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The “Servicio Hispano-Canadiense de Transfusion de Sangre” in the Spanish Civil War (1936-1939)
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14
BULLETIN O F ANESTHESIA HISTORY
The " Servicio Hispano-Canadiense de Transfusion de Sangre" in the Spanish Civil War ( 1 936- 1 939) by A. Franco, M.D., Ph.D.; J.e. Diz, M.D., Ph.D.; RJ. Aneiros, M.D.;J. Cortes, M.D., Ph.D., andJ. Alvarez, M.D., Ph.D. Sel'vicio de Anestesiologia y Reanimaci6n, Hospital General de Galicia-Clinico Universitario, Santiago, Spain
At the outbreak of the Spanish Civil War ( 1 9 3 6 - 1 939) in J uly, 1 936, there was no proper development of blood transfusion techniques in Spain, which were in a stage that we could designate as the "heroic pe riod." Also, the Spanish Army lacked a for mally organized blood bank and conse quently the need to improvise transfusion centres on both the loyalist (Republican) and rebel (right-wing Nationalist) sides was urgent due to the increas ing number of wounded. These centres were probably the first that appeared in the history of mili tary medicine.! In Madrid j ust before the war, there were two departments of Hematology, one in the hospital of the Red C ross (Dr. EI6segui), and the other in the School of Medicine (Prof. Pittaluga) .!-3 But d ue to the partition of the country after the national uprising, the Red Cross department j o ined the army of General Franco, while the other stayed
Figure 1: Norman Bethune in Spain, 1 937.
in the republican side. In the same period, the Republicans organized a centre of pre served blood in Barcelona at the end of August, 1 936, under the initiative of the Partido Socialista Unificado (Unified Social ist Party) and directed by the hematologist D r. Frederic D unln Jorda. This centre sup plied blood to the Arag6n battlefronts. 4•s These three centres were operating in Sep tember, 1 936.3 The well-known C a n a d ian s urgeon Norman B e th une ( 1 890- 1 9 39) a rrived Mad rid in November, 1 9 3 6, when the battles a round Madrid were especially in tense. He r e a l ized t h a t the s upply of blood was an immediate priority and he o rganized the " S e rvicio Canadiense de Transfusi6n de Sangre," which played an important role in the war and was a clea r example of t h e social ideas of B ethune . In this paper we will offe r a s ummary of the h istory of this centre of blood trans fus i o n , b a s e d on s o m e documents we found re cently, which co rroborate the info rm a tion we h a d previously. Norman B e t h un e (1 890-1 939) (Figure 1), was b o rn in Graven h urst, Onta rio, and was a thoracic s urgeon in Montreal in the early 1 930s. From an early age he was drawn to social ist ideas and was an active member of the communist pa rty. He went to Russia to study socialized medicine and was a social activist who to the was d rawn anti-fascist cause in Spain. S upported by the Canadian Committee to Aid Spanish De mocracy, he arrived Madrid at the beginning of Novem ber, 1936. He immediately made several trips around the country, visited Repub lican a rmy hospitals, and came into contact with sev eral Republican authorities and the International B ri-
gades. He then established, in a central street in M adrid (Principe de Ve rga ra street), a blood transfusion centre which he called the Servicio Canadiense de TJ'ansfusi6n de Sangre (Canadian Service of Blood Trans fusion) (Figure 2) . The centre's staff com prised Bethune and three other Canadians, one American and six Spaniards, two of the last being physicians. Bethune left Spain on May 1 8, 1 937, and was welcomed in Canada as a hero. Later he j o ined the Red Army of Mao Zedong, in which he developed an important activity. He died in China as a result of septicemia contracted th rough a finger inj ury s us tained during an operation in Octobe r, 1939. Bethune is considered a national hero in China.6-1o Instituto Hispano-Canadiense de Transfusion de Sangre
