History of blood transfusions and soldiers at war
In 1628, Dr William Harvey was an English physician who published a book in which he described the circulation of blood in humans. Researchers commenced experiments involving the intravenous injection of various substances into animals, which progressed into blood transfusions between animals. Richard Lower, a member of the Oxford Experimental Group, showed that transfusion could be used in cases of severe blood loss by exsanguinating a dog and transfusing it with blood from another.
Dr Jean-Baptiste Denys (1643–1704) was personal physician to King Louis XIV and was noted for having performed the first fully documented human blood transfusion. In 1667 he administered transfusions of calf's blood to a man who died during the transfusion. Denys was charged with murder and although he was acquitted, the practice of blood transfusion was deemed a criminal act by the French parliament in 1670. The Royal Society expressed uncertainty about blood transfusion and the next year Pope Innocent XI banned it. Experimentation was certainly slowed down.
Dr James Blundell (1790-1878) was an English obstetrician who performed the first successful transfusion of human-to-human blood, to treat a haemorrhage in 1829. Blundell introduced two instruments for transfusions (the impellor and the gravitator) which appeared in The Lancet of 1829.
Dr Blundell's blood transfusion
Having been impressed by a voluntary blood transfusion carried out in London’s King’s College Hospital, Percy Lane Oliver set up a volunteer panel of blood donors in 1921. This eventually led to the creation of the British Red Cross Blood Transfusion Service.
It was not until the Spanish Civil War that large-scale blood transfusion became possible. This was among the first conflicts to result in widespread targeting of civilians; Dr Frederic Durán-Jordà established a blood transfusion service in Barcelona in 1936, for transfusing both soldiers and civilians. Sadly for Spain, he was exiled to the UK after the Civil War.
Dr Norman Bethune was a surgeon who was invited by the Committee to Aid Spanish Democracy to bring a surgical team to Madrid in 1936. Recognising the importance of bringing blood to wounded soldiers and civilians where they fell, rather than transporting patients to hospital for transfusion, Bethune introduced the mobile blood bank.
In the USA, Dr Charles Drew proved that plasma could be stored significantly longer than whole blood. He supervised the Blood for Britain Campaign which met the desperate need for blood to treat those wounded during the Blitz. To encourage donation, Drew first devised the use of bloodmobiles, trucks with refrigerators serving as donation centres, early in WW2.
The main stimulus to develop blood and blood component therapy in the US was the Japanese attack on Pearl Harbour. Dr Edwin J Cohn of Harvard University developed a method of manufacturing albumin, a soluble protein found in blood plasma, for transfusion. Medics on the battlefield simply reconstituted the dried plasma by adding water before transfusion, saving hundreds of thousands of lives in the Pacific battlefields.
The Korean War (1950–53) saw the invention of a simple plastic bag and led to a major development in blood transfusion. The bag had many advantages over the glass bottles, in terms of weight, storage and transport. The first polyethylene blood collection bag had two tubes, one for blood collection and one to deliver blood to the recipient.
War was always the major force in the organisation of blood supplies and stimulated the development of new medical technologies! Thank you to Shaun McCann, George McLoughlin and Phil Learoyd.
Dr Jean-Baptiste Denys (1643–1704) was personal physician to King Louis XIV and was noted for having performed the first fully documented human blood transfusion. In 1667 he administered transfusions of calf's blood to a man who died during the transfusion. Denys was charged with murder and although he was acquitted, the practice of blood transfusion was deemed a criminal act by the French parliament in 1670. The Royal Society expressed uncertainty about blood transfusion and the next year Pope Innocent XI banned it. Experimentation was certainly slowed down.
Dr James Blundell (1790-1878) was an English obstetrician who performed the first successful transfusion of human-to-human blood, to treat a haemorrhage in 1829. Blundell introduced two instruments for transfusions (the impellor and the gravitator) which appeared in The Lancet of 1829.
Blood transfusion nurses, end of WW1
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Postpartum haemorrhage, extreme malnutrition, puerperal fever, ruptured uterus and hydrophobia were all indications for transfusion then. Ten transfusions performed by Dr Blundell in the literature but of these, only five were described as successful.
