Blood Transfusion: 350 Years

By Paul Theerman, Associate Director

Three hundred and fifty years ago, on December 17, 1666, the Philosophical Transactions published the first account of blood transfusion, in the form of a letter from physician Richard Lower to chemist Robert Boyle.1 Lower’s experiments transfused blood from one dog to another. The article provided his methods, specifying where the arteries and veins were to be cut, how the quill was to be inserted that formed the blood’s conduit between animals, and many other details of the operation.

richard-lower-portrait

Richard Lower (1631-1691), anatomist. Oil painting by Jacob Huysmans. Source: Iconographic Collections, Wellcome Library, London, accessed through Wellcome Images.

In addition to reporting on dog-to-dog transfusions, Lower also mentioned experiments between sheep, and interspecies transfusion between dogs and sheep, alternating donor (“emitter”) and recipient. In this first communication on the subject, Lower also laid out a broad experimental program:

’Tis intended, that these tryals shall be prosecuted to the utmost variety the subject shall beare: As by exchanging the bloud of Old and Young, Sick and Healthy, Hot and Cold, Fierce and Fearful, Lame [i.e., Tame] and Wild Animals, &c. and that not only of the same, but also of differing kinds.

The 1660s were the first heady days of the new Royal Society, whose motto, Nullius in verba (“nothing through words”), was the hallmark of the new “experimental philosophy.” And so these experiments have a bit of the quality of “ringing the changes”: try all kinds of animals, in all kinds of conditions, and see what happens!

Underlying the work, though, was the stronger sense of “blood as medicine.” Seventeenth-century physicians were well aware that too little blood led to death. But more, there was a general notion that blood and health were linked, a notion that came straight out of the humoral tradition. Sanguineous dispositions were healthy ones, in distinction to the melancholic ones that too much black bile created. A balance of humors, of course, was the best, but ruddy blood had an implicit edge.

In the same letter, then, Lower made these observations:

It seems not irrational to guess afore-hand, that the exchange of bloud will not alter the nature or disposition of the Animals, upon which it shall be practiced . . . . The most probable use of this Experiment may be conjectured to be, that one Animal may live with the bloud of another; and consequently that those animals that want bloud, or have corrupt bloud, may be supplied from other with a sufficient quantity, and of such as is good . . . .

Blood transfusion could serve as a type of reverse blood-letting; for those patients with too little blood, more could be supplied, and especially “good” blood rather than “corrupt.” Animals would serve as the blood source without fear that people would take on animal natures.

Human experimentation followed quickly. Similar experiments had been going on in France, and in June 1667, physician Jean-Baptiste Denis undertook the first transfusions into a human. His account, translated and published in the Philosophical Transactions, was called “Touching a Late Cure of an Inveterate Phrensy, by the Transfusion of Blood.”2 Calves’ blood served to restore to his right mind a man under the influence of a “phrensy.” In this case, the animal was chosen for “its mildness and freshness,” in order to temper the blood of the unfortunate—a different understanding from the English!

major_watermark

This image relates more to infusion than to transfusion, that is, placing medicines directly into the body through the bloodstream. The technique lent itself to infusions of blood itself. Source: Johann Daniel Major, Chirurgia infusoria, placidis cl. virorum dubiis impugnata, cum modesta, ad eadem, responsione (Kiloni [Kiel]: Sumptibus Joh. Lüderwald, imprimeb. Joach. Reumannus, 1667), p. 2

On November 23 of that same year, Lower and his colleague, physician Edmund King, transfused sheep’s blood into a Mr. Arthur Coga, also of unsound mind. The transfusion seemed to have a good effect:

The Man after this operation, as well as in it, found himself very well, and hath given in his own Narrative under his own hand, enlarging more upon the benefit, he thinks, he hath received by it, than we think fit to own as yet.3

purmann_watermark

An image attributed as Lower and King’s 1667 transfusion of Arthur Coga. Source: Matthias Goffried Purmann, Grosser und gantz neugewundener Lorbeer-Krantz, oder Wund Artzney (Frankfort; Leipzig: Widow & heirs of M. Rohrlach, Leignitz, 1705), opposite page 292 of part 3.

But transfusion as a therapy soon petered out. One case in France died. Though Coga survived, he did not fully recover, and he was soon drinking up the 20 shilling fee he received for undertaking the procedure. Blood transfusion was mocked and abandoned in England, and outlawed in France.4

Blood transfusion only revived in the middle of the 19th century, chiefly as a way of restoring blood volume. With the investigation of blood types before World War I, and Rhesus factors before World War II, transfusion became mobilized for war with the establishment of blood banks. In the last half of the 20th century, transfusion from banked blood became standard medical practice in surgeries of all kinds, and (using blood products) for hemophilia.

Suggested Reading:

  1. Holly Tucker, Blood Work: A Tale of Murder and Medicine in the Scientific Revolution (New York: W.W. Norton and Company, 2011).
  2. Anita Guerrini, Experimenting with Animals and Humans: From Galen to Animal Rights (Baltimore: the Johns Hopkins University Press, 2003.)

