Download PDF
Thromb Haemost 1965; 14(03/04): 626-639
DOI: 10.1055/s-0038-1654896
Übersichten — Review — Revues Générales
Schattauer GmbH

The Hemostatic Paradox and its Present Problems

Jacques Roskam
1   Professor Emeritus of the University of Louvain
› Author Affiliations
Further Information

Publication History

Publication Date:
27 June 2018 (online)

Also available at
    Permissions and Reprints

Summary

In recent years great progress has been made concerning the reasons of many paradoxical data recorded in disordered arrest of bleeding. They are emphasized in the present paper where some of the still unsolved problems are merely mentioned.

From the data recently disclosed, the role of platelets in hemostasis appears even more prominent than before : they are not only the building stones of the dam which stops the blood flowing from small arteries and veins, but they also bring with them in their “plasmatic atmosphere” the cement, i.e. the adsorbed blood clotting factors, which causes them to be firmly united into a sort of concrete.

Then this biological concrete is transformed into a sort of armoured-concrete by means of fibrin strands originated in the free circulating plasma. These strands strengthen the hemostatic plug and fasten it more firmly to the lips of the wound.

Analysis of hemorrhagic diseases discloses that besides platelet and/or blood clotting deficiencies, a peripheral factor not infrequently contributes, sometimes for a great part, to prolonged arrest of bleeding.

Such analysis also confirms usual “multicausation” in disordered hemostasis.

 

