78 THE H^BMORRHAGIC DIATHESIS 



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. Dyspncea should be avoided. 



Weil recommends the injection of horse-serum, 

 conveniently obtained as diphtheria antitoxin. It 

 probably increases the rate of blood-clotting, but 

 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 coagula- 

 bility to haemophiliac blood, and that is to supply 

 normal blood. 



Goodman has published a \vell-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 motion- 

 less and pallid, scarcely breathing, with haemoglobin 

 down to 12 per cent, and haemorrhage continuing. 



Goodman decided to inject normal human blood. 



