TRANSFUSION OF BLOOD 843 



substance has been added may be found in the papers of Kimpton and 

 Brown, Vincent (a), Lindeman, and linger (a) (&). 



The reasons for the use of an anticoagulant for transfusions are sim- 

 plication of technic ; the necessity for haste becomes a secondary considera- 

 tion and it is often more convenient since the donor and recipient need 

 not be in the same room. One person can perform a transfusion with the 

 citrate method, and it is usually possible to avoid exposure of veins by 

 skin incision. 



There is theoretical ground for objection to the use of sodium citrate 

 on the grounds of toxicity, but the experience of Weil, Lewisolm(a) (&), 

 and many others, shows that in doses up to 5 grams the drug has 110 dem- 

 onstrable ill effects. Investigation of the effect of citrate upon the coagula- 

 tion time of the blood in vivo has demonstrated that in animals the 

 coagulation time is greatly shortened. In man, there has been observed 

 no important change in the coagulation time after the injection of citrated 

 blood, when the coagulation time was not abnormal. However, transfusion 

 of citrated blood appears to be able to shorten a patient's abnormally long 

 coagulation time in the same manner as blood to which no substance 

 has been added. The effect of citrate upon hemolysis of red cells has 

 been referred to. 



For details of the methods for the use of citrated blood, the reader 

 may consult articles by Robertson, Drinker and Brittingham, and 

 Lewisohn. 



