Abstract
While working upon the relationship of sodium citrate to bile salt hemolysis, interest was aroused in the microscopic picture produced in blood by addition of this sodium salt. As far as has been ascertained the changes observed have not been heretofore described, nor has it been explained in what manner a 30% sodium citrate solution stops hemorrhage when injected intravenously or intramuscularly, whereas the less concentrated solutions (4-10%) act as anti-coagulants when added to blood for transfusion.
In our observations fresh defibrinated blood, serum from clotted blood, citrated blood and blood added to the dilutant from the finger tips were studied. In each case the findings corresponded. The solutions of sodium citrate used varied in dilutions from 0.2 to 50% by weight and in all cases distilled water was used as vehicle. Saline (0.2 to 30%) was run in comparison but findings with this salt were limited to crenation in the hyper and swelling with chromolysis in the hypotonic dilutions.
When blood serum is added to a 20-50% solution of sodium citrate a flocculent, milky precipitate is formed. This redissolves macroscopically on adding more serum. This precipitate also forms in 20-50% sodium citrate solution when serum which has been passed through a Berkefeld filter or has been kept at 55°C. for an hour is added. Positive tests for globulin are obtained from the precipitate, which microscopically appears as a coarse granular material with a tendency to aid in the clumping and enmeshing of red and white blood cells and which when observed under the microscope does not disappear in toto on the addition of more serum. Fragmenting leucocytes are seen in 20-50% dilutions of sodium citrate with thread-like filaments projecting from apparently injured portions of their surface membrane.
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