bluuebunny/crossref_metadata_2025_split huggingface dataset:
BLOOD VOLUME IN WOUNDED SOLDIERS
Authors: Robertson Oswald H. , Bock Arlie V. 
Published: June 2004

Blood volume tests made by the vital red method (Keith, Rowntree, and Geraghty) on patients after hemorrhage showed a marked reduction in the total blood bulk. Not uncommonly the blood volume was less than 60 per cent of the normal. The reduction after a certain point had been reached seemed to parallel the decrease in blood pressure. This relation of diminished blood volume to low pressure suggested a rough method of estimating blood volume from the change in blood pressure.
By means of the blood volume and the hemoglobin per cent the actual amount of blood loss was determined. Cases of severe anemia showed a loss of as much as five-sixths of their total hemoglobin.
Progressive changes in blood volume following hemorrhage were estimated in three ways: (1) repeated vital red tests; (2) calculation from changes in hemoglobin per cent produced by the injection of gum acacia; (3) calculation from changes in hemoglobin per cent following the dilution of the blood by the patient's own body fluids.
The effects of the different methods of transfusion and of injection of gum acacia on blood volume were observed. No differences were apparent. It was found that transfusion and gum injections only partially restored the blood volume. Forced fluids by mouth were found to bring about its complete restoration in a comparatively short time.
It was observed that the organism did not restore its blood volume beyond a certain point when a further increase in it would, by dilution, have brought the hemoglobin per cent to a very low figure. In such cases a further increase of the blood volume occurred only when the hemoglobin rose. In cases with a low hemoglobin per cent as the result of a restoration of the blood bulk an abnormally high blood pressure appeared, which continued until the hemoglobin per cent again increased.
Accompanying the low blood pressure seen shortly after hemorrhage was a well marked difference in hemoglobin per cent between capillary and venous blood, with a relative concentration on the capillary side. As compensation occurred and blood pressure rose this difference lessened until the two readings were identical, indicating an even redistribution of the red blood cells.
Reticulated red cell counts made in these cases showed that a marked bone marrow stimulation occurs after hemorrhage. However, except in the very anemic cases the degree of increased blood production seemed to depend largely on the restoration of the blood volume. The patients who were put on forced fluids, with consequent rapid restoration of blood volume, showed a much higher per cent of reticulated cells than those in whom no attempt was made to increase the amount of fluid in circulation.
BLOOD VOLUME IN WOUNDED SOLDIERS
Authors: Robertson Oswald H. , Bock Arlie V. 
Published: June 2004

Blood volume tests made on a number of soldiers recovering from hemorrhage have shown that in many instances dilution of the blood occurs very slowly. The principal reasons for this seem to be (a) an initial lack of reserve fluid of the tissues, and (b) the absence of any subsequent attempt by the body to make up this fluid deficiency.
By putting such patients on a large fluid intake by mouth and rectum it has been found that their blood volume can be promptly and greatly increased. Hemorrhage cases transfused, yet still showing a low blood volume, were first treated in this way. Then the effect of forced fluids without transfusion was tried. Immediately after a hemorrhage, or as soon as the patient came under observation, he was given large quantities of water by mouth, and salt solution by rectum. Under such treatment the blood pressure soon began to show a progressive rise, the volume increased, and the red cells became more evenly redistributed, as shown by the relative hemoglobin percentages of the capillary and venous blood. These changes were often well marked after only 2 or 3 hours of the treatment.
More than this, forcing fluids in cases where the amount of bleeding is difficult to estimate on account of the presence of a high hemoglobin percentage is of distinct value, since the dilution of the blood which results serves to show the extent of the hemorrhage through the drop in hemoglobin that it entails.
In attempting to determine the condition of the patient after hemorrhage with a view to deciding the most suitable form of treatment, it is of much importance to learn the total blood loss—which is often not even indicated by the hemoglobin concentration of the remaining blood. With a total hemoglobin reduced to 25 per cent or under transfusion is needful. New blood is necessary, not only to supply more oxygen-carrying cells, but also because it actually enables the circulation to increase its volume. For, as has been pointed out in Paper I, the hemoglobin percentage must be above a certain point if a rapid restoration of the blood volume by means of the organism's own activities is to come about. With the total hemoglobin above 25 per cent the chief need is for increased blood volume, and if the patient's condition demands an immediate and large addition of circulating fluid, gum acacia solution should be given. If the condition is not so urgent, forced fluids by the alimentary tract are indicated.
The blood volume can be considerably reduced and yet a normal blood pressure maintained. It is pointed out that the vasomotor mechanism which, has adapted itself to the diminished blood bulk may in any individual case be very near the margin of its compensatory power. Increased strain in such instances may cause a failure of this mechanism with a resulting fall in blood pressure.
The beneficial results of forced fluids after secondary hemorrhage suggest the value of the early use of fluids by the alimentary tract in cases of primary hemorrhage.
SPIROCHÆTA HEBDOMADIS, THE CAUSATIVE AGENT OF SEVEN DAY FEVER (NANUKAYAMI)
Authors: Ido Yutaka , Ito Hiroshi , Wani Hidetsune 
Published: June 2004

