Historical Aspects

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Historical Aspects
Over the years through sustained research, the science of blood banking has attained its present status
of getting recognition as new speciality. The metamorphosis has occurred due to combined effort of
eminent scientific personality from different fields whose contribution has a salutory effect in the
emergence of this multidisciplinary speciality. It will thus be apropos to acknowledge the pioneers in
this field through the historical aspects of its development.
·
Blood due to its mystic property always remained a myth and draw attention of the people as a
living force of the body. People believed in its beneficial and life saving property so much so that
in ancient Rome the spectators used to run to the arena to drink the blood of dying gladiators with
the hope that the strong and brave quality in the blood will be transmitted to them through drinking.
Ancient Egyptian used blood bathing to resuscitate and rejuvanate the old and the sick. In the middle
century the blood was used as a tonic drink.
In summer of 1492 an attempt of first recorded but unsuccessful transfusion was done. Ailing Pope
Innocent vm was transfused with blood from three robust young boys. Both the recipient and donors
died at a later period.
That there .could be possible transmission of disease through blood was also not unknown.
Nostradamus was actively involved in treating the Plague victims in town of Marseilles and Provence
in France during 1544 to 1546. In his recipe he prescribed rose pills (Moultes opescules - 1555). He
also insisted on fresh air, running water and he refused to bleed the patient. Traditionally it is accepted
that Adreas libavius was the first to advocate a blood transfusion in 1615.
William Harvey described circulation of blood in 1616 which is the most important milestone in
the development and further investigation on intravenous infusion and transfusion therapy. In 1665
Richard Lower, an English Physiologist performed experiment in dogs by directly transfusing from
artery to vein. Jean Baptiste Denys, physician to Louis XIV transfused a young man suffering from
leutic madness. Blood was transfused directly from carotid artery of lamb into the vein of the recipient.
Procedure though successful, was followed by passage of very dark coloured urine as black as soot
from the patient. Denys continued his experiment but fourth patient in the series died. In this patient
symptoms observed by Denys was the first recorded sign and symptom of a transfusion reaction and
are as follows -
"First transfusion no detectable symptom. Second transfusion arm become hot, pulse
rose, sweat burst over forehead, pain in kidneys and urine very dark in fact black." Following this
bizzare incident transfusion was
prohibite~
except with sanction from Faculty of medicine in Paris.

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2
Blood Banking and Transfusion
The practice of transfusion thus remain suspended for a pretty long time after this incident. And it
was in 18] 8 James Blundell revived the practice of blood transfusion. James Blundell was a obstetrician
and his idea developed when he experienced helplessness in treating women who bled profusely during
delivery or in post partum period. He and his associates did a lot of experiments which revealed
that:
1. Blood loss through haemorrhage if not checked and or replaced could be detrimental and fatal
to the patient.
2. Species has to be observed in practice of transfusion -
Homologus transfusion.
In 1829 first exchange transfusion was attempted in case of a rabies patient, the procedure was
later developed by Robertson in 1924 after the first world war. He first experimented in rabbits and
later on carried out in human being. Similarly autologus transfusion was suggested by William
Highmore and later developed by Milles G Langston and Dalesandro in 1971 -
Leap frog technique.
In the year 1899 Shattock observed agglutination phenomenon in blood of patient having febrile
disease but failed to observe it in normal blood. According to shattock it could be due to increased
coagulability and rouleaux formation in febrile blood. The phenomenon of isoagglutination i.e,
agglutination in human blood by human serum has been observed by Karl Landsteiner and later
confirmed by Ehrlic and Mongenroth.
In 1900 Lartdsteiner discovered A, B, 0, blood group followed by discovery of AB group in 1902
by Decastelle and Sturli.
In between 1908 to 1910 Ottenbergh, Vandangren and Hirszfield established inheritance of blood
group which was later explained by Bernstein approximately around 1925.
Frossman antigen was discovered in 1911. Animal kingdom is divided in positive and negative
on the basis of presence or absence of Frossman antigen in tissue. Again in around 1908 to 1913
Ottenbergh did successful selection of compatible blood for transfusion. Moss published paper - studies
of isoagglutinin and isehaemolysin in 1910. But then speedy transfusion was a problem till 1914 and
1915 to avoid clot formation some ingenious devices like syringe designed by Waller was in use. In
1914 Hustin, Agote, Lawishon and Weiner noted that if citrate is added in small non-toxic quantity
it prevented coagulation of blood. Again in 1916 ROllS and Turner found that addition of Dextrose
added to in vitro longevity of blood stored at 4°e. Dr. Oswal Robertson used previously collected blood
to transfuse the injured soldiers during the first world war and this started the story of blood bank.
In 1927 and 1928 MN system was discovered by Levine and Landsteiner. P blood group was also
discovered during this period. The ABO blood group system was recognised internationally, during
1928 it was accepted by the League of Nations.
ABO variants was described by Fiseher and Hahn as early as 1935. Friedenrich described A3 in
1936. Aint was described by Landsteiner and Levine in 1930. Transfusion of cadaver blood was
described in lAMA in 1936 by Russian investigator Yadin and Shamov. The date 15.3.1937' was
landmark in history of Blood Banking sciences. On this day Dr. Bernard Fantus established the first
blood bank in Cook Country, Hospital, Chicago, USA with first blood bank technologist -
Charles
J. Manas (Pharmacist by profession) and first supervisor was Dr. Elizabeth Schirmer,
The phenomenon of immune isoagglutination was discovered by Levine and Statson in antepartum
clinic of Bellevue Hospital, on July 12, 1937. Further research on this led to discovery of Rh 'system
by them in 1939. More work was done by Prof. Fisher, Dr. Race, Dr. Wiener on Rh system and its
genetics during 1939 and 1940 and by Mourant in 1945.

