Simple anemia cannot be regarded as a pathologic entity; it is secondary to some other morbid condition. Although the primary ailment may not always be discoverable, it should be sought for in every instance. All maladies that are accompanied by hemorrhage, whether it be considerable or small, or that cause destruction of blood-corpuscles within the bloodvessels, will produce anemia. We likewise find this condition occurring in connection with many constitutional affections in which nutrition is disturbed and there is a failure of function on the part of the blood-producing tissues. The cases of simple anemia in which it is most difficult to discover a cause are chiefly met with among those who are imperfectly nourished or for some reason are leading an unhygienic life. They are usually individuals who have gradually become enfeebled by their mode of life, or by a diet deficient in quantity or quality. In many instances anemia can be corrected without medicinal treatment, by the necessary changes in the life of the patient.

As simple anemia is secondary to other maladies, necessarily the details of the treatment can best be described in connection with the primary affections, and need not be repeated here. It is always essential that the diet be so adapted to the needs of the individual that it will not produce indigestion and that it will afford an abundance of nourishment. The general principles are the same that apply in cases or chlorosis, and the dietetic and hygienic regime is fully described in the next section of this chapter. In a few instances simple anemia will be found to accompany hypochlorhydria, and the diet will then have to be adapted to the digestive powers of the stomach. It must be that which would be prescribed in a case of chronic gastritis in which gastric juice is deficient. An abundance of fresh air, active exercise within the capacity of the patient, and, if possible, a change of climate as well as of diet, are desirable in nearly all cases.

It must be remembered that iron derived from food is needed to make hemoglobin but that inorganic as well as organic compounds of iron will stimulate the production of blood corpuscles. Macallum and others have shown that iron of all kinds is taken into the lymph channels and first deposited in nodes and spleen and later distributed widely to the organs and tissues of the body. If iron is excluded from the diet of animals they do not thrive and when it is not supplied to those in whom anemia has been artificially produced a restoration to health does not take place. The experiments of Hauserman demonstrate that inorganic iron will not prevent the development of anemia if only food poor in iron is given during long periods of time. Nevertheless inorganic iron can stimulate blood formation although it does not seem to enter into the production of hemoglobin.

Most of the iron which is administered to patients is un-absorbed from the intestines, moreover, iron is eliminated through the walls of the intestines as well as absorbed through them. It has been shown that a fasting animal eliminates 10 milligrams in feces per square meter of surface of intestines; and only a trifle more when food poor in iron is given, but when food rich in iron is eaten from 43 to 78 milligrams per square meter of intestines is found in the feces and in an isolated intestinal loop only 6 or 8. Therefore the conclusion stated above can be drawn that small quantities are eliminated by the intestines, and that when large quantities are eaten most of it remains in the feces unabsorbed.

These physiologic facts point to the need of dietetic management in anemias. The following list of common foods and their content of iron will be useful in guiding one in the prescription of a diet. However, in simple anemia as has already been said, the condition of digestion and the nature of the disease producing the anemia must largely govern one in selecting a diet.

Diet In Diseases Of The Blood

Ten or twelve milligrams of iron in food will maintain equilibrium. This amount is easily supplied by the average diet of men.