1. Spirochata hebdomadis is always present in seven day fever and can be confirmed by animal experiments with guinea pigs of light weight.
2. The causative agent of this disease can also be found in film preparations of the blood of patients, though it is not present in large numbers.
3. Spirochæta hebdomadis is discharged in the urine of patients having seven day fever. The number of spirochetes in the urine is great during convalescence.
4. Seven day fever is a disease found not only in the Prefecture of Fukuoka, but in many other districts of Japan as well.
THE USE OF THE FINAL HYDROGEN ION CONCENTRATION IN DIFFERENTIATION OF STREPTOCOCCUS HÆMOLYTICUS OF HUMAN AND BOVINE TYPES
Authors: Avery Oswald T. , Cullen Glenn E. 
Published: June 2004

1. Under the conditions of these experiments, there appears to be a distinct and constant difference in the final hydrogen ion concentration of Streptococcus hæmolyticus from human and bovine sources.
2. Of 124 strains of Streptococcus hæmolyticus from known human origin, 116 reached a final hydrogen ion concentration of from pH 5.0 to 5.3. Only 8 reached a pH more acid than 5.0 and none more acid than pH 4.8.
3. Of 45 strains of Streptococcus hæmolyticus from bovine sources, including 26 strains isolated from milk and the udder of cows, and 19 from cream cheese, 40 reached a final hydrogen ion concentration of pH 4.3 to 4.5. Of the remaining 5 which reached a pH of 5.0 to 5.2, two were of known human type and three of uncertain diagnosis.
4. A rapid and practical application of this method is proposed as a presumptive test in the differentiation of human and bovine types of Streptococcus hæmolyticus.
A STUDY OF ATYPICAL TYPE II PNEUMOCOCCI
Authors: Stillman Ernest G. 
Published: June 2004

1. At least twelve subgroups of atypical Type II pneumococcus may be recognized by specific agglutination reactions. They have been designated Subgroups IIa, IIb, IIc, IId, IIe, IIf, IIg, IIh, IIj, IIk, IIl, and IIm.
2. These subgroups have an incidence of 11 per cent in lobar pneumonia, and of 18 per cent in normal mouths.
3. Certain groups, IIb, IIc, IIf, and IIm, occur in normal mouths.
4. Subgroups IIa and IIh are met with largely in connection with disease.
5. The mortality of acute lobar pneumonia due to these atypical Type II pneumococci is fairly high—32 per cent.
THE DETERMINATION OF THE LENGTH OF LIFE OF TRANSFUSED BLOOD CORPUSCLES IN MAN
Authors: Ashby Winifred 
Published: June 2004

1. It is possible in mixtures of corpuscles of different groups to separate the corpuscles practically quantitatively by treating with a serum that agglutinates the corpuscles of one kind, leaving the others unagglutinated.
2. After a recipient has been transfused with blood of a group other than his own, specimens of his blood treated with a serum that will agglutinate his own corpuscles but not the transfused corpuscles show unagglutinated corpuscles in large numbers.
3. These unagglutinated corpuscles which appear in the recipien's blood after such a transfusion are the transfused corpuscles and their count is a quantitative indicator of the amount of transfused blood still in the recipient's circulation.
4. The life of the transfused corpuscle is long; it has been found to extend for 30 days and more. The beneficial results of transfusion are without doubt not due primarily to a stimulating effect on the bone marrow, but, it is reasonable to assume, to the functioning of the transfused blood corpuscles.
I. RENAL FUNCTION INFLUENCED BY INTESTINAL OBSTRUCTION
Authors: McQuarrie Irvine , Whipple G. H. 
Published: June 2004

