THE COAGULATION DEFECT IN HEMOPHILIA. STUDIES ON THE REFRACTORY PHASE FOLLOWING REPEATED INJECTIONS OF GLOBULIN SUBSTANCE DERIVED FROM NORMAL HUMAN PLASMA IN HEMOPHILIA 1

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Abstract
Data are presented showing that while lyophilized globulin substance and plasma are effective in shortening the coagulation time of hemo-philic blood in vitro and in vivo the use of air dried plasma is ineffective. Unlike globulin substance repeated injs. of either normal human plasma or lyophilized plasma into hemophilic patients maintain a shortened blood coagulation time without the development of a refractory phase. The adm. to a hemophilic patient of an intramusc. inj. of normal human plasma at the height of the refractory phase produced by globulin substance abolishes the refractory phenomenon. There are evidently substances other than globulin substance deficient in hemophilic blood.