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Disseminated Intravascular Coagulation: An Intermediary Mechanism of Disease

Oscar D. Ratnoff, MD
JAMA. 1965;192(2):175-176. doi:10.1001/jama.1965.03080150105046.
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As its title states, the thesis of Dr. McKay's monograph is that diffuse intravascular coagulation is important in the pathogenesis of a number of different disease states. It has been known since Woolridge's experiments in the 1880's that the intravenous injection of clot-promoting agents may be followed by diffuse intravascular coagulation. As a consequence, the animal's plasma is depleted of fibrinogen. Paradoxically, then, the induction of intravascular clotting leads to a bleeding tendency.

Dr. McKay reviews the voluminous clinical literature in which various clinical syndromes are attributed to the process of thrombosis in small blood vessels. These disorders include such apparently diverse processes as snake bite, amniotic fluid embolism, and intravascular hemolysis. Moreover, he summarizes some of the studies in which attempts have been made to produce experimental counterparts of human disease. To my knowledge, this is the first time anyone has tried to assemble information about these important processes


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