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BMJ 1996; 312 doi: (Published 06 January 1996) Cite this as: BMJ 1996;312:28
  1. Jeff Aronson

    Curious, yellow

    A young man, drunk, had been worsted in a dust up with his landlord. He presented a week later with neurological signs and symptoms that made us do a lumbar puncture. Sure enough, the spinal fluid was uniformly blood stained. Later I discussed the case with the medical students. Talking about the possibility that the fracas and the clinical presentation had been unrelated, we discussed the changes that you expect in the spinal fluid after subarachnoid haemorrhage. What does xanthochromia mean? they asked. I saw the chance for a brief diversion. In Greek, I explained, xanthos means yellow, any kind of yellow, or even brown; one of Achilles's horses was called Xanthos, or Bayard—the other was called Balios, Dapple—and Xanthippe, the name of the spirited wife of Socrates, means “bay filly.” Chroma means colour, originally the colour of the skin, but then extended to mean colour generally.

    Now, I asked them, can you think of any other words with xanthos in them? They recalled the xanthines, derivatives of xanthic acid, so called because it leaves a lemon yellow residue when reacted with nitric acid, and for a minute or two we discussed caffeine, theophylline, and the treatment of asthma, and then progressed to hypoxanthine, purine metabolism, and the treatment of gout. They had not heard of xanthopsia but were interested in digitalis toxicity. We stored up those subjects for future tutorials.

    Any others? I asked, hoping for xanthoma and xanthelasma. They thought hard. A light came into the eyes of one of them. “Yes,” she said triumphantly, “chrysanthemum.”

    I decided that it was time to return to subarachnoid haemorrhage.—JEFF ARONSON is a clinical pharmacologist in Oxford

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