Associated with the intoxication of intestinal obstruction there exists a definite impairment of the excretory function of the kidneys.
The degree of functional depression corresponds roughly with the intensity of the clinical intoxication.
The decrease in the urea ratio and in the capacity of the kidneys to excrete sodium chloride is more marked than is the percentage decrease of phenolsulfonephthalein elimination.
The great increase in the non-protein nitrogen of the blood usually observed in acute intestinal obstruction, which has hitherto been explained as being due entirely to an increased rate of protein catabolism, is due in part to retention of the products released from the injured cell protein.
It is probable that the impaired renal function is due to direct action of the toxic substances upon the renal epithelium.
The actual demonstration of this renal injury is perhaps the strongest evidence so far obtained to prove the presence of an actual toxic substance in the blood during intestinal obstruction.
This obscure disability of the kidneys during the height of the intoxication of acute ileus should always be considered in the clinical management of this condition. It may also serve as a guide to indicate the degree of intoxication.
II. RENAL FUNCTION INFLUENCED BY PROTEOSE INTOXICATION
Authors: McQuarrie Irvine , Whipple G. H. 
Published: June 2004

The injection of the toxic proteose obtained from the contents of the obstructed small intestine causes a definite impairment of the eliminative function of the kidneys as shown by a decreased capacity to excrete urea, sodium chloride, and phenolsulfonephthalein.
This involvement of the renal function is similar to that shown by the preceding report (1) to accompany the intoxication of intestinal obstruction.
The observed depression of function is readily demonstrable even when large amounts of fluid and urea, dye, or salt are injected directly into the blood stream.
There is in all probability a temporary injury of the kidney cells, since the most important extrarenal factors have been largely eliminated in the above experiments.
There is no appreciable impairment of the renal function following the injection of a number of other proteose preparations from a variety of sources.
This study affords new evidence in favor of the view that the function of an organ can be profoundly disturbed for a time without any demonstrable anatomical lesions.
The repair of this type of injury promptly follows the disappearance of the intoxication and is functionally and anatomically perfect.
RESULTS OF PROPHYLACTIC VACCINATION AGAINST PNEUMONIA AT CAMP WHEELER
Authors: Cecil Russell L. , Vaughan Henry F. 
Published: June 2004

