Classification of Anemias.pdf

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In her menta l cond iti on 8S she ls today enthu..iastlc and hope lui and ~
willing to accep t evecy suggest ion mode lor her betterment.
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Two Yt"ars 1lI with severe sprue, HI'S n marked pelll\4OrolU ras b On lorearms
an~ neck.
LIV~~~t1~~~ toL~~~~ '[~B~t':ntrr~:8t~~rn~to~e:~(~ :~~I~ ~~'fn'f:r ~~ t~~nna~
re pu tation !IS all educat or. In 1snu l\ry 01 1928 developed t ypical Z
sprue. Went Irom had to worse until he had lost seventy-five pounds
In weight (Irom ISOto 105 pou nds). Developed a pernlclo us type 01anemia
an d was placed on a fru it diet . On th is regime he becam e almost well ~
of his diarrhea but was so much worsc rrom tbo pern icious an emia an d
cachell.. which de veloped tI",t ho embar ked lor Porto Ri co. On the wsy
down he 610 Ireely 01 evcr y t h
l n~ and contlnued to eat lor tw o weeks alter a
rea ching this island . He thus gained welght, reaching 147 poun ds. One
day , att er a hcavy cereal In take be ha ll an acute relapse 11 11 ,1 lost twonty
pounds In three da ys. I th on placed him on IDs y die t for spru e lind In
sIlty-t wo days he had gained filt}··lour pounds. He now weighs, at ti me
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01 dl.chllrge 191 pounds. bu t up t o ooly a mon th ago steadily relused
to gain IIIblood val ues, remain ing around 50 per eenj hemoglobin In spite of
a rise In erythrocytes. For the first three weeks I used liver extrn ct hut
resolved to stop It In absence 01bene fit un tllI shou ld nourish him sut llclent ­
Iy to bring about a replacement 01megaloblaats nnd a heel thy reaction to
the horm one. 'Phls o~ hl en tl y is what occurred lor on bo~inlllni again tba
!lver ertrac t a polyoythemla ensued and a slow rise III bem oglobtn . The
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patient Is at pr68ent 10apparent robust heal th .
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