Aft e r t h e visits of B e th un e to the battlefronts a ro und Madrid, he realized that there was an urgent need to s upply blood to the wounded. Then he traveled to Paris and London to buy mate rial with the funds of the Canadian Committee, and also to learn the techniques of blood p reservation. Th e transfusion centre sta rted work without delay and, aided by p ublicity on the radio and in the press, the centre had 1 000 donors on its books by the end ofl936. Each donor gave 500 mI., about eight pro cedures being pe rformed each day. The blood was p ut into a bottle labelled with the name of the donor and the date of ex traction and, after adding a sodium citrate solution to the bottle, it would be placed in a refrigerator at 1 DC. The centre supplied blood to the fronts a round Madrid, as did those of the S ierra d e G ua d a rrama and the U n iv e r s ity. Bethune himselfwent with the blood to the battlefronts several times. The service soon expanded, with control of three other cen ters in Madrid, Valencia af.ld J aen, supply ing blood to many major battles of the war, including J a rama, Guadalaj a ra, Malaga and B runete. Although the activity of the centre was clearly beneficial for the loyalist side, the republican a uthorities decided to supervise
BULLETIN OF ANESTHESIA H ISTORY
15
taking the blood to the wounded and not the wounded to the blood. Bethune him selfwent often to the battlefront in the Ford vans of the Institute, the so-called rubias (blondes), provided by the Canadian COIll mittee to Aid Spanish Democracy. Bethune also visited other cities in the ea rly part of the war and traveled from Barcelona to Malaga (about 1 200 km) along the Mediterranean coast in a Renault car, trying to ascertain if the techniques of blood preservation were correct. Near Malaga he witnessed the battle there, assisting some of the 40,000 people esca ping from Malaga to Almeria, and so saw first-hand some of the barbaric fighting by the Fascists on the Mediterranean coast, one of the most fa mous episodes of the stay of Bethune in Spain (Figure 4) . The labor of Bethune and his team was also significant scientifically since they contributed to the spread of techniques of blood preservation and indirect transfu sion. As an example, the c entre of Prof. Pittaluga in Madrid had made 700 direct transfusions before the a rrival of Bethune, Continued Oil Next Page
Figure 2: Staff of the "Servicio Canadiense de 1l'ansfusion de Sangre/' in the Principe de Vergara Street, just besides the headquarters of the Institute, with a Renault tyuck. its operations more closely and incorpo ra ted to the staff more Spanish doctors. Later, in Februa ry, 1937, the Republican authorities combined the lwo centres of blood transfusion of Madrid (the centre of Bethune and the centre of the School of Medicine directed by Prof. Pittaluga) in a single Institute, the Instituto Hispano Canadiense de Tra nsfusion de Sangre (Spanish-Canadian Institute of B lood Transfusion) . Initially Bethune was the di rector of this Institute (commissioned at the rank of Major), sharing the responsi bilities with the Spanish Major Vicente Goyanes. Bethune did not like this new situation and his relations with the Republican offi cials became strained, owing to the constant pressure they placed on him and to his impatience and independence and overin dulgence in alcohol. Under these circum stances, Bethune left Spain in May, 1 937. In October, 1 937, D r. Vicente Goyanes (Figure 3) became the chief of the Insti tute that operated until March, 1 939, when the troops of General Franco conquered Madrid.ll In 1937 the staff of the Institute numbered 1 00 and the donors 3,875; five cars transported the blood to the transfu sion sites. An average of 1 00 liters of blood
were transfused e a c h month, although i n cer t a i n b a t t l e s a ro un d Madrid they transfused up to 1 00 liters a day. A total of 1 900 transfu sions were performed in 1 937. Significance of the work of Bethune in Spain
The centre of blood t r a nsfusion tha t Bethune organized was not the first of the Span ish Civil War, but it was very important because of its humanitarian role and unique o rganiza tion. Especially impor tant was his concept of
Figure 3: Major Vicente Goyanes Alvarez, head of the Institute after Bethune, in a Ford van provided by the Canadian Committee.
