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Article
May 1915

THE FACTORS OF COAGULATION IN PRIMARY PERNICIOUS ANEMIA

Author Affiliations

BOSTON

From the Peter Bent Brigham Hospital, Boston.

Arch Intern Med (Chic). 1915;XV(5_1):733-745. doi:10.1001/archinte.1915.00070230090006
Abstract

Within the past two years it has become more and more possible to study the factors concerned in blood coagulation. The literature of this period has even given promise of an etiological classification of hemorrhagic disease, but developments have not borne out this promise. If we accept the theory of Howell,1 there are five factors in coagulation — antithrombin, thromboplastin, calcium salts, prothrombin and fibrinogen — which may show variations in disease. Antithrombin, prothrombin, calcium salts and fibrinogen are present in the circulating blood. The prothrombin, however, is held in combination with antithrombin and thus prevented from activation into thrombin by calcium. Without thrombin there can be no coagulation. The presence of thrombin is secured through the fixation or neutralization of antithrombin by thromboplastin. This last substance, thromboplastin, frees the blood of antithrombin; under these conditions calcium at once forms thrombin from prothrombin; thrombin reacts with

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