-------------+-----------------------------+---------- | Coagulation time. | Minutes. -------------+-----------------------------+---------- Bulger | Before transfusion | 82 | 1 day after transfusion | 10 | 8 days ” ” | 8 | 25 ” ” ” | 40 -------------+-----------------------------+---------- Minot & Lee | Before transfusion | 150 | After ” | normal | 3 days after transfusion | 60 | 5 ” ” ” | 100 -------------+-----------------------------+---------- Addis | Before transfusion | 245 | After ” | 24 | 25 days after transfusion | 200 | After 8 cc. serum injected | 38 -------------+-----------------------------+---------- In treating jaundice or hæmophilia the transfusion may be performed by the method of choice described in Chapter VII of the present work. The addition of an anticoagulant to the blood does not render it any less efficient as a hæmostatic agent. In all cases the coagulation time of the patient’s blood is found to be reduced after transfusion, whether sodium citrate be used as an anticoagulant or not. The explanation of this may be found in the fact referred to on p. 120, that the citrate is very rapidly destroyed in the circulation, and so cannot for long influence adversely the hæmostatic properties of normal blood. The seeming paradox of using an anticoagulant in an endeavour to promote the coagulation of the blood is heightened by the work of Ottenberg, who has shown that the coagulation time may be reduced by the intravenous injection of sodium citrate alone. In this experiment 20 cc. of a 3 per cent. solution of sodium citrate were injected into a hæmophilic, whose coagulation time had been found to be 85 minutes. Ten minutes after the injection it was found to be 25 minutes. Two days later it had risen again to 85 minutes. This observation has not been confirmed but, if it be true, citrated blood is likely to be actually more efficient in the treatment of hæmophilia than untreated blood. The amount of blood to be transfused in hæmophilia will vary with the age of the patient and according to whether he is suffering from acute anæmia or not. If hæmostatic effects only are wanted, 100 cc. of blood will be enough. If anæmia is also present, the dosage will be governed by the same considerations as have already been discussed in the section on the treatment of hæmorrhage.