TRANSCRIBER’S NOTE Italic text is denoted by _underscores_. Bold text is denoted by =equal signs=. Footnote anchors are denoted by [number], and the footnotes have been placed at the end of the book. Bibliography references are denoted by (number), and the list can be found near the end of the book. A superscript is denoted by ^x or ^{xx}, for example 4^o. A subscript is denoted by _{x}, for example C_{6}H_{5}NO_{2}. Basic fractions are displayed as ½ ⅓ ¼ etc; other fractions are shown in the form a/b, for example 1/13 or 1/10·5. Obvious typographical errors and punctuation errors have been corrected after careful comparison with other occurrences within the text and consultation of external sources. No other changes to the text have been made. BLOOD TRANSFUSION OXFORD MEDICAL PUBLICATIONS BLOOD TRANSFUSION BY GEOFFREY KEYNES M.A., M.D. CANTAB., F.R.C.S. ENG. SECOND ASSISTANT, SURGICAL PROFESSORIAL UNIT ST. BARTHOLOMEW’S HOSPITAL LONDON HENRY FROWDE _AND_ HODDER & STOUGHTON THE _LANCET_ BUILDING 1 BEDFORD STREET, STRAND, W.C.2 _First published in 1922_ PRINTED IN GREAT BRITAIN BY HAZELL, WATSON AND VINEY, LD., LONDON AND AYLESBURY. PREFACE Blood transfusion is of rapidly growing importance in modern therapeutics, yet the subject has only been represented in the medical literature of this country hitherto by isolated communications concerning special points. The present work seeks to give a connected account of the whole subject and of the problems arising from it, together with practical instructions for performing transfusions by an efficient and simple method. I am indebted for helpful criticisms and suggestions to Professor A. V. Hill, F.R.S., of Manchester University. Dr. J. H. Drysdale has kindly allowed me to use the records of three cases of pernicious anæmia treated in his wards at St. Bartholomew’s Hospital. Dr. Joekes has permitted me to refer to some of his own observations concerning abnormal serum reactions. Dr. R. M. Janes has given me some account of the important work recently done by Dr. Bruce Robertson and himself at the Hospital for Sick Children, Toronto. The Bibliography at the end of the book makes no pretence of being absolutely complete. It is, however, more extensive than any that has yet been printed, and I believe that it contains references to nearly all the contributions of present importance published up to the date of going to press. Numbers referring to the Bibliography have been inserted in the text only where no name is given to the authority quoted. GEOFFREY KEYNES. 86, HARLEY STREET, W.1. _February 1922_. CONTENTS CHAPTER I PAGE HISTORICAL SKETCH 1 CHAPTER II INDICATIONS FOR BLOOD TRANSFUSION: HÆMORRHAGE AND SHOCK 19 CHAPTER III