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BULLETIN OF ANESTHESIA HISTORY
Civil War
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COIllill I/ed ji-om Page 15
but they did not preserve the blood.12 However, Bethune recognized that, sci entifically, the most important centre of blood transfusion of the republican side was the centre of Barcelona headed by the hematologist Frederic Duran Jorda.4 This centre had better equipment and higher scientific standards. Bethune emphasized that his Institute had a good organization and that it took the blood directly to the ba ttlefronts. The Institute of Bethune was in con tact with other centres of blood transfu sion on the Republican side, including t h o s e of B a r c e l o n a ,4 Va l e n c i a l ] a n d Linares . There were other centres work ing independently, not so closely con nected to the Republican authorities, in the R e d C r o s s o f B a r c e l o n a ( D r. Miserachs),14 and a blood bank in Geneva which sent preserved blood to Catalufia and Valencia (Roger Fischer) , I 5 Comments
The life and activity of Norman Bethune has been possibly magnified, mainly in Canada and China, but his fight as an anti-fascist in the Spanish Civil War and his humanitarian role is undeniable. In Spain historians and people forgot Bethune and his participation in the Civil War for a long period. Recently, with the commemo ration of the sixty years after the beginning of the war, and a series of homages to the International Brigades (although Bethune never joined them!), his name appeared in publications and several institutions paid homage to Bethune.16,17 Recently we found unpublished docu ments of Bethune during his stay in Spain. Most of them do not offer new information, but clarify his personality and ideas. As an example, we consulted confidential docu ments of Bethune about the organization of the Institute and the plans for getting donors, in which he contemplates the char acteristics of the Spaniards. We also exam ined a detailed description of the travel of Bethune from Barcelona to Malaga. One of the most interesting documents is a copy of the account that Dr. Vicente Goyanes gave to Dr. Carlos EI6segui (at that moment head of the Nationalist army transfusion services) when the Nationalists conquered Madrid in Spring, 1 939. In that document Goy a n e s listed the equipment of the "Instituto Hispano-Canadiense," detailing the material provided by the C anadian Committee. In g e n e r a l t e r m s , t h e a c tivity o f Bethune in S p a i n reveals h i s socialist
Figure 4: Norman Bethune aiding Spanish refugees escaping from Malaga. ideas and is a good example of one of the most important elements of the Spanish Civil War, the associated propaganda. He was especially careful with this facet and tried to give world-wide publicity to the activity of the C anadian Committee and his team in S pain, with the distribution of photographs, books, movies, and with his relation with several war correspon dents. Since the nationalists won the war, the activity of the transfusion services of the Republican side was diminished for many years. Although the scientific activity and medical care of the transfusion services of the National side was also important, it is possible that it was somehow augmented by the propaganda .2,),18-20 References 1 . F r a n c o A , Alvarez J , A n e i r o s F et al. Historia de l a transfusi6n sanguine a en Espana (1 874-1 940). Act A llest Reallim (Madrid) 7 : 4 1 -52, I 1997. 2 . E I 6 s e g u i C . Mallllal de He m o terap i a . Madrid: E d . Marban, 1 954. 3 . EI6segui C . Pasado, presell te y futuro de la Hematologfa eu Espalla. Libro homenaje al Prof. Vara L6pez. Valladolid: Ed. Sever-Cuesta, 1 9 7 5 . 4 . D uran J orda F. E 1 Servicio d e transfusi6n d e s a n g re de B a r c e l o n a . Rev Sail G u e rra 1 : 307-32 1 , 1 9 3 7 . 5 . Vives J . Re s u l t a do s o b t e n i d o s e n 1 3 0 t r a n s fu s i o n e s c o n s a ngre c i tr a t a d a , m e t o d o D u r a n . Rev Sail Guerra 2 : 1 0 1 - 1 05 , 1 9 3 8 . 6 . S tewart R . Bethulle. Toronto: New Press, 1973. 7 . A l l a n T, Gordon S . The Scalpel alld t h e Sword: the Story of Normau Bethulle. Toronto: McClelland and S tewart Ltd., 1 9 7 1 .
8 . Franco A, Cortes J , Alvarez J, D i z J C . The development o f blood transfusion: the contribu tions o f Norman Bethune i n Spanish Civil War ( 1 9 3 6 - 1 939). Call J A llaestil 43 : 1 076-1078, 1 996. 9 . S tewart R . The mind of Norman Bethune. Toronto: McGraw Hill Reyerson Limited, 1 99 0 . 1 0 . S h e p h a rd D A E , L e v e s q u e A ( e d s ) .
