TREATMENT OF PARAPLEGIA RESULTING FROM TRAUMA TO THE SPINAL CORD

4. Blood.— As already indicated, the first weeks after spinal cord injury are marked by an extremely abnormal blood picture. In the first twenty-four hours there begins a series of poorly understood changes. Serum protein begins to fall sharply, followed later by a drop in hemoglobin, and later by a decrease in red blood cells. At the end of the first week, the serum protein may reach levels below 5.0 Gm. per hundred cubic centimeters, the hemoglobin below 10 Gm. per hundred cubic centimeters and the red blood cells below 3,500,000 per cubic millimeter. In the presence of decubiti and bladder infection, these low levels are usually reached, and the albumin-globulin ratio is reversed. If decubiti are not present at this time, they are most likely to develop unless careful turning is carried out. It is far better to anticipate these changes by the administration of whole blood, calculated as 1 pint (473 cc.) for each 0.5 Gm. that