Hemophilia.

Abstract

Hemophilia is limited to the male sex while it is transmitted through the unaffected female. Hence she must potentially have the disease. There are two possibilities. Is the disease manifest only in the presence of the male sex organs or are its symptoms held in abeyance in the presence of the female sex organs?

Two high grade hemophiliacs have been treated with ovarian extract. The first, age 10 years, had been under observation “for 18 months prior to the institution of treatment. During this time he was admitted to the hospital several times in severe bleeding phases necessitating transfusion. The coagulation time of the blood usually exceeded one hour. Beginning May 5, 1930, he was given ovarian extract daily until January 1, 1931. He has remained symptom-free with normal blood findings to date (March 17, 1931).

This patient's older brother, the more severe hemophiliac of the 2, was placed on ovarian extract April 5, 1930. After his blood findings became normal (May 2, 1930) a fresh human ovarian transplant was made into the anterior abdominal wall. (The idea of the ovarian transplant was suggested by Dr. H. B. Thomas and he performed the operation.) There was no excessive hemorrhage at the time of the operation. This patient remained free from symptoms with normal blood findings until October 8, 1930, (5 months after the transplant) at which time he had a bleeding phase.

The blood platelets in hemophilia are normal in number and normal morphologically. The resistance of the platelets was measured just as the resistance of red blood cells by the fragility test. The 12 test tubes were arranged as for an ordinary fragility test with salt concentrations varying from 0.28% to 0.5%.