|
Hypochromic anemia is a generic term for any type of anemia in which the red blood cells (erythrocytes) are paler than normal. (''Hypo''- refers to ''less'', and ''chromic'' means ''color''.) A normal red blood cell will have an area of pallor in the center of it; it is biconcave disk shaped. In hypochromic cells, this area of central pallor is increased. This decrease in redness is due to a disproportionate reduction of red cell hemoglobin (the pigment that imparts the red color) in proportion to the volume of the cell. In many cases, the red blood cells will also be small (microcytic), leading to substantial overlap with the category of microcytic anemia. The most common causes of this kind of anemia are iron deficiency and thalassemia. Hypochromic anemia was historically known as chlorosis or green sickness for the distinct skin tinge sometimes present in patients, in addition to more general symptoms such as a lack of energy, shortness of breath, dyspepsia, headaches, a capricious or scanty appetite and amenorrhea. ==Historical understanding== In 1554, German physician Johannes Lange described the condition as "peculiar to virgins". He prescribed that sufferers should "live with men and copulate. If they conceive, they will recover." The name "chlorosis" was coined in 1615 by Montpellier professor of medicine Jean Varandal from the word "Chloris" (Greek: ''χλωρις'') meaning "greenish-yellow," "pale green," "pale," "pallid" or "fresh". Both Lange and Varande claimed Hippocrates as a reference. In addition to "green sickness", the condition was known as ''morbus virgineus'' ("virgin's disease") or ''febris amatoria'' ("lover's fever"). Francis Grose' 1811 ''Dictionary of the Vulgar Tongue'' defined "green sickness" as: "The disease of maids occasioned by celibacy."〔(1811 Dictionary of the Vulgar Tongue ) by Francis Grose〕 In 1681, English physician Thomas Sydenham classified chlorosis as a hysterical disease affecting not only adolescent girls but also "slender and weakly women that seem consumptive." He advocated iron as a treatment: "To the worn out or languid blood it gives a spur or fillip whereby the animal spirits which lay prostrate and sunken under their own weight are raised and excited". Daniel Turner in 1714 preferred to term chlorosis "the Pale or White Sickness ... since in its worst State the Complexion is rarely or ever a true Green, tho' bordering on that Hue". He went on to describe it as "an ill Habit of Body, arising either from Obstructions, particularly of the menstrual Purgation, or from a Congestion of crude Humours in the Viscera, vitiating the Ferments of the Bowels, especially those of Concoction, and placing therein a depraved Appetite of Things directly preternatural, as Chalk, Cinders, Earth, Sand, &c". One of his case studies was that of an 11-year-old girl who was found, on investigation, to have been eating large quantities of coal. Chlorosis is briefly mentioned in Casanova's ''Histoire de ma vie'': "I do not know, but we have some physicians who say that chlorosis in girls is the result of that pleasure onanism indulged in to excess". In 1841, the Bohemian doctor and pharmacist Albert Popper published a treatment for Chlorosis containing ''Vitriolum martis'' (sulfuric acid and iron) and ''Sal tartari'' (potassium carbonate) in ''Österreichische medicinische Wochenschrift'' which was republished and refined in the following years. In 1845, the French writer Auguste Saint-Arroman gave a recipe for a treatment by medicinal chocolate that included iron filings in his ''De L'action du café, du thé et du chocolat sur la santé, et de leur influence sur l'intelligence et le moral de l'homme''〔(Louis E. Grivetti, "From Aphrodisiac to Health Food: A Cultural History of Chocolate" ) ''Karger Gazette'' 6 no. 68.〕 and in 1872, French physician Armand Trousseau also advocated treatment with iron, although he still classified chlorosis as a "nervous disease".〔''Disease of Virgins; Green Sickness, Chlorosis and the Problems of Puberty'' by Helen King〕〔''The appetite as a voice'', by Joan Brumberg, pages. 164-165.〕 In 1887, physician Sir Andrew Clark of London Hospital proposed a physiological cause for chlorosis, tying its onset to the demands placed on the bodies of adolescent girls by growth and menarche. In 1891, Frank Wedekind's play ''Spring Awakening'' referenced the disease. In 1895, University of Edinburgh pathologist Ralph Stockman built upon experiments demonstrating that inorganic iron contributed to hemoglobin synthesis to show that chlorosis could be explained by a deficiency in iron brought on by loss of menstrual blood and an inadequate diet. Despite the work of Stockman and the effectiveness of iron in treating the symptoms of chlorosis, debate about its cause continued into the 1930s. A character in T. C. Boyle's ''The Road to Wellville'' suffers from chlorosis, and the narrator describes her green skin and black lips. In 1936, Arthur J. Patek and Clark W. Heath of Harvard Medical School concluded that chlorosis was identical to hypochromic anemia. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Hypochromic anemia」の詳細全文を読む スポンサード リンク
|