TRANSFU SION OF BLOOD has been regarded as a recognized and legitimate opera tion in obstetric surgery since the year 1824, when Dr. Blundell published his well-known work, entitled Physiological and Pathological Researches. The operation had, however, been vaguely known to the medical profession for the last four centuries; and there are obscure allusions in the Roman poets, which would seem to indicate that it was prac ticed as early as the Augustan age: IIt repleam vacuas juvenili sanguine venal.
Ovid.
The earliest authentic case on record is, so far as we know, that of pope Innocent who was unsuccessfully operated on iu April, 1492. `• The vital powers of Inno cent VIII. rapidly gave way; he had for some time fallen into a kind of somnolency, which was sometimes so profound that the whole court believed him to be dead. All means to awaken the exhausted vitality had been resorted to in vain, when a Jew doctor proposed to do so by the transfusion, by a new instrument, of the blood of a young person—an experiment which had hitherto only been made on animals. Accordingly, the blood of the decrepit old pontiff was passed into the veins of a youth, whose blood was transferred into those of the old man. The experiment was tried three times, and at the cost of the lives of three boys, probably from air getting into their veins, but without any effect to save that of the pope."—Villari's Life of Saeoluirola. Although Libavius, in 1615, accurately describes the operation, there is no evidence that he ever Practiced it. Passing over various experiments by Wren and Lower (both of Oxford) in the transfusion of blood from one animal to another, we find Denys of Montpellier, in June, 1667, injecting the blood of calves into the veins of a young man who had been much weakened, and had become torpid and slightly dropsical, in consequence of repeated bleedings. The first operation restored him to perfect health. Subsequent cases of his gave rise to a most virulent controversy, which ended with the decision, " that for the future, no transfusion should be made upon the human body but by the approbation of the physicians of the Parisian faculty." In November of the same year, Lower publicly made a similar experiment, which seems to have been successful; and in the followiugycar and Manfridi repeated the experiment in Italy. But the operation, although thus fairly started, soon fell into obscurity, doubtless from a want of success, due partly to the blood of calves and sheep, instead of human blood, being used, and partly to hopeless cases of old age and decrepitude being selected for its application.
At the present day transfusion is an operation which is almost always restricted * to cases of profuse hemorrhage in connection with labor; and as Dr. Playfair, in his excellent Handbook, of Obstetric 1865), observes: "The benefits derived from it are probably twofold: 1. The actual restitution of blood which has been lost; and 2. The supply of a sufficient quantity of blood to the heart, to stimulate it to con traction, and thus to enable the circulation to be carried on until fresh blood is formed. Its stimulant action is probably of far the most importance and if the operation is per formed before the vital energies are entirely exhausted, the effect is most marked, and indeed may be said to be almost unfailing."—Pp. 212, 213. Blundell was in error in believing that the blood of animals of the same species was essential: Dr. Brown-Sequard having since shown that the blood of various animals can be used indiscriminately, pro vided only certain precautions are taken; and the important} discovery has recently been made by Panum that defibrillated blood is in every respect as well suited for the opera tion as pure blood.
"The cases suitable for the operation," says Dr. Playfair, "are those in which the patient is reduced to an extreme of exhaustion from hemorrhage during or after labor or miscarriage. The operation will not come into contemplation until other and simpler means have been tried and failed, and when symptoms indicate that life is on the verge of extinction." The value of the operation in suitable cases is proved by statistical evidence. Mr. Soden of Bath has recorded 36 cases, in 29 of which the patients were rescued from an apparently hopeless state; and out of 57 cases recorded by prof. Martins of Berlin, 43 were entirely successful, and 7 temporarily so. Of the various syringes that have been invented for this operation, Dr. Playfair gives the preference to that of Dr. Orally Hewitt. The blood to be injected should be taken from the arm of a strong and healthy man who can spare a sufficient quantity, since a change of persons leads to delay, and should therefore be avoided. Generally speaking, from four to six ounces Of blood are sufficient, but more may be required. It would be out of place to enter, in these pages, into details regarding the mode of performing the operation. They are fully described in Dr. Playfair's work.