Normall Bethuue: his times alld h is legacy/"sou epoque et SOil message. " Ottawa: Canadian Public Health Association, 1 9 82. 1 1 . Anonymous. Diario Oficial del Miuisterio de Defellsa Naciollal 4:33, 5 Oct 1 93 7 . 1 2 . Goyanes V. La transfusi6n de sangre e n el sector centro. Rev Sail Guerra 1 : 1 59 - 1 75, 1 93 7 . 1 3 . Barber G . L a transfusi6n de sangre en la guerra actual. Rev Sau Guerra 1 : 1 94-203, 1 93 7 . 1 4 . Miserachs M . EI Servicio de Transfusi6n de S a ngre seis meses despues. Cmz Roja EspOllola Bol Of de la Brig no. 1 , 1 : 1 9- 2 1 , 1 9 3 8 . 1 5 . Valtuena J A . La Guerra Civil Espanola vista desde Ginebra. ]ANO 5 1 : 5 04, 1 996. 16. Arino JR. E1 medico de los brigadistas. El Pais, miercoles 3 1 de Julio de 1 996; 2 1 :num 7023. 1 7 . Homenaje a Norman Bethune. C uaderno conmemorativo del 60 aniversario de su llegada a E s p a n a . Asocia c i 6 n espanola de estudios canadienses y centro de estudios canadienses de l a Universidad de L a Laguna, 1 99 6 . 1 8 . Hernandez J . La transfusi6n sanguinea en el ejercito. Ejercito 67 : 1 3-20, 1 947. sanitaria ayuda La n. 1 9 . C alvo internacional a la Republica Espanola ( 1 9 3 6 - 1 9 3 9 ) . Medicilla Militar 5 0 : 3 38-347, 1 994. 20. Navarro JR. La Sauidad ell las Brigadas Illtemaciollaies. Madrid: Adalid, 1 9 89.
14
BULLETIN O F ANESTHESIA HISTORY
The " Servicio Hispano-Canadiense de Transfusion de Sangre" in the Spanish Civil War ( 1 936- 1 939) by A. Franco, M.D., Ph.D.; J.e. Diz, M.D., Ph.D.; RJ. Aneiros, M.D.;J. Cortes, M.D., Ph.D., andJ. Alvarez, M.D., Ph.D. Sel'vicio de Anestesiologia y Reanimaci6n, Hospital General de Galicia-Clinico Universitario, Santiago, Spain
At the outbreak of the Spanish Civil War ( 1 9 3 6 - 1 939) in J uly, 1 936, there was no proper development of blood transfusion techniques in Spain, which were in a stage that we could designate as the "heroic pe riod." Also, the Spanish Army lacked a for mally organized blood bank and conse quently the need to improvise transfusion centres on both the loyalist (Republican) and rebel (right-wing Nationalist) sides was urgent due to the increas ing number of wounded. These centres were probably the first that appeared in the history of mili tary medicine.! In Madrid j ust before the war, there were two departments of Hematology, one in the hospital of the Red C ross (Dr. EI6segui), and the other in the School of Medicine (Prof. Pittaluga) .!-3 But d ue to the partition of the country after the national uprising, the Red Cross department j o ined the army of General Franco, while the other stayed
Figure 1: Norman Bethune in Spain, 1 937.