When the Franco-Prussian War (1870–71) was raging in Europe, the possibility of using blood transfusions on the battlefield arose. Dr J Roussel of Geneva had first used his method of direct arm to arm transfusion with success in 1865 for a patient with puerperal haemorrhage. The apparatus he used was described in the Gazette des Hospitaux in 1867, though Roussel complained in 1876 that the apparatus was not used as it might have been in the Franco-Prussian war.
To overcome the hazard of coagulation and to prevent exposure of the donor's blood to air, obstetrician Dr James Aveling made a simple apparatus for direct transfusion from donor to recipient's vein in 1865. In 1872 a patient had suffered a severe postpartum haemorrhage; an immediate transfusion was made and the patient made a good recovery. And when no other therapies seemed to work with severe anaemia, transfusions became an acceptable practice from the late 1870s up to WWI.
Not only did doctors not know how to stop blood clotting in the late C19th, but when they did manage transfusion, the patient could still inexplicably die. It wasn’t until the C20th that different blood groups were discovered! Identification of three major blood groups was described by Nobel Prize winner Karl Landsteiner in 1901. 6 years later, Czech neurologist Dr Jan Jansky accurately described four major blood groups (A, B, O and AB). This was the critical issue!
Yet despite new knowledge of blood groups and prevention of blood clotting, blood transfusion was not widely adopted in WW1. Note that in 1915, Capt OH Robertson of Harvard Medical School demonstrated that blood could be safely transfused to wounded soldiers. He developed the transfusion bottle and pioneered universal donor blood, but the medical profession remained very sceptical.
Not only did doctors not know how to stop blood clotting in the late C19th, but when they did manage transfusion, the patient could still inexplicably die. It wasn’t until the C20th that different blood groups were discovered! Identification of three major blood groups was described by Nobel Prize winner Karl Landsteiner in 1901. 6 years later, Czech neurologist Dr Jan Jansky accurately described four major blood groups (A, B, O and AB). This was the critical issue!
Yet despite new knowledge of blood groups and prevention of blood clotting, blood transfusion was not widely adopted in WW1. Note that in 1915, Capt OH Robertson of Harvard Medical School demonstrated that blood could be safely transfused to wounded soldiers. He developed the transfusion bottle and pioneered universal donor blood, but the medical profession remained very sceptical.
The Lancet 1829
Having been impressed by a voluntary blood transfusion carried out in London’s King’s College Hospital, Percy Lane Oliver set up a volunteer panel of blood donors in 1921. This eventually led to the creation of the British Red Cross Blood Transfusion Service.
It was not until the Spanish Civil War that large-scale blood transfusion became possible. This was among the first conflicts to result in widespread targeting of civilians; Dr Frederic Durán-Jordà established a blood transfusion service in Barcelona in 1936, for transfusing both soldiers and civilians. Sadly for Spain, he was exiled to the UK after the Civil War.
Dr Norman Bethune was a surgeon who was invited by the Committee to Aid Spanish Democracy to bring a surgical team to Madrid in 1936. Recognising the importance of bringing blood to wounded soldiers and civilians where they fell, rather than transporting patients to hospital for transfusion, Bethune introduced the mobile blood bank.
In the USA, Dr Charles Drew proved that plasma could be stored significantly longer than whole blood. He supervised the Blood for Britain Campaign which met the desperate need for blood to treat those wounded during the Blitz. To encourage donation, Drew first devised the use of bloodmobiles, trucks with refrigerators serving as donation centres, early in WW2.
The main stimulus to develop blood and blood component therapy in the US was the Japanese attack on Pearl Harbour. Dr Edwin J Cohn of Harvard University developed a method of manufacturing albumin, a soluble protein found in blood plasma, for transfusion. Medics on the battlefield simply reconstituted the dried plasma by adding water before transfusion, saving hundreds of thousands of lives in the Pacific battlefields.
The Korean War (1950–53) saw the invention of a simple plastic bag and led to a major development in blood transfusion. The bag had many advantages over the glass bottles, in terms of weight, storage and transport. The first polyethylene blood collection bag had two tubes, one for blood collection and one to deliver blood to the recipient.
War was always the major force in the organisation of blood supplies and stimulated the development of new medical technologies! Thank you to Shaun McCann, George McLoughlin and Phil Learoyd.
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