In 1916 a medical student in Prague, Paul Kaznelson, became interested in the problem of thrombocytopenic purpura. He had encountered a patient with this disease, a woman of 36 years who for most of her life had bruised easily and had frequent nosebleeds and copious menstrual bleeding. She had a palpable spleen and a platelet count of 500/cu mm when, on the recommendation of young Kaznelson, Professor Doktor Schloffer performed a splenectomy and cured the purpura. Within four weeks the platelet count was 500,000/cu mm.1 Four years later the woman was in good health with a normal platelet count. She probably had what we now call immune thrombocytopenic purpura (ITP) and her recovery established splenectomy as an effective treatment for chronic ITP; 80% to 90% of patients with this variety of hypersplenism are cured thereby.
Kaznelson did more than this. Along with Ernst Frank he instigated one of the