Chapter VII: The Methods of Blood Transfusion (2)

The method of choice is undoubtedly that used by Bruce Robertson, who has performed a much larger number of transfusions upon infants and children than any other worker in this field of surgery. He has found that the internal saphenous vein near the ankle is a vessel possessing a fairly wide lumen and thick walls even in infants, so that a needle or cannula can be introduced into it with comparative ease and rapidity. The vein must, of course, be freely exposed through an incision, but its situation removes any objection there might otherwise be to this operation. Robertson has usually employed the syringe-cannula method described earlier in the present chapter, but there is no objection to the use of an anticoagulant. The small amount of blood to be given, 15 cc. per pound of body weight, makes the use of the transfusion flask unnecessary. It is better to use a 20 cc. syringe, into which 2 cc. of a 10 per cent. solution of sodium citrate is drawn as a preliminary. The needle in the donor’s vein and the cannula in the infant’s saphena should each be provided with a rubber connexion, which can be clipped, or pinched by an assistant, when the syringe is not attached. The syringe containing the citrate is filled with blood and injected into the infant as often as may be necessary until the total amount decided upon has been given.

Robertson has used this method for complete replacement of the circulating blood in treating streptococcal septicæmia following erysipelas, and for shock in children due to burns. The infant’s blood is removed through the anterior fontanelle, while a fresh supply is injected into the saphenous vein. Complete replacement has not, so far as I know, ever been performed upon an adult, but the process is feasible, given a large enough assemblage of donors. In this way some _vieillard_ might attempt the rejuvenation, which at present, as we are told, has only been obtained from the transplantation of “monkey glands” by Viennese professors.

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130. HUNT, E. L., & INGLEBY, H.: “A case of peptic ulcer with grave
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131. HUNT, V. C.: “Reaction following blood transfusion by the
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133. HUTCHISON, R.: “Three cases of melæna neonatorum successfully
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134. HÜTER, C.: “Ein Fall von Kohlenoxydvergiftung; Heilung durch
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135. INGEBRIGTSEN, R.: “The influence of iso-agglutinins on the
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136. JANEWAY, H. H.: “An improved device for transfusion.” _Ann.
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137. JANSKY, J.: “Hæmatologische Studien bei psykotiken.” _Klincky
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138. JANSKY, J.: “Recommendation by a committee that the Jansky
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139. KAHN, A.: “Continuous transfusion. The production of
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140. KARSNER, H. T.: “Laboratory problems of blood transfusion.”
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141. KEATOR, H. M.: “Transfusion in case of toxæmia of early
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145. KIMPTON, A. R., & BROWN, J. H.: “A new and simple method of
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146. KIMPTON, A. R.: “Further notes on transfusion by means of
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147. KIMPTON, A. R.: “Transfusion. Experiences in over two hundred
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148. KIMPTON, A. R., & BROWN, J. H.: “Technique of transfusion
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149. KING, E.: “An account of an easier and safer way of
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150. KING, E.: “The method of transfusing into the veines of men.”
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151. KING, E.: “An account of the experiment of transfusion,
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153. KUSH, M.: “An automatic transfusion apparatus.” _Journ. Am.
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154. LAMBERT, S. W.: “Melæna neonatorum, with report of a case
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155. LANDOIS, L.: “Die Transfusion des Blutes.” Berlin, 1866.
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156. LANDSTEINER, K.: “Ueber Agglutinationserscheinungen normalen
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157. LAPAGE, C. P.: “Two cases of melæna neonatorum treated by
injection of fresh citrated blood.” _Proc. Roy. Soc. Med._, 1920,
xiii. Sect. Child. Dis., 158-160.

158. LAURIE, R. D.: “Melæna neonatorum treated by blood
transfusion.” _Brit. Med. Journ._, 1921, i. 527.

159. LEARMONTH, J. R.: “The inheritance of specific iso-agglutinins
in human blood.” _Journ. Genetics_, 1920, x. 141.

160. LEE, R. I.: “A simple and rapid method for the selection of
suitable donors for transfusion by the determination of blood
groups.” _Brit. Med. Journ._, 1917, ii. 684.

161. LEISRINK, H.: “Ueber die Transfusion des Blutes.” _Samm. Klin.
Vortr., No. 41._ Leipzig, 1872, 235.

162. LESPINASSE, V. D.: “The treatment of hæmorrhagic disease of
the new-born by direct transfusion of blood, with a clinical report
of fourteen personal cases.” _Journ. Am. Med. Assoc._, 1914, lxii.
1866.

163. LESPINASSE, V. D.: “Technique of direct transfusion of blood,
using iridio-platinum tubes.” _Chicago Med. Rec._, 1915, xxxvii.
589.

164. LESSER, L.: “Transfusion and autotransfusion.” _Samml. Klin.
Vortr., No. 86_, Leipzig, 1875. _Inn. Med., No. 29_, p. 665.

165. LEVIN, I.: “Plastic surgery of blood vessels and direct
transfusion of blood.” _Ann. of Surg._, N.Y., 1913, May.

166. LEWISOHN, R.: “A new and greatly simplified method of blood
transfusion.” _N.Y. Med. Rec._, 1915, lxxxvii. 141.

167. LEWISOHN, R.: “Blood transfusion by the citrate method.”
_Surg. Gynec. and Obstet._, 1915, xxi. 37.

168. LEWISOHN, R.: “The citrate method of blood transfusion in
children.” _Am. Journ. Med. Sci._, 1915, cl. 886.

169. LEWISOHN, R.: “The importance of the proper dosage of sodium
citrate in blood transfusion.” _Ann. of Surg._, 1916, lxiv. 618.

