A CASE OF HEREDITARY HEMORRHAGIC TENDENCY (HEMOPHILIA) REPORTED IN 1832 BY A PHYSICIAN PRACTICING IN SIMPSONVILLE, KENTUCKY

Abstract

Credit is usually given to Dr. J. C. Otto (1774-1844) of Philadelphia for offering, in 1803, the first clear description of a bleeding disease affecting males and sparing females.1 Twenty-nine years later, Dr. James N. Hughes of Simpsonville, Kentucky, apparently unaware of Otto's report, published this succinct clinical report of a case of hemophilia, including the hereditary aspects of this disease.2 On visiting the house of a respectable farmer of this neighbourhood, my attention was directed to the case of a youth ten or twelve years old, which appeared to be rheumatic, and which was so pronounced. The correctness of my opinion was called in question by an old lady present, who was herself a member of the family, and intimately acquainted with the history of the case. On further inquiry I ascertained it to be one of hereditary origin, the rheumatism being only the sequel of another affection to which the boy had been subjected from infancy, viz. haemorrhage. Learning that this disease was common in every branch of the N. family, of which that of my friend Mr. P. was one, I enquired particularly concerning it, when the following facts were communicated: 1st. That spitting, vomiting and purging of blood; bloody urine; bleeding at the nose; extravasations of blood among the muscles and integuments of the body generally, especially of the extremities, producing dark discolorations and swelling, attended frequently, after a few days, continuance, with obtuse pain and stiffness, and copious and obstinate haemorrhage from very inconsiderable incisions, on whatever part of the body they are made, have been exceedingly common among the male members of the connection.