1. The transmission of the disease in all the cases
is according to the usual rule - through the
female line.
2. The Prolific tendency of the disease is well
marked in all the family pedigree charts.
3. There is an absence of symptoms in early infancy.
4. No prodromel symptoms were ever complained of.
5. The frequent nocturnal onset of symptoms is
well seen in these cases.
6. The joint symptoms are shown to occur at an
earlier age than is generally stated - five
years instead of twelve to fourteen years - they are very rapidly recovered from. In the
foregoing cases the knee joints were most
frequently ffected, and next the elbow
joints. X ray photographs may be useful in
diagnosis.
Facts noted about the Blood:
7. Blood Counts were done on fully 40 occasions.
The Red. Counts and Haemoglobin showed nothing special to note. The White Counts,
however, in no case shoved a leucopaenìa, es
stated by Wright , but were found to be all
normal or slightly raised.
8. The differential Counts (300 cells being counted in each film) likewise show no departure
from the normal, and no evidence was seen,
in either the blood of the patients themselves, or that of their. non-haemophilic relatives, of a polymorphonuclear leucopaenia,
stated by Wright to be a constant feature of
the disease.
9. The Blood Pressure was normal.
10. The Viscosity of the Blood in the majority of
the cases was below normal, and in only one
case was it above normal; as held to be the
usual rule by Neil.
11. The local applications to bleeding surfaces
are shown to be of little use. Local applitions of normal horse serum are equally
disappointing
12. The Coagulation of haemophilic blood shows no
material difference from that of normal
blood, except that it takes place in a relatively much longer time. Experiments
shored that each successive specimen of
blood taken from the same puncture wound increased in rate of coagulation, till it became instantaneous, and this delay is supposed to be due more to a qualitative than
to a quantitative change in the blood.
13. The series of blood coagulation estimations,
(of which about 500 were done) taken at
each sitting, were found to vary considerably in time, and to a greater extent than
could be accounted for by experimental
error. Those taken from the control and
from the "non-bleeder" relations of the patients were not found to vary to an appreciable extent.
14. In so- called "Spontaneous Haemophilia", normal
serum has been found to give excellent results, but in true hereditary haemophilia,
it never brought about a sudden fall in coagulation time. In the severe cases, it
had some slight effect, but in the milder
cases appeared to be inert. an the whole,
therefore, normal serum, as a therapeutic
agent in haemophilia, was found to be disappointing, and its action on the blood coagulation uncertain, slight and transient.
