. Emotions strong enough to affect the nervous system, reflexes from pain, or reactions from shocks or blows upon the abdomen, may cause a fatal anemia of the brain. If not so severe, they may cause fainting. This condition can be brought about by tapping the abdomen and drawing off the fluid, removing large tumors, or emptying the fluid out of an ovarian cyst that is very large and which has overdistended the abdomen. By taking off the pressure, a reaction follows; the blood flows into the blood vessels of the abdomen too rapidly, causing fainting by emptying the brain. If the patient is very low, it may cause death.

Local anemia affecting various organs is made possible by inheriting a predisposition. Irritation of the liver from overstimulation may cause hyperemia of the organ. If this condition is continued until there is a permanently enlarged state of the blood vessels, a sudden sickness, followed by fasting, may bring on an anemic state that will not be in keeping with any other part of the body. This may be true of any other of the organs of the body. Plethora of years' standing builds an enlarged state of the blood vessels. It takes time to readjust to a normal state.

Reybaud's disease, which is an affection of the peripheral vessels, causes what is known as local syncope. This may occur in the viscera as well as in the extremities. Where it occurs in the brain it causes temporary aphasia.

General Anemia

This condition may be brought on from the continuous toxin poisoning produced by putrefaction in the intestines. Where a condition of this kind runs on for a very great length of time, patients become pale; the tongue is pale; the mucous membrane is bleached. The entire organism suffers more or less from oxygen starvation, and on this account there is more or less decomposition from a lack of oxygen in the system. When this is added to the original toxin poisoning, patients are put in line for building malignant diseases, especially sarcomas.

Anemia From Hemorrhage

This may either occur from a traumatic cause or it may be spontaneous. In injuries, if a large blood vessel is wounded, the bl eeding may be very rapid and end fatally in a very short time. If the blood vessel is small, the anemia will come on slowly. Fatal hemorrhage is favored by a condition of the blood in which it refuses to coagulate. When the blood is lacking the proper amount of fibrin, the tendency is for wounds to continue bleeding, or for spontaneous bleeding to take place, such as nose-bleeding or bleeding from the lungs. Hemorrhage from any part of the body may be continuous. There are people who are called bleeders. They belong to the class who are lacking in fibrin. The primary cause of a lack of this fibrin is undoubtedly toxin poisoning. Septic or pus poisoning also affects the blood in this way.

After childbirth post-partum hemorrhage may be so severe as to cause death from this cause. Such diseases as alburninuria or Bright's disease favor hemorrhage. Gastric cancer kills the life of the blood, which is equivalent to the influence of a fatal hemorrhage. Lead, mercury, arsenic, and other mineral poisons cause anemia. All toxins produced by the action of bacterial fermentation on food end in anemia.

Hyperpyrexia kills the life of the blood and produces anemia.

Treatment

In almost fatal hemorrhage from injuries it is considered good treatment to transfuse blood. My objection to this is that the blood transfused is not adapted to this particular case. Besides, it further shocks the patient to have blood thrown into the veins as suddenly as it has been lost, and the two shocks are more than the patient can stand. I remember having a patient who almost had a fatal hemorrhage from the bowels--a boy eleven years old, with typhoid. The first day he took his bed he bled to syncope. I was sent for. His pulse, as nearly as I could make out, ran about 180, He was apparently about as near death as it is possible to be. I had the pillows taken out from under his head, the foot of the bed raised, and insisted that no one should speak to him or make any noise. Occasionally the nurse was to put a teaspoonful of water to his lips--not in the mouth. Otherwise he was to be left entirely alone, without any nourishment whatever. In ten days his pulse was down to one hundred, and the feeding was begun. He made a splendid recovery.

Why should transfusion be given in such cases? Nature can make blood out of the tissues of the body as fast as it is necessary to be made; and that is the only legitimate, rational, and logical source of supply. Patients should be left entirely alone. They are shocked by being tormented with dressing and nurses. Where a patient is still living after having excessive hemorrhage, if he can be protected from shocks, such as noises, annoyances, handling, and the usual attention which patients receive, I believe that the majority would get well.

Hemorrhage from the lungs and other parts of the body must be treated according to the needs of the case. Excessive bleeding at the nose is often an indication of high blood pressure and arteriosclerosis. The quickest and safest way to control the case is to proscribe food, and even water, for the first twenty-four hours. Keep the patient in a horizontal position, without any pillow under the head. Then, when the hemorrhage has ceased, no food is to be given for at least forty-eight hours after, and then only a very little. Such cases must be instructed to eat more moderately than ever before. If they will not heed, they may have apoplexy with paralysis following in the course of a year or two.

Of course, each case must be treated according to its needs. Certainly these patients are to be controlled in regard to their eating. They are to be given the proper food. If they have no desire for it, they are to wait, and touch nothing at all, until an appetite comes for wholesome food. Such cases ought to be kept away from food for from seventy-two hours to one week. In that time nature will have taken up a great deal of the watery tissues, the blood will be more concentrated and vastly richer, and they will be started well on the road to full recovery. But they cannot be cured unless they stop their trashy eating. They should have the tensing exercise, and be kept away from company. They must be sent to bed early, should get up late, and should lie down after lunch each day. They are easily enough cured if the discipline is rigidly carried out.