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Article
December 1940

SICKLE CELL DISEASE: PATHOGENIC, CLINICAL AND THERAPEUTIC CONSIDERATIONS

Arch Surg. 1940;41(6):1344-1362. doi:10.1001/archsurg.1940.01210060041005
Abstract

Since the original description of sickle cell anemia by Herrick in 1910,1 sufficient data have been accumulated to permit certain statements concerning the pathologic physiology involved and to warrant certain practical conclusions as to the management of the condition. The purpose of this contribution is to put on record additional data derived from personally studied material, as well as additional conclusions, chiefly therapeutic, derived from these data and from other data already on record in the literature.

It was striking to observe, in the material examined, that:

1. Sickle cell anemia is not infrequently entirely overlooked by the clinician and is discovered only by the pathologist at necropsy. The diagnosis is established by the observation of a small, markedly atrophied spleen, which consists merely of a mass of partially calcified fibrotic tissue. This type of spleen is unknown in any other diseases except those in which complete destruction of

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