The factors of coagulation in the experimental aplastic anemia of Benzol poisoning : with special reference to the origin of prothrombin / by S.H. Hurwitz, M.D., and C.K. Drinker, M.D.

  • Hurwitz, S. H.
Date:
[1915?]
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Licence: In copyright

Credit: The factors of coagulation in the experimental aplastic anemia of Benzol poisoning : with special reference to the origin of prothrombin / by S.H. Hurwitz, M.D., and C.K. Drinker, M.D. Source: Wellcome Collection.

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    THE FACTORS OF COAGULATION IN THE EXPERI¬ MENTAL APLASTIC ANEMIA OF BENZOL POISONING, WITH SPECIAL REFERENCE TO THE ORIGIN OF PROTHROMBIN* By S. H. HURWITZ, M.D., and C. K. DRINKER, M.D. (From the Laboratory of Surgical Research of the Harvard Medical. School, and the Medical Clinic of the Peter Bent Brigham Hospital, Boston.) INTRODUCTION. In the course of a study (1) on the factors of coagulation in a case of aplastic anemia we were impressed with the analogy existing between the symptom- complex in this disease and that observed by Selling (2, 3) in three cases of benzol poisoning. The chief clinical features presented by Selling’s three patients were: first, purpura hemorrhagica, with typical skin lesions, bleeding from the mucous membranes, and retinal hemorrhages; second, a blood picture charac¬ terized by a leucopenia of a marked grade, a striking reduction in the blood platelets, and anemia. Pathologically these patients showed well marked aplasia of the bone marrow. A study of his three patients induced Selling to try to produce in animals aplastic anemia with benzol. This he accomplished success¬ fully in rabbits and showed that benzol is a powerful leucotoxic agent, acting chiefly upon the bone marrow, although producing changes of some degree also in other hematopoietic organs. Workers who have studied the blood in benzol poisoning have concerned themselves thus far chiefly with the formed elements. Selling (3) found both a reduction in the red corpuscles and a striking diminution in the leucocytes, with an almost total disappearance of these elements in the blood of fatally poisoned animals. In addition, Duke (4) found a marked drop in the platelet count. Ac¬ cording to Duke, a sufficiently low reduction in blood plates will lead to the pro¬ longed bleeding time noted in benzol intoxication. Duke’s studies included also occasional determinations of the blood fibrinogen; but we have been unable to find any complete and systematic studies of the factors of coagulation in experi¬ mental conditions associated with aplasia of the bone marrow. The present series of experiments was undertaken with the hope of learning something about the factors of coagulation in benzol poisoning, but as the work progressed it seemed to give additional in¬ formation concerning the relation of the bone marrow to the origin of the factors of coagulation studied by us; namely, prothrombin, antithrombin, and fibrinogen. * Received for publication, February 8, 1915* 401