We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......


William Dameshek, M.D.
JAMA. 1960;173(9):1025-1029. doi:10.1001/jama.1960.73020270010012.
Text Size: A A A
Published online

That the basic aspects of medicine—its chemistry, immunology, and genetics—should be becoming ever more complex is not difficult to understand. But that even relatively simple clinical decisions should have become matters for controversy is at first blush surprising. This has happened in the management of idiopathic thrombocytopenic purpura (ITP). Why it has happened, what are the controversial points, and how they can be resolved —these are the subjects of the present discussion.

When in 1916 Kaznelson1 of Prague, cognizant of the rather dramatic effects of splenectomy in some cases of hemolytic anemia as described by Banti and Micheli in 1913-1915, suggested that the operation might be beneficial in Werlhof's disease, it was fortunate that in the first cases the operation was successful; in others, the results were far from encouraging. Nevertheless, news of this new mode of therapy for a previously intractable and at times serious disease spread rapidly,


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.