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December 1942, Vol 28, No. 6 >
ARTICLE | December 1942

HEMORRHAGE AFTER CATARACT EXTRACTION: Title and subTitle BreakA CLINICAL AND EXPERIMENTAL INVESTIGATION OF ITS CAUSE AND TREATMENT FREE

GERARD DeVOE, M.D.
[+] Author Affiliations

Submitted in partial fulfilment of the requirements for the degree of Doctor of Medical Sciences in the Faculty of Medicine, Columbia University.


Arch Ophthalmol. 1942;28(6):1069-1096. doi:10.1001/archopht.1942.00880120133009
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Comments

Postoperative hemorrhage following cataract extraction has long been recognized as one of the more common accidents that may disturb an otherwise uneventful convalescence. The reported incidence of its occurrence varies from 1 to 35 per cent, the extremes representing, perhaps, differences in technic and skill or, more probably, differences in the manner in which examinations were made and recorded.

At the Institute of Ophthalmology it was felt that such hemorrhage was occurring with more than the usual frequency. Accordingly it was decided to investigate a series of consecutive cataract operations from a number of different aspects to determine (a) the true incidence of this complication and, (b) whether any contributing factor or factors could be discovered. If such factors could be discovered, more logical treatment or preventive measures could obviously be initiated. Four hundred and fifty-three cases were studied and the following points investigated: (1) incidence, (2) severity of hemorrhage,

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Vail.1m Davis.1q

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1 +
(a) Wheeler, J. M.:  A Study of Hemorrhage into the Anterior Chamber Subsequent to Operation for Hard Cataract , Tr. Am. Ophth. Soc. 14:742, 1916;.
2 +
(b) Marshall, C. D.:  On the Immediate and Remote Results of Cataract Extraction , Roy. London Ophth. Hosp. Rep. 14:56, 1895;.
3 +
(c) Derby, H. :  Report on Sixty-Four Cataract Extractions According to the Method of von Graefe , Arch. Ophth. 3:74, 1873;
4 +
(d)  One Hundred Cases of Cataract Extractions with a Single Failure, with a Discussion of Advantages of Non-Anesthesia in This Operation , Tr. Am. Ophth. Soc. 3:195, 1881;.
5 +
(e) Franke, E.:  On the Extraction of Cataract According to Jacobson's Method , Arch. Ophth. 10:121, 1881;.
6 +
(f) Strawbridge, G.:  Report of Two Hundred and Sixty-One Cases of Cataract Extractions , Tr. Am. Ophth. Soc. 4:298, 1885;.
7 +
(g) Vail, D.:  On the Mechanism and Causes of Hyphema After Cataract Extraction , Am. J. Ophth. 24:922, 1941;.
8 +
(h) Arnold, T.:  Mitteilungen über vier hundert Staroperationen , Arch. f. Augenh. 25:41, 1892;.
9 +
(i) Köllner, H.:  Erfahrungen an 1,284 Kataraktextractionen mit Iridektomie , Ztschr. f. Augenh. 15:506, 1906;.
10 +
(j) Schreiber, L.:  Bemerkungen über die Kataraktextractionen in den Jahren 1893/96 , Jahresb. ü. d. Leistung. d. Ophth. 27:98, 1896;.
11 +
(k) Uhthoff, W.:  Cataract Operations in Diabetics , Arch. Ophth. 38:49, 1909;.
