Experimental Study on the Agastric Anemia with Concomitant Splenectomy Part I. On the Pictures of Peripheral Blood and Bone Marrow

It had been reported, in 1921 by Hartman, that the anemia gravis was observed in totally gastrectomized patient. The anemia, although, had thought to be derived from the absence of Castle's intrinsic factor in accordance with achlorhydria after gastrectomy. It is natural to think that the functional defect of the stomach causes an insufficiency in metabolism, and there are many reports to show various kinds of different results; hyperchrcomic, hypochromic or normochromic. None of them has shown the pernious anemia in the experimental animals. Recently, splenectomy had been frequently performed, under the neccesity, with gastrectomy as a radical operation for gastric carcinoma. We must thoroughly investigate the physiological action of the spleen and know the influence of splenectomy on the agastric anemia. Following results show the pictures of peripheral blood and bone marrow of the rats after subtotal gastrectomy and splenectomy. 1) Group splenectomized simply It showed transitory anemia after operation, which became in normal limit four months postoperatively, and followed by rather higher level than before. But the leucocytosis remained for longer period; the splenic function was compensated by the liver, and functional defect of the spleen gave no influences on the body as the liver function was normal. 2) Group gastrectomized subtotally with splenectomy It showed marked anemia already a month postoperatively, which was gradually increasing the grade. In the group, especially the hemoglobin decreased considerably, and decrease of red cells reduction of erythrocytic diameter, marked increase in immatured red cells, drop of color index were observed. It showed tendency to increase in leucocytes number postoperatively. In the bone marrow picture, increase in erythroblasts (especially basophilic ones) was evident, and comparative decrease in granulocytes was observed. As a whole, it was microcytic hypochromic anemia, and showed disturbance in maturation without a picture of pernicious anemia