Studies on the Initiation of Blood Coagulation. Ii. An Anticoagulant Inhibiting the Activation of a Plasma Thromboplastic Factor 1

hemorrhagic manifestations. The patient had three spontaneous abortions at ages 21, 23, and 30 years. and she was delivered of normal children at the ages of 23 and 32. Following the third abortion the patient bled profusely and was transfused with 500 cc. of whole blood. Since that time she had had persistent evidence of a hemorrhagic diathesis with vaginal bleeding, cutaneous ecchymoses, deforming hemarthroses, bleeding gums, and hemorrhage following tooth extractions. She had been treated elsewhere without benefit with multiple blood transfusions, antihemophilic globulin, splenic irradiation, protamine sulfate, Rutarbin, Koagamin, and ovarian irradiation. On physical examination the findings of note were cutaneous ecchymoses, and limitation of motion and deformity of several of the large joints attributable to old hemarthroses. The remainder of the physical examination was not remarkable. The whole blood clotting time was prolonged to between three and five hours, but the prothrombin time was normal.