  • References

  • 1 Apitz K, Hühn V. Über die Thrombopenie bei Benzolvergiftung der Ratte. Z. ges. exp. Med. 111: 540 1943;
    PubMedGoogle Scholar
  • 2 Bedson S. P. Blood-platelet anti-serum, its specificity and role in the experimental production of purpura. J. Pathol. Bact. 25: 94 1922;
    CrossrefPubMedGoogle Scholar
  • 3 Bizzozero G. Sur un nouvel élément morphologique du sang chez les mammifères et sur son importance dans la thrombose et dans la coagulation. Arch. it. Biol. 01: 1 1882;
    PubMedGoogle Scholar
  • 4 Bizzozero G. D’un nouvel élément morphologique du sang chez les mammifères et sur son importance dans la thrombose et dans la coagulation. Arch. it. Biol. 02: 345 1882; and 3: 94 (1883).
    PubMedGoogle Scholar
  • 5 BorchgrevinJc C. F, Owren P. A. The hemostatic effect of normal platelets in haemophilia and factor V deficiency. Actamed. scand. 170: 375 1961;
    PubMedGoogle Scholar
  • 6 BorchgrevinJc C. F, Waaler B. A. The secondary bleeding time. A new method for the differentiation of hemorrhagic diseases. Acta med. scand. 162: 361 1958;
    PubMedGoogle Scholar
  • 7 Bounameaux Y. Dosage des facteurs de coagulation contenus dans l’atmosphère plasmatique des plaquettes humaines. Rev. franç. Etud. clin. biol. 02: 52 1957;
    PubMedGoogle Scholar
  • 8 Bounameaux Y. L’accolement des plaquettes à une surface étrangère. Thrombos. Diathes. haemorrh. (Stuttg.) 01: 209 1957;
    PubMedGoogle Scholar
  • 9 Bounameaux Y. L’accolement des plaquettes aux fibres sous-endothéliales. Thrombos. Diathes. haemorrh. (Stuttg.) 06: 504 1961;
    PubMedGoogle Scholar
  • 10 Bounameaux Y, Roskam J, Lewalle J. The resistance of the hemostatic plug “in vivo” in healthy men, in thormbocytopenia and under the influence of indirect anticoagulants in Hemophilia and other hemorrhagic states. Univ. North Carolina Press; 251 1959
    Google Scholar
  • 11 Brohm : Quoted by E. Frank.
    PubMed
  • 12 Gaen J, Cousin C. Le trouble d’adhésivité « in vivo » des plaquettes dans la maladie de Willebrand et les thrombasthénies de Glanzmann. Nouv. Rev. franç. Hémat. 02: 685 1962;
    PubMedGoogle Scholar
  • 13 Denys J. Etudes sur la coagulation du sang dans un purpura avec diminution notable des plaquettes. Cellule. 03: 445 1887;
    PubMedGoogle Scholar
  • 14 Dishoek HAEv, Jongkees LBW. A new way to determine bleeding time. Lancet. 238: 692 1940;
    PubMedGoogle Scholar
  • 15 Duesberg J. P. Le temps de saignement humain selon la technique de Dishoek et Jongkees. Rev. belge Path. 18: 333 1947;
    PubMedGoogle Scholar
  • 16 Duke W. W. The relation of blood platelets to hemorrhagic disease. J.A.M.A. 55: 1185 1910;
    CrossrefPubMedGoogle Scholar
  • 17 Frank E. Die hämorrhagischen Diathesen. In: Schittenhelms Handbuch der Krankheiten des Blutes. Bd. 2, S. 289 Springer; Berlin: 1925
    Google Scholar
  • 18 Hardisty R. M, Dormandy K. M, Hutton R. A. Thrombasthenia. Studies on three cases. Brit. J. Haematol. 10: 371 1964;
    PubMedGoogle Scholar
  • 19 Hayem G. Sur le mécanisme de l’arrêt de hémorragies. C.R. Acad. Sci. Paris. 95: 18 1882;
    PubMedGoogle Scholar
  • 20 Hugues J. Contribution à l’étude des facteurs vasculaires et sanguins dans l’hémostase spontanée. Arch, intern. Physiol. 61: 565 1953;
    PubMedGoogle Scholar
  • 21 Hugues J. Accolement des plaquettes aux structures conjonctives périvasculaires. Thrombos. Diathes. haemorrh. (Stuttg.) 08: 241 1962;
    PubMedGoogle Scholar
  • 22 Hugues J. Unpublished observations.
    PubMed
  • 23 Hugues J, Lapiére C. M. Nouvelles recherches sur l’accolement des plaquettes aux fibres du collagène. Thrombos. Diathes. haemorrh. (Stuttg.) 11: 327 1964;
    PubMedGoogle Scholar
  • 24 Inceman S, Caen J, Bernard J. La « métamorphose visqueuse » des plaquettes de thrombasthénie de Glanzmann. Nouv. Rev. franç. Hématol. 03: 575 1963;
    PubMedGoogle Scholar
  • 25 Jackson D. P, Morse E. E, Zieve P. D, Conley C. L. Thrombocytopathic purpura associated with defective clot retraction and absence of platelet fibrinogen. Blood. 22: 827 1963;
    PubMedGoogle Scholar
  • 26 Jaques L. B. Spontaneous hemorrhage with anticoagulants. Circulation. 25: 130 1962;