170. LEWISOHN, R.: “Modern methods of blood transfusion.” _Journ.
Am. Med. Assoc._, 1917, lxviii. 826.

171. LEYTON, O.: “Transfusion in diseases of the blood.” _Brit.
Med. Journ._, 1919, i. 279.

172. LIBAVIUS, A.: “Denfensio syntagmatis arcanorum chymicorum.”
Frankfort, 1615, ch. iv., p. 8.

173. LIBMAN, E., & OTTENBERG, R.: “A practical method for
determining the amount of blood passing over during direct
transfusion.” _Journ. Am. Med. Assoc._, 1914, lxii. 764.

174. LIBMAN, E., & OTTENBERG, R.: “Recent observations on blood
transfusion.” _Tr. Coll. Phys. Phila._, 1917, xxxix. 266.

175. LICHTENSTEIN: “Eigenbluttransfusion bei Extrauteringravidität
und Uterusruptur.” _Münch. Med. Wchnschr._, 1915, lxii. 1597.

176. LINDEMAN, E.: “Simple syringe transfusion with special
cannulas.” _Am. Journ. Dis. of Children_, 1913, vi. 28.

177. LINDEMAN, E.: “Blood transfusion. Report of one hundred and
thirty-five transfusions by the syringe-cannula system.” _Journ.
Am. Med. Assoc._, 1914, lxii. 993.

178. LINDEMAN, E.: “Reactions following blood transfusion by the
syringe cannula system.” _Journ. Am. Med. Assoc._, 1916, lxvi. 624.

179. LINDEMAN, E.: “The total blood volume in pernicious anæmia.”
_Journ. Am. Med. Assoc._, 1918, lxx. 1292.

180. LITTLE, G. F.: “Transfusion of antibacterial blood. Report of
case.” _Journ. Am. Med. Assoc._, 1920, lxxiv. 734.

181. LOSEE, J. R.: “Blood transfusion.” _Am. Journ. Med. Sci._,
1919, clviii. 711.

182. LOSEE, J. R.: “Blood transfusion in obstetrics.” _Med. Rec._,
1920, xcvii. 265.

183. LÖWENTHAL, W.: “Ein Beitrag zur Lehre von der Transfusion des
Blutes.” _Berl. Klin. Wchnschr._, 1871, viii. 487.

184. LOWER, R.: “The method observed in transfusing the blood out
of one animal into another.” _Philosophical Trans._, 1666, i. 353.

185. McCLURE, R. D.: “Pernicious anæmia treated by splenectomy, and
systematic, often-repeated transfusion of blood. Transfusion in
benzol poisoning.” _Journ. Am. Med. Assoc._, 1916, lxvii. 793.

186. McCLURE, R. D., & DUNN, G. R.: “Transfusion of blood. History,
methods, dangers, preliminary tests, present status. Report of one
hundred and fifty transfusions.” _Johns Hopkins Hosp. Bull._, 1917,
xxviii. 99.

187. McGRATH, B. F.: “A simple instrument for [direct]
transfusion.” _Journ. Am. Med. Assoc._, 1914, lxii. 40.

188. McGRATH, B. F.: “Vascular suture in transfusion.” _Journ. Am.
Med. Assoc._, 1914, lxii. 1326.

189. McGRATH, B. F.: “A simple apparatus for transfusion by the
aspiration-injection method.” _Surg. Gynec. and Obstet._, 1914,
xviii. 376.

190. MADGE, H. M.: “On transfusion of blood.” _Brit. Med. Journ._,
1874, i. 42.

191. MANN, F. C.: “Experimental surgical shock. The treatment of
the condition of low blood pressure, which follows exposure of the
abdominal viscera.” _Am. Journ. Physiol._, 1919, l. 86. (Also in
_Collected Papers of the Mayo Clinic_, 1919, xi. 1225.)

192. MARTIN: “Ueber eine mit günstigem Erfolge bei einer
lebensgefährlichem Intrauterinblutung vollzogene Transfusion.”
_Monatschr. f. Geburtsk. u. Frauenk._, 1861, xvii. 269.

193. MARTIN: “Iso-agglutination beim Menschen.” _Centralblatt f.
Bact._, 1905, xxxix. 704.

194. MELENEY, H. E., STEARNS, W. W., FORTUINE, S. T., & FERRY, R.
M.: “Post-transfusion reactions: a review of 280 transfusions.”
_Am. Journ. Med. Sci._, 1917, cliv. 733.

195. MILLER, G. I.: “Blood transfusion, indications and technique.”
_Med. Rec._, 1915, lxxxviii. 425.

196. MINOT, G. R.: “Methods for testing donors for transfusion of
blood and consideration of factors influencing agglutination and
hæmolysis.” _Boston Med. and Surg. Journ._, 1916, clxxiv. 667.

197. MINOT, G. R., & LEE, R. I.: “The blood platelets in
hæmophilia.” _Arch. Int. Med._, 1916, xviii. 474.

198. MINOT, G. R., & LEE, R. I.: “Treatment of pernicious anæmia,
especially by transfusion and splenectomy.” _Bost. Med. and Surg.
Journ._, 1917, clxxvii. 761.

199. MOREL, L.: “Transfusion of blood.” _Arch. gen. de Chir._,
1914, viii. 1.

200. MOSS, W. L.: “Studies on iso-agglutinins and iso-hemolysins.”
_Johns Hopkins Hosp. Bull._, 1910, xxi. 63.

201. MOSS, W. L.: “Paroxysmal hæmoglobinuria: blood studies in
three cases.” _Johns Hopkins Hosp. Bull._, 1911, xxii. 238.

202. MOSS, W. L.: “A simple method for the indirect transfusion of
blood.” _Am. Journ. Med. Sci._, 1914, cxlvii. 698.

203. MOSS, W. L.: “A simplified method for determining the
iso-agglutinin group in the selection of donors for blood
transfusion.” _Journ. Am. Med. Assoc._, 1917, lxviii. 1905.

