NORMAL SERUM THERAPY 831 



recipient. Most observers are now agreed that preliminary agglutination 

 and hemolysin tests should be conducted in order to avoid the occasional 

 occurrence of severe reactions ascribed to intravascular agglutination, 

 hemolysis, or both. The technic of these tests is described on page 311. 

 If a macroscopic technic is employed the reactions should not be read 

 as negative until at least two hours have elapsed. If there is sufficient 

 time a Wassermann reaction should be conducted with the serum of 

 the donor. 



Methods. A large number of methods have been advocated for 

 the transfusion of blood. A number of these are direct methods and some- 

 what intricate and painful surgical operations, as the methods of Carrel, 1 

 Crile, 2 Elsberg, 3 Sauerbruch, 4 Hartwell, 5 Levin, 6 Janeway, 7 Soresi 8 

 and McGrath, 9 employing sutures and cannulas to connect the vessel 

 of the donor with the vessel of the recipient. In 1909 Brewer and 

 Leggett 10 used simple glass tubes coated with paraffin with satisfactory 

 results; Pope 11 modified this method by using a rubber tube between 

 two glass cannulas inserted in the vessels of donor and recipient; Bern- 

 heim 12 used two silver cannulas in the same manner, one cannula fitting 

 into the other and completing the connection. In all of these methods, 

 however, accidents were likely to occur which interfered with the success 

 of the operation; furthermore, it was difficult to maintain an aseptic tech- 

 nic and the amount of blood transfused could not be exactly determined. 



To prevent coagulation and permit the withdrawal of blood and 

 its injection into the recipient without direct connection between the 

 vessels paraffin coated receptacles were employed by Curtis and David, 13 

 Kimpton and Brown, 14 Satterlee and Hooper 15 and Percy. 16 



As early as 1892 Ziemssen 17 employed a syringe method. He used 

 a number of needles which were put directly into the veins of recipient 



1 Jour. Exper. Med., 1907, ix, 226; ibid., 1908, x, 98; ibid., 1910, xii, 460. 



2 Hemorrhage and Transfusion; 1908, Appleton & Co. 



3 Jour. Amer. Med. Assoc., 1909, lii, 887. 



4 Munch, med. Wchnschr., 1915, Lxii, No. 45. 



5 Jour. Amer. Med. Assoc., 1909, lii, 297. 



6 Ann. of Surg., 1913, May. 7 Ann. of Surg., 1911, Ixiii, 720. 



8 Internal. Cong, of Med., Budapest, 1909. 



9 Jour. Amer. Med. Assoc., 1914, Ixii, 40. 



10 Surg. Gyn., and Obstet., September, 1909. 



11 Jour. Amer. Med. Assoc., 1913, Ix, 1284. 



12 Jour. Amer. Med. Assoc., 1912, Iviii, 1007. 



13 Jour. Amer. Med. Assoc., 1911, Ivi, 35. 



14 Jour. Amer. Med. Assoc., 1913, Ixi, 117. 



15 Surg., Gyn., and Obstet., 1914, xix, 235. 



16 Surg., Gyn., and Obstet., 1915, xxi, 360. 



17 Munch, med. Wchnschr., 1892, No. 19, 323. 



