Intravascular agglutination or clumping of red blood cells can be easily observed within the blood vessels of the ocular conjunctiva with sufficient oblique illumination and 50X or more magnification. It is a very common phenomenon.
The clear-cut lumps or aggregates, known as "sludge," agglutinates, "masses," "red or white thrombi," are observed regularly circulating in the blood stream during acute, chronic, and progressive illness and in old age, not to mention severe trauma and burns. In addition, exposure to cold, a cut, a bruise, a slight burn, a word that shocks, or a conscious or an unconscious emotional thought, even the prick of a pin, can evoke some "sludging" of the blood.1 Originally the researches of Knisely, Bloch, et al. stimulated my clinical curiosity, and I have examined all of my patients for "sludge" for over a decade. Recently the studies of Lars-Erik Gelin2 have emphasized that slight injuries
FOWLER EP. Intravascular Agglutination of the Blood: Major Factor in Otosclerosis, Ménière's Disease, Tinnitus, Vertigo; Neural Defness—Total, Partial, Transitory, Recurrent, Progressive. AMA Arch Otolaryngol. 1957;66(4):408–413. doi:10.1001/archotol.1957.03830280038005
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