Paroxysmal Hemoglobinuria

Abstract

It is well known that with some remedies, e. g., arsphenamine, mercury, bismuth and iodide of potassium, several years of continuous administration are required to ensure complete recovery from paroxysmal hemoglobinuria. Recently, S. Inamori of the department of pediatrics at Manchuria Medical College reported that the inoculation of Spirochaeta morsus-muris brings about complete cure in cases of hemoglobinuria in a short period. About ten months elapsed after the treatment of the patient before Inamori was able to confirm his statements, because the patient did not visit the hospital for a long time after the treatment was completed. Lately, there has been another opportunity to use this treatment in a similar case, and the result was so striking that it seems to be worth while to report it in full. REPORT OF A CASEHistory.\p=m-\S. M., a girl, aged 4\m=3/4\years, was admitted to the hospital on Oct. 29, 1931. Both parents were healthy, and she had two healthy brothers. The mother had had no abortions. The patient was the third child, and was born easily at the end of the full term. Her past history was unimportant.During the last two winters, whenever the child caught a cold, she used to complain first of thirst. This was followed by prostration, pallor and swelling, pain, and cyanosis of the backs of the hands and feet, accompanied by fever, and finally the passing of reddish-brown urine. The aforementioned symptoms usually disappeared after about half an hour or so, when the patient stayed in a warm place.Examination.-The structure and the general nutrition of the patient were nor¬ mal, except that she was very pale. The cubital lymph nodes on both arms were swollen to the size of the lens of an eye. The thorax was normal. The liver was palpable at 0.5 cm. beneath the border of the ribs ; the spleen was palpable and its consistence was normal. The child had many decayed teeth. There were no signs of syphilis or edema. The knee reflexes were normal. The temperature was 36.9 C. (98.4 F.) ; the pulse was full and regular and registered 110. The respira¬ tions were 32. The weight was 14,550 Gm. The urine was yellow, clear and acid. There were a trace of albumin and a few leukocytes.