APPENDIX 309 



should be subjected to the Wassermann test, to avoid the 

 introduction of syphilitic infection into the recipient. 



Simple clinical tests for haemolysis and agglutination have 

 been described by Epstein and Ottenberg (Arch. Int. Med., 

 May, 1909). They have devised a technic in which only 

 very small quantities of blood are required, and which is 

 easy of performance. The blood may be obtained by punct- 

 uring the finger as in the case of the Wassermann test. One 

 or two c.c. of blood are allowed to drop into a tube containing 

 an excess of 1 per cent, sodium citrate in normal salt solu- 

 tion. This is centrifuged to wash the red cells, which can 

 be made up to any desired percentage. Another cubic 

 centimetre of the blood is collected, allowed to coagulate, 

 and the serum to separate. In studying haemolysis, the 

 mixture of serum of the donor and red cells of the recipient, 

 and vice versa, must be made within 12 or at most 24 hours 

 of collecting the blood. One volume of corpuscle suspension 

 and one or more volumes of serum are drawn up into a 

 Wright capillary pipette, thoroughly mixed, and incubated 

 in an upright position for two hours. At the end of this 

 time the occurrence of haemolysis can be easily noted if it 

 has taken place. 



It is found that a near blood-relative (sister or brother) 

 of the patient is the most satisfactory donor, with the 

 smallest chances of untoward results. A robust person 

 should of course be selected if possible. 



Many methods have been devised for the transmission of 

 blood from one person to another. Some of these are direct, 

 i.e., by the anastomosis of a vessel of the donor with that of 

 the recipient. Other methods are indirect, i.e., by collec- 

 tion of blood from the donor in a suitable vessel, and sub- 

 sequent introduction of it into the recipient. Brewer and 