12 +
(l) Knapp, H.:  Bericht über hundert Staarextractionen nach der neuen von Graefe'schen Methode eingeführt , Arch. f. Ophth. 13:85, 1867;
13 +
 Bericht über ein zweiter Hundert Staarextractionen durch den Linearschnitt im Scleralbord , KnappArch. f. Ophth. 14:285, 1868;
14 +
 Bericht und Bemerkungen über ein drittes Hundert Staaroperationen nach der peripherlinearen Extractionsmethode , Arch. f. Augen-u. Ohrenh. 1:44, 1869-1870;
15 +
translated, Arch. Ophth. 1:103, 1869;
16 +
 Bericht und Bemerkungen über ein viertes und fünftes Hundert Staarextractionen nach Gräfes Methode , Arch. f. Augen- u. Ohrenh. 6:314, 1877;
17 +
translated, Arch. Ophth. 6:3, 1877;
18 +
 Bericht über ein sechstes Hundert Staarextractionen , Arch. f. Augenh. 8:378, 1879;
19 +
translated, Arch. Ophth. 8:200, 1879;
20 +
 Report of a Seventh Hundred of Cataract Extractions, with Historical and Critical Remarks, Particularly on the Peripheral Opening of the Capsule , Arch. Ophth. 10:295, 1881;
21 +
 Report of the Eighth Series of One Hundred Consecutive Cataract Extractions, with Remarks , Arch. Ophth. 12:69, 1883;
22 +
 Cataract Extraction, Without Iridectomy , Arch. Ophth. 16:54, 1887;
23 +
 Report on the First Series of One Hundred Cataract Extractions Without Iridectomy , Arch. Ophth. 17:51, 1888;
24 +
 Report on a Second Series of One Hundred Successive Cataract Extractions Without Iridectomy , Arch. Ophth. 18:1, 1889;
25 +
 Report of a Third Series of One Hundred Cataract Extractions Without Iridectomy , Arch. Ophth. 19:280, 1890;.
26 +
(m) Vail, D., Jr.:  Hyphema After Cataract Extraction , Tr. Am. Ophth. Soc. 31:496, 1933;.
27 +
(n) Philps, A. S.:  Post-Cataract Hyphaema , Brit. J. Ophth. 24:122, 1940;.
28 +
(o) Berens, C., and Bogart, D.:  Certain Postoperative Complications of Cataract Operations, with Especial Reference to Study of 1,004 Operations , Am. J. Surg. 42:38, 1938;.
29 +
(p) Stallard, H. B.:  A Corneo-Scleral Suture in Cataract Extractions: Its Technique and Advantages , Brit. J. Ophth. 22:269, 1938;.
30 +
(q) Davis, F. A.:  Personal Experiences with Intracapsular Cataract Extractions , Arch. Ophth. 19:867 ( (June) ) 1938;.
31 +
(r) Wright, R. E.:  Lecture on Cataract Surgery , Am. J. Ophth. 20:248, 1937;.
32 +
(s) Lehrfeld, L., and Donnelly, E. J. :  Corneoepiscleral Suture in Cataract Extraction , Arch. Ophth. 24:401 ( (Aug.) ) 1940;.
33 +
(t) McLean, J. M.:  A New Corneoscleral Suture , Arch. Ophth. 23:554 ( (March) ) 1940;.
34 +
(u) Leech, V. M., and Sugar, H. S. :  Reduction of Postoperative Complications in Cataract Operations with Corneoscleral Sutures , Arch. Ophth. 21:966 ( (June) ) 1939;.
35 +
(v) Vogt, A. :  Zur Stardiskussion in Heidelberg , Klin. Monatsbl. f. Augenh. 101:530, 1938;.
36 +
(w) von Herrenschwand, F.:  Die Wundsprengung nach Altersstar-Extraktion und ihre Verhütung durch die Anlegung eines vorbereitenten Bindehautlappens , Ztschr. f. Augenh. 83:87, 1934;.
37 +
(x) Kawahara, G.:  Ueber die Vorder-Kammerbildung und Vorder-Kammerbildungblutung nach Kataraktextraktion , Zentralbl. f. d. ges. Ophth. 31:693, 1934;.
38 +
(y) Reiser, K. :  Unsere Erfahrungen mit der intracapsularen Starextraktion , Klin. Monatsbl. f. Augenh. 101:692, 1938;.
39 +
(z) Schmidt, K. :  Prognose der Operationsmöglichkeit bei verschiedenen Starformen , Klin. Monatsbl. f. Augenh. 96:118, 1936;.
40 +
Van Lint, A.:  Extraction extracapsulaire de la cataracte complications postopératoires , in Bailliart, P.; Coutela, C.; Redslob, E., and Velter, E.: Traité d'ophtalmologie , Paris, Masson & Cie, 1939;, vol. 7, p. 650.
41 +
Collins, T.:  Postoperative Complications of Cataract Extraction , Tr. Ophth. Soc. U. Kingdom 34:41, 1914;.
42 +
Henderson, T.:  A Histological Study of the Normal Healing of Wounds After Cataract Extraction , Ophth. Rev. 26:127, 1907;.
43 +
Worth, C., in discussion on Collins,3 p. 67.
44 +
Vail, footnote 1 g and m.
