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Rh injury. In severe cases, this was a necessary adjunct to the local use of the drug. The discovery of the "sulfa drugs" and the discovery of the use of blood plasma are the two greatest advances in war surgery since anesthesia and antisepsis were given to the world. They have put into our hands better, surer means of saving the wounded from infection and from the fatal effects of shock than those of us who served in the military hospitals during World War I ever expected to see. The best field preventive of shock is blood plasma. It should be given to all seriously wounded patients as soon after injury as possible; certainly within from five to ten minutes after they are received at the first casualty clearing station. Transfusions of plasma, given at this time, do more to cut down the mortality from shock than any other single factor we have at hand today.

Today every ship in the United States Navy carries a large supply of dried blood plasma. Liquid plasma, ready for immediate use, is a must in every naval hospital. Every hospital corpsman, at battle stations, carries a first-aid kit which contains syrettes of morphine to be administered to all gravely injured and a supply of blood plasma and sterile needles for prompt intravenous therapy.

Blood plasma is human blood from which the blood cells have been removed. It has the advantage over whole blood in that it does not require typing. Also, it can be given on the field more rapidly and easily than whole blood can be transfused. The powdered plasma has only to be regenerated by the addition of distilled water, which does not have to be warmed prior to injection. In preparing the dry plasma, the blood is processed and the plasma separated, dried, and packed in compact, waterproofed containers, ready for instant use. Liquid plasma has been transported without refrigeration from Washington to California and to Cuba for use by medical officers stationed there.

In cases where there has been considerable hemorrhage, whole blood must be administered. But even in these cases it is often wise