1. 13,460 men, or about 80 per cent of the entire camp strength, were vaccinated against pneumonia with pneumococcus lipovaccine.
2. The dosage employed in all cases was 1 cc. of the lipovaccine containing approximately 10 billion each of Pneumococcus Types I, II, and III.
3. Both the local and general reactions produced by the vaccine were usually mild. Only 0.7 per cent of those who received the vaccine were sufficiently affected to need hospital care. None of these was seriously ill, and a majority of them returned to duty on the 2nd or 3rd day after admission.
4. Most of the troops inoculated were under observation for 2 or 3 months after vaccination. During this period there were 32 cases of Pneumococcus Type I, II, and III pneumonia among the vaccinated four-fifths of camp, and 42 cases of pneumonia of these types among the unvaccinated one-fifth of camp. If, however, all cases of pneumonia that developed within 1 week after vaccination are excluded from the vaccinated group, there remain only 8 cases of pneumonia produced by fixed types, and these were all secondary to severe attacks of influenza. This exclusion is justified by the fact that protective bodies do not begin to appear in the serum until the 8th day after injection of pneumococcus lipovaccine.
5. There is no evidence whatever that pneumococcus vaccine predisposes the individual even temporarily toward either pneumococcus or streptococcus pneumonia.
6. The weekly incidence rate for pneumonia (all types) among the vaccinated troops was conspicuously lower than that for the unvaccinated troops.
7. The pneumonia incidence rate per 1,000 men during the period of the experiment was twice as high for unvaccinated recruits as for vaccinated recruits, and nearly seven times as high for unvaccinated seasoned men as for vaccinated seasoned men.
8. Influenza causes a marked reduction in resistance to pneumonia even among vaccinated men. Of the 155 cases of pneumonia (all types) developing 1 week or more after vaccination, 133 were secondary to influenza.
9. The death rate for 155 cases of pneumonia (all types) that developed among vaccinated men 1 week or more after vaccination was only 12.2 per cent, whereas the death rate for 327 cases of all types that occurred among unvaccinated troops was 22.3 per cent. The death rate for primary pneumonia among vaccinated troops was 11.9 per cent. Among unvaccinated, it was 31.8 per cent, almost three times as great. On the other hand, the mortality rate in pneumonia secondary to influenza is about the same for the vaccinated and unvaccinated groups.
10. In conclusion, it must be admitted that the results of pneurnococcus vaccination at Camp Wheeler have not been so striking as those obtained at Camp Upton in 1918, largely on account of the influenza epidemic; but, although influenza obscured to some extent the effect of pneumococcus vaccination at Camp Wheeler, the results are sufficiently encouraging to justify its further application in civil as well as in military life.
THE PASSAGE OF MENINGOCOCCIC AGGLUTININS FROM THE BLOOD TO THE SPINAL FLUID OF THE MONKEY
Authors: Amoss Harold L. , Eberson Frederick 
Published: June 2004

Agglutinins for the meningococcus were not found in the spinal fluid of normal monkeys which had received antimeningococcic serum intravenously.
The intraspinal injection of isotonic salt solution, normal horse serum, or a culture of living meningococci allows agglutinins for the meningococcus to pass from the blood to the spinal fluid of the passively immunized monkey; and the rate of the passage is affected by the severity of the inflammation induced in the meninges.
The rates of elimination from the blood and spinal canal of meningococcic antibodies, as shown by the agglutination reaction, were compared in monkeys treated with immune serum (a) intraspinally, (b) intravenously, and (c) intraspinally and intravenously in combination.
(a) When immune serum is given intraspinally the agglutinins are very much diminished after 8 hours and practically disappear at 12 hours. They appear in the blood at the 4th hour after injection and quickly diminish.
(b) After intravenous injection of immune serum, when the meninges are inflamed, agglutinins appear in the spinal fluid in small amounts in about 12 hours and increase to the 25th hour. More than one-half of the agglutinins disappear from the blood within 8 hours and remain in low concentration at 25 hours.
(c) After combined intraspinal and intravenous injection the agglutinins remain in higher concentration in the spinal fluid and for a longer time than by method (a) or (b). The curve descends after 12 hours, and agglutinins are present at 25 hours. They remain in maximum concentration in the blood for 25 hours.
EXPERIMENTS ON THE MODE OF INFECTION IN EPIDEMIC MENINGITIS
Authors: Amoss Harold L. , Eberson Frederick 
Published: June 2004

The lower monkeys as represented by Macacus rhesus are resistant to a high degree to infection with cultures of the meningococcus introduced into the general blood.
The lower monkeys are less resistant to infection when the meningococcus cultures are injected directly into the subarachnoid space by lumbar puncture.
Relatively virulent cultures, which have been passed through several monkeys, acquire the power of surviving in the circulating blood of the monkeys for a maximum period of about 72 hours. Nothing has, however, been observed to indicate that the injected meningococci actually multiply in the blood.
It has not been found possible to direct the meningococci circulating in the blood into the cerebrospinal meninges of monkeys. In this effort an aseptic meningitis was induced by injecting horse serum, saline solution, or protargol into the subarachnoid space preceding the introduction of the meningococci into the blood.
In rabbits the meningococci were able to pass into the spinal fluid from the blood when a physical break in the continuity was made; however, under the conditions of chemical inflammation of the meninges the rabbit reacted just as the monkeys, and the organisms did not pass.
Because of the high insusceptibility of the monkey to infection with meningococcus, it is not believed that the experiments throw any new light on the mode of invasion of the body in man by that microorganism.
The experiments do not lend any support to the notion that an intraspinal injection of the antimeningococcus serum, early in the course of invasion of meningococcus in man, and possibly at a period at which the meninges do not yet show evidences of inflammation, favors its diversion from the blood stream into the subarachnoid space.
AN EXPERIMENTAL STUDY OF THE DIRECT INOCULATION OF BACTERIA INTO THE SPLEEN OF LIVING ANIMALS; AND A CONTRIBUTION TO THE KNOWLEDGE OF THE IMPORTANCE OF A LESION IN ANIMAL TISSUE FOR THE LODGMENT AND MULTIPLICATION OF BACTERIA WITHIN IT
Authors: Cheesman T. M. , Meltzer S. J. 
Published: June 2004