204. NIX, J. T.: “Blood transfusion simplified. Deductions from
nineteen cases, eleven human and eight on dog.” _New Orleans Med.
and Surg. Journ._, 1916, lxix. 435.

205. OEHLECKER, F.: “Bluttransfusion von Vene zu Vene mit Messung
der übertragenen Blutmenge.” _Zentralbl. f. Chir._, 1919, xlvi. 17.

206. OEHLECKER, F.: “Direkte Bluttransfusion von Vene zu Vene bei
perniziöse Anæmie.” _München. Med. Wchnschr._, 1919, lxvi. 895.

207. ORÉ: “Études historiques et physiologiques sur la transfusion
du sang.” Paris, 1868.

208. OTTENBERG, R.: “Transfusion and arterial anastomosis.” _Ann.
Surg._, 1908, xlvii. 486.

209. OTTENBERG, R.: “Transfusion and the question of intravascular
agglutination.” _Journ. of Exp. Med._, 1911, xiii. 425.

210. OTTENBERG, R.: “The effect of sodium citrate on blood
coagulation in hæmophilia.” _Proc. Soc. for Exp. Biol. and Med._,
1916, xiii. 104.

211. OTTENBERG, R.: “Medico-legal applications of human blood
grouping.” _Journ. Am. Med. Assoc._, 1921, lxxvii. 682.

212. OTTENBERG, R., & FRIEDMAN, S. S.: “The occurrence of grouped
iso-agglutination in the lower animals.” _Journ. Exp. Med._, 1911,
xiii. 531.

213. OTTENBERG, R., & KALISKI, D. J.: “Accidents in transfusion.
Their prevention by preliminary examination. Based on an experience
of 128 transfusions.” _Journ. Am. Med. Assoc._, 1913, lxi. 2138.

214. OTTENBERG, R., KALISKI, D. J., & FRIEDMAN, S. S.:
“Experimental agglutinative and hemolytic transfusions.” _Amer.
Journ. Med. Res._, 1913, xxviii. 141.

215. OTTENBERG, R., & LIBMAN, E.: “Blood transfusion; indications;
results; general management.” _Am. Journ. Med. Sci._, 1915, cl. 36.

216. OTTENBERG, R., & THALIMER, W.: “Studies in experimental
transfusion.” _Journ. Med. Res._, 1915-16, xxxiii. 213.

217. PANUM, P. L.: “Experimentelle Untersuchungen über die
Transfusion, Transplantation, oder Substitution des Blutes in
theoretischer und praktischer beziehung.” _Virchow’s Arch. f. Path.
Anat._, 1863, xxvii. 240, 433.

218. PEMBERTON, J. DE J.: “Blood transfusion.” _Surg. Gynec. and
Obstet._, 1919, xxviii. 262. (Also in _Collected Papers of the Mayo
Clinic_, 1918, x. 508.)

219. PEMBERTON, J. DE J.: “Practical considerations of the dangers
associated with blood transfusions.” _Journ. Iowa State Med. Soc._,
1920, x. 170. (Also in _Collected Papers of the Mayo Clinic_, 1919,
xi. 635.)

220. PERCY, N. M.: “A simplified method of blood transfusion, with
report of six cases of pernicious anæmia treated by massive blood
transfusions and splenectomy.” _Surg. Gynec. and Obstet._, 1915,
xxi. 360.

221. PETERSON, E. W.: “Purpura hæmorrhagica treated by blood
transfusion.” _Post-Graduate_, N.Y., 1914, xxix. 499.

222. PETERSON, E. W.: “Results from blood transfusion in the
treatment of severe post-operative anæmia and the hæmorrhagic
diseases.” _Journ. Am. Med. Assoc._, 1916, lxvi. 1291.

223. PÉTREN, G.: “Coagulation time in icterus.” _Beitr. z. Klin.
Chirurg._, 1920, cxx. 501.

224. PONFICK: “Experimentelle Beiträge zur Lehre von der
Transfusion.” _Virchow’s Arch. f. Path. Anat._, 1875, lxii. 273.

225. POOL, E. H.: “Transfusion and splenectomy for von Jaksch’s
anæmia in an infant.” _Ann. Surg._, March 1915. (In Transact. of
N.Y. Surg. Soc.)

226. POOL, E. H., & McCLURE, R. D.: “Transfusion by Carrel’s
end-to-end suture method. With report of cases.” _Ann. Surg._,
1910, lii. 433.

227. POPE, L.: “Simplified transfusion.” _Journ. Am. Med. Assoc._,
1913, lx. 1284.

228. PRIMROSE, A.: “The value of the transfusion of blood in the
treatment of the wounded in war.” _Ann. Surg._, 1918, lxviii. 118.

229. PRIMROSE, A., & RYERSON, E. S.: “The direct transfusion of
blood, its value in hæmorrhage and shock and in treatment of the
wounded in the war.” _Brit. Med. Journ._, 1916, ii. 384.

230. RAMIREZ, M. A.: “Horse asthma following blood transfusion.”
_Journ. Am. Med. Assoc._, 1919, lxxiii. 984.

231. RAMSAY, J.: “Transfusion of blood in nephritis.” _Brit. Med.
Journ._, 1920, i. 766.

232. RANSOM, S. H.: “The treatment of staphylococcus septicæmia by
transfusion of immune blood.” _Ann. Surg._, 1917, lxvi. 513.

233. RAULSTON, B. O., & WOODYATT, R. T.: “Blood transfusion in
diabetes mellitus.” _Journ. Am. Med. Assoc._, 1914, lxii. 996.

