Two hundred years ago, this coming Tuesday, a doctor in London performed the first successful blood transfusion, using human blood. Strange as it may seem, for centuries before, many physicians felt blood was blood and a number of blood transfusions were attempted using animal blood transfused into humans. The outcomes of these procedures were usually so abysmal that blood transfusions of any kind were banned in most of the countries of Europe for over a hundred years. It was not until the autumn of 1818, that an experienced and talented physician, who had been studying the possibilities of the process, took the chance that his technique would enable him to save the life of a woman who had just given birth. He was certain that without intervention, she would surely die.
The first successful blood transfusion, human to human . . .
Blood is a fluid which flows through the body of humans, as well as host of other animals. It transports oxygen and nutrients to the cells of the body and carries away waste from those same cells. In addition, the white cells in blood work to protect the body from invasion by foreign pathogens. Even our prehistoric ancestors had some concept of blood and were aware of its significance to continued life in all creatures. Therefore, it was quite natural that blood was associated with a wide range of beliefs across many cultures around the world, both pagan, and later, divine.
Ancient cultures, particularly the Greeks and Romans, studied the properties of blood and came to the conclusion that it was one of the four "humors" which governed the functioning of the human body. They were of the opinion that all four humors must be in balance to ensure a person’s health. As the centuries progressed, many other physicians and men of science made additional discoveries with regard to blood and how it circulates through the body. In 1628, the physician, William Harvey, is believed to be the first to fully understand the circulatory system and describe it in detail. His work was based on the earlier work of other physicians who had written about various aspects of the functioning of the heart and lungs, as well as veins and arteries. But it was Harvey who was finally able to grasp the complete functioning of the system of blood circulation, with the realization it was the heart, not the lungs, which pumped blood through the body. He was also able to identify the differences between veins and arteries, something which had not previously been understood.
The first known attempt at a blood transfusion was made within a few years of William Harvey’s identification of the circulatory system. Initial attempts were made between animals, most often dogs. Theses transfusions were typically accomplished by connecting the vein of one animal to another. In some cases, the animals survived the process, in others they did not. However, at that time, physicians did not distinguish between the blood of humans and that of animals. In France, in the mid-seventeenth century, a young boy who had been injured, was given the blood of a lamb. This was done on the assumption that a creature seen as holy by the church would have pure blood which would cause no harm to the boy. The boy did survive, but it is now believed that was due to the fact that he actually received very little of the lamb’s blood and he was young enough and strong enough to fight off the effects of foreign blood introduced into his system.
Several months later, the winter of 1667, that same French doctor, Jean-Baptiste Denys, by name, was determined to perform another blood transfusion, by which he hoped to make his reputation. His chosen subject, Antoine Mauroy, was a former valet who had become increasingly erratic in his behavior. By that winter, Mauroy was terrifying people in the streets of Paris with his peculiar and often violent behavior. Denys, like many others at that time, believed that the blood in the body was primarily responsible for a person’s behavior. Therefore, Denys proposed that he would replace Mauroy’s blood with that of a calf, since it was thought that the introduction of the blood of a calm and docile creature would cause Mauroy to behave more like a gentle calf. The authorities, who were finding Mauroy to be ever more dangerous, agreed that this transfusion should be carried out, despite the fact that Mauroy himself refused. Eventually, several strong watchmen captured Mauroy and dragged him, kicking and screaming, to the place where Denys planned to perform the transfusion. The struggling Mauroy was tied hand and foot to the table, after which, Denys connected his vein to that of the calf by a series of quills which he had spliced together to carry the blood. This process was repeated twice more, over the course of a few weeks. Sadly, a few days after the third transfusion, Antoine Mauroy died. Dr. Denys was tried for murder, but was eventually acquitted. The French College of Physicians, and later, the French government, banned blood transfusions. After a few similar attempts at blood transfusions in other countries, most countries banned them outright and that aspect of medicine was essentially ignored by most physicians for nearly a century and a half.
That all began to change at the turn of the nineteenth century. James Blundell was born in London, in 1790, the son of a haberdasher. He was initially educated in the metropolis by two of his uncles, the Reverend Thomas Thomason and the physician, John Haighton. Blundell became increasingly interested in the study of medicine and spent some time at Guy’s Hospital, in London, where his uncle, Dr. Haighton, practiced and lectured. Haighton had a particular interest in obstetrics and Blundell went on to specialize in that field. He then studied at the renowned Edinburgh Medical School, where he earned his medical degree in 1813. The following year, James Blundell returned to London, where he offered a popular series of lectures on midwifery and physiology. In 1818, John Haighton retired from Guy’s Hospital, and James Blundell was chosen to replace him. Blundell devoted the majority of his time and effort to the diseases of women, with a specialized focus on obstetrics.
