Studies in isoagglutination. I. Transfusion and the question of intravascular agglutination / by Reuben Ottenberg.

  • Ottenberg, Reuben, 1882-1959.
Date:
1911
Catalogue details

Licence: In copyright

Credit: Studies in isoagglutination. I. Transfusion and the question of intravascular agglutination / by Reuben Ottenberg. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    tion, but did change entirely the nature of the agglutination;— instead of a few large clumps, innumerable microscopic clumps were produced. This was particularly true of the first five mixtures in the series; in the other mixtures the absorption of agglutinin by the excess of agglutinable cells present also played a part; and in the last two, they apparently prevented agglutination, as in the experiments referred to in table II. This, of course, is extremely significant for transfusion; a few large clumps might cause serious or fatal embolism. A consider- able number of microscopic clumps, becoming plugged in widely scattered capillaries might cause few or no symptoms. The micro- scopic appearances were controlled by making a similar series of mixtures of each of the specimens of blood used with another blood of its own class. In none of these were any clumps observed. From this experiment it is seen, then, that when the proportion of agglutinative to agglutinable blood is small (i to 4 or less), no agglutination occurs, all the agglutinin being absorbed by the excess of substratum. When the proportion is reversed, agglutination occurs but is microscopic. When the bloods are mutually aggluti- native (one of class II, the other of class III), one finds, likewise, that the blood shows no agglutination to the naked eye but shows microscopic clumps in all proportions (table V). In this instance both of the inhibitory factors are in play; either the one or the other variety of red cells being always present in too great a pro- portion to be agglutinated completely. The excess of cells func- tionates as non-agglutinable, and interferes (probably mechanic- ally) with the agglutination of the other species of red cells, which, in many of the mixtures, are present in small amounts compared to their agglutinative serum, and would otherwise be agglutinated completely. There is no doubt, then, that concentrated non-agglutinable cells interfere with the agglutination of actually agglutinable cells pres- ent in the same mixture. This interference is probably mechanical; it does not occur when both varieties of cells are present in small amounts. Additional experiments were performed to determine whether similar conditions prevail when one or the other blood is very