in the republican side. In the same period, the Republicans organized a centre of pre served blood in Barcelona at the end of August, 1 936, under the initiative of the Partido Socialista Unificado (Unified Social ist Party) and directed by the hematologist D r. Frederic D unln Jorda. This centre sup plied blood to the Arag6n battlefronts. 4•s These three centres were operating in Sep tember, 1 936.3 The well-known C a n a d ian s urgeon Norman B e th une ( 1 890- 1 9 39) a rrived Mad rid in November, 1 9 3 6, when the battles a round Madrid were especially in tense. He r e a l ized t h a t the s upply of blood was an immediate priority and he o rganized the " S e rvicio Canadiense de Transfusi6n de Sangre," which played an important role in the war and was a clea r example of t h e social ideas of B ethune . In this paper we will offe r a s ummary of the h istory of this centre of blood trans fus i o n , b a s e d on s o m e documents we found re cently, which co rroborate the info rm a tion we h a d previously. Norman B e t h un e (1 890-1 939) (Figure 1), was b o rn in Graven h urst, Onta rio, and was a thoracic s urgeon in Montreal in the early 1 930s. From an early age he was drawn to social ist ideas and was an active member of the communist pa rty. He went to Russia to study socialized medicine and was a social activist who to the was d rawn anti-fascist cause in Spain. S upported by the Canadian Committee to Aid Spanish De mocracy, he arrived Madrid at the beginning of Novem ber, 1936. He immediately made several trips around the country, visited Repub lican a rmy hospitals, and came into contact with sev eral Republican authorities and the International B ri-
gades. He then established, in a central street in M adrid (Principe de Ve rga ra street), a blood transfusion centre which he called the Servicio Canadiense de TJ'ansfusi6n de Sangre (Canadian Service of Blood Trans fusion) (Figure 2) . The centre's staff com prised Bethune and three other Canadians, one American and six Spaniards, two of the last being physicians. Bethune left Spain on May 1 8, 1 937, and was welcomed in Canada as a hero. Later he j o ined the Red Army of Mao Zedong, in which he developed an important activity. He died in China as a result of septicemia contracted th rough a finger inj ury s us tained during an operation in Octobe r, 1939. Bethune is considered a national hero in China.6-1o Instituto Hispano-Canadiense de Transfusion de Sangre
Aft e r t h e visits of B e th un e to the battlefronts a ro und Madrid, he realized that there was an urgent need to s upply blood to the wounded. Then he traveled to Paris and London to buy mate rial with the funds of the Canadian Committee, and also to learn the techniques of blood p reservation. Th e transfusion centre sta rted work without delay and, aided by p ublicity on the radio and in the press, the centre had 1 000 donors on its books by the end ofl936. Each donor gave 500 mI., about eight pro cedures being pe rformed each day. The blood was p ut into a bottle labelled with the name of the donor and the date of ex traction and, after adding a sodium citrate solution to the bottle, it would be placed in a refrigerator at 1 DC. The centre supplied blood to the fronts a round Madrid, as did those of the S ierra d e G ua d a rrama and the U n iv e r s ity. Bethune himselfwent with the blood to the battlefronts several times. The service soon expanded, with control of three other cen ters in Madrid, Valencia af.ld J aen, supply ing blood to many major battles of the war, including J a rama, Guadalaj a ra, Malaga and B runete. Although the activity of the centre was clearly beneficial for the loyalist side, the republican a uthorities decided to supervise
BULLETIN OF ANESTHESIA H ISTORY
15
