APPENDIX 



PART A 



SERUM TREATMENT OF HEMORRHAGE 



NORMAL FRESH SERUM— PRECIPITATED HORSE SERUM- 

 TRANSFUSION OF BLOOD 



Normal Fresh Serum 



The most frequent cause of persistent hemorrhage from 

 small vessels is a defect in the coagulation of the blood. 

 Without going into the details of the theory of coagulation 

 of the blood, it is now believed that delayed coagulation is 

 generally due to a deficiency of thrombin or fibrin ferment in 

 the blood-serum. In cases of pathological hemorrhage this 

 deficiency may be supplied by the administration of normal 

 blood-serum, and obstinate and persistent hemorrhage has 

 frequently been checked by this means after all other agencies 

 had failed. This is now recognized as the best form of treat- 

 ment for persistent capillary hemorrhage whether inherited 

 or acquired, such as that due to haemophilia, hemorrhage of 

 the new-born, puerperal hemorrhages, pulmonary, intestinal, 

 nasal, and renal hemorrhage, and traumatic hemorrhage. 

 While theoretically human serum should be more effective in 

 treatment, yet Clowes and Busch (N. Y, Med. Jour.y Jan. 4, 

 1913) have shown that, practically, horse serum answers the 

 purpose just as well, and is more available. In emergencies, 

 when normal horse serum cannot be quickly obtained, diph- 

 theria antitoxin may be employed with good results. 



Administration and Dosage. — The serum is usually ad- 

 ministered hypodermically, but may also be given intraven- 

 306 