    CrossrefPubMedGoogle Scholar
  • 27 Johnson S. h, Monto R. W, Rebuck J. W. Specific platelet alterations related to hematological disorders in Blood platelets. 523 Little: Brown and Cy, Boston (Mass); 1960
    Google Scholar
  • 28 Jorgensen L, Borchgrevink C. F. The haemostatic mechanism in patients withhaemorrhagic diseases. Acta path, microbiol. scand. 60: 55 1964;
    CrossrefPubMedGoogle Scholar
  • 29 Lewalle J, Bounameaux Y, Roskam J. Etude clinique in vivo de la résistance du clou hémostatique chez l’homme. Thrombos. Diathes. haemorrh. (Stuttg.) 03: 165 1959;
    PubMedGoogle Scholar
  • 30 Macfarlane R. G. In 1er Symposium de la Fondation Valentino Baldacci. Madrid, 27—30 mai 1955. 96 Omnia Medica; Pisa: 1955
    Google Scholar
  • 31 Movat H, Fernando N. Allergie inflammation. The earliest fine structural change at the blood-tissue barrier during antigen-antibody interaction. Al. J. Pathol. 42: 41 1963;
    PubMedGoogle Scholar
  • 32 Nilsson I. M, Blombäck M. Von Willebrand’s disease in Sweden. Occurrence, pathogenesis and thromboplastin in Heparin and Thromboplastin with a Survey on von Willebrand’s disease. Thrombos. Diathes. haemorrh. (Stuttg.) Suppl. 2 ad vol. 09: 103 1962;
    PubMedGoogle Scholar
  • 33a O’Brien J. R. A comparison of platelet aggregation produced by seven compounds and a comparison of their inhibitors. J. clin. Pathol. 17: 275 1964;
    CrossrefPubMedGoogle Scholar
  • 33b Owren P. A. The haemostatic plug. In: Fibrinogen and fibrin. Turnover of clotting factors. Thromb. Diath. haemorrh. (Stuttg.) Suppl. 13: 325 1964;
    PubMedGoogle Scholar
  • 34 Roskam J. Contribution à l’étude de la physiologie normale et pathologique du globulin (plaquette de Bizzozero). Arch, intern. Physiol. 20: 241 1923;
    PubMedGoogle Scholar
  • 35 Roskam J. Pathogénie de la prolongation des hémorragies dans les syndromes hémogéniques et dans l’hémophilie vraie. Presse méd. 972 1923;
    PubMedGoogle Scholar
  • 36 Roskam J. Purpuras hémorrhagiques et thrombopénie (Etude clinique). Sang. 03: 497 1929;
    PubMedGoogle Scholar
  • 37 Roskam J. Purpuras hémorragiques et thrombopénie (Etude expérimentale). Sang. 08: 129 1934;
    PubMedGoogle Scholar
  • 38 Roskam J. Syndromes hémophilohémogéniques par administration de liquoïde. Sang. 08: 605 1934;
    PubMedGoogle Scholar
  • 39 Roskam J. Introduction à l’étude pharmacodynamique des hémostatiques par la méthode de la corrélation. Arch, intern. Pharmacodyn. 58: 28 1938;
    PubMedGoogle Scholar
  • 40 Roskam J. Mécanisme de la prévention et du traitement des thromboses par l’héparine. Arch, intern. Pharmacodyn. 68: 66 1942;
    PubMedGoogle Scholar
  • 41 Roskam J. L’hémostase spontanée. 188 Masson; Paris: 1951
    Google Scholar
  • 42 Roskam J. Faits et hypothèses dans les domaines de l’hémostase spontanée, de la thrombose et de la coagulation. Schweiz, med. Wschr. 90: 947 1960;
    PubMedGoogle Scholar
  • 43 Salmon J. Fibrinolyse et pathologie vasculaire. 219 Editions Arscia, S.A; Bruxelles: 1964
    Google Scholar
  • 44 Sokal G. Plaquettes sanguines et structure du caillot. 234 Editions Arscia, S.A; Bruxelles: 1960
    Google Scholar
  • 45 Tanjun Y, Caen J. Platelet adhesion and cohesion to the mesenter of tne rat. IEG # 2 Scientific Memo # 20 (1964) (communication personnelle).
    PubMedGoogle Scholar
  • 46 Tocantins L. M. The mechanism of hemostasis. Ann. Surg. 125: 292 1947;
    CrossrefPubMedGoogle Scholar
  • 47 Ungar G, Yamura T, Isola J, Kobrin S. Further studies on the role of protease in the allergic reaction. J. exp. Med. 113: 354 1961;
    PubMedGoogle Scholar
  • 48 Zucker M. B. Platelet release and aggregation as related to the definition of viscous metamorphosis. Thrombos. Diathes. haemorrh. (Stuttg.). (In press.)
    PubMedGoogle Scholar
  • 49 Zucker M. B. Unpublished observations quoted in IEG # 2 Scientific Memo # 17 Part II (1964). (communicationpersonnelle).
    PubMedGoogle Scholar
  • 50 Zucker M. B, Borrelli J. Platelet dumping produced by connective tissue suspensions and by collagen. Proc. Soc. exp. Biol. (N.Y.) 109: 779 1962;
    CrossrefPubMedGoogle Scholar