Abstract

The main features of Christmas disease, a hereditary disorder of blood coagulation, are outlined, and a family of coal-miners who suffer from this disorder is described.

The affected male members of two generations have spent their working lives underground. Three of the eight affected miners were temporarily severely disabled by episodes associated with their bleeding diathesis, and one died in 1894 from haemorrhage following an injury.

A mild degree of Christmas disease caused an increased occupational morbidity in some members of this family, but did not shorten their overall working life-span. Twelve further cases of Christmas disease are briefly described.

One affected man had an episode of cerebral haemorrhage, possibly associated with the physiological effects of contact with nitroglycerine. A review of the literature suggests that nitroglycerine may have a significant aetiological action in the development of cerebral haemorrhage in men with a defective haemostatic mechanism.

Finally, it is suggested that an analogous situation may exist in patients under anticoagulant treatment, who use nitrates or other vasodilator drugs therapeutically.