The polycythemia associated with cardiac disease is to be regarded as a conservative process, wherein the increase in the number of oxygen-carrying cells compensates more or less for the imperfect circulation resulting from obstruction to the blood-stream, or admixture of venous with arterial blood. The observations of Weil1 favor this conception of erythrocytosis, and the experiments of Seller,2 who induced polycythemia in animals by reduction of the oxygen tension of the inspired air, indicate that bone-marrow reacts physiologically to partial asphyxia, by hyperplasia and increased cell output.
In certain cases of congenital cardiac defect, the remarkable grade of cyanosis would suggest that, in spite of the increase in the number of erythrocytes, the tissues are not perfectly supplied with the adequate amounts of oxygen, inasmuch as the cyanosis is here due to the venous character of the blood in superficial capillaries. Lepine3 found as high
FOSTER NB. A STUDY OF THE NITROGEN AND SULPHUR METABOLISM IN MORBUS CERULEUS. Arch Intern Med (Chic). 1910;VI(1):24–27. doi:10.1001/archinte.1910.00050290029004
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