Origin of Blood Transfusion — Chirurgia Infusoria

The frontpiece of Purmann's book

Since ancient times, blood has been considered the most sacred element of the body. It contained vital energy, the main factor of life. But not only that — it was also a repository of special spiritual qualities that defined a person. Animal blood could not be considered equal to human blood. But the inquiring minds of Renaissance scientists expressed various, sometimes mind-boggling ideas, including the possibility of replenishing blood loss in the wounded or replacing “bad” blood with “good” blood in the seriously ill. In the 17th century, William Harvey's discovery of continuous blood circulation led to the idea of new therapeutic methods.

The early history of blood transfusion was presented in numerous publications in France, England, and Italy. Many of these works already raised the question of the priority of discoveries, who deserves credit for performing the first blood transfusion—between animals, from animal to human, and from human to human. 

 

Short Chronology of the First Blood Transfusions

1628. William Harvey (1578–1657) in his publication refuted the previously accepted Galenic views on the origin and movement of blood in the human body and mathematically demonstrated the existence of systemic blood circulation driven by the heart.

1665. In the end of February 1665, Richard Lower (1631–1691) successfully performed blood transfusion from one dog to another at the University of Oxford. The recipient dog survived, but the donor dog died from blood loss.

1667 (15th of June 1667). Jean-Baptiste Denis performed a blood transfusion from a lamb to a human in Paris (xenotransfusion). Denis transfused about 12 ounces of lamb blood into the patient. The patient, a 15-year-old boy with a severe fever, survived.

 

Blood transfusion between dogs by Richard Lower

Many researchers mistakenly cite the year of Richard Lower's experiment. They erroneously take as the date of priority a letter from Robert Boyle (representing the Royal Society) dated June 26, 1666, which is included in the book Tractatus de corde. Item de motu & colore sanguinis et chyli in eum transitu, written by Richard Lower and published in 1669.

In the fourth chapter of this book, entitled De Transfusione Sanguinis ex animali alio in aliud: Quo tempore & quâ occasione ab Authore inventa sit. (About the transfusion of blood from one animal to another: when and under what circumstances it was invented by the author), Lower cites this letter addressed to him as evidence in defense of his primacy in performing animal-to-animal blood transfusion. This date today is often mistakenly attributed to the experiment itself. However, earlier in the same chapter, there is a description and an earlier date for the initial experiment:

Quocirca cum ex voto omnia expectationi responderent, tandem Oxonii sub finem Februarii, anni 1665. præsentibus Doctiss. viris Doctore Johanne Wallis Mathematices Professore Saviliano, Domino Thomâ Millington, Medicinæ Doctore. Aliisque ejusdem Academiæ Medicis experimentum hoc novum jucundo sane spectaculo atque optimis auspiciis exhibui ("Therefore, since everything responded to expectation according to my desire, I finally exhibited this new experiment at Oxford toward the end of February, in the year 1665, in the presence of the most learned men: Doctor John Wallis, Savilian Professor of Mathematics, Mr. Thomas Millington, Doctor of Medicine, and other physicians of the same University; [it was] truly a pleasing spectacle and performed under the best auspices.")

The men mentioned as witnesses were titans of the scientific revolution: John Wallis was a world-renowned mathematician, and Thomas Millington was a co-founder of the Royal Society and personal doctor to King William III and Queen Mary II. Thus, this evidence alone was sufficiently compelling. However, Lower mentions that a repeat demonstration was held later in London, and even publishes the full text of the correspondence with Robert Boyle.

Interestingly, later in this chapter there is a phrase that serves as the key to the purpose of the entire book. Lower writes that a certain Dionysius. This man, Dionysius, is none other than the Frenchman Jean-Baptiste Denis, a rival who claims to have been the first to perform a blood transfusion on a human being in Paris — in fact, the first in the world. The eternal Roman-Sacony rivalry was expressed here in the feeling that Denis stole his intellectual achievement. However, in fairness, it should be noted that this book was published post facto, in response to roumors about blood transfusions that had reached the islands from the continent.

 

Matthaes Purmann

In his Grosser und gantz Neu-gewundener Lorbeer-Krantz, Oder Wund-Artzneÿ Silesian surgeon Matthaeus Purmann wrote:  D. Ettmüller in his Dissertatione medica de Chirurgia Infusoria, which is also very useful to me in the present chapter, because it is in few hands and is also somewhat difficult Latin, which not many surgeons understand. Chirurgia Transfusoria was also popular and well-known some time ago, but it has now fallen into disrepute because it is difficult to perform and helps few people. I did, however, have a fortunate example of it in Frankfurt an der Oder in 1668, when I was staying with Balthasar Kaufmann, who suffered greatly from it, and I treated him several times by drawing blood from the median vein. I had a successful experiment with the young Mr. Weislein, who was suffering greatly from consumption. We gradually drained a quantity of his blood from the median vein on several occasions, and immediately afterwards replaced it with blood from a lamb, whose jugular vein had been opened. This finally had such an effect that he was completely healthy within three months. On the other hand, however, we performed it very unsuccessfully on two soldiers from the Royal Regiment and on a citizen, for the first two, who were dead scurvy, and the other, who had a very bad hairworm, became much worse as a result, and lost so much strength that they have hardly recovered from their melancholy in a year and a day, which will also be apparent to the reader."

 

William Harvey's 'de Motu Coris' - Blood Circulation

William Harvey (1578–1657) published Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus (Frankfurt: William Fitzer, 1628), in which he overturned the long-standing Galenic doctrine that blood was continuously produced in the liver from digested food, consumed by the tissues, and moved back and forth in the veins with only a small portion passing from the right to the left side of the heart through invisible pores in the interventricular septum. Harvey demonstrated instead that the heart functions as a pump and that blood circulates in a closed system through arteries and veins. He supported this conclusion with anatomical observations and quantitative reasoning: by calculating the volume of blood expelled by the heart with each contraction and multiplying it by the number of heartbeats per hour, he showed that the amount of blood passing through the heart far exceeded the total volume of the body, which would be impossible unless the same blood continually recirculated; he also performed ligature experiments on arteries and veins that demonstrated the directional flow of blood and the function of venous valves.

 

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