Abstract
Modern Medicine can never cease to honour the
spirit of William Harvey who dared to challenge
classical doctrine in quest of the ultimate
truth. His lesson in critical reinvestigation of
the bases of an unsatisfactory hypothesis may still
be learned with advantage. Studies in the group of
diseases known as "splenic anaemia" have too long been
haunted by the spectre of " Banti's Disease ", an
ill-defined conception shrouded in an obscurity
which has proved an insurmountable barrier.
The last account given by Banti of his
disease was based on a study of 50 personal cases.
Almost without exception, the writings on splenic anaemia since Banti's work became generally known, have
been confused by attempts to correlate the findings
with Banti's descriptions. This method of approach
invariably led into a blind alley, owing to
the rigid and highly individualistic views held
by Banti. On the basis of pathological material
from 89 cases of splenic anaemia, the writer has ventured
to break away from this classical method of
approach. The term "splenic anaemia" is used in
its original historical sense as a generic term
for a group of diseases. The commonest member of this group is hepatolienal fibrosis. Banti's
disease is relegated to a minor position as one of
the syndromes which may occur among the varying
clinical and pathological manifestations of this
disease. This broader outlook has led to a new
conception of the pathogenesis of hepatolienal
fibrosis, which, if substantiated, may have its
repercussions on the rationale of treatment. The
value of splenectomy has been called in question.
As the primary object of the work was
the elucidation of the pathology of the various
diseases classed as "splenic anaemia", little new
ground has been broken in the study of the clinical
features. Nevertheless the mass of material has
yielded data, which, though meagre on some points,
may be of some value as a starting place for the
further study of the manifold inter-relations of
the liver, spleen and haematopoietic system.
