152 TRANSFUSION. 



blood or blood poisoning, especially such as follows the respiration 

 of carbonic acid, ordinary illuminating gas, chloroform, etc. The 

 instruments required are a knife, forceps, scissors, a cannula, and 

 a glass funnel with rubber tube. 



In mediate transfusion the healthy animal is bled into a tall 

 vessel placed in water at blood-heat. The blood is then whipped 

 until all fibrin is separated so that no clots may form, which might 

 produce emboli in the vessels of the recipient. In the meantime a 

 large vein or even an artery in the subject is opened, the cannula 

 inserted, and some blood allowed to escape in order to expel all air 

 from the cannula. The defibrinated blood having been filtered 

 through fine linen is used to fill the syringe or funnel, care being 

 again taken that no air remains in the instrument. The syringe or 

 tube from the funnel is then connected with the cannula, and the 

 blood passed slowly into the veins of the subject. 



After transfusion it sometimes happens that the body temperature 

 falls, cyanosis and severe dyspnoea set in, followed by hemoglobinuria, 

 or even death. The cause of this intoxication is probably the presence 

 of fibrin ferment in the transfused blood. To prevent this the blood 

 is often conveyed direct from blood-vessel to blood-vessel by a con- 

 necting rubber tube. This operation is termed immediate trans- 

 fusion. Apart from the difficulties of the process and the impossi- 

 bility of controlling the quantity of blood introduced, there is con- 

 siderable danger of the formation of clots. Considering its risks 

 transfusion is nowadays practically abandoned, especially as it has 

 been shown that the dangerous symptoms depend not so much on 

 the want of blood as on the sinking of blood-pressure. The whole 

 value of transfusion, therefore, lies in its providing a sufficient 

 quantity of fluid for the heart to act upon. 



Similar results may be more safely obtained by subcutaneous, 

 intra-peritoneal, or intra-venous injection of artificial serum or 

 sterilised solution ("9 per cent.) of sodium chloride to which has been 

 added a few drops of carbonate of potash solution. The injection 

 of saline solution should be carried out with close attention to asepsis. 

 The fluid should be heated to a temperature slightly above the 

 normal body temperature of the patient ; it must be injected slowly 

 and preferably by means of a syringe provided with a two-way stop- 

 cock and corresponding tubes. After injecting physiological saline 

 solution, the patient must be warmly clothed and frequently fed 

 with highly nutritive foods. Plenty of fluid should be given ; warm 

 milk, wine, brandy, meat extracts and eggs are all useful in restoring 

 the condition of the blood. 