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Historical Aspects
3
In 1939 again Tisilus and Kabat showed that plasma protein can be separated in four by process
of electrophoresis and in 1964 these antibody containing protein were designated as immunoglobulin.
During the course of investigation of Rh system Landsteiner and Wiener discovered an antiger
in human being with the help of Rhesus monkey antibody. This antigen was named LW antigen after
its discoverer in 1940.
Spirochaetes does not survive more than 72 hours in citrated blood at 4°C to 6°C was described
by Bloch in 1941. Turner et a1. in 1941 and Kolmer in 1943. In 1943 again ultimate anticoagulan1
and preservative was described by Loutit and Mollison.
Coombs Mourant and Race reintroduced the antiglobulin test in 1945.The method was originally
described by Moraschi in 1908. In 1945 again Diamond and Denton used Bovine albumin in blood
group serology.
In 1946 and 1947 susceptibility of red cells to agglutination by prior enzyme treatment was
described by Pickles and Morton respectively. Between 1946 to 1967 other blood group system were
discovered viz. Luthran - 1946 by Callender and Race, Kell by Coombs et ale in 1946, ss by Walsh
and Montogomery in 1947, Sanger and Race in 1947" Duffy system by Cutbush and Cherian in 1950,
Kidd by Allen et ale in 1951, Bombay group by Bhende and Bhatia in 1952, I blood group system
in 1956 by Wiener et ale Also other groups like Diego, Cartwright Xg, Dombrock and Colton was
successively discovered around 1946 to 1970.
First blood cell separator by Cohn et al. in 1951 and later developed by Tullis et al. during 1956
and 1967. Plastic transfusion set by Prof. Carl W. Walter of Harvard Medical school, his research
started in 1947 which culminated in development of this system in 1952 and was approved by US
Government in 1961. Australia antigen was discovered by Blumbergh in 1964. Continuous flow cell
separator by Tudoson et ale in 1968.
In 1969, genetics and biochemical aspect of human blood group was described by Morgan and
Watkins. In 1971 Elisa was introduced by Avrameas and Guilbert. In 1971 again Edelman described
the antibody (immunoglobulin) structure. In 1972 Singer and Nicholson described the fluid Mosaic
model of red cell membrane.
Hybridoma technique described by Kohler & Millestin in 1975, later on human hybridoma was
developed by Croce et al., 1980. Olsson and Kaplan described humanhybridoma producing monoclonal
antibody. HTLV was discovered by Poisez in 1980-81. HIV was discovered (first case) in 1981.Second
generation test for detection of HIV by immunoreactive bead assay was discovered during late eighty's.
Recommended further reading
1. Text Book of Blood Banking Sciences, Chester, M. Zmijewski and Walter E. Haesler, First edition, 1982.
Appleton-Century-Crofts.
2. The Final Prophecies of Nostradamus, Erika Cheetham, Reprint edition, 1991, Macdonald and Company,
London and Sydney, Indian publisher, Rupa & Co.
3. Blood Transfusionin Clinical Medicine, P.L. Mollison, Seventh edition, 1983, Blackwell Scientific Publication.
4. Introduction to Transfusion Medicine, Zarin Bharuchaand D.M. Chouhan, First edition, 1990, D.K. Publisher,
Bombay, India.