45 +
Jensen, V.:  Hemorrhages into the Anterior Chamber of the Eye in Cataract Operation With and Without the Use of Adrenalin , Acta ophth. 10:382, 1932;.
46 +
(a) Focosi, M.:  Sul comportamento della pressione arteriosa durante alcuni interventi chirurgici oculair : Utilita ed cazione del salasso; sulla patogenesi di alcune complicazioni operatorie , Boll. d'ocul. 18:689, 1939;
47 +
abstracted, Am. J. Ophth. 23:1412, 1940;.
48 +
(b) Kirby, D. B.:  Prevention and Handling of Complications Arising During and After Cataract Extraction: Some Practical Points , Arch. Ophth. 25:866 ( (May) ) 1941;.
49 +
(a) Gifford, S. R.:  The Prevention of Complications in the Cataract Operation , Illinois M. J. 68:243, 1935;.
50 +
(b) Carle, T.:  Ueber postoperative Kammerblutungen bei intrabulbären Eingriffen , Acta ophth. 10:242, 1932;.
51 +
Elschnig, A.:  Kritischer Bericht über das Schrifftum 1934 bis einschliesslich 1938 , Zentralbl. f. d. ges. Ophth. 43:321, 1939;.
52 +
Peter, L. C.:  Sutures in Cataract Extraction , Tr. Am. Ophth. Soc. 45:46, 1941;.
53 +
Ellett, E. C., in discussion on Peter.11
54 +
Castroviejo, R.: Personal communication to the author.
55 +
Verhoeff, F. H.:  A Corneoscleral Suture in Operations for Cataract , Tr. Am. Ophth. Soc. 25:48, 1927;.
56 +
Höjer, J. A.:  Studies in Scurvy , Acta pædiat. 3:8,1924;.
57 +
Abt, A. F., and Farmer, C. J.:  Vitamin C: Pharmacology and Therapeutics , J. A. M. A. 111:1555 ( (Oct. 22) ) 1938;.
58 +
Ralli, E. P.; Friedman, G. J., and Sherry, S.:  Vitamin C: Requirements in Man , J. Clin. Investigation 18:705, 1939;.
59 +
Kajdi, L.; Light, J., and Kajdi, C. :  A Test for the Determination of Vitamin C Storage; Vitamin C Index , J. Pediat. 15:197, 1939;.
60 +
Rapaport, H. G., and Miller, S. H.:  The Determination of Vitamin C in Children by Intradermal Injection , J. Pediat. 15:503, 1939;.
61 +
(a) Wright, I. S., and Lilienfeld, A.:  Pharmacologic and Therapeutic Properties of Crystalline Vitamin C (Cevitamic Acid), with Especial Reference to Its Effects on Capillary Fragility , Arch. Int. Med. 57:241 ( (Feb.) ) 1936;.
62 +
(b) Göthlin, G. F.  When Is Capillary Fragility a Sign of Vitamin C Subnutrition in Man? Lancet 2:703, 1937;.
63 +
(c) Sloan, R. A.:  Comparison of Methods for Detecting and Grading Subclinical Scurvy , J. Lab. & Clin. Med. 23:1015, 1938;.
64 +
(a) Abt, A. F.; Farmer, C. J., and Epstein, I. M.:  Normal Cevitamic Acid Determinations in Blood Plasma and Their Relationship to Capillary Fragility , J. Pediat. 8:1, 1936;.
65 +
(b) Crandon, J. H.; Lund, C. C., and Dill, D. B.:  Experimental Human Scurvy , New England J. Med. 223:353, 1940;.
66 +
Scarborough, H., and Stewart, C. P.:  Effect of Hesperidin (Vitamin P) on Capillary Fragility , Lancet 2:610, 1938;.
67 +
Bentsath, A.; Rusznyak, S., and Szent-Györgi, A.:  Vitamin Nature of Flavones , Nature, London 138:798, 1937;
68 +
 Vitamin P , BentsathNature, London 139:326, 1937;
69 +
140:426, 1937.
70 +
Jersild, T.:  Therapeutic Effect of Vitamin P in Schönlein-Henoch Purpura , Lancet 1:1445, 1938;.
71 +
Ivy, A. C., and Gray, J. S.:  The Application of Recent Contributions in Basic Medical Sciences to Surgical Practice : Vitamin P and Capillary Fragility , Internat. Abstr. Surg. 69:1939;
72 +
Surg., Gynec. & Obst. , (July) 1939;.
