Chapter VII: The Methods of Blood Transfusion (3)

Shock, 20
abdominal operations in relation to, 27
alkaline administration during, 34
anaphylactic, _see_ Anaphylactic shock
avoidance of, following hæmorrhage, 29
blood count during, 39
blood volume changes in, 24, 25, 27, 32
capillary system during, 27, 28, 29
causal theories of, 26, 27
conditions of the blood during, 24, 27, 28, 39
effects of, how combated, 33
experimental production of, 30
fluid administration during, 34
gum treatment of, 35, 36
hæmorrhage always associated with, 26
hæmorrhage and, differential diagnosis, 38, 39
hydrogen-ion concentration in relation to, 28, 32
low blood pressure the essential feature of, 27
mechanism of production of, 30
post-operative, 31
primary, 29
reinfusion treatment, 42
saline treatment of, 33
secondary, 29
conditions predisposing to, 29
signs and symptoms of, 26, 29, 38
theories regarding, 26
toxic theory of, 30
transfusion treatment of, 20, 26, 31
indications for, 40

Skin eruption, as symptoms of blood reaction, 76, 77

Sodium bicarbonate, in treatment of shock, 34

Sodium citrate, absorption and elimination of, 120
action of, 122
as an anticoagulant, 16, 121
coagulation time of the blood reduced by, 47
dosage, 121, 122
elimination of, 120
form in which used, 123
in hæmophilia, 47
in prevention of clotting, 119, 120
reactions following use of, 122, 123
tolerance to, 122
toxicity of, 77

Sodium phosphate, use of, 16

Solutions, for transfusion, essential constituents of, 36, 37
viscosity and osmotic pressure of, 36

Spinal anæsthesia, transfusion in conjunction with, 33

Splenic anæmia, 50

Stansfeld’s apparatus, 134

Staphylococcal septicæmia, blood transfusion in, 59, 60

Sterility and blood groups, 80

Streptococcal septicæmia, blood transfusion in, 136

Syphilis, transmission by blood transfusion, 68

Syringe, cleansing of, 114
Higginson’s, 13, 14
whole blood transfusion with, technique, 112-114

Tissue transplantation, success of, dependent upon compatibility of
blood groups, 80

Tissues, damage to, producing toxic substances, 30

Tourniquet, Canti’s, 126, 128

Toxæmia, 58-66
acute, in bacterial diseases, 60
blood transfusion in, 31, 58, 60, 61
of pregnancy, transfusion treatment of, 62
traumatic, 30-32
production of, 30

Toxic theory of shock, 30

Transfusion, apparatus for, 115, 126, 127, 130-133
in early experiments, 10, 13
recent improvements in, 15
continuous, 60
direct method, technique, 108-111
early objections to, 9
history of, 1
ideal method of, 124, 132
indirect method, technique, 111-112
of infants, 134
technique, 134
recent advances in knowledge and technique of, 15-17
repeated, 57
Robertson’s citrate method, 121, 124
apparatus for, 124, 134
whole blood, with syringes, technique, 112
with anticoagulants, technique, 118-134
with Kimpton-Brown tube, 114

Traumatic toxæmia, 30-32

Tuberculosis, transfusion in, 62

Twins, blood groups in, 92

Typhoid, transfusion in, 62

“Universal donors,” 72, 73

“Universal recipients,” 72

Urine, hæmoglobin in, 39, 70, 76
suppression of, 76, 77

Urticaria, following transfusion, 77

Uterus, rupture of, 42

Vaccine, injection of, into blood donors, 59, 60

Vaso-motor failure, in shock, 26

Vein, for direct transfusion, 108, 109
injection of blood into, 134, 135
insertion of cannula in, 131
occlusion of, prevention of, 109
puncture of, 113
technique, 126-128
prevention of injury to, 113, 124

Venesection, preceding transfusion, 60
in carbon monoxide poisoning, 65

Venospasm, 27

Venous circulation, condition during shock, 39

Viscosity, 36
significance of, 36

Vital red, use of, 23

War, transfusion in, 17

Water, during severe shock, 34

Whole blood transfusion, apparatus for, 114
objections to, 118
prevention of clotting, 114, 118
with Kimpton-Brown tube, technique, 114-118
with syringes, 112-114

Willis, Thomas, 3

“Wound shock,” 29

Wren, Sir Christopher, vein injections by, 2, 3

FOOTNOTES:

[1] The first reference to this that I can find is in “Moines et Papes,” by Emile Gebhardt, _La Chronique Médicale_, November 1912.

[2] _Life and Times of Rodrigo Borgia_, A. H. Mathew, D.D., 1912, p. 66.

[3] This refers to the experiment of Denys, mentioned above.

[4] Birch’s _History of the Royal Society_, 1756, ii. p. 216.

[5] The notation used here is that initiated by Moss in 1910. This does not agree with the notation introduced three years previously by Jansky, the Groups I and II of Moss corresponding to the Groups IV and III of Jansky and _vice versa_. The difference has given rise to confusion and some disasters, and it has been recently recommended by an American Medical Committee that the notation of Jansky be universally adopted on grounds of priority. This decision is no doubt fully justified in American practice, but in this country the notation of Moss has been so generally used that I have not attempted to reverse it. The possible dangers that may arise should, however, be realized.

[6] _Mendelism_, R. C. Punnett, 5th ed., Macmillan, 1919.

[7] J. A. Kolmer, _Infection, Immunity, and Specific Therapy_, ed. 2, Saunders Co., 1917, p. 287: “With the increasing number of blood transfusions the phenomena of iso-agglutination and iso-hæmolysis are of considerable practical importance, especially if the patient is suffering from cancer, when the serum is likely to be actively hæmolytic for the donor’s corpuscles.” No authority is given.

[8] This embodies the same principle as the “dropper” designed by R. D. Laurie.

[9] A very convenient form of tourniquet is that designed by R. G. Canti. It is sold by Messrs. Maw & Sons, and by Messrs. Allen & Hanburys.