“The primary factor in thrombosis after injury to the blood-vessels”

Abstract

No uniformity of opinion exists in regard to the essential processes leading to thrombosis. According to some authors thrombosis is essentially due to coagulation of plasma or of cells. Others hold that two factors enter: Agglutination and coagulation. Klemensiewicz and Gutschy expressed the opinion that the primary formation of a fibrinous membrane at the place of injury is necessary.

We find the same diversity of views in regard to the so-called first coagulation of arthropod blood, which, as the author has already shown experimentally, is identical with thrombosis in that animal. That no explanation of thrombosis has found general recognition so far is due to the fact that microscopic examinations alone, based on staining reactions, are entirely inadequate for a decision of this question. Almost all previous work rests mainly on morphological investigation.

Sahli's work, however, forms an exception. He found that after injection of leech extract into the circulation of a rabbit, thrombi no longer formed around foreign bodies introduced into the blood-vessels. He concluded quite logically that his results prove the correctness of the view of Hanau and others, namely, that thrombosis is a process of coagulation. The results of his experiments are directly opposed to the fact repeatedly pointed out by the author, viz., that agglutination of blood plates occurs in birds and in mammalian-blood outside of the body under conditions that entirely exclude coagulation, as after phosphorus poisoning, also in hirudin blood, and in bird's blood collected according to Delezenne's method.

In birds and dogs the blood was made temporarily noncoagulable by injecting hirudin or peptone. In a number of experiments not only was the increase in the coagulation time of the blood in the injected animal observed, but the blood was also tested in regard to its reaction toward the tissue coagulins which accelerate the coagulation of the blood.