The Effect of [3,3′—Methylene—Bis—(4-Hydroxycoumarin)] (Dieumarol) on the Prothrombin and Coagulation Times of the Blood
Abstract
After experimenting with spoiled sweet clover for several years, Link and his associates1 in 1941 isolated the active hemorrhagic factor (3,3′— methylene—bis—(4-hydroxycoumarin)] and were able to produce it by synthesis. This work was probably stimulated by the observations of Schofield2 and Roderick.3 Although it had been known for many years that cattle occasionally showed signs of hemorrhage for no obvious reason, it remained for these workers to demonstrate that this hemorrhagic tendency was related to the eating of spoiled sweet clover. In June 1941 Butt, Allen, and Bollman4 reported that the oral administration of this compound to animals and man prolonged the prothrombin and coagulation times with an effect similar to that of heparin.
During the past six months this drug has been used clinically in over 20 cases in which such a reaction would be helpful in the management of the patient. Table 1 shows the clinical conditions treated.
| Disease | No. of Cases |
|---|---|
| Pulmonary embolism postoperative | 4 |
| Acute thrombophlebitis | 8 |
| Rheumatic heart disease with subacute bacterial endocarditis | 6 |
| Thrombo-angiitis obliterans | 4 |
| Thrombosis retinal vein | 1 |
| Total cases | 23 |
The following three cases are presented to show the effects of [3,3′— methylene—bis (4-hydroxycoumarin)] on the prothrombin and coagulation times.*
Although no name has been definitely adopted for this preparation, it will be referred to as dieumarol in the following cases. These are among the earlier cases treated with this drug, and as yet the dosage has not been standardized. As will be observed, the drug was used. . .
