SCIENCE

17^th Century Blood Transfusions - success or failure?

Chaired by Andy Pepperdine

Dr Pete Moore

Freelance Author

29 July 2005

Pete Moore has completed post-doctoral research fellowships with The Wellcome Trust and British Heart Foundation, and is now an author and medical journalist.

In this talk, the history of Man's attitude and beliefs about the blood was outlined upto the 17^th century, when a number of experiments took place in both England and France to attempt to transfer blood from one person to another. The legal and social side-effects of these attempts stifled further work on the matter for 200 years.

The prevailing beliefs about the blood at that time had the origins in early Greek myths. In the stories of Jason and the Argonauts, the clear implication is that ‘life is in the blood’ when a potion containing young blood was used to revive an older man who received it. This was later developed by Plato, Socrates and Aristotle, who held that blood was the critical fluid, and that the heart was the centre of life.

The first scientific analysis was performed by Claudius Galen (130-210AD), who had the advantage of treating gladiators at the arenas. He saw first hand the immediate results of injury and had an opportunity to examine the workings of the body in more detail than before. He produced a superb treatise on anatomy and physiology which lasted for 1500 years. He had noticed that there were two types of blood, blue flowing in the veins, and red in the arteries. The blue oozed slowly out, whereas the red was pumped out. He thought that the liver made the blood and that the heart was a furnace with the chambers warming the blood. Even Leonardo da Vinci, whose anatomically drawings are so detailed and accurate, followed Galen in believing that the heart was a furnace.

‘Sheep to Man’ (Purmann, 1705).
from Pete Moore’s Blood & Justice (JohnWiley & Sons, 2003)
© US National Library of Medicine

Then everything changed in 1624 when William Harvey published his book De motu cordis ‘on the motion of the heart’. He had started making some measurements of the size of the chambers in the heart, and estimated the flow of blood out of the heart. Remembering the way that Aristotle had deduced the water cycle by showing that there was not enough water in the hills to supply all the water in the rivers over time, and so the hill water must be replenished in some way (by rain), Harvey realised the same was true of blood flow. There was not enough blood in the veins to supply the volume being pumped out. It had to recycled somehow, although it was not until 1661, four years after Harvey's death, that Marcello Malpighi found the capillaries that linked the arteries to the veins.

However, the idea of circulating blood was gaining ground. In 1656, Robert Boyle, Christopher Wren and others stared injecting dogs with opium, and were surprised at the rapid response the drug had when taken in that way. It was clear that the blood was acting as a transport medium, although these experiments were difficult to do with the crude tools available at that time. Hypodermic needles were a long way in the future, and the most painstaking and careful work was carried out by Richard Lower, a Cornishman who was then a doctor in Oxford, who attributed the transfer of the drugs to the blood. Later he was responsible for the observation that the blood changed colour when it flowed through the lungs, becoming a brighter red. These experiments culminated in exchanging blood between dogs, a process that was not hindered by any animal rights activists; in fact, they were sometimes done as a public demonstration. No doubt because of the lack of fine and sterile instruments, these were variable in the outcomes, sometimes the dogs died, but not always.

The centre of interest and experimentation shifted to Paris and to Claude Perrault, who headed a team that tried to replicate the English experiments with dogs. Again, the results were not consistent, and so their enthusiasm began to wane. But Jean-Baptiste Denis and Paul Emmerey continued to refine the techniques, and developed the fore-runner to modern hypodermic needles which meant that the skin no longer needed to be opened up during the process. They then heard of about a 15 or 16-year old boy who had a fever that was not being cured by the usual methods of bleeding, and by this time, the lad was probably weak from lack of blood. It occurred to them to add more blood, and chose a lamb as the donor. After the transfer, they waited, and the youth recovered, and after a few days was much better. From our current knowledge it would seem the most likely explanation is that he was no longer losing blood by being bled; and it was noted that he suffered a nose-bleed which we can now ascribe to the reaction to the lamb's blood, which was not enough to cause a massive immune reaction.

In December 1667, they had heard of Antoine Mauroy, a healthy young man who had deranged behaviour that no one could explain or cure, and Denis made arrangements to transfer some blood from a calf to him. The transfusion was a success, and they carefully watched Mauroy to see that he would survive. In fact, it was so successful, that they planned a second transfusion the following day. The effects of this second lot of foreign blood were rather more dramatic, with vomiting and black urine (an expected response as we now know). But after a good night's sleep, the first he had had for several weeks, he seemed as normal as he had ever been.

But word now got out among the public that the scientists had been working secretly on moving blood from one animal to another, and now to a man. But this was thought then to be meddling with the very staff of life, similar to the current controversy over human cloning. However, so far as Denis was concerned, Mauroy seemed to have been cured, and was a calm clear-headed man instead of the mad and dangerous one before the treatments.

However, Mauroy deteriorated again, and his wife asked Denis to perform a third transfusion, thinking that it had been the cause of the improvements. Unfortunately, the result this time was that Mauroy died in a night of confusion. Denis was apprehended for murder and was tried in April 1668. He was acquitted, but Mauroy’s widow was then accused of murder. It was an unfair balance, as Denis had many influential supporters by this time, and Mauroy's widow was a poor woman trying to make a living. In the following international debate about the wisdom of blood transfusions, scientific clarity was an early victim. It was too much, too fast, for the public to go along with, and the Pope banned all such treatment, thus putting the idea off-limits for over 200 years.

Further Reading

Moore, Pete. Blood and Justice (Wiley, 2003) has a full bibliography on all aspects of this part of scientific history.