=Nephritis.=--A single case of nephritis successfully treated by
blood transfusion has been recorded by Ramsay. The patient, a man
aged 22, had been ill for ten days. He was slightly drowsy and had a
furred tongue. His systolic blood pressure was 100 mm. and diastolic
60. His urine had a specific gravity of 1010, and contained much
albumin and many granular casts, but no blood cells. Vomiting was
incessant. On the second day after admission he passed 2 ozs. of
urine and his systolic blood pressure fell to 90 mm., his diastolic
to 40 mm. His low blood pressure and the evident imminence of
suppression of urine suggested the administration of blood; he was
accordingly given 1,140 cc. of fresh blood. His blood pressure
immediately rose to 100 mm. systolic, and 50 mm. diastolic, and
the other symptoms abated. He passed 24 ozs. of urine during the
ensuing twenty-four hours. He was afterwards treated with alkalies,
intravenously and by the mouth, and his condition steadily improved.
It cannot be inferred from the evidence that his recovery is to be
attributed entirely to the transfusion, but it appears to have been
initiated by this treatment, which was a reasonable one in view of
the symptoms. No other similar cases have as yet been recorded.
=Carbon Monoxide Poisoning.=--In any condition in which the function
of a large proportion of the red blood cells as oxygen carriers
has been temporarily destroyed or impaired, it is a rational
procedure to replace as many of them as possible with normal red
cells. The evidence that transfused blood cells can carry out their
functions in their new host has been given on another page. In
carbon monoxide poisoning the oxyhæmoglobin has been converted into
carboxyhæmoglobin, which is more stable than the oxygen compound, and
therefore useless for purposes of respiratory exchange. Undoubtedly
the ideal treatment for carbon monoxide poisoning is by putting the
patient in a specially constructed chamber in which he can breathe
oxygen under a pressure of about three atmospheres. By this means
the carboxyhæmoglobin is dissociated and replaced by oxyhæmoglobin.
An oxygen chamber is usually not available, though a very useful
substitute may be tried in the shape of a Haldane’s oxygen mask.
Failing this, there is evidence to show that a blood transfusion is
an effective form of treatment. Nevertheless, although poisoning with
coal gas is by no means a rare event, this treatment does not seem
to have had the attention it undoubtedly deserves. Transfusion was
first used for carbon monoxide poisoning by Hüter in 1870, who was
able to record a case in which recovery appeared to have been due to
the treatment. It was also advocated by Lauder Brunton in 1873. After
this date recorded cases are few, but in 1916 Burmeister put this
form of treatment on a more scientific basis by direct experiment.
Using rabbits and dogs he showed that if the animals treated with
coal gas were transfused without a venesection, 75 per cent.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account