I. Cultures of B. coli communis, B. typhosus and Staph. pyogenes aureus, when injected into the tissue of the normal spleen, soon disappear from that organ, and indeed from the normal body generally.
II. Bacteria injected into a spleen after the whole or a part of the vessels have been tied, multiply in the spleen with great rapidity and continue to supply bacteria to the blood, whence in the healthy body they soon disappear.
III. Bacteria injected into the spleen, or subcutaneous tissue, or into the blood current through the ear vein, in cases in which moderate lesions have been made by cauterization or compression in the spleen, liver, kidney, uterus, testicle, peritoneum, or subcutaneous tissue, usually find lodgment in these lesions and multiply there.
IV. Even in cases in which numerous foci existed, from which the blood was constantly provided with a fresh supply of bacteria, only few bacteria were found at any time in the blood.
NOTES UPON AN EPIDEMIC OF FOWL CHOLERA AND UPON THE COMPARATIVE PRODUCTION OF ACID BY ALLIED BACTERIA
Authors: Higgins Charles H. 
Published: June 2004

(a). The bacillus isolated by me from the outbreak of choleraic diarrhœa corresponds closely in all essential particulars with that of European chicken cholera.
(b). It differs, consequently, from that isolated from previous outbreaks of choleraic diarrhœa in the United States.
(c). A study of the acid production by this and allied bacilli would seem to show that the amount of acid produced by so variable a microbe varies greatly and is incapable of affording a further means of distinguishing between allied forms.
ETIOLOGY OF YELLOW FEVER
Authors: Noguchi Hideyo 
Published: June 2004

By the employment of methods designed to promote the growth both of aerobic and anaerobic organisms, particularly those belonging to the class of spirochetes, it was possible to obtain a pure culture of a delicate organism, the morphological features of which place it in the genus Leptospira. On three occasions, that is, from three out of eleven cases of yellow fever, the organism was directly cultivated. These three strains were found to induce the characteristic symptoms and lesions when tested on guinea pigs. The organism was designated Leptospira icteroides.
Leptospira icteroides was also obtained in pure culture from the blood of guinea pigs which succumbed to infection after being inoculated with the blood or organ emulsions from patients suffering from yellow fever. These cultures also proved to be virulent when tested on susceptible animals.
The morphological characteristics and certain biological properties of the organism were considered in detail. It is invisible under translucent illumination and is difficult to stain by most aniline dyes. It is highly sensitive to the presence of bacteria and is rapidly destroyed in a medium in which certain other organisms are present. The presence of blood serum (man, sheep, horse, rabbit, etc.) seems to be essential for its growth. It grows well at a temperature of about 25–26°C. and more quickly at 37°C., though at the latter temperature it dies out within a few weeks. At 25°C. under favorable conditions and in suitable culture media it remains viable for several months without losing its virulence. Leptospira icteroides multiplies by transverse division.
The virulence attained by some strains was such that 0.00001 cc. of a culture could induce typical fatal infection in guinea pigs. There exists a considerable variation among guinea pigs in their susceptibility to Leptospira icteroides.
The organism is killed within 10 minutes at a temperature of 55°C. and is also destroyed by complete desiccation or freezing and thawing. Bile and bile salts dissolve it in certain concentrations, but not saponin.
Leptospira icteroides passes through the pores of Berkefeld filters V and N, and there is a possibility of its having a granular phase of life under certain conditions.