antisocial, and had intellectual difficulties. A psychotherapist she saw regularly diagnosed a narcissistic personality disorder. After four years of self bleeding she stopped for one year, and her haemoglobin concentration became 120-130 g/l.

Cigarette smoking is known to affect many haematological parameters but little is known of their rate of return to normal on withdrawal of cigarettes. Two groups of chronic smokers were studied whilst smoking and in the 2 weeks after cessation. A rapid return towards normal was found in the elevated haemoglobm concentration, packed cell volume, red cell count, white cell count, neutrophil count, lymphocyte count and platelet count, indicating that at least some of the abnormalities in these parameters are an acute, reversible effect of cigarette smoking rather than being a response to tissue damage.

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