Anaemia in Poor Class Women

Abstract

that a large-scale investigation into the incidence, aetiology, and treatment of anaemia among the poor classes should be carried out in Aberdeen. This work has entailed estimation of the haemoglobin levels of more * Read in opening a discussion in the ESection o)f l)bstctrh s aIl(1 Gvnaecology at the Annual MIeeting of the British MIedical Association, Oxford, 1936.

Haematological Findings in Non-white Sick Children in Capetown

“…All the reports in the literature dealing with the question of the relationship between socio-economic status and haemoglobin level in healthy subjects conclude that low economic circumstances are associated with a lowered haemoglobin level (Fullerton, 1936;McCance et al, 1938;Committee on Haemoglobin Surveys, 1945;Berry et al, 1952). In the only report found on ill children, Somerford (1938) stated that the socio-economic status does not appear to influence the haemoglobin level.…”

Hypochromic Anaemias and Iron Deficiency

“…During the first sixteen days her haemoglobin rose only 13 per cent., which is below the accepted standards of satisfactory response (Fullerton, 1934;Heath, 1933), and thereafter the rate of recovery steadily declined in spite of the fact that during the first nine days of iron therapy alone enough iron was retained to allow the haemoglobin to rise to 100 per cent.…”

“…If the mode of action ot iron is simply to correct the iron deficiency in the body it is difficult to explain why large doses are required. The discrepancy between iron need in the body and the size of the average optimum dose led Schulten (1930) to reject the view (Fullerton, 1934;Heath, Strauss, and Castle, 1932) that iron therapy was effective by virtue of correcting a deficiency. He quoted the possibility of a catalytic (fermentartigen) action, although admitting that this explained nothing, and appeared to lean towards the explanation attributed to Elvehjem (Dameshek, 1934) that the large doses were effective in virtue of their supplying by contamination another haemopoietic factor such as copper.…”

“…Heath, Strauss, and Castle (1932), however, showed on a number of cases of hypochromic anaemia treated by injections of iron that the iron content of the haemoglobin formed as a result of treatment was roughly equal to the amount of iron injected, or in other words that the utilization of injected iron was 100 per cent. This has been taken (Fullerton, 1934) as establishing the view that the hypochromic anaemias are conditioned solely by a state of iron deficiency, and that iron therapy acts solely in virtue of rectifying a state of iron deficiency. This assumption is not necessarily justified, for the cases observed by Heath, Strauss, and Castle were not treated throughout the whole recovery period by iron injections, and even in the short periods of observation there were significant variations from 100 per cent.…”

“…Quite frequently chronic blood loss or dietetic inadequacy are believed to be aetiological factors. Heath (1933) Widdowson:and McCance, 1936Davidson and Fullerton, 1933Reznikoff et al, 1934Marlow and Taylor, 1934 Wright, 1934 Henrique andRoland, 1928 Baldridge, 1935;Gillett et al, 1918;Ohlson andDaum, 1935 White House Conference, 1932 Fullerton, 1936 * 5 litres of blood, 13.8 grammes haemoglobin per cent., 0.335 grammo iron per cent. in haemoglobin.…”