BLOOD TRANSFUSION. The process of transferring whole blood from the blood vessels of one individual to that of another. Transfusion can only be accomplished in ani mals of the same species.
History.—Transfusion of blood dates as far back as the time of the ancient Egyptians. The earliest reported case is that practised on Pope Innocent VIII in 1492. The operation cost the lives of three youths and the Pontiff's life was not saved. Great strides in the re search and practice of transfusion on animals were made after Harvey's discovery of the circulation of blood in the middle of the 17th century. Physicians in Germany, England and France were especially active in the work of blood transfusion after this discovery. They reasoned, that as the blood is the principal medium by which the body is nourished, trans fusion, therefore, is a quicker and shorter road to feed an ill-nourished body than eating food which but turns to blood after several changes. So transfusion was thought of not only as a cure, but also as a rejuvenator. At tempts were then made to cure various dis eases, such as fevers, leprosy, insanity and hydrophobia. Lamb's blood was used for trans fusions into human beings with varying suc cess. Curious to relate, the Faculty of Medi cine of Paris refused to recognize Harvey's discovery and also opposed any progress made in the art of transfusion. They persecuted those who were active in the research work of transfusion. It was in the end of the 18th and in the beginning of the 19th century that the most active work in establishing trans fusion as a surgical procedure after hem orrhage was done.
Before performing transfusion, the follow ing factors must be seriously considered: (1) A propelling force to insure the free flow of blood from the donor to the recipient. (2) Prevention of clotting while transfusing. (3) To guard against the injection of air into the vessels. (4) To guard against infection or disease that a donor may transmit to the recipi ent. (5) The hemolitic effect of donor's blood on the blood of the recipient must first be tested before transfusion is attempted. The propelling forces are three: First, normal arterial pressure, the blood flowing from an artery of the donor to the vein of the recipient by direct connection. Second, high venous pressure produced by throwing an elastic band around the arm of the donor tightly enough to shut off the return venous flow,— the blood then passes through transfusion needles and tubes from the distended vein of the donor to the relaxed vein of the recipient; and the third, is the syringe method. A syringe can
be used to draw the blood from the vein of the donor and immediately to inject it into the vein of the recipient. There is another syringe method, wherein the blood, after being drawn from the donor, can be preserved and in jected at some later time into the vein of the recipient. This method is for the convenience of the donor and recipient when they cannot be brought together. When transfusion is done by direct connection of vessels, the inner membranes of the artery and vein must be brought in accurate contact, or if connecting tubes are used, they must be lined with an oily substance.
Apparatus Unger inserts a transfusion needle and tube into the vein of the donor and another needle and tube into the vein of the recipient; these two are con nected by syringe and stopcocks so that blood may be drawn from the donor and by shutting off the stopcock on the donor's side, the blood is immediately injected into the vein of the recipient. The syringe is graduated so that the amount withdrawn is under constant supervision. Hustin and Lewisohn collect the necessary amount from the donor by means of a syringe into a flask and add sodium citrate to prevent clotting. Then the blood can be transported to the bedside of the recipient. A simple apparatus devised for blood trans fusion is the following: A piece of tub ing of known calibre with rubber tubing slipped over each end and these in turn connected with transfusion needles. As this instrument is of uniform calibre, the amount of blood withdrawn from the donor can be estimated by the length of time the instrument is kept in situ.
Modern Transfusion as em ployed in modern practice is of inestimable value. Profuse hemorrhages from wounds, after operations, and after accouchements are markedly benefited by transfusion. The result ing anemia in these hemorrhages from the loss of red blood-cells and hemoglobin is al most immediately corrected by transfusion. Hemophelia and purpura hemorrhagica, where the clotting qualities of the blood are partly or wholly deficient, causing hemorrhages, either spontaneous or from wounds wholly uncon trollable, are invariably controlled by trans fusion. Chronic suppuration, tuberculosis and anemia have been treated by transfusion with moderate success.