EARLY HISTORY OF BLOOD-TRANSFUSION

EARLY HISTORY OF BLOOD-TRANSFUSION

792 EARLY HISTORY OF BLOOD-TRANSFUSION beginners are spurred to explore for themselves and develop precision of observation and discrimination in ev...

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EARLY HISTORY OF BLOOD-TRANSFUSION

beginners are spurred to explore for themselves and develop precision of observation and discrimination in evaluating different techniques. Dr. Carleton also misses a few opportunities of pointing out the physiological significance of the facts he gives. For example, he mentions the experimental work of Langley and Anderson, in which they demonstrated to

that the central end of the severed vagus nerve passes into and ends within the superior cervical ganglion of the sympathetic, but says nothing of the bearing of this finding on the question of cholinergic endings.

transfusion is also mentioned in Hermann Grube’s " De Transplantatione Morborum Analysis nova " of 1674. G. A. Mercklin’s " De Ortu et Occasu Transfusionis Sanguinis," published at Nuremberg in 1679, contains the earliest illustrations of blood-transfusion. The frontispiece depicts a transfusion from animal to man and two scenes of transfusion from man to man by the veins of either the arms or the hands.

Synopsis of Clinical Laboratory Methods (2nd ed.) By W. E. BRAY, B.A., M.D., professor of clinical pathology, University of Virginia ; director of clinical laboratories, University of London: Henry Kimpton. Virginia Hospital.

Pp. 408.

18s.

THE second edition of this book presents clearly practical directions for clinical pathology, including bacteriology, hsematology and biochemistry. The book is intended solely for the one-man pathologist, and as such will be useful. It is popular in America.

EARLY HISTORY OF BLOOD-TRANSFUSION

FIG. I-The syringe with its pipe and funnel ready for use : (a) the cylinder ; (b) the piston ; (c) the pipe, the extremity of which is introduced into the vein ; (d) the funnel ; (e) the lever, which acting on (f), the stop-cock, opens or closes the communication of the syringe with the funnel or pipe as may be required. FIG. 2-The stop-cock turned by the depression of the lever (e), shown in fig. 1.

The astonishing fact is that the transfusion of sheep’s blood was successful in the first two cases. Subsequently, however, numerous fatalities led the

IN the first issue of a new medical periodical, Dr. Cochran gives a brief outline of the history of blood-transfusion.1 In 1661, forty-five years after Harvey’s discovery of the circulation of the blood, Richard Lower,2a London anatomist, performed the first successful blood-transfusion, uniting with a goose-quill an artery of a dog with a vein of another dog. He repeated his experiment before the Royal Society. In 1662 Jean-Baptiste Denis, using 9 oz. of lamb’s blood, performed the operation for the first time on a human being-a boy, aged 15, anaamic from repeated venesection for fever. Astonishing improvement is said to have taken place. On Nov. 23, 1664, Lower and King performed their first transfusion on a man and used sheep’s blood. The operation was performed repeatedly at meetings of the Royal Society before 1671, the object being to stave off impending insanity. Lower2 wrote that " Harvey became pre-eminent by first demonstrating that blood circulated in the vessels inside the body. That this circulation could be extended outside the body was first discovered by me." Samuel Pepys met the patient on Nov. 30, 1667, and described him " cracked a little in his head " and " the first sound as man that ever had it tried in England, and but one Lower was probably also we hear of in France." the father of intravenous therapy, for he experiinjected into the veins of living animals mentally " various solutions of opiates, emetics, and kindred other medicines," besides wine and beer. Further details of the early history of bloodtransfusion are available from other sources. In 1667 Denis’s Letter on the Transfusion of Blood was translated into English, but suppressed by the editor of the Philosophical Transactions. In 1668 George Actonsuggested the transfusion of the blood of stags, eagles, and other long-living animals to prolong human life. In the same year Emilio Maria Manolessi published his " Relazione dell’ Esperienze fatte in TrasInghilterra, Francia, ed Italia intorno alla fusione del Sangue," giving details not only of the English and French experiments but also of similar operations performed at Rome and Bologna. Blood-

was

1. Cochran, G. C., jun., Brooklyn Hosp. J. January 1939, p. 52. 2. Lower, R., Treatise on the Heart, 1671. 3. Acton, G., Physical Reflections upon a Letter written by J. Denis to Monsieur de Montmort ... concerning a New Way of Curing sundry Diseases by Transfusion of Blood, London, 1668.

4. Lane, S., Lancet, 1840-41, 1, 185. 5. Holmes, T., and Hulke, J. W., A System of Surgery, 3rd ed., London, 1883, vol. i, p. 356. 6. Trans. obstet. Soc. May 4, 1874. 7. Roussel, J., Transfusion of Human Blood, London, 1877.

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Parisian court to forbid transfusions from animals to Pope issued a special edict to ban it. Consequently the practice lay dormant for 150 years, until it was resuscitated by James Blundell (1790-1877) for post-partum haemorrhage (see the memoir at the end of Ashwell’s Practical Treatise on Parturition, London, 1828). It was he who discovered that blood from the same species was necessary for a safe transfusion. He has eleven successful transfusions to his credit. Severe reactions and occasional deaths led Prevost and Dumas in 1826 to suggest the use of defibrinated blood, but the first transfusion of such blood was done by Larsen in 1847 with an egg-beater. In 1840, Samuel Lane,4lecturer on anatomy and surgery in St. George’s School at Hyde Park Corner, being called in to attend to a boy, aged 11, dying from haemorrhage after a slight operation (Dieffenbach’s) for squint, consulted Blundell concerning his technique and experience of blood-transfusion and proceeded to perform it on the boy with a syringe, tube, and funnel (see figure). About 10-12 oz. of blood was taken from " a stout healthy young woman," and " in the course of an hour or two the boy sat up in his bed and drank a glass of wine and water from his own hand." An idea of the position of blood-transfusion in surgery about half a century later can be gained from Holmes and Hulke,5 who said: " The name of Dr. Blundell is permanently associated with the operation of transfusion." They mentioned the transfusion of other substances-e.g., milk for haemorrhage by and, in America, sheep’s blood for Wagstaffe " phthisis." They also said that " Monsieur Roussel has proposed repeated transfusion of healthy blood as a remedy in mental disorders "-a harking back to Lowell in 1664. It was recognised that, for " haemorrhage, in great emergencies water alone may be injected." Aveling’s apparatus6 for direct transfusion was said to be simple, whereas that of Roussel7 man, and in 1675 the

complicated.