Blood and Blood Vessels in Infantile Scurvy. 131 



periosteum of the long bones. It is very often classed under the 

 hemorrhagic diatheses. There has been no comprehensive study 

 of the blood made in this condition. I have had an opportunity 

 to examine the blood in eight cases, more specially from the point 

 of view of coagulation. As is well known there is more or less 

 secondary anemia, a deficiency of hemoglobin and of red blood 

 cells. In addition to this there has been in all the cases examined 

 an increase of leucocytes. The platelets which have been ex- 

 amined several times in each case have been found to be normal 

 in number. 



Special attention was paid to the coagulability of the blood. 

 For this purpose the blood was removed directly from the veins 

 into sodium oxalate, was centrifuged, and the plasma was titrated 

 with varying amounts of per cent, calcium chloride solution. 

 At least two tests of this nature were made in each case. The 

 prothrombin was found to be about normal. In a few cases it was 

 somewhat less than that of the normal control, which was always 

 tested at the same time and in the same way as the case of scurvy. 

 The antithrombin was not found to be in excess. The calcium, 

 which by some has been blamed for the bleedings, was found to be 

 quite sufficient for coagulation. That is to say, in the prothrombin 

 test no more calcium had to be added to produce a clot in the 

 cases of scurvy than in the normal cases. 



Having found that the blood was normal in these respects, a 

 test of the blood vessels was carried out. For this purpose a 

 method was used which may be termed the capillary resistance 

 test — the large vein was constricted in the upper arm by a blood 

 pressure apparatus, using a pressure of about 80 mm. of mercury, 

 and this pressure was continued for exactly three minutes. The 

 bandage was then removed and petechial spots were looked for 

 upon the forearm. Normally this degree of pressure is insufficient 

 to bring about petechias. In the case of scurvy, however, numer- 

 ous little hemorrhages were found to follow this compression of 

 the veins. This result is met with regularly. It may be argued 

 from this result that the blood vessels in this disease suffer with 

 the tissues in general, and that as a result they become more per- 

 meable. This is probably not distinctive of scurvy, but occurs in 

 other diseases where the capillaries are involved. It may be 



