Blog archives for the day Monday, February 22nd, 2010

An inquiry into the cause for anemia should answer the questions: (one) Is there proof for the deficiency of necessary blood-building blocks (iron, intrinsic and extrinsic factors, metals, protein)?, (2) Is there proof for deficient production within the marrow (pernicious anemia, aplastic anemia, myelophthisic anemia)?, (3) Is there proof for excessive red cell destruction or hemoglobin alteration (hemolytic anemias, sickle cell anemia, Mediterranean anemia, methemoglobinernia, hemoglobinuria, uremia, sepsis)?, (4) Is there proof for blood loss (gastrointestinal hemorrhage, renal hemorrhage, menorrhagia, etc.)?, (five) Does the hemoglobin level within the blood give a false picture of the whole hemoglobin mass within the body (hemoconcentration after hemorrhage; hemodilution throughout pregnancy)?

When a reasonable attempt to answer these questions has been made, therapy for anemia and the headache attendant upon it may be intelligently instituted. Every now and then, I’m approached by people who are seeking answers to the query of–how to find a job. A word of caution is issued against the employment of compounds containing acetylsalicylic acid within the symptomatic relief of headache arising within the course of gastrointestinal bleeding. The frequency with which bleeding from gastritis and peptic ulcer is related to the ingestion of such compounds appears more than coincidental, especially in the sunshine of their known local irritative effects on the gastric mucosa, and their tendency to depress prothrombin levels. The tendency for compounds containing phenacetin to have an effect on capillary permeability and to foster prolonged bleeding times should be remembered, especially in patients who have painful, profuse menstruation and resultant anemia. The hazards of steroid and Butazolidin therapy in patients with potential bleeding gastrointestinal lesions desires emphasis, since each of these forms of treatment which may be used to alleviate headache in bound conditions are apt to cause gastrointestinal bleeding and any anemia.

Acetanilid is another headache remedy which, when employed in excess, may cause more headache by its tendency to change hemoglobin to methemoglobin, with resultant anoxemia. And as a result of it’s a moisturizer and a cleanser,Avocado continues workingafter you bathe. Headache is an episodic incidence, when hemolytic crises take place within the body, whether because of congenital or acquired hemolytic anemia, transfusion reactions, sickle cell disease, Cooley’s or Mediterranean anemia, paroxysmal hemoglobinemia, favus bean poisoning, or reactions to chemicals, like the sulfonamides, arsenic, aniline dyes and venoms. Presumably the headache mechanisms in these rather rare states have to try and do not solely with the vasodilatation arising from anoxemia, but also from the fever and toxicity occurring within the course of these hemolytic episodes. The treatment of the headache in these conditions should incorporates as simple and few pain-relieving medicines as possible, typically of the codeine or morphine variety, with avoidance of medicine which, in themselves, may manufacture hypersensi-tivity reactions. The use of cold applications should obviously be avoided in “cold” hemoglobinuria.