Chlorosis (medicine)

For iron deficiency in plants, see Chlorosis (plant disorder).

In medicine, chlorosis (also known as "green sickness") is a form of anemia named for the greenish tinge of the skin of a patient. Its symptoms include lack of energy, shortness of breath, dyspepsia, headaches, a capricious or scanty appetite and amenorrhoea. Today this disease is diagnosed as hypochromic anemia.

History

In 1554, German physician Johannes Lange described the condition as "peculiar to virgins". He prescribed that sufferers should "live with men and copulate. If they conceive, they will recover." The name "chlorosis" was coined in 1615 by Montpellier professor of medicine Jean Varandal from the word "Chloris" (Greek: χλωρις) meaning "greenish-yellow," "pale green," "pale," "pallid" or "fresh". Both Lange and Varande claimed Hippocrates as a reference.

In addition to "green sickness", the condition was known as morbus virgineus ("virgin's disease") or febris amatoria ("lover's fever"). Francis Grose' 1811 Dictionary of the Vulgar Tongue defined "green sickness" as: "The disease of maids occasioned by celibacy."^[1]

In 1681, English physician Thomas Sydenham classified chlorosis as a hysterical disease affecting not only adolescent girls but also "slender and weakly women that seem consumptive." He advocated iron as a treatment: "To the worn out or languid blood it gives a spur or fillip whereby the animal spirits which lay prostrate and sunken under their own weight are raised and excited."

Chlorosis is briefly mentioned in Casanova's Histoire de ma vie: "I do not know, but we have some physicians who say that chlorosis in girls is the result of that pleasure [onanism] indulged in to excess."

In 1845 the French writer Auguste Saint-Arroman gave a recipe for a treatment by medicinal chocolate that included iron filings in his De L'action du café, du thé et du chocolat sur la santé, et de leur influence sur l'intelligence et le moral de l'homme^[2] and in 1872, French physician Armand Trousseau also advocated treatment with iron, although he still classified chlorosis as a "nervous disease".^[3][4][5]

In 1887, physician Andrew Clark of London Hospital proposed a physiological cause for chlorosis, tying its onset to the demands placed on the bodies of adolescent girls by growth and menarche. In 1891, Frank Wedekind's play Spring Awakening referenced the disease. In 1895, University of Edinburgh pathologist Ralph Stockman built upon experiments demonstrating that inorganic iron contributed to hemoglobin synthesis to show that chlorosis could be explained by a deficiency in iron brought on by menstrual blood loss and an inadequate diet. Despite the work of Stockman and the effectiveness of iron in treating the symptoms of chlorosis, debate about its cause continued into the 1930s. A character in T. C. Boyle's The Road to Wellville suffers from chlorosis, and the narrator describes her green skin and black lips.

In 1936, Arthur J. Patek and Clark W. Heath of Harvard Medical School concluded that chlorosis was identical to hypochromic anemia.^[6]

References

1. ^ 1811 Dictionary of the Vulgar Tongue by Francis Grose
2. ^ Louis E. Grivetti, "From Aphrodisiac to Health Food: A Cultural History of Chocolate" Karger Gazette 6 no. 68.
3. ^ Guggenheim, KY (1995). "Chlorosis: the rise and disappearance of a nutritional disease" (pdf). The Journal of Nutrition 125 (7): 1822–5. PMID 7616296. http://jn.nutrition.org/cgi/reprint/125/7/1822.pdf.  edit
4. ^ Disease of Virgins; Green Sickness, Chlorosis and the Problems of Puberty by Helen King
5. ^ The appetite as a voice, by Joan Brumberg, pages. 164-165.
6. ^ Patek, Arthur J.; Heath, Clark W. (April 25, 1936). "Chlorosis" (PDF). Journal of the American Medical Association 106 (17): 1463–1466. http://jama.ama-assn.org/cgi/reprint/106/17/1463.