54 



Scientific Proceedings (63). 



the alkali is stopped, the carbon dioxide sinks again to normal 

 limits. We have found this method of much assistance in diag- 

 nosis and consequently of great value in the institution of treat- 

 ment. 



A report upon further phases of intoxication will subsequently 

 be made. 



34 (966) 



Fibrinogen deficiency in hemophilia. 

 By Alfred F. Hess, M.D. 



[From the Research Laboratory, Board of Health, New York City.] 



The amount of fibrinogen of the blood seems to vary within 

 wide variations both in man and in animals. In hemophilia there 

 have been some estimations of the percentage of fibrinogen based 

 upon the amount of fibrin obtained after coagulation. However, 

 these data are so divergent as to allow of no satisfactory deduction, 

 quite apart from the fact that they give no information as to the 

 quality of the fibrinogen. 



In the estimations of fibrinogen here reported, a functional 

 method has been made use of. Precipitated fibrinogen, made 

 approximately according to the method of Hammarsten, has been 

 added to the whole blood of cases of hemophilia, of purpura, and 

 of normal adults and children. To ten drops of blood, one, two, 

 and three drops of fibrinogen have been added; a fourth tube 

 serving as a control. In this way we are able to ascertain whether 

 the fibrinogen had a complementary action in hemophilia, as 

 compared to the other cases, and also whether it brought the 

 clotting time of the blood close to the normal. In all cases, the 

 fibrinogen had been previously tested with calcium and found not 

 to clot over night upon the addition of a few drops of a ^ per cent, 

 solution of calcium chloride. In three cases of typical hereditary 

 hemophilia, repeated tests showed that the addition of one drop 

 of the fibrinogen solution to the whole blood markedly hastened 

 the coagulation time. In one of these instances, a case of severe 

 hemophilia, the clotting time was reduced by fibrinogen in four 

 consecutive tests from 90 to 13 minutes, from 55 to 14 minutes, 



