142 THE HEMORRHAGIC DIATHESIS 



..apparently not until many hours have passed, and 

 consequently it often fails in practice. 



There remains one last resort in the most desperate 

 cases, and no patient should be allowed to die of 

 haemophilia without its being attempted. We have 

 seen that there is only one way to restore prompt 

 coagulability to haemophiliac blood, and that is to 

 supply normal blood. 



Goodman has published a well-written, almost 

 dramatic description of his treatment of a Jewish 

 boy, aged two and a half, a well-known bleeder and 

 member of a bleeder family, who was moribund from, 

 haemorrhage from a cut inside the cheek, which had 

 oozed incessantly for two days. Pressure, adrenalin, 

 styptics, calcium salts, and horse-serum (antitoxin) 

 had all been tried in vain, and finally the child lay 

 motionless and palhd, scarcely breathing, with 

 haemoglobin down to 12 per cent, and haemorrhage 

 continuing. 



Goodman decided to inject normal human blood. 

 A donor, not a relative, was tested by Wassermann's 

 test for syphilis, and declared free. Under novocain 

 anaesthesia his radial artery was connected by an 

 Elsberg cannula with the child's femoral vein. 

 There were some initial difficulties in getting a good 

 flow, and hot cloths had to be applied ; finally the 

 basilic vein was substituted for the femoral on account 

 of differences in the level of these patients. Trans- 

 fusion was continued for twenty-eight minutes. 

 During this time colour gradually mounted up in 

 the cheeks of the little sufferer, the breathing became 

 audible once more, the almost watery blood acquired 