References

  1. “The Method Observed in Transfusing the Bloud out of One Animal into Another,” Phil. Trans. 1665-1666 1, 353-358. Accessed November 7, 2016.
  2. “An Extract of a Letter, Written by J. Denis, Doctor of Physick and Professor of Philosophy and Mathematics at Paris, Touching a Late Cure of an Inveterate Phrensy by the Transfusion of Blood,” Phil. Trans. 1666-1667 2, 617-623. Accessed November 7, 2016.
  3. “An Account of the Experiment of Transfusion, Practised upon a Man in London,” Phil. Trans. 1666-1667 2, 557-559. Accessed November 7, 2016.
  4. Elizabeth Yale, “First Blood Transfusion: A History,” JSTOR Daily: Where News Meets Its Scholarly Match, April 22, 2015. Accessed November 7, 2016.

A History of Blood Transfusions

By Danielle Aloia, Special Projects Librarian

World Blood Donor Day 2014June 14 is World Blood Donor Day, a date selected to coincide with the birthday of Karl Landsteiner (1868–1943), the father of blood transfusions. Landsteiner discovered the A, B, AB, and O blood types in 1901, making blood transfusions safer. His work earned him the the Nobel Prize in Physiology or Medicine in 1930.1 The Word Health Organization (WHO) created this event to honor Dr. Landsteiner and to bring attention to the need for timely access to safe blood and blood products through voluntary donations.2

Recorded evidence of blood transfusions date back to the 16th century; there has been much speculation as to who first tried it and who first succeeded. Some tales are based on evidence and some seem to have been fabricated. Dr. Richard Lower is credited with performing the first successful blood transfusion from one animal to another in the 17th century. But it wasn’t until 1818 that Dr. James Blundell, a gynecologist, made a fairly successful attempt; after the procedure, patients who had been near death showed temporary improvement. Blundell continued to improve on the process and in 1829, he published the first report on a “human life being saved by transfusion” in the Lancet.3

Figure from Dr. Blundell's article in the June 13 ,1829 issue of The Lancet, "Observations on Transfusion of Blood."

Figure from Dr. Blundell’s article in the June 13, 1829 issue of The Lancet, “Observations on Transfusion of Blood.”

From the RAMC Muniment Collection in the care of the Wellcome Library. Credit: Wellcome Library, London.

From the RAMC Muniment Collection in the care of the Wellcome Library. Credit: Wellcome Library, London.

Even after Landsteiner’s 1901 discovery, the ability to safely store and preserve blood donations took several more decades of study. During the First World War, O. H. Robinson, an army doctor,  introduced an effective anti-coagulant for long-term human blood storage.4 Percy Oliver began the first blood donor service with the British Red Cross. In the 1920s, he was asked to help with the growing need for blood and developed the first system of a volunteer donation and screening process. It wasn’t until 1941 that the Red Cross in the US started actively collecting blood from donors on request of the US government.4

This year’s World Blood Donor Day campaign highlights the importance of safe blood and the prevention of unnecessary deaths during pregnancy. The loss of blood during childbirth has been studied throughout history5 and continues to be a medical concern. About 800 women, nearly all in developing countries, die of pregnancy- and childbirth-related causes every day.2 A 2006 WHO analysis identified hemorrhaging as the leading cause of maternal deaths in Africa and in Asia.6 In developing countries donated blood is most often used for pregnancy complications7 whereas only 2.2% of donated blood in the US is used for obstetrics.8

Blood donation is one of the single most important contributions a person can make in saving the lives of others. Every two seconds someone needs blood and every pint of blood can save several lives.9 The more donated blood, the more lives saved.

References

1. NobelPrize.org. Karl Landsteiner – Biographical. Available at: http://www.nobelprize.org/nobel_prizes/medicine/laureates/1930/landsteiner-bio.html. Accessed June 11, 2014.

2. World Health Organization. Campaign essentials: World blood donor day 2014.; 2014. Available at: http://apps.who.int/iris/bitstream/10665/112768/1/WHO_World-Blood-Donor-Day_2014.1_eng.pdf?ua=1&ua=1. Accessed June 11, 2014.

3. Walker K. The Story of Blood. London: H. Jenkins; 1958.

4. Duffin J. History of Medicine: A Scandalously Short Introduction. Toronto: University of Toronto Press; 2010.

5. Schorn MN. Measurement of blood loss: review of the literature. J Midwifery Womens Health. 55(1):20–7. doi:10.1016/j.jmwh.2009.02.014.

6. Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PFA. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367(9516):1066–74. doi:10.1016/S0140-6736(06)68397-9.

7. World Health Organization. WHO | 10 facts on blood transfusion. Available at: http://www.who.int/features/factfiles/blood_transfusion/blood_transfusion/en/index1.html. Accessed June 12, 2014.

8. Whitaker B, Hinkins S. The 2011 national blood collection and utilization survey report. Washington, D.C.; 2013. Available at: http://www.aabb.org/research/hemovigilance/nbcus/Documents/11-nbcus-report.pdf. Accessed June 12, 2014.

9. Blood Centers of the Pacific. 56 Facts About Blood and Blood Donation. 2005. Available at: http://www.bloodcenters.org/blood-donation/facts-about-blood-donation/. Accessed June 11, 2014.