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April 1951


AMA Arch Surg. 1951;62(4):486-492. doi:10.1001/archsurg.1951.01250030494004

IT IS NOW eight years since Knisely and his associates first reported their observations on the curious phenomenon of red cell agglutination within vascular walls. To this phenomenon they applied the term "sludge." A great deal of earnest and interested work has been done, and many articles on the subject have been published showing the presence of sludged blood in conjunction with nearly all pathologic conditions of the body. It has been found coincident with disease. shock and trauma of all sorts: its ubiquity challenged investigators to perform the difficult tasks of accounting for its presence and determining its significance. By 1947 the concept of sludge, by virtue of the widest implications given it. had become the nexus of a whole system of thinking about disease. It had become somehow identified as the cause of specific pathologic findings or of complications in conditions which it accompanied.

Sludge, for example, is

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