SUNDAY, DAY 7
MEDICAL MILESTONES
Although blood transfusion has been practiced successfully for less than a century, the idea that fresh blood gives new life has been around for much longer.
The first authentic attempt at transfusion may have been the case of Pope Innocent VIII (1432–1492) around 1492. An unknown illness left the pope semicomatose, and he was transfused with the blood of three young boys. All three donors died, as did the pope shortly afterward.
In the 17th century, the English physician William Harvey (1578–1657) discovered that blood flowed through arteries in one direction and veins in another, paving the way for new theories about transfusion. The English physician Richard Lower (1631– 1691) performed one of the first successful animal-to-human transfusions in 1667, by putting blood from a sheep into the vein of a man’s arm. The French physician Jean-Baptiste Denys (1640–1704) wrote that he preferred animal donors to humans because their blood was less likely to be “rendered impure by passion or vice.” However, in 1668, Denys performed a calf-to-human transfusion and his patient became sick to his stomach and urinated black liquid—then died after a second transfusion a few months later. A lawsuit followed, and the practice of blood transfusion was banned by the Catholic Church and abandoned by scientists. (It is understood today that animal and human blood are incompatible, and that anything more than a very small transfusion can cause a deadly “hemolytic transfusion response.”)
It wasn’t until the 19th century that interest in blood transfusion was renewed, most notably by the physician James Blundell (1790–1877), the “father of modern blood transfusion.” Blundell determined that blood from one animal could not be substituted with blood from another, and he introduced the idea of using a syringe for human-to-human transfusions. In 1829 he performed what is considered the first successful transfusion, on a woman with severe postpartum bleeding.
The discovery of the different blood types and the development of anticoagulants greatly reduced the mortality and complications associated with blood transfusions. Human blood was first classified by Karl Landsteiner (1868–1943) as type A, B, AB, or O. Further typing by Alexander Wiener (1907–1976) in the 1950s showed that some people, about 85 percent, share a factor with rhesus monkeys, the Rh factor. The immune systems of women who lack it can react with their Rh-positive babies’ blood during pregnancy, causing “Rh disease” in the newborn. Today, Rh immuno globulin injections for pregnant women prevent this from happening.