The William Sydney Thayer and Susan Read Thayer lectures in clinical medicine : Lecture 1, The hereditary factor in some diseases of the haemopoietic system. Lecture 2, Some diseases in the Jewish race / by Sir Humphry Rolleston Bart., K.C.B., M.D., Regius Professor of Physic in the University of Cambridge.

  • Rolleston, Humphry Davy, Sir, 1862-1944
Date:
[1928?]
Catalogue details

Licence: In copyright

Credit: The William Sydney Thayer and Susan Read Thayer lectures in clinical medicine : Lecture 1, The hereditary factor in some diseases of the haemopoietic system. Lecture 2, Some diseases in the Jewish race / by Sir Humphry Rolleston Bart., K.C.B., M.D., Regius Professor of Physic in the University of Cambridge. Source: Wellcome Collection.

    16/48 (page 74)
    Hereditary, congenital, and familial haemolytic jaundice In 1887 Spencer Wells removed from a woman aged 24 years the spleen which before operation was thought to be a uterine or ovarian tumour; like his operation on what was diagnosed as an ovarian cyst but turned out to be tuberculous peritonitis, the abdomen being closed with a depressing prognosis, and a happy recovery, this was an example of what may be called a fortunate mistake. Since the age of 9 years this patient had been subject to recurring attacks of jaundice, which ceased after splenectomy. In 1914 she was well, but her red blood corpuscles still shewed fragility (Dawson). This observation is important as bearing on the question whether the fragility of the reds is an hereditary character or whether it is due to the influence of the spleen. Although it has been regarded as exceptional (Moynihan), fragility of the red cells appears to persist after splenectomy (Camp¬ bell and Warner), and hence this blood trait is not dependent on the spleen and may be regarded as a constitutional anomaly. In a few recorded cases (Giffen and Sanford; Campbell and Warner) relatives of patients with chronic haemolytic jaundice have shewn the char¬ acteristic fragility of the red blood corpuscles and, though apparently normal, may convey that disease to their children. Further, accord¬ ing to Campbell and Warner the disease behaves as a Mendelian dominant. The small size of the red cells, first noticed by Chauffard, was thought by Naegeli to indicate that the patients belonged to a different type of the human species; but against this interesting conception there are two points: in the first place, Meulengracht’s statement that it is confined to those members of the family with symptoms and not found, as fragility has been, in their otherwise normal relatives, and secondly, that according to Whitcher the microcytosis tends to pass away after splenectomy and so is presumably due to the presence of the spleen. In regard to the effect of splenectomy it might be con¬ sidered that this is not an argument of value, as this operation might interfere with the congenital anomalous mechanism responsible for the microcytosis. The number of records on the effect of splenectomy on the fragility and especially on the microcytosis is small, and further observations are desirable on the questions whether the persistence of the fragility is absolute and exactly the same as before splenectomy,