taking the blood to the wounded and not the wounded to the blood. Bethune him selfwent often to the battlefront in the Ford vans of the Institute, the so-called rubias (blondes), provided by the Canadian COIll mittee to Aid Spanish Democracy. Bethune also visited other cities in the ea rly part of the war and traveled from Barcelona to Malaga (about 1 200 km) along the Mediterranean coast in a Renault car, trying to ascertain if the techniques of blood preservation were correct. Near Malaga he witnessed the battle there, assisting some of the 40,000 people esca ping from Malaga to Almeria, and so saw first-hand some of the barbaric fighting by the Fascists on the Mediterranean coast, one of the most fa mous episodes of the stay of Bethune in Spain (Figure 4) . The labor of Bethune and his team was also significant scientifically since they contributed to the spread of techniques of blood preservation and indirect transfu sion. As an example, the c entre of Prof. Pittaluga in Madrid had made 700 direct transfusions before the a rrival of Bethune, Continued Oil Next Page
Figure 2: Staff of the "Servicio Canadiense de 1l'ansfusion de Sangre/' in the Principe de Vergara Street, just besides the headquarters of the Institute, with a Renault tyuck. its operations more closely and incorpo ra ted to the staff more Spanish doctors. Later, in Februa ry, 1937, the Republican authorities combined the lwo centres of blood transfusion of Madrid (the centre of Bethune and the centre of the School of Medicine directed by Prof. Pittaluga) in a single Institute, the Instituto Hispano Canadiense de Tra nsfusion de Sangre (Spanish-Canadian Institute of B lood Transfusion) . Initially Bethune was the di rector of this Institute (commissioned at the rank of Major), sharing the responsi bilities with the Spanish Major Vicente Goyanes. Bethune did not like this new situation and his relations with the Republican offi cials became strained, owing to the constant pressure they placed on him and to his impatience and independence and overin dulgence in alcohol. Under these circum stances, Bethune left Spain in May, 1 937. In October, 1 937, D r. Vicente Goyanes (Figure 3) became the chief of the Insti tute that operated until March, 1 939, when the troops of General Franco conquered Madrid.ll In 1937 the staff of the Institute numbered 1 00 and the donors 3,875; five cars transported the blood to the transfu sion sites. An average of 1 00 liters of blood
were transfused e a c h month, although i n cer t a i n b a t t l e s a ro un d Madrid they transfused up to 1 00 liters a day. A total of 1 900 transfu sions were performed in 1 937. Significance of the work of Bethune in Spain
The centre of blood t r a nsfusion tha t Bethune organized was not the first of the Span ish Civil War, but it was very important because of its humanitarian role and unique o rganiza tion. Especially impor tant was his concept of
Figure 3: Major Vicente Goyanes Alvarez, head of the Institute after Bethune, in a Ford van provided by the Canadian Committee.
'3
16
BULLETIN OF ANESTHESIA HISTORY
Civil War
.
.
.
COIllill I/ed ji-om Page 15
but they did not preserve the blood.12 However, Bethune recognized that, sci entifically, the most important centre of blood transfusion of the republican side was the centre of Barcelona headed by the hematologist Frederic Duran Jorda.4 This centre had better equipment and higher scientific standards. Bethune emphasized that his Institute had a good organization and that it took the blood directly to the ba ttlefronts. The Institute of Bethune was in con tact with other centres of blood transfu sion on the Republican side, including t h o s e of B a r c e l o n a ,4 Va l e n c i a l ] a n d Linares . There were other centres work ing independently, not so closely con nected to the Republican authorities, in the R e d C r o s s o f B a r c e l o n a ( D r. Miserachs),14 and a blood bank in Geneva which sent preserved blood to Catalufia and Valencia (Roger Fischer) , I 5 Comments
The life and activity of Norman Bethune has been possibly magnified, mainly in Canada and China, but his fight as an anti-fascist in the Spanish Civil War and his humanitarian role is undeniable. In Spain historians and people forgot Bethune and his participation in the Civil War for a long period. Recently, with the commemo ration of the sixty years after the beginning of the war, and a series of homages to the International Brigades (although Bethune never joined them!), his name appeared in publications and several institutions paid homage to Bethune.16,17 Recently we found unpublished docu ments of Bethune during his stay in