73 +
Lund, C. C, and Crandon, J. H.:  Human Experimental Scurvy and the Relation of Vitamin C Deficiency to Postoperative Pneumonia and to Wound Healing , J. A.M. A. 116:663 ( (Feb. 22) ) 1941;.
74 +
Lanman, I. H., and Ingalls, T. H.:  Vitamin C Deficiency and Wound Healing , Ann. Surg. 105:616, 1937;.
75 +
Hartzell, J. B.; Winfield, J. M., and Irvin, J. L.:  Plasma Vitamin C and Serum Protein Levels in Wound Disruption , J. A. M. A. 116:669 ( (Feb. 22) ) 1941;.
76 +
Hunt, A. H.:  Role of Vitamin C in Wound Healing , Brit. J. Surg. 28:436, 1941;.
77 +
Urbanek, J., and Albrecht, W.:  C Vitamin und Lebensalter , Ztschr. f. Augenh. 95:129, 1938;.
78 +
Bartlett, M. K.; Jones, C. M., and Ryan, A. E.:  Vitamin C Studies in Surgical Patients , Ann. Surg. 111:1, 1940;.
79 +
Holman, E. F.:  Vitamins and Protein Factors in the Preoperative and Postoperative Care of the Surgical Patient , Surg., Gynec. & Obst. 70:261, 1940;.
80 +
Abt and Farmer.16 Urbanek and Albrecht.25
81 +
Field, H., Jr., and Melnick, D.:  Clinical Determination of Vitamin Nutrition , J. Lab. & Clin. Med. 26:45, 1940;.
82 +
Dam, H.:  Cholesterinstoffwechsel in Hühnereiern und Hünchen , Biochem. Ztschr. 215:475, 1929;.
83 +
McKee, R. W.; Binkley, S. B.; MacCorquodale, B. W.; Thayer, S. A., and Doisy, E. A.:  Studies in Vitamin K , J. Am. Chem. Soc. 61:1295, 1939;.
84 +
Norcross, J. N., and McFarland, M. D.:  Intravenous Use of 2-Methyl-1,4-Naphthoquinone in Hypoprothrombinemia: Clinical Observations , J. A. M. A. 115:2156 ( (Dec. 21) ) 1940;.
85 +
Rhoads, J. E., and Fliegelman, M. T.:  The Use of 2-Methyl-1,4-Naphthoquinone (Synthetic Vitamin K Substitute) in Treatment of Prothrombin Deficiency in Patients , J. A. M. A. 114:400 ( (Feb. 3) ) 1940;.
86 +
Andrus, W. D.:  Newer Knowledge of Vitamin K , Bull. New York Acad. Med. 17:116, 1941;.
87 +
Smith, H. P.; Ziffren, S. E.; Owen, C. A., and Hoffman, G. R.: Clinical and Experimental Studies on Vitamin K. J. A. M. A. 113:380 ( (July 29) ) 1939;.
88 +
Warren, R., and Rhoads, J. E.:  The Hepatic Origin of the Plasma Prothrombin Observations After Total Hepatectomy in Dog , Am. J. M. Sc. 198:193, 1941;.
89 +
Burch, E. P.:  Treatment of Hemorrhagic Retinitis with Vitamin K , Minnesota Med. 22:32, 1939;.
90 +
Maumenee, A. E.; Hellman, L. M., and Shettles, L. B.:  Factors Influencing Plasma Prothrombin in the Newborn Infant : IV. The Effect of Antenatal Administration of Vitamin K on the Incidence of Retinal Hemorrhage in the Newborn , Bull. Johns Hopkins Hosp. 68:158, 1941;.
91 +
Pray, L. B.; McKeown, H. S., and Pollard, W. E.:  Hemorrhagic Diathesis of the Newborn: Effect of Vitamin K Prophylaxis and Therapy , Am. J. Obst. & Gynec. 42:836, 1941;.
92 +
Quick, A. J.:  The Clinical Significance of Prothrombin as a Factor in Hemorrhage , Pennsylvania M. J. 43:125, 1939;.
93 +
Foss, B.:  Gibt es eine K Vitamininsufficienz bei Blutungen nach intrabulbären Eingriffen? Acta ophth. 19:15, 1941;.