Blundell was aware that a great many women died of severe postpartum hemorrhage after childbirth, including some of his own patients. He was convinced that it was the loss of blood which caused these women to die, and if some way could be found to replace the blood they had lost, they would have a good chance at survival. During his time in Edinburgh, Blundell had become acquainted with another young doctor, John Henry Leacock. In 1816, Dr. Leacock had conducted a series of experiments which definitively proved that blood could not be successfully transfused from one species to another. Leacock had clearly shown that species compatibility was essential for a successful blood transfusion. Blundell was fully aware of this research, since he, himself, had arranged to have it published, along with the results of additional, related experiments he had conducted in London.
The other issue with which Dr. Blundell struggled was the mechanical means by which a blood transfusion was to be accomplished. He determined that a syringe would best serve the purpose. Very crude syringes had been made since the mid-seventeenth century, and typically consisted of a length of quill attached to a small bladder. In order to use such a syringe, an incision first had to be made to open a vein, into which the quill would be pushed, then firm pressure on the bladder would force its contents into the vein. Later in the seventeenth century, a more sophisticated device was made by a German medical student. This device consisted of a metal barrel and plunger, to which a hollow needle was directly attached. However, though this device more closely resembled a modern syringe, it was used only to inject fluid into corpses in order to trace the path of blood vessels. It was not generally used on living patients, even as late as the early nineteenth century.
Nevertheless, Blundell had become familiar with this type of syringe during his studies in Edinburgh and though it might serve his purposes. He had a syringe made to his specifications, with a brass barrel, a steel needle and steel plunger with a ceramic handle. Fortunately, as he refined his version of the device and explored how best to use it, he discovered that it was crucial to be sure that even the tiniest amount of air be expelled from his syringe prior to making any injection. His experiments also showed that the blood taken from either an artery or a vein would be effective, and that it could be held in a vessel outside the donor’s body for a short period without any detrimental effects. Even so, he determined that the blood should be transfused into the recipient as soon as possible after it was taken from the donor. He also discovered that the transfusion process should be done at a slow pace, to allow the recipient to most advantageously assimilate the new blood. In addition, he found that it was not necessary, or even desirable, to replace the full amount of blood which had been lost in order to restore the patient to health. In fact, Dr. Blundell was the first person to conduct a true and exhaustive scientific investigation of the process of blood transfusions and to develop an apparatus by which such transfusions could be most efficiently accomplished.
Then, on Friday, 25 September 1818, the concept of human-to-human blood transfusions was no longer simply academic. One of Dr. Blundell’s patients, a young woman who had just given birth, was suffering from a severe postpartum hemorrhage. Though he was finally able to stop the bleeding, Dr. Blundell realized his patient was very weak and there was every likelihood that she would die if something more was not done for her, soon. In the hope of saving her life, he explained the process of blood transfusion to his patient’s husband. The young man, eager to do anything which might save his wife, agreed to allow Dr. Blundell to give her a blood transfusion. He even offered his own blood for transfusion to his wife.
Using his specially-made syringe, Dr. Blundell withdrew about four ounces of blood from the upper arm of his patient’s husband. Ensuring there was no air in the syringe, he then carefully, and slowly, injected the blood into one of the veins in his patient’s upper arm. She slept for some time afterward, but during that interval, her pulse became stronger and more even, and her extreme pallor was gradually replaced by a more healthy color. Eventually, she made a full recovery, with no ill effects. Over the course of the next several years, Dr. Blundell gave blood transfusions to ten other patients, five of whom survived the procedure. Some of those who died may have been too ill to be restored by a blood transfusion. It must also be noted that this was nearly a century before the concept of blood types and blood groups was discovered and understood. Therefore, it is also possible that at least some of those patients who died may have inadvertently, and unknowingly, been given the wrong type of blood.
Despite the fact that not all of his first patients survived, Dr. Blundell had conclusively proven that human-to-human blood transfusions could be done successfully and lives could be saved. That initial success finally broke the taboo which had existed against research into blood transfusions for more than a century. With Blundell’s research as a foundation, may other physicians and men of science devoted further study to all aspects of blood and the potential of transfusions to save lives. Curiously, though research continued and expanded, blood transfusions did not become common until the early twentieth century. Once the properties of the various blood types and groups were better understood, blood transfusions between humans could finally be accomplished successfully, on a routine basis. But the very first successful human-to-human blood transfusion took place during our favorite decade.
Dear Regency Authors, might a blood transfusion provide the foundation for a dramatic scene in one of your upcoming romances? Perhaps the hero, like the husband of Dr. Blundell’s patient, offers his blood to save the life of his wife. Or might that play out the other way round, when the wife offers her blood to save her husband? There is certainly a great potential there for romantic metaphors around the gift of one’s life’s blood to one’s beloved. Will you have Dr. Blundell on hand to perform the blood transfusion? Or, will one of your fictional characters have learned the procedure from Dr. Blundell, and have his own specially-made syringe available? There is another decision to be made, too. Will you allow the transfusion in your story to be successful, or will it fail, with the tragic loss of a life? Then again, the news of the successful blood transfusion might be sufficient to create a scene or two in a Regency romance, in which the characters discuss the pros and cons of such a procedure. Are there other ways in which this revolutionary procedure might infuse a story of romance in the Regency?