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October 27, 1923


JAMA. 1923;81(17):1461-1462. doi:10.1001/jama.1923.02650170059032

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To the Editor:  —In a recent article on splenectomy in chronic hemorrhagic (thrombocytopenic) purpura, Brill and Rosenthal state that experience has led them to believe "that transfusion is not only useless as a curative measure, but seems to increase the bleeding" (Am. J. M. Sc.166:503, 1923). Unfortunately, they do not report their two cases in detail. Our experience in the blood service at the Boston City Hospital has been more with the acute than the chronic type, but it has led to quite the contrary opinion.In these acute cases we have found the value of transfusion very great. In order, however, that its benefits may be realized, certain facts in regard to platelets and the limitations of the influence of transfusion on them must be heeded. It is true that a single transfusion will stop the bleeding only in a very mild case, and that the benefit

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