234. RICHARDSON, B. W.: “The cause of coagulation of the blood. The
Astley Cooper prize essay for 1856, with additional observations
and experiments.” London, 1858.

235. RICHARDSON, E. H.: “Treatment of the emergency cases of
ectopic pregnancy.” _Johns Hopkins Hosp. Bull._, 1916, xxvii. 262.

236. ROBERTSON, L. B.: “The transfusion of whole blood.” _Brit.
Med. Journ._, 1916, ii. 38.

237. ROBERTSON, L. B.: “A contribution on blood transfusion in war
surgery.” _Lancet_, 1918, i. 759.

238. ROBERTSON, L. B.: “Blood transfusion in hæmorrhagic disease of
the new-born.” _Brit. Med. Journ._, 1921, i.

239. ROBERTSON, L. B.: “Blood transfusion in severe burns in
infants and young children.” _Canad. Med. Assoc. Journ._, 1921, xi.
744.

240. ROBERTSON, L. B., & WATSON, C. G.: “Further observations on
the results of blood transfusion in war surgery.” _Ann. Surg._,
1918, lxvii. 1.

241. ROBERTSON, O. H.: “The effects of experimental plethora on
blood production.” _Journ. Exper. Med._, 1917, xxvi. 221.

242. ROBERTSON, O. H.: “A method of citrated blood transfusion.”
_Brit. Med. Journ._, 1918, i. 477.

243. ROBERTSON, O. H.: “Transfusion with preserved red cells.”
_Brit. Med. Journ._, 1918, i. 691.

244. ROBERTSON, O. H.: “Memorandum on blood transfusion.” _Rep. of
the Med. Res. Com._, iv. 1919, 143.

245. ROBERTSON, O. H., & BOCK, A. V.: “Memorandum on blood volume
after hæmorrhage.” _Rep. of the Med. Res. Com._, vi. 1919, 213.

246. ROBERTSON, O. H., & BOCK, A. V.: “Blood volume in wounded
soldiers.” _Journ. Exp. Med._, 1919, xxix. 139.

247. ROSE, A.: “A case of melæna neonatorum successfully treated by
the injection of blood serum.” _Brit. Med. Journ._, 1917, ii. 762.

248. ROSE, C. W., & HUND, E. J.: “Treatment of pneumonic
disturbances complicating influenza.” _Journ. Am. Med. Assoc._,
1919, lxxii. 642.

249. ROUS, P., & TURNER, J. R.: “The preservation of living
red blood cells in vitro. I. Methods of preservation. II. The
transfusion of kept cells.” _Journ. Exp. Med._, 1916, xxiii. 219.

250. ROUS, P., & WILSON, G. W.: “Fluid substitutes for transfusion
after hæmorrhage.” _Journ. Am. Med. Assoc._, lxx. 219-222.

251. RUECK, G. A.: “Transfusion by the gravitation method.” _Med.
Rec._, 1915, lxxxvii. 354.

252. SALANT, W., & WISE, L. E.: “The action of sodium citrate and
its decomposition in the body.” _Journ. Biolog. Chem._, 1917,
xxviii. 27.

253. SANFORD, A. H.: “Iso-agglutination groups: a diagram showing
their interrelation.” _Journ. Am. Med. Assoc._, 1916, lxvii. 808.

254. SANFORD, A. H.: “Selection of the donor for transfusion.”
_Journ. Lancet_, 1917, xxxvii. 698.

255. SANFORD, A. H.: “A modification of the Moss method of
determining iso-hæmagglutination groups.” _Journ. Am. Med. Assoc._,
1918, lxx. 1221. (Also in _Collected Papers of the Mayo Clinic_,
1918, x. 504.)

256. SATTERLEE, H. S., & HOOKER, R. S.: “Experiments to develop a
more widely useful method of blood transfusion.” _Arch. Int. Med._,
1914, xiii. 51.

257. SATTERLEE, H. S., & HOOKER, R. S.: “The further development
of an apparatus for the transfusion of blood.” _Surg. Gynec. and
Obst._, 1914, xix. 235.

258. SATTERLEE, H. S., & HOOKER, R. S.: “The use of hirudin in the
transfusion of blood.” _Journ. Am. Med. Assoc._, 1914, lxii. 1781.

259. SATTERLEE, H. S., & HOOKER, R. S.: “Transfusion of blood, with
special reference to the use of anticoagulants.” _Journ. Am. Med.
Assoc._, 1916, lxvi. 618.

260. SAUERBRUCH: “Artery of donor introduced directly into
recipient’s vein for transfusion of blood.” _Münch. Medizin.
Wchnschr._, 1915, lxii. No. 45.

261. SCHEEL, O., & BANG, O.: “Transfusion in a case of pernicious
anæmia.” _Norsk Mag. f. Lægevidenskaben_, 1920, March.

262. SCHLOSS, C. M., & COMMINSKEY, L. J. J.: “Spontaneous
hæmorrhage in the new-born.” _Am. Journ. Dis. Child._, 1911, i. 276.

263. SCHULTZ, W.: In Gravitz. “Klinische Pathologie des Blutes.”
Leipsic, 1911, p. 381.

264. SCHWEITZER: “Blood reinfusion in extra-uterine pregnancy.”
_Münch. Med. Wchnschr._, 1921, lxviii. 699.

265. SIMONS, I.: “Experiences with the sodium citrate method of
indirect transfusion of blood.” _Journ. Am. Med. Assoc._, 1915,
lxv. 1339.

266. SHATTOCK, S. G.: “Chromocyte clumping in acute pneumonia and
certain other diseases, and the significance of the buffy coat in
the shed blood.” _Journ. Path. and Bact._, 1900, vi. 303.