94 +
Kronfeld, P. C.:  Clinical Aspects of Vitamin Deficiencies in Ophthalmology , Illinois M. J. 80:298, 1941;.
95 +
Eagles, H., in MacLeod, J. J. R.: Physiology in Modern Medicine , ed. 9, St. Louis, C. V. Mosby Company, 1941;, p. 313.
96 +
Quick, A. J.:  A Classification of Hemorrhagic Diseases Due to Defects in the Coagulation Mechanism of the Blood , Am. J. M. Sc. 199:118, 1940;.
97 +
Macfarlane, R. G.:  Critical Review : The Mechanism of Hemostasis , Quart. J. Med. 37:1, 1941;.
98 +
Drury, D. R., and McMaster, P. D.:  The Liver as the Source of Fibrinogen , J. Exper. Med. 50:569, 1929;.
99 +
Aggeler, P. M., and Lucia, S. P.:  The Potency of Blood Coagulating Substances , Am. J. M. Sc. 199:181, 1940;.
100 +
Grossman, A. M.: The Plasma Prothrombin Concentration in Normal Infancy, Thesis, Marquette University, Milwaukee, 1939.
101 +
Butt, H. R., and Snell, A. M.: Vitamin K , Philadelphia, W. B. Saunders Company, 1941;.
102 +
Hellman, L. M., and Shettles, L. B.:  Factors Influencing Plasma Prothrombin in the Newborn: Prematurity and Vitamin K , Bull. Johns Hopkins Hosp. 65:138, 1939;.
103 +
Shettles, L. B.; Delfs, E., and Hellman, L. M.:  Factors Influencing Plasma Prothrombin in the Newborn Infant : II. Antepartum and Neonatal Ingestion of Vitamin K Concentrate , Bull. Johns Hopkins Hosp. 65:419, 1939;.
104 +
Quick, A. J.:  The Normal Antithrombin of the Blood and Its Relation to Heparin , Am. J. Physiol. 123:712, 1938;.
105 +
Ravdin, I. S.; Riegel, C., and Morrison, J. L.:  Coagulation of Blood: Comparative Values of Calcium and Glucose as Agents for Decreasing Clotting Time , Ann. Surg. 91:801, 1930;.
106 +
Quick, A. J.:  Diagnosis of Hemophilia , Am. J. M. Sc. 201:469, 1941;.
107 +
Goar, E. L.:  Management of the Complications of Intraocular Surgery , Am. J. Surg. 42:62, 1938;.
108 +
(a) Tainter, M. L., and Throndsen, A. H.:  Hemostatic Effects of Administration of Calcium, Viosterol, Styptisate and Ceanothyn by Mouth , J. Am. Dent. A. 25:638, 1938;.
109 +
(b) Tainter, M. L.; Throndsen, A. H., and Richardson, A. P.:  Alleged Hemostatic Action of Gelatin, Coagulin, Fibrogen and Histidine Administered by Mouth , J. Am. Dent. A. 26:420, 1939;.
110 +
(a) Kugelmass, I. N.:  "Bleeding" and "Clotting" Diets , M. Clin. North America 19:989, 1935;.
111 +
Rhoads, J. E.; Fliegelman, M. T., and Panzer, L. M.:  The Mechanism of Delayed Wound Healing in the Presence of Hypoproteinemia , J. A. M. A. 118:21 ( (Jan. 3) ) 1942;.
112 +
Whipple, A. O., and Elliott, R. H. E., Jr.:  The Repair of Abdominal Incisions , Ann. Surg. 108:741, 1938;.
113 +
Thompson, W. D.; Ravdin, I. S., and Frank, I. L.:  Effect of Hypoproteinemia on Wound Disruption , Arch. Surg. 38:500 ( (March) ) 1938;.
114 +
Ziegler, S. L.:  The Problem of Choroidal Hemorrhage in Cataract Extraction , in Contributions to Ophthalmic Science , Dedicated to Dr. Edward Jackson, Menasha, Wis., George Banta Publishing Company, 1926;.
115 +
Thiellez, L. :  Un traitement des hémorrhagies expulsives , Bull. et mém. Soc. franç. d'opht. 35:406, 1922;.
116 +
Sollmann, T.: Manual of Pharmacology , ed. 5, Philadelphia, W. B. Saunders Company, 1936;, p. 436.
