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The transmission of syphilis by blood transfusion
DIECKiUANN
:
AHRIJPTIO
5-E
PLAC’ENT.tE
eident as the cause. Braxton Hicks, about lY&j-70, stressed the fact that the ‘? Goodell, in 1880, by the hemorrhage of premature detachment was i ‘concealed. caption of his thesis accentuated the fact of concealment. As a result, in the years thereafter, if the bleeding was entirely concealed it was R. case of detachment II~’ the normally situated placenta; if external bleeding occurred the case was prolrabl~ The third error arose wlten the term ‘( abruptirt a high lateral placenta previa. placentae ’ ’ was coined, for nowadays clinicians arc looking for a violent, surirlcn onset. In 1899, after debating the matter with professors of Greek and Latin ir+ the University of Chicago, it was agreed that ohlntio pZnc:r~tat, or pltrcc,~,tn trhl~/~r expressed graphically the clinic entity. I am still convinced that etiologically there are three types of ablatio: first, once due to an injury; second, one due to pathologic alterations of the uteroplancnt,al union; anti third, one due to some toxemia. My conviction is that the poisonous element is not closely allied to the eclamptic poison, each of these poisons 1r:tviny a peculiarly selective power. My inclination is t,c hold that the thirtl cause, probabl,v, is the most frequent etiology. McGoogan very kimlly emphasized some DR. DIECKMANN (closing) .-Dr. points which I neglected to state. In regard to the type of vascular disease, it must. be a different type from what we see in eclampsia. Whether you want to call it ii chronic nephritis, vascular disease, or hypertension does not make a bit of differenec In the last, few except we should agree on what we mean by these different things. years I have accepted the internist’s point of view that chronic nephritis does not mean chronic glomerulonephritis. In regard to purpura, I have seen four cases in pregnarcy, none of the patients having abruptio or bleeding. 1 like the term nbZntio plnccntne hetter than nbruptio, I)ut I like prtnurt~~r~ tlctnc-h,nrnt IJetter than either of the two. With regard to the control of hemorrhage, I may say that the patient whose I operated chart I showed had 1,400 cc. of titrated blood and continued to bleed. We usually remove the upon her myself and she had a Couvelaire type of uterus. uterus in women who have had several children. I had to remove the uterus l)p supravaginal hysterectomy about five hours after the cesarean.
Jones, Rathmell, aad Wagner: sion, Am. J. Syph. & Neurol.
The Transmission 19:
of Syphilis
by Blood Transfu-
30, 1935.
The procedure of blood transfusion should be carried out by competent and welltrained men. Institutional work should be guided by a physcian who is qualified and who should insist upon a minute examination of blood donors at frequent intervals for the presence of a syphilitic infection. There should be available at all times the facilities of a laboratory wherein the common serologic examinations of donor’s and recipient’s blood for the presence of :I syphilitic infection are contluctcd. This examination should be made on the day of transfusion. Laboratory reports should be written, not telephoned, given bo residents verbally, or relayed to nurses. Such reports should be made by a competent technician and sl.ould be attached to the patient’s records at the time of transfusion. No physician should consider the transfusion of blood, except in the gravest emergency, unless the donor gives a history, physical examination and laboratory test,s which are all negative for syphilis. The authors do not agree wi+.h the statements of observers who feel that inactive syphilis may not be transmitted, All syphilitics are pot,ential transmitters. C. 0.
MALANI).
:
AHRIJPTIO
5-E
PLAC’ENT.tE
eident as the cause. Braxton Hicks, about lY&j-70, stressed the fact that the ‘? Goodell, in 1880, by the hemorrhage of premature detachment was i ‘concealed. caption of his thesis accentuated the fact of concealment. As a result, in the years thereafter, if the bleeding was entirely concealed it was R. case of detachment II~’ the normally situated placenta; if external bleeding occurred the case was prolrabl~ The third error arose wlten the term ‘( abruptirt a high lateral placenta previa. placentae ’ ’ was coined, for nowadays clinicians arc looking for a violent, surirlcn onset. In 1899, after debating the matter with professors of Greek and Latin ir+ the University of Chicago, it was agreed that ohlntio pZnc:r~tat, or pltrcc,~,tn trhl~/~r expressed graphically the clinic entity. I am still convinced that etiologically there are three types of ablatio: first, once due to an injury; second, one due to pathologic alterations of the uteroplancnt,al union; anti third, one due to some toxemia. My conviction is that the poisonous element is not closely allied to the eclamptic poison, each of these poisons 1r:tviny a peculiarly selective power. My inclination is t,c hold that the thirtl cause, probabl,v, is the most frequent etiology. McGoogan very kimlly emphasized some DR. DIECKMANN (closing) .-Dr. points which I neglected to state. In regard to the type of vascular disease, it must. be a different type from what we see in eclampsia. Whether you want to call it ii chronic nephritis, vascular disease, or hypertension does not make a bit of differenec In the last, few except we should agree on what we mean by these different things. years I have accepted the internist’s point of view that chronic nephritis does not mean chronic glomerulonephritis. In regard to purpura, I have seen four cases in pregnarcy, none of the patients having abruptio or bleeding. 1 like the term nbZntio plnccntne hetter than nbruptio, I)ut I like prtnurt~~r~ tlctnc-h,nrnt IJetter than either of the two. With regard to the control of hemorrhage, I may say that the patient whose I operated chart I showed had 1,400 cc. of titrated blood and continued to bleed. We usually remove the upon her myself and she had a Couvelaire type of uterus. uterus in women who have had several children. I had to remove the uterus l)p supravaginal hysterectomy about five hours after the cesarean.
Jones, Rathmell, aad Wagner: sion, Am. J. Syph. & Neurol.
The Transmission 19:
of Syphilis
by Blood Transfu-
30, 1935.
The procedure of blood transfusion should be carried out by competent and welltrained men. Institutional work should be guided by a physcian who is qualified and who should insist upon a minute examination of blood donors at frequent intervals for the presence of a syphilitic infection. There should be available at all times the facilities of a laboratory wherein the common serologic examinations of donor’s and recipient’s blood for the presence of :I syphilitic infection are contluctcd. This examination should be made on the day of transfusion. Laboratory reports should be written, not telephoned, given bo residents verbally, or relayed to nurses. Such reports should be made by a competent technician and sl.ould be attached to the patient’s records at the time of transfusion. No physician should consider the transfusion of blood, except in the gravest emergency, unless the donor gives a history, physical examination and laboratory test,s which are all negative for syphilis. The authors do not agree wi+.h the statements of observers who feel that inactive syphilis may not be transmitted, All syphilitics are pot,ential transmitters. C. 0.
MALANI).