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Patients suffering from hepatic cirrhosis of moderate or advanced degree frequently have an ill-defined coagulation disorder and may, espe-cially if subjected to operative stress, develop a severe hemorrhagic diathesis, often associated with pathological plasma proteolysis (pathological fibrinolysis). Moreover, many such patients may exhibit, constantly or intermittently, evidence of abnormal plasminogen-plasmin system activity (fibrinolysis), documented by rapid lysis of their clotted blood and other tests. Interest in this latter phenomenon stems from Goodpastures paper (1), published in 1914, in which he reported that blood, drawn from four cirrhotic patients, when clotted, underwent spon-taneous lysis more rapidly than did that from con-trol subjects. Later Ratnoff (2) confirmed this finding and substantially extended study of this phenomenon. He noted that rapid plasma clot lysis was a frequent accompaniment of Laennecs cirrhosis, was sometimes observed in patients who experienced hepatic damage during the course of some other illness, but was not observed in either acute hepatitis or obstructive jaundice without obvious associated hepatic damage. Subsequently, other authors (3-8) have reported that a high proportion of patients, suffering from advanced hepatic cirrhosis, exhibited rapid spontaneous whole blood clot lysis, shortened euglobulin lysis times, and other evidence of enhanced plasmino-gen-plasmin system activity. Moreover it has been reported (7, 9, 10) that the administration * Submitted for publication September 6, 1963; accepted
Fletcher et al. (Wed,) studied this question.