117 +
Spanyol, V.:  Beseitigung postoperativer Blutergüsse der vorderen Kammer und ein Versuch zur Vereitelung neuer Blutaustritte in dieselbe , Klin. Monatsbl. f. Augenh. 96:670, 1936;.
118 +
Black, M. :  Hemorrhage After Cataract Operation , Am. J. Ophth. 7:539, 1924;.
119 +
Busacca, A. :  Advantages of the Use of Coagulants in Ocular Operations, Especially in Extraction of Cataract and in Plastic Operations , Arch. Ophth. 20:406 ( (Sept.) ) 1938;.
120 +
Gold, H.:  Control of Hemorrhage by Thromboplastic Agents , Internat. Clin. 2:293, 1932;
121 +
3:237, 1932.
122 +
Bethea, O. W.:  Thromboplastic Agents in Clinical Medicine , Internat. M. Digest 25:375, 1934;.
123 +
Graves, R. C., and Kickham, C. J. E.:  Congo Red for the Control of Bleeding , New England J. Med. 214:782, 1936;.
124 +
Milliken, L. F.:  The Use of a New Blood Coagulant in Transurethral Prostatic Resection , J. Urol. 42:75, 1939;.
125 +
Steinberg, A., and Brown, W. R.:  A New Concept Concerning the Mechanism of Clotting and the Control of Hemorrhage , Am. J. Physiol. 126:638, 1939;.
126 +
Schumann, E. A.:  Newer Concepts of Blood Coagulation and the Control of Hemorrhage , Am. J. Obst. & Gynec. 38: 1002, 1939;.
127 +
Foster, R. H. K.:  On the Role of Oxalic Acid in Blood Clotting , Proc. Soc. Exper. Biol. & Med. 44:136, 1940;.
128 +
Martin, G. J.:  The Mechanics of Action of Dicarboxylic Acids in Blood Coagulation , Am. J. Physiol. 130:574, 1940;.
129 +
Calder, R. M., and Kerby, G.:  The Effect of Nicotinic Acid on Blood Coagulation , Am. J. M. Sc. 200:590, 1940;.
130 +
Parfentjev, I. A.:  A Globulin Fraction in Rabbit's Plasma Possessing Strong Clotting Property , Am. J. M. Sc. 202:578, 1941;.
131 +
Taylor, F. H. L.; Lozner, E. L., and Adams, M. A.:  The Thrombic Activity of a Globulin Fraction Derived from Rabbit Plasma , Am. J. M. Sc. 202:585, 1941;.
132 +
Lozner, E. L.; MacDonald, H.; Finland, M., and Taylor, F. H. L.:  The Use of Rabbit Thrombin as a Local Hemostatic , Am. J. M. Sc. 202:593, 1941;.
133 +
Warner, E. D.; Brinkhous, K. M.; Seeger, W. H., and Smith, H. P.  Further Experience with the Use of Thrombin as a Hemostatic Agent , Proc. Soc. Exper. Biol. & Med. 41:655, 1939;.
134 +
Rosenfeld, S., and Lenke, S. E.:  Tiger Snake Venom for the Treatment of Accessible Hemorrhage , Am. J. M. Sc. 190:779, 1935;.
135 +
Swett, W. F.:  Snake Venom: Its Use in Postoperative Hemorrhage of the Eye , California & West. Med. 48:173, 1938;.
136 +
Alvaro, M. E.:  Snake Venom in Ophthalmology , Am. J. Ophth. 22:1130, 1939;.
137 +
(a)  Snake Venom Solution (Moccasin) Not Acceptable for New and Nonofficial Remedies, report of the Council on Pharmacy and Chemistry , J. A. M. A. 114:2218 ( (June 1) ) 1940;.
138 +
(b)  Cobra Venom Solution, preliminary report of the Council on Pharmacy and Chemistry , J. A. M. A. 115:1196 ( (Oct. 5) ) 1940;.
139 +
Eagle, H.:  The Coagulation of Blood by Snake Venom and Its Physiologic Significance , J. Exper. Med. 65:613, 1937;.
140 +
Snake Venom,  report of the Council on Pharmacy and Chemistry , J. A. M. A. 104:1073 ( (March 30) ) 1935;.
141 +
Vail.1m Philps.1n Berens and Bogart.10 Wright.1r Focosi.8a Kirby.8b Gifford.9a
142 +
Vail.1m Davis.1q

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