Chlorosis

Chlorosis. 1. A serious constitutional defect, to which many different kinds of plants are liable. It consists in an absence of chlorophyll, a consequent pallid hue, and general weakness. It may occur in plants growing in abundant light, and seems most common in badly-drained soil and in cold, damp weather. It may arise from a deficiency of iron or potash, or from the attacks of moulds. The term has also been applied to the abnormal replacement of floral by green leaves, of which "green roses" are the most familiar instance.

2. Chlorosis, or "green sickness" (Gk. chloros, green), is a form of anaemia or bloodlessness affecting young girls at the time of puberty. In cases of marked chlorosis there is a considerable diminution in the amount of the red colouring matter of the blood (haemoglobin). The natural ruddy aspect of the countenance in health gives place to a wax-like pallor; the lips, gums, and conjunctive are unusually pale, and in extreme instances the face presents a distinctly greenish hue. Haemoglobin (q.v.) is the great oxygen carrier of the blood. Hence deficiency of haemoglobin, besides manifesting itself in the altered appearance of the patient, causes imperfect aeration of the tissues, and produces breathlessness. Again, an anaemic condition of the brain is well known to be one of the causes of headache; and thus the three cardinal symptoms of chlorosis (viz. pallor, shortness of breath, and headache) are all directly traceable to the altered condition of the blood. Other symptoms are frequently associated with the three already named. Dyspeptic troubles are common, and the occasional association of ulcer of the stomach with chlorosis gives them considerable importance. Apart from the pain after food, vomiting, and haematemesis of gastric ulcer, it is, however, common for chlorotic girls to suffer from flatulence, loss of appetite, and constipation. Neuralgia is of frequent occurrence. Anasarca may be present in slight degree. The menstrual functions are generally disturbed. The monthly flow is commonly absent, but it may be excessive, and there is not unfrequently leucorrhoea. Auscultation of the heart frequently reveals a systolic murmur over the left base, and the pressure of the stethoscope on the veins of the right side of the neck usually readily evokes a peculiar continuous noise, known as the bruit de diable. Loss of flesh is for the most part conspicuous by its absence, but there is always impairment of energy and depression of spirits, and sometimes a markedly hysterical condition may be developed. The cause of the disease is obscure. Haemoglobin contains iron, and the administration of iron in large doses is almost always followed by rapid recovery from chlorosis. Beyond this nothing certain can be said. As regards conditions predisposing to chlorosis, the subjects of the disease are young women usually between 15 and 25 years of age; the immense majority of them work for long hours in a confined and ill-ventilated atmosphere, their food is often deficient in quantity or quality or both, and they almost invariably suffer from obstinate constipation. The treatment of the disease is, almost without exception, most satisfactory, provided the patient can carry out the directions given to her. Pure air, good food, the regulation of the action of the bowels, and the administration of iron in large doses; these things granted, the recovery of the patient proceeds by rapid strides. Many girls are so habituated to a vitiated atmosphere in the workroom that they regard all attempts at ventilation with horror; and most young women neglect any sort of regularity in the matter of the evacuation of the bowels. An endeavour should, therefore, be made to obtain some approximation to a compliance with ordinary hygienic teaching on these particulars.