Clots Unblocked

A brand new drug that prevents fatal blood clots and a radical use of ice to treat damaged circulation were discussed in a review of treatments for circulatory ills made last fortnight before the New York Physicians Association by Dr. Samuel Silbert.

Sweet Clover. The remarkable drug known as dicoumarin may even reduce to zero the 6% of post-operative deaths caused by thrombi (fixed blood clots) and emboli (wandering blood clots). Dicoumarin is found in spoiled sweet clover, was originally tracked down as a poison which causes hemorrhages in cows, is now synthesized.

In the last few years, thrombi have effectively been treated by heparin--a compound obtained from lungs and livers of animals. Heparin injections cost from $10 to $15 a day, must be dripped into a patient's veins continuously for about two weeks.

Dicoumarin, just as effective as heparin, is far cheaper and may be given by mouth. Dr. Silbert predicted that dicoumarin will soon be used not only as a cure for thrombi, but as a routine preventive in all major operations and confinements. At present it is used in the Mayo Clinic, the University of Wisconsin, and by Drs. Irving Sherwood Wright and Andrew Gabriel Prandoni of Columbia, who made a technical report on it last fortnight.

Heat v. Cold. Blood clots may lodge in the lungs, cause instant death. They may also form in arms or legs, choke off circulation. If they lodge in an artery, they prevent the flow of fresh, oxygen-rich blood from the heart to the limb; if they dam up a vein, they prevent the return of used blood, heavy with body poisons, to the heart. Without proper circulation of the blood to keep them alive, body tissues die, become gangrenous.

Standard gangrene preventive for legs and feet with blocked circulation is plenty of heat. This, says Dr. Silbert, is in many cases "absolutely incorrect." Reason: heat increases metabolism of the tissues, raises their need for fresh blood. To prevent gangrene, tissue metabolism in the legs should be slowed down, the blood vessels given less work to do. Hence he puts ice bags around legs and feet until pain disappears and the limb is able to get enough circulation from substitute blood vessels.

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