267. SMITH, T.: “Transfusion of blood in the case of a patient
suffering from purpura.” _Lancet_, 1873, i. 837.

268. SORESI, A. L.: “New instrument for direct transfusion of blood
and temporary anastomosis between blood vessels.” _XVI. Internat.
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269. SORESI, A. L.: “Clinical indications for direct transfusion of
blood, with the author’s technique.” _Med. Rec._, 1912, lxxxi. 835.

270. SPENCER, W. G.: “Transfusion of blood in civil practice.”
_Med. Sci. Abstr. and Rev._, 1919, i. 309.

271. STANLEY, L. L.: “Blood transfusion apparatus.” _Journ. Am.
Med. Assoc._, 1920, lxxiv. 671.

272. STANSFELD, A. E.: “The principles of the transfusion of
blood.” _Lancet_, 1917, i. 488.

273. STANSFELD, A. E.: “An apparatus for the transfusion of blood
by the citrate method.” _Lancet_, 1918, i. 334.

274. SYDENSTRICKER, V. P. W., MASON, V. R., & RIVERS, T. M.:
“Transfusion of blood by the citrate method.” _Journ. Am. Med.
Assoc._, 1917, lxviii. 1677.

275. TARR, E. M.: “Intravenous injections in infancy. Advantage of
the superior longitudinal sinus route.” _Arch. Pediatr._, 1919,
xxxvi. 71.

276. TELFER, S. V.: “Note on the preparation of sterile gum acacia
solution for intravenous injection.” _Rep. of the Med. Res. Com._,
i., 1919, 42.

277. TERRIEN, E.: “Transfusion of blood in malignant measles.”
_Bull. Soc. Méd. des Hôp._, 1919, xliii. 1134.

278. THALIMER, W.: “Hæmoglobinuria after a second transfusion with
the same donor.” _Journ. Am. Med. Assoc._, 1921, lxxvi. 1345.

279. THOMAS, T. G.: “The intravenous injection of milk as a
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280. UNGER, L.: “Melæna neonatorum.” _Wien. Klin. Woch._, 1912,
xxxix.

281. UNGER, L. J.: “A new method of syringe transfusion.” _Journ.
Am. Med. Assoc._, 1915, lxiv. 582.

282. UNGER, L. J.: “Recent simplifications of the syringe method
of transfusion.” _Journ. Am. Med. Assoc._, 1915, lxv. 1029.

283. UNGER, L. J.: “Transfusion of unmodified blood, an analysis of
one hundred and sixty-five cases.” _Journ. Am. Med. Assoc._, 1917,
lxix. 2159.

284. UNGER, L. J.: “Precautions necessary in the selection of a
donor for blood transfusion.” _Journ. Am. Med. Assoc._, 1921,
lxxvi. 9.

285. VINCENT, B.: “Blood transfusion for hæmorrhagic diseases of
the new-born. The use of the external jugular vein in infants.”
_Boston Med. and Surg. Journ._, 1912, clxvi. 627.

286. VINCENT, B.: “Blood transfusion with paraffin-coated needles
and tubes.” _Surg. Gynec. and Obstet._, Nov. 1916.

287. VINES, H. W. C.: “Anaphylaxis in the treatment of hæmophilia.”
_Quart. Journ. Med._, 1920, xiii. 257.

288. VINES, H. W. C.: “The coagulation of the blood. I. The rôle of
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287.

289. VOGEL, K. M., & McCURDY, U. F.: “Blood transfusion and
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290. WAAG, A.: “Repeated small injections of blood in pernicious
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291. WALLICH, V., & LEVADITI, C.: “Recherches sur les réactions
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292. WARD, G.: “Transfusion of plasma.” _Brit. Med. Journ._, 1918,
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293. WATSON, J. J.: “A method of fixation of vein to facilitate the
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294. WAUGH, W. G.: “An investigation of the end result in one
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295. WEIL, P. E.: “Serum treatment of hæmophilia.” _Lancet_, 1920,
ii. 300.

296. WEIL, R. J.: “Sodium citrate in the transfusion of blood.”
_Journ. Am. Med. Assoc._, 1915, lxiv. 425.

297. WILLIAMSON, H.: “Blood transfusion before operation in severe
secondary anæmias.” _Lancet_, 1920, i. 867.

298. WOLTMANN, H.: “Transfusion by the citrate method in a
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299. WREN, SIR C.: “An account of the rise and attempts of a
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_Philosophical Trans._, 1665, i. 128.

300. ZIEMSSEN, VON: “Ueber die subcutane Blutinjection und über
eine einfache Methode der intravenösen Transfusion.” _Münch. Med.
Wchnschr._, 1892, xix. 323.

301. ZIMMERMANN, R.: “Blood transfusion in gynæcological cases.”
_Münch. Med. Wchnschr._, 1920, lxvii. 898.

302. ZIMMERMANN, R.: “Testing donor’s blood before transfusion.”
_Zentralbl. f. Chir., Leipzig_, 1920, xliv. 1146.

INDEX

Abdominal operations, shock in relation to, 27
value of transfusion following, 32

Abdominal veins, “bleeding into,” 27

Accidents, loss of blood following, 20

Acholuric jaundice, blood condition in, 93
blood groups of patients with, 93
transfusion in, 94

Acidosis, in pregnancy, 63

Agglutination, 84, 85
abnormal, 56
among animals, 79
in infants and children, 84
method of the test, 101
phenomenon of, 71-73
potential, of fœtal corpuscles, 85
preceding hæmolysis, 70, 76

Agglutinins, 71
in the blood, discovery of, 15
in maternal blood serum and milk, 86
“major” and “minor,” 73
“minor” in citrated blood, 123

