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June 1960

Deficiency in the Prothrombin Complex with Obscure Etiology

Author Affiliations

Los Angeles With the Technical Assistance of Mary Baker, B.A.

From the Department of Medicine, School of Medicine, University of California at Los Angeles, and the Hematology Research Laboratory, Wadsworth Hospital, Veterans Administration Medical Center, Los Angeles. This work was supported in part by the U.S. Public Health Service, under contract #H-1069, by a grant from Parke, Davis & Company, and by a grant from The Gladys Bowyer Foundation.

AMA Arch Intern Med. 1960;105(6):921-928. doi:10.1001/archinte.1960.00270180099013

Prior to 1934, any male with a congenitally acquired bleeding disorder was promptly classified as a hemophiliac. Women were not allowed this distinction, but were merely called "bleeders." However, in 1934 there began a series of important observations which clarified the role of the prothrombin complex in the clotting mechanism and the importance of vitamin K and bishydroxycoumarin (Dicumarol). Quick and his co-workers opened up a new era in the study of coagulation by describing a simple quantitative test for the estimation of prothrombin.1 Thus, for the first time, it became possible to classify patients with the common cause of bleeding into two groups; (1) those involving defects in thromboplastin formation, and (2) those with defects in the prothrombin complex.

Tn 1941 Rhoads and Fitzhugh2 ushered in this new era when they reported a patient who had been called a hemophiliac for nine years, but the development of