Spain. Most of them do not offer new information, but clarify his personality and ideas. As an example, we consulted confidential docu ments of Bethune about the organization of the Institute and the plans for getting donors, in which he contemplates the char acteristics of the Spaniards. We also exam ined a detailed description of the travel of Bethune from Barcelona to Malaga. One of the most interesting documents is a copy of the account that Dr. Vicente Goyanes gave to Dr. Carlos EI6segui (at that moment head of the Nationalist army transfusion services) when the Nationalists conquered Madrid in Spring, 1 939. In that document Goy a n e s listed the equipment of the "Instituto Hispano-Canadiense," detailing the material provided by the C anadian Committee. In g e n e r a l t e r m s , t h e a c tivity o f Bethune in S p a i n reveals h i s socialist
Figure 4: Norman Bethune aiding Spanish refugees escaping from Malaga. ideas and is a good example of one of the most important elements of the Spanish Civil War, the associated propaganda. He was especially careful with this facet and tried to give world-wide publicity to the activity of the C anadian Committee and his team in S pain, with the distribution of photographs, books, movies, and with his relation with several war correspon dents. Since the nationalists won the war, the activity of the transfusion services of the Republican side was diminished for many years. Although the scientific activity and medical care of the transfusion services of the National side was also important, it is possible that it was somehow augmented by the propaganda .2,),18-20 References 1 . F r a n c o A , Alvarez J , A n e i r o s F et al. Historia de l a transfusi6n sanguine a en Espana (1 874-1 940). Act A llest Reallim (Madrid) 7 : 4 1 -52, I 1997. 2 . E I 6 s e g u i C . Mallllal de He m o terap i a . Madrid: E d . Marban, 1 954. 3 . EI6segui C . Pasado, presell te y futuro de la Hematologfa eu Espalla. Libro homenaje al Prof. Vara L6pez. Valladolid: Ed. Sever-Cuesta, 1 9 7 5 . 4 . D uran J orda F. E 1 Servicio d e transfusi6n d e s a n g re de B a r c e l o n a . Rev Sail G u e rra 1 : 307-32 1 , 1 9 3 7 . 5 . Vives J . Re s u l t a do s o b t e n i d o s e n 1 3 0 t r a n s fu s i o n e s c o n s a ngre c i tr a t a d a , m e t o d o D u r a n . Rev Sail Guerra 2 : 1 0 1 - 1 05 , 1 9 3 8 . 6 . S tewart R . Bethulle. Toronto: New Press, 1973. 7 . A l l a n T, Gordon S . The Scalpel alld t h e Sword: the Story of Normau Bethulle. Toronto: McClelland and S tewart Ltd., 1 9 7 1 .
8 . Franco A, Cortes J , Alvarez J, D i z J C . The development o f blood transfusion: the contribu tions o f Norman Bethune i n Spanish Civil War ( 1 9 3 6 - 1 939). Call J A llaestil 43 : 1 076-1078, 1 996. 9 . S tewart R . The mind of Norman Bethune. Toronto: McGraw Hill Reyerson Limited, 1 99 0 . 1 0 . S h e p h a rd D A E , L e v e s q u e A ( e d s ) .
Normall Bethuue: his times alld h is legacy/"sou epoque et SOil message. " Ottawa: Canadian Public Health Association, 1 9 82. 1 1 . Anonymous. Diario Oficial del Miuisterio de Defellsa Naciollal 4:33, 5 Oct 1 93 7 . 1 2 . Goyanes V. La transfusi6n de sangre e n el sector centro. Rev Sail Guerra 1 : 1 59 - 1 75, 1 93 7 . 1 3 . Barber G . L a transfusi6n de sangre en la guerra actual. Rev Sau Guerra 1 : 1 94-203, 1 93 7 . 1 4 . Miserachs M . EI Servicio de Transfusi6n de S a ngre seis meses despues. Cmz Roja EspOllola Bol Of de la Brig no. 1 , 1 : 1 9- 2 1 , 1 9 3 8 . 1 5 . Valtuena J A . La Guerra Civil Espanola vista desde Ginebra. ]ANO 5 1 : 5 04, 1 996. 16. Arino JR. E1 medico de los brigadistas. El Pais, miercoles 3 1 de Julio de 1 996; 2 1 :num 7023. 1 7 . Homenaje a Norman Bethune. C uaderno conmemorativo del 60 aniversario de su llegada a E s p a n a . Asocia c i 6 n espanola de estudios canadienses y centro de estudios canadienses de l a Universidad de L a Laguna, 1 99 6 . 1 8 . Hernandez J . La transfusi6n sanguinea en el ejercito. Ejercito 67 : 1 3-20, 1 947. sanitaria ayuda La n. 1 9 . C alvo internacional a la Republica Espanola ( 1 9 3 6 - 1 9 3 9 ) . Medicilla Militar 5 0 : 3 38-347, 1 994. 20. Navarro JR. La Sauidad ell las Brigadas Illtemaciollaies. Madrid: Adalid, 1 9 89.