“Agglutinophilic” properties of blood corpuscles, 72, 85

Agote, Prof., first transfusion of citrated blood by, 16

Air hunger, 21

Air-lock in transfusion apparatus, 125, 131, 133

Alkaline solution in treatment of shock, 34

Alkalinized blood, 63

Amaurosis, 21

Amputations, value of transfusion following, 32

Anæmia, 19, 50
acute, 19, 20
amount of blood necessary in transfusion treatment, 25
effect of transfusion on, 22
following hæmorrhage, 20, 24
signs and symptoms of, 20
transfusion treatment of, 31
aplastic, 50
hæmophilia with, 48
splenic, 50
_see also_ Pernicious anæmia

Anæsthesia, transfusion in conjunction with, 33

Anæsthetics, shock accentuated by administration of, 31

Anaphylactic shock, following transfusion, 77
in pernicious anæmia, 57
influence on coagulation time of blood, 45

Anastomosis, Crile’s method, 109
for direct transfusion, 108, 109

Antecubital veins, injection of blood into, 134, 135

Anti-agglutinins, 74

Antibodies, in the blood, 58

Anticoagulants, 16
action of, 120, 122
in hæmophilia, 47
sodium citrate, 121
transfusion with, 118

Aplastic anæmia, 50

Arm tourniquet, 126, 128

Army, blood transfusion in, 17

Arteries, in direct transfusion, 108, 109
occlusion of, prevention of, 109
selection of, for transfusion, 108

Asthma, transmission of, 68

Auto-hæmolysins, development of, 94

Auto-hæmolysis of blood outside the body, 94
phenomenon of, 94, 95

Bacteria, blood inhibiting growth of, 58

Bacterial infections, 58-63
transfusion in relation to, 58, 60

Benzol poisoning, transfusion treatment of, 65, 66

Blood, administration of, apparatus for, 115, 126, 127, 130-133
methods, 108, 112, 130-135
time occupied in, 131, 132
agglutinins and iso-agglutinins in, 15, 71, 72, 74
amount in the body, how measured, 22, 23
animals’, use of, 5, 6, 8, 9, 15
anti-agglutinins in, 74
antibodies in, 58
auto-hæmolysis of, 94
bactericidal power of, 58
calcium content of, 120
citrated, _see_ Citrated blood
clotting of, _see_ Coagulation
coagulation of, _see_ Coagulation
defibrinated, early use of, 11, 12
examination of, for transfusion, 56, 57, 95
hydrogen-ion concentration of, 28
immunized, in pyogenic infections, 58
inhibiting growth of bacteria, 58
loss of, _see_ Hæmorrhage
maternal, agglutinins in, 86
of donors, _see_ Blood donors
of patients, reinfusion with, 42, 43
testing of, 56
rapid administration, danger of, 78
substitutes for, 35, 36
testing of, for transfusion, 68, 83, 92, 95
total quantity in the body, 22
transfused, corpuscles in, 37
relative value of corpuscles and plasma in, 36, 37
withdrawal of, methods and technique, 108, 112, 116, 126-128

Blood clot, mechanism of formation of, 119
rapid hæmorrhage causing, 24
_see also_ Coagulation

Blood corpuscles, “agglutinophilic” properties of, 72, 85
and plasma, relative value of, 36, 37
clumping together of, 70
condition during shock, 39
conditions due to alterations in, 50
destruction of, in the toxæmias, 64
effect of transfusion on, 52
fœtal, potential agglutination of, 85
in transfused blood, 36, 37
function of, 37
quantity and concentration during shock, 28
transfusion of, 64

Blood count, during shock, 39
following hæmorrhage, 39
following transfusion, 40
in pernicious anæmia, 51, 53-56

Blood diseases, 50-58

Blood donor, 69
blood of, 56, 57
agglutinating power of serum of, 72-74
testing of, 68
transmission of disease by, 67, 68
characteristics of, 100
choice of, 68, 96-107
effect of blood loss on, 99
for new-born infants, 49
for pernicious anæmia, 56, 57
injury to, during transfusion, 111, 124
members of patient’s family as, 85, 90, 92, 95
“professional,” 69, 98
testing of, 83, 92, 95-97
for blood groups, 101
treatment of, 60, 99, 100
“universal,” 72, 73
vaccine treatment of, prior to withdrawal of blood, 60
withdrawal of blood from, 108, 109, 124
by anastomosis, 108, 109
by Kimpton-Brown tube, 116, 117
by needle, 126-128
by syringe, 112, 113

Blood groups, 67, 69, 70, 101
among animals, 79
and disease, relation between, 81, 93
classification of, 70, 71
compatibility of, 72, 75, 80
in families, 84, 90, 92
testing of, 102
earliest classification of, 15
family incidence of, 84, 90, 92
incidence among our own population, 83
incompatibility of, 80, 92
earliest reference to, 6
in animals, 80
in families, 84, 90, 92
symptoms of, 75-77
testing for, 101, 102
inheritance of, 86, 87, 90, 91
medico-legal considerations, 92
maternal, compared with those of infants, 86, 92
over-lapping of, 72, 96
pathology of, 79
phenomena of, 69-75
physiology of, 79
popular beliefs concerning, 84
racial incidence of, 81, 82
reactions between the serum and corpuscles of, 70, 71, 72, 73
testing for, in blood donors, 97, 101
transfusion in relation to, 95
“unit characters” in, 86, 87, 88

Blood measurements, 22, 23

Blood plasma, in transfused blood, 36, 37

Blood pressure, 21
as an indication for transfusion, 40
danger points in, 21
following loss of blood, 21
low, essential feature of shock, 27
transfusion treatment of, 32

Blood reactions, 70, 71, 72, 80, 101
clinical picture of, 75
disease in relation to, 93
family incidence of, 84, 90, 92, 95
following transfusion, 95, 96, 122, 123
in infants, 84, 90, 92
incompatibility of, transfusion in relation to, 96
intensity of, variations in, 73
recognition of symptoms of, 75-77
variation in degree of, 76

