of them
recovered. Of a series of control animals, which were not transfused,
nearly all died.
Most writers on the subject have recommended that as much blood
be taken from the patient by venesection as is to be replaced by
transfusion. On theoretical grounds this seems to be sound, though
it is not supported by the results of Burmeister’s experiments.
Nevertheless, in a recent series of seven cases reported by Bruce
Robertson, in which 1,000 cc. of blood were removed and the same
amount given by transfusion, satisfactory results were obtained. If
no venesection is done, there is some risk that the transfusion may
put an additional load upon an already over-strained right heart,
so that a preliminary venesection is certainly a wise precaution.
Transfusion should not be withheld until the patient is _in
extremis_; if no oxygen chamber is available, it should be given
at once. A minimum amount of 750 cc. of blood should be taken by
venesection, and 1,000 cc. of blood should be given. If the patient’s
condition does not then show enough improvement, this should be
repeated.
=Nitrobenzol and Benzol Poisoning.=--Blood transfusion for poisoning
with nitro-benzol (C_{6}H_{5}NO_{2}) has been recommended by
Hindse-Nielsen, who records a case in which it was successfully
employed. The patient, a girl of 19, had taken a tablespoonful of
the poison several hours before, and her condition appeared to be
hopeless. She was deeply cyanosed, the mucous membranes being of a
dark blue colour. Washing out the stomach and inhalation of oxygen
were tried without effect. Finally she was bled to the extent of
600 cc., and 1,000 cc. of citrated blood were injected. Her colour
at once became more normal and recovery followed. The literature
does not contain records of any other cases treated in this way,
but the condition is analogous to coal-gas poisoning referred to in
the last paragraph, oxyhæmoglobin being in this case replaced by
methhæmoglobin, and its treatment by transfusion has, therefore, a
rational basis.
A somewhat similar condition is seen in benzol poisoning, though
there is an additional destruction of red blood cells. Three cases
treated by transfusion have been reported by McClure. One patient,
whose red blood cells had been reduced to 1,460,000 per cmm., was
extremely ill, but recovered after five transfusions up to a total
amount of 1,500 cc.
=Diabetes.=--Blood transfusion has been used in treating diabetes
mellitus, but there is no evidence to show that it is of any service.
Ottenberg and Libmann transfused four patients who were already in
diabetic coma, but no improvement resulted. Another patient who was
transfused by Raulston was actually made worse, as was indicated by
an increased output of sugar, acetone, and ammonia compounds.
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