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July 1943


Author Affiliations


From the Division of Medicine, the Mayo Clinic.

Arch Intern Med (Chic). 1943;72(1):69-77. doi:10.1001/archinte.1943.00210070077007

The hemorrhagic phenomena, so often a complication of hepatic disease, has long presented a serious medical problem, particularly when the disease is severe and of long duration. The isolation of vitamin K and its application to control of the hemorrhagic tendency in hepatic disease created the impetus for study which has increased appreciation of the role of the liver in the synthesis of factors necessary for normal coagulation of blood. For many years thrombin has been known to play a definite part in coagulation of blood, and its precursor, prothrombin, has been shown to be a product of hepatic metabolism. It now is known that a normally functioning liver is one factor necessary for the maintenance of a normal level of prothrombin in the plasma.1

Experimentally and clinically, it has been demonstrated that in certain diseases of the liver, a diminished level of prothrombin in the blood often is

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