ACQUIRED HEMOLYTIC ICTERUS*

HEMOLYTIC icterus, in its literal sense, is a term so broad and inclusive that it may embrace a wide variety of conditions in which there is hemolysis of the erythrocytes and anemia. By common usage the term is applied to a more specific entity characterized not only by increased hemolysis and anemia, but by splenomegaly, increased fragility of the erythrocytes and evidences of bone marrow stimulation. This disease has been subdivided into the familial or congenital (Chauffard-Minkowski) type and the acquired (Hayem-Widal) type. The former represents a definite, clear-cut, clinical entity, whereas there is a diversity of opinion as to whether or not the acquired form should be so recognized. There are many who feel the term " acquired hemolytic icterus " should be eliminated, believing that all such cases are in reality manifestations of the familial or congenital form, and that there is a latent, inherent tendency of the erythrocytes in these individuals to hemolize, requiring only some infectious, toxic, or metabolic disturbance to bring this to light.1'2 A diagnosis of acquired hemolytic icterus has been made i