Blood recipients, “universal,” 72, 95

“Blood relations,” transfusion in relation to, 84, 92, 95

Blood serum, agglutination test of, 101
preservation of, 101, 102
stock, 101
collection of, 102

Blood volume, changes in, in hæmorrhage and shock, 24, 25, 27
diminution in shock, 27, 32
estimation of, 22
imperfect oxygenation due to, 36
life dependent on, 24, 25

Blundell, James, his “impellor,” 10, 11
transfusion by (in 1818), 10, 11

Body, total quantity of blood in the, 22

Breathing, difficult, during transfusion, 78

Burns, transfusion for shock due to, 136

Calcium, action of, 120
in the blood, forms in which present, 120
precipitation of, 119

Cancer, transfusion for, 9, 18

Cannula, for direct transfusion, 110
for indirect transfusion, 130

Capillary circulation, condition during shock, 39
stagnation of, following hæmorrhage and shock, 27, 29

Carbon monoxide poisoning, 64
condition of the blood in, 64
transfusion treatment of, 64, 65

Children, transfusion of, technique, 134
_see also_ Infants

Chloroform, shock accentuated by administration of, 31

Chlorosis, 50

Circulation, blood volume necessary to maintain balance of, 24, 25
capillary and venous, comparison during shock, 39
condition during shock and hæmorrhage, 27, 28, 29, 39
stagnation of, 28
_see also_ Blood

Citrate reactions, 122, 123

Citrated blood, 16, 121, 124
administration of, methods, 129-134
keeping and care of, 128, 129
reaction following use of, 122, 123
transfusion of, 121, 124
first recorded case of, 16
in pernicious anæmia, 51, 56
_see also_ Sodium citrate

Clotting, _see_ Coagulation

Coagulation, deficient, following hæmorrhage, 41
difficulties connected with, in early experiments, 11, 12
effect of transfusion on, 42

Coagulation, mechanism of production of, 119
outside the body, 118, 119
prevention of, 114, 120

Clotting, prevention of, by sodium citrate, 119, 120
prevention of, during transfusion, 109, 110, 112
transfusion simplified by prevention of, 119

Coagulation time, anaphylactic shock influencing, 45
effect of transfusion on, 46, 47
hæmorrhage in relation to, 44, 45
in jaundice, 44
prolongation of, 44

Coal-gas poisoning, transfusion treatment of, 64

Coga, Arthur, 8

Cold, predisposing to shock, 29, 30

Cox, Thomas, transfusion experiments by, 3

Crile, improvement in technique of transfusion by, 15
method of direct transfusion, 109

Curtis and David, improvements in technique of transfusion by, 16

Daniel, of Leipsic, 3

Darwin, Erasmus, 9

Death, loss of blood causing, 24

Denys, John, first human transfusion performed by, 3, 5, 6

Diabetes mellitus, transfusion in, 66

Diphtheria, 60
acute toxæmia in, 60
experimental transfusion in, 60, 61

Direct transfusion, apparatus for, 109, 110
methods, 108, 109, 110
objections to, 110, 111
technique of, 108-111

Disease, relation between blood groups and, 81, 93
transmission by blood transfusion, 68

Drysdale, Dr. J. H., 52

Duodenal ulcer, severe hæmorrhage from, transfusion treatment, 41

Eclampsia, “fœtal threat” in relation to, 85
transfusion treatment, 62

Ectopic gestation, rupture of, transfusion following, 42

Elsberg and Bernheim’s method of direct transfusion, 109

Emboli, multiple, 77

Endocarditis, transfusion for, 60

Ether, shock accentuated by administration of, 31

Fever, transfusion for, 9

Fluids, administration of, during shock, 34

“Fœtal threat,” 85

Folli, Francesco, supposed blood transfusion by (1654), 2

Fontanelle, use of, 135, 136

Forced fluids, 34

Fullerton’s method of direct transfusion, 110

Gametes, segregation of, 88

Gastric ulcer, severe hæmorrhage from, transfusion treatment, 41

Grafts, tissue, 80

Gum transfusion, 35, 36, 37
and blood transfusion, relative value of, 35, 37
objections to, 36

Gurye, Gaspar de, 6

Hæmatemesis, treatment of, 41

Hæmoglobin percentage, during shock and hæmorrhage, 39

Hæmoglobinuria, 6, 7, 70
as symptom of blood reaction, 76
following blood transfusion, 76
paroxysmal, blood condition in, 94

Hæmolysed blood, toxicity of, 77

Hæmolysins, 71

Hæmolysis, 94, 95
agglutination preceding, 70, 76
early reference to, 6

Hæmophilia, anæmia with, 48
anticoagulants in, 47
blood condition in, 45
sodium citrate administration in, 47, 48
transfusion treatment of, 45-48

Hæmophilics, coagulation time of blood of, 46, 47
transfusion beneficial to, 46

Hæmorrhage, 20
acute anæmia following, 20, 24
blood counts following, 39
blood-volume changes in, 24, 25, 27

Hæmorrhage, coagulation time in relation to, 44, 45
condition of blood following, 24, 27, 28, 39
danger of, 20, 23
effects of, how combated, 33
following gastric or duodenal ulcer, transfusion treatment, 41
general treatment of, 31, 33
gum treatment of, 35, 36
in new-born infants, transfusion treatment, 49
intraperitoneal, 42
limits of, 24
post-partum, transfusion treatment, 42
rapid, 23, 24
reflex compensation for, 99
reinfusion treatment of, 42
saline treatment of, 33
secondary, 40, 41
indications for transfusion in, 41
shock always associated with, 20, 26
shock and, clinical difference between, 38
signs and symptoms of, 38
transfusion treatment of, 20, 25, 31
effects of, how judged, 40
indications for, 40
traumatic, 40

