Onyalai: A review

Summary

1. 1.

   The nomenclature and previous literature relating to onyalai and allied diseases are briefly reviewed.

2. 2.

   The aetiology and clinical features of onyalai are discussed.

3. 3.

   The treatment of the disease is reviewed and an account given of Morris's method of treating the condition by intramuscular injections of whole blood from a healthy donor.

4. 4.

   Prognosis is discussed and is shown to depend to a great extent on prompt treatment with whole-blood injections. No definite statement can be made on the question of relapses and recurrences.

5. 5.

   A general account of the postmortem findings in onyalai is given.

6. 6.

   The laboratory findings are discussed, the important points being (a) thrombocytopenia, (b) prolonged bleeding time, (c) normal coagulation time, (d) a positive capillary resistance test.

7. 7.

   The suggestion is made, based on laboratory and clinical findings, that onyalai is an acute form of essential thrombocytopenia due to defective maturation of the megakaryocytes of the marrow with an associated modification of the capillary endothelium as a contributory cause in the production of the haemorthagic bullae.