To the Editor:— InThe Journal, Sept. 17, 1955, page 171, Krevans and Jackson described a "Hemorrhagic Disorder Following Massive Whole Blood Transfusions" associated with a fall in platelet level. It is well known that simple reduction of circulating platelets is not enough to produce hemorrhage. Other factors are involved, especially those that injure capillary walls. It is my feeling that one such factor is time alteration of bank blood. Most banks allow blood to be used within 21 days. During this time, even under the best conditions of storage, many leukocytes, erythrocytes, and platelets die and become not only useless but probably toxic in effect. Also, as time goes on, the multiplication of psychrophilic micro-organisms increases the toxic effect of certain units of stored blood. Small as each of these factors may be in one pint, their cumulative effect can be dangerous in massive transfusions. Then, the combination of