autohaemotherapy with a glass bottle. A brief digression is necessary in regards to blood anticoagulants. Is sodium citrate the best anticoagulant? It is, provided is not in excess (Chapter 7) to avoid a transitory hypocalcemia and it is safe in practically all patients, including those already under either anticoagulants (Warfarin, heparin, hirudin), or antiplatelet drugs (aspirin, dipyridamole, ticlopidine, clopidogrel), or thrombolytic agents (streptokinase, tissue plasminogen activator), or patients with hepatic diseases and a low prothrombin level. In these cases, use of heparin may aggravate the dyscoagulation and cause severe haemorrhages. I will remind that heparin can induce thrombocytopenia (Warkentin, 2003) and platelet aggregation (Bocci et al., 1999a) using high ozone concentrations (near 80 mcg/ml per ml of blood). Nevertheless heparin is regularly used during EBOO and dialysis and, bearing in mind the above indicated restrictions, may be useful in vascular diseases and cancer because of the increased release of a number of growth factors from platelets (Valacchi and Bocci, 1999) and cytokines from leukocytes (Bocci et al., 1993a, b). Thus, only after a careful analysis of the patient, the ozonetherapist can select the most idoneous anticoagulant. 39 ONE BIG PROBLEM THAT WEAKENS THE VALIDITY OF OZONETHERAPY IS THAT OUR METHOD IS NOT USED BY ALL OZONETHERAPISTS. How can we compare anecdotal results (already questionable), if ozonetherapists disagree about the blood and gas volumes, ozone concentrations and exposure times? What is most disheartening about this chaotic situation is that behind it there are commercial interests (plastic or glass, small or large bottles, lack of appropriate transfusion tubing with a filter, etc.), mental reservations, lack of basic knowledge and plain stupidity. Obviously this is an ideal ground for quacks but even an Italian physician, who thinks he is an excellent ozonetherapist, has boasted of performing the whole procedure in 6 min when the correct time is about 40 min! To my dismay, I recently heard that another ozonetherapist in Turin, as the first thing in the morning, fills up with the gas all the glass bottles to be used during the day! Moreover there are two modifications regarding the technique of exposing blood to the gas that need to be briefly mentioned: the first uses hollow capillary fibres and is expensive, unnecessarily complex and has resulted in a commercial failure. The second system delivers gas as mini bubbles and claims that full blood ozonation is achieved in a few seconds. We tested it and found considerable blood foaming because gas should never be bubbled through the blood. Furthermore we measured a marked hemolysis and a low oxygenation (pO at about 90 mm Hg) meaning that the 2 gas had not been entirely equilibrated with blood. By comparison our method requires at least 5 min of gentle mixing (to avoid foaming), but allows complete ozonation and oxygenation as it is well demonstrated by a very high pO Haemolysis remains negligible. 2. Another critical issue that remains to be scientifically settled is the volume of blood to be collected for each treatment. Needless to say the volume of blood should not be imposed by any commercial purpose or by a trivial timing aspect. The volume of blood must be flexible and must be in relation to the patient’s body weight, sex, stage and type of disease. To avoid any risk of lipothymia, no more than 270 ml blood should be withdrawn and a 500 ml glass bottle appears suitable in all cases. In Germany, some practitioners believe that 50 ml, or at most 100 ml, is optimal. There is neither experimental nor clinical support for this contention and this belief disagrees with the classical biochemical and pharmacological concepts