THE HEMORRHAGIC DIATHESIS 141 



the method is simple and painless, and has some- 

 times succeeded. 



Styptics such as ferric chloride, tannin, or alum 

 may be applied to the wound, but they are painful 

 and lead to much sloughing, so it is well first to 

 give a brief trial to fresh normal blood applied by 

 wool pledgets, and to Wright's physiological styptic 

 (thrombokinase), composed of one part of minced 

 thymus in ten parts of normal saline. This produces 

 a firm clot, but does not act as quickly as the 

 escharotic styptics. 



Internally, Wright gives calcium salts, preferably 

 the lactate, but admittedly this is a bow drawn at a 

 venture, because the calcium is often absorbed very 

 badly, and may already be at the optimum in the 

 blood. The first difficulty may be obviated in some 

 patients by using magnesium lactate or carbonate. 

 The doses of any of these drugs should be 60 grains 

 for adults, and 15 grains for children, at once, followed 

 by lo-grain doses three times a day for three days 

 for adults, with a corresponding reduction for 

 children. Calcium salts reverse their effect after 

 three days. 



To the same authority we are indebted for the 

 suggestion that we should administer carbon dioxide 

 gas, either from a Kipp's apparatus containing 

 marble and hydrochloric acid, or from a cylinder of 

 the gas. Venous blood is much more coagulable 

 than arterial. Dyspnoea should be avoided. 



Weil recommends the injection of horse-serum, 

 conveniently obtained as diphtheria antitoxin. It 

 probably increases the rate of blood-clotting, but 



