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To the Editor:—
The remarks of de Takats in The Journal (Oct. 18, 1941, p. 1378) on the unusually prolonged coagulation time in our case of cavernous sinus thrombophlebitis treated with heparin are well received. Since this was the first case of this kind which we were fortunate enough to be able to treat with heparin, we attempted to approximate the regimen which had proved so successful in Schall's hands (The Journal, Aug. 23, 1941, p. 581). We are aware from the experience of others and our own subsequent experience that in cases of uninfected thrombophlebitis a coagulation time approximating twenty minutes seems to be adequate. However, in cases of septic cavernous sinus thrombophlebitis, in which the mortality is admittedly high and the prognosis always grave, it seems to us that a more prolonged coagulation time provides a greater margin of safety. We agree with de Takats that the complication
Ershler IL, Blaisdell IH. HEPARIN FOR PROLONGED COAGULATION TIME. JAMA. 1941;117(24):2095. doi:10.1001/jama.1941.02820500077028