The Use of Liver and Iron in the Treatment of Anemia
Anemia is a reduction in the capacity of the blood to transport oxygen. Hemoglobin is the direct carrier of oxygen; the red cell acts as a container for the hemoglobin. In every anemia there is a decrease in hemoglobin; there may or may not be a reduction in the number of erythrocytes. The red cells are always altered, however, since the amount or concentration of hemoglobin in the cell must be abnormal, even if the number of erythrocytes is unchanged.
The total mass of red cells or erythron, which is best thought of as a vessel containing hemoglobin, is always changing. The normal erythron is kept at a constant volume, is made up of a constant number of red cells, and contains a constant amount of hemoglobin. In an adult male it has a volume of 2250 cc., contains nearly 800 grams of hemoglobin, and is made up of about 25 trillion red cells. The continuous alteration in the erythron is due to the fact that a red cell lives only about one month. When a cell dies, the stroma making up the framework disintegrates and hemoglobin is set free. The hemoglobin released is not used again as such but is broken up. Iron is split off, however, and a large part becomes a part of newly-made hemoglobin. It is possible the porphyrin nucleus of the disintegrated hemoglobin may be similarly employed. The stroma is not used again. Roughly, each day a trillion cells with a volume of 100 cc.