Hæmorrhagic diseases, 44-50

Hæmostasis, blood transfusion producing, 42, 44, 45, 48

Harvey, William, his theory of the circulation, 2

Heart, dilatation of, 78
effect of loss of blood on, 23

Helmholtz, method of transfusion of infants, 135

Heredity, blood groups in relation to, 86, 87, 90, 91
Mendelian theory of, 86, 90

Higginson’s transfusion instrument, 13, 14

Hirudin, use of, 16

Histamine, 30
production of, 30
production of shock by, 30

Horse asthma, transmission of, 68

Howard’s method of transfusion of infants, 135

Hydrogen-ion concentration in the blood, 28, 31
shock in relation to, 28, 32

Hydrophobia, transfusion for, 9

Immunized blood, transfusion by, in pyogenic infections, 58

Incompatibility, symptoms of, 6, 75

Indirect transfusion, 111

Infants, blood groups in, 84, 92
compared with those of mothers, 86, 92
blood reactions in, 84, 90, 92
transfusion of, 48
conditions necessitating, 49, 134
dosage, 136
technique, 134-136
with maternal blood, 85, 92
withdrawal of blood from, 136

Influenzal pneumonia, transfusion for, 61

Innocent VIII, 2

Internal saphenous vein, injection of blood into, in infants, 135

Iso-agglutinins, 72, 79
distribution among animals, 79, 80

Iso-hæmolysins, 72, 79
in animals, artificial reproduction of, 96

Isotonic saline solution in treatment of shock, 34

Jaundice, 44
acholuric, transfusion in, 94
blood groups in patients with, 93
hæmorrhage following operation in cases of, 44
transfusion in cases of, 44

Joekes, Dr., 52, 57

Jugular vein, injection of blood into, 135

Keith, on blood volume changes, 24, 27
on shock and hæmorrhage, 32

Kimpton and Brown, improvements in technique of transfusion by, 16

Kimpton-Brown tube, whole blood transfusion with, technique, 114

King, Edmund, transfusion experiments by, 3, 4, 8

Lamb’s blood, early transfusions with, 5, 9, 15

Legitimacy, inheritance of blood groups in relation to, 92

Leukæmia, 50
blood groups in patients suffering from, 81

Lewisohn’s sodium citrate experiments, 16, 120, 122, 123

Longitudinal sinus, use of, 135

Lower, Richard, transfusion experiments by, 3, 8

Malaria, transmission by transfusion, 67, 68

Malignant disease, blood groups in patients suffering from, 81, 93

“Maternal threat,” 85, 92

Measles, blood injections in, 62

Median basilic vein, accessible for direct transfusion, 108
incision of, 130
puncture of, 126-128

Melæna neonatorum, transfusion for, technique, 134, 135
value of transfusion in, 48

Mendelian theory, 86, 90
of blood groups, 86, 87, 88, 90

Milk, injection of, 15
maternal, agglutinins in, 86

Muscle, damaged, production of histamine from, 30

Needle, for transfusion, 126
case of, 126
improved form of, 113

Nephritis, transfusion treatment of, 63

New-born infants, blood donors for, 49
blood reactions of, 84, 90, 92
hæmorrhagic disease of, 48, 49
transfusion of, 48
technique, 134-136
with maternal blood, 84, 85, 92

Nitrobenzol poisoning, transfusion treatment of, 65

Obstetrics, transfusion in, 42

Operations, shock following, 31
value of transfusion following, 32

Osmotic pressure, 36
significance of, 36

Oxygenation, imperfect, blood loss causing, 36
solutions increasing, 37

Oxyhæmoglobin, conversion into carboxyhæmoglobin in carbon monoxide
poisoning, 64

Pain, predisposing to shock, 29

Paraffin wax, coating of glass tube with, 114, 116
in prevention of clotting, 110, 114

Paroxysmal hæmoglobinuria, blood conditions in, 94

Pedigree of blood groups, 90

Pellagra, transfusion in cases of, 66

Pepys, Samuel, 7, 8, 9

Pernicious anæmia, 50
blood condition in, 93
blood count in, 51, 53-56
blood groups in patients with, 93
subcutaneous blood injections in, 58
transfusion treatment of, 50-58, 95
complications of, 57
cases illustrating, 53-55
choice of blood donor, 56, 57
dosage, 52
reactions following, 57

Perspiration, blood loss due to, 28

Placenta prævia, transfusion following, 42

Pneumonia, transfusion in cases of, 61

Poisoning, transfusion treatment of, 64, 65

Post-operative shock, 31

Post-partum hæmorrhage, 42

Pregnancy, toxæmias, of “fœtal threat” in relation to, 85
transfusion treatment of, 62

“Professional” blood donor, 69, 98

Purpura, transfusion in cases of, 49, 50

Pyæmia, transfusion in cases of, 59
transfusion in, 58

Radial artery, accessible for direct transfusion, 109
exposure of, 111
objections to use of, 111

Reactions, 75, 76
following transfusions, 57, 122, 123
_see also_ Blood reactions

Reinfusion with patient’s own blood, 42, 43

Rejuvenation, 136

Replacement of blood, complete, 136

Respiratory system, effect of loss of blood on, 23
exhaustion of, 21

Robertson, Bruce, transfusion of infants and children by, 135, 136

Robertson, Oswald, transfusion with citrated blood by, 121, 124

“Robertson’s bottle,” 124, 125

Saline infusion, treatment of shock by, 33

Saphenous vein, internal use of, 130, 135

Sauerbruch’s method of direct transfusion, 108

Segregation of the gametes, 88

Septicæmia, transfusion for, 59, 136

Serum, _see_ Blood serum