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Brief history of blood transfusion
be leisurely and carefree
Blood symbolizes life, which is natural for people who live in the present. The importance of blood cannot be overemphasized. Any qualified intelligence personnel knows that large-scale blood transportation is an accurate signal that war is about to break out. Today, blood transfusion is a basic procedure in surgery, and many people are saved because of blood transfusion technology. However, the beginning of blood transfusion therapy, which has a great influence on human health, is due to a complete misunderstanding. It is difficult to find a second similar example in the history of medicine and even the whole history of science. It all started with the story of Antoine molloy, the first famous patient in the history of human blood transfusion.
Murray lives in a small village near Paris. When he is insane, he will beat his wife violently and set fire to the houses on the roadside. These behaviors made him very famous. /kloc-in the winter of 0/667, Molly's madness broke out again. She streaked in Paris. A nobleman found him, and out of kindness, Murray was taken to the residence of physician Dennis, because he was trying to transfuse animal blood into human body to treat human diseases, especially mental diseases. To understand this incredible treatment, we need to know the classic of western traditional medicine-body fluid theory.
Bleeding used to be the cure for all diseases. ...
Body fluid theory was founded by Hippocrates, the father of western medicine, and has ruled western medical practice for thousands of years. Its essence is to attribute the disease to the imbalance of body fluids, and the main means to restore balance are vomiting, sweating, diarrhea and bloodletting. Among them, bloodletting therapy is the most respected. As a main "universal" treatment method, it has been practiced enthusiastically and faithfully for at least 2,500 years. This can be seen from a ballad widely circulated in 12 century.
Let your body bleed and change your face.
find everything fresh and new
Clear thinking, no sadness.
Exercising internal organs is good for sleep.
Sharp hearing and exuberant spirit.
Loud every day
Today, we can still see some remains left over from the bloodletting era. For example, red and white stripes, the symbol of barber industry, used to be the main practitioner of bloodletting therapy. When bleeding, the patient holds a stick with red and white stripes, with white representing bandage and red representing blood. The name of The Lancet, one of the best medical journals today, also comes from the main tool of bloodletting therapy.
/kloc-The Lancet and The Lancet in the 0/8th century.
At that time, consanguinity was often intertwined with spirit, personality, soul and so on. This inspired a French doctor, Jean-Baptiste Denis, who transfused animal blood into human body to change people's personality or mental state. For this reason, Dennis wrote a rigorous academic paper, starting from philosophical assumptions, to the legality of human obtaining and using animal blood, and finally animal experiments showed the benefits of blood transfusion. Therefore, in the paper, he suggested that animal blood should be transfused to human beings to treat a series of diseases caused by blood, such as leprosy, ulcer and madness.
Before treating Murray, Dennis tried to transfuse blood to a teenager and a worker, without many side effects, but without any significant achievements. For Dennis, I'm afraid there is no better person to test his theory than Murray. 65438+February 19 at 6: 00 pm, Dennis injected 280ml calf blood into Murray's body, hoping to treat Murray's madness with the blood of "gentle calf". Murray received two blood transfusions, and the imported calf blood triggered a serious immune response in his body, leaving Murray in a state of high fever and shock near death. Fortunately, he survived, and within a few months he temporarily calmed down and didn't go crazy. This miraculous treatment immediately caused a great shock in Europe, and blood transfusion therapy became fashionable for a while. Some doctors even think that the disharmony in marriage can be completely solved by exchanging blood between husband and wife. However, it is very dangerous to transfuse animal blood to people, and death is inevitable. In addition, many conservative intellectuals opposed the change, and finally the bishop banned blood transfusion therapy throughout Europe. In the following 150 years, blood transfusion was just a miracle, only for people to explore in theory.
James brendel's blood transfusion. The Lancet, 1828- 1829
18 18, a young obstetrician, Dr. James Blundell, couldn't stand the frequent death of maternal bleeding. After careful consideration and systematic animal experiments, Dr. brendel summed up two basic principles of blood transfusion: 1, only human blood can be used; 2, can only be used for a large number of people who are dying of blood loss. Later, blood transfusion was given to 1 1 patients with massive blood loss, and 5 of them were successfully rescued. Blondel's success once again aroused the medical community's interest in blood transfusion. Doctors even invented many instruments to facilitate blood transfusion. Although many doctors follow Brownell's principle, not everyone does. Some people even put milk into patients' blood. You can imagine what the result will be, while others have unnecessary blood transfusion. Not surprisingly, with the resurgence of blood transfusion therapy, criticism and opposition have followed, and many famous doctors accuse blood transfusion therapy of grandstanding. However, in 1873, the Polish doctor G. Gesellius collected all the blood transfusion records he could get in previous decades. Statistics show that 44% of patients were saved by blood transfusion, and they would have died. This study has given the voice of support for blood transfusion the upper hand in the medical field. However, it was 19 12 that made blood transfusion therapy famous. The winner was Dr. Alexis Carrel.
Dr. Karel is French, but he is dissatisfied with the conservatism in French surgery. He first went to Canada, and finally settled in new york, USA, and entered the newly established Rockefeller Medical Research Center to do research on vascular anastomosis. He pioneered the field of microsurgery today. In order to study vascular anastomosis, Karel invented a special needle and thread and a special anastomosis technique. But the direct reason why he won the Nobel Prize was that his assistant, Dr Adrian V.S. Lambert, called for help in the middle of the night.
1908 In March, Dr. Lambert's daughter was born. Like all new parents, the Lamberts are naturally very excited and excited. However, the good times did not last long. For several days, the baby's nose and mouth kept oozing unexplained blood, which made young parents deeply afraid. Nothing can stop the bleeding. Although Lambert's two younger brothers are surgeons, no one dares or can give blood to such a small baby. In desperation, Lambert thought of the vascular anastomosis research that Dr. Karel was engaged in, which was the only operation that could give blood to the little guy. It was already late at night, and Lambert and his brothers rushed to Karel's house to wake him up from his sleep. Although Karel indicated that he did not have a medical license in new york, and matching the donor's artery with the recipient's vein would probably bring serious problems to the donor. But Lambert is obviously willing to bear all legal responsibilities and consequences, so Karel quickly packed his tools and rushed to Lambert's house.
According to Karel, the scene was very bleak. Lambert's wife is beside her unconscious and extremely pale little daughter, and seems to want to pass on her life to the child, but she is exhausted and extremely weak, and can hardly move. After seeing the child's condition, Karel was very worried that the child might die before the operation. After a short argument, Karel chose Lambert as a blood donor. He carefully isolated the radial artery of Lambert's left hand and matched it with the only available popliteal vein for the baby. After several failures, the operation finally succeeded. The baby was rescued, and Lambert's hand circulation recovered well, showing no signs of paralysis. Lambert's grateful wife wrote to Rockefeller Research Center, thanking them for funding Dr. Karel's research, because it was the research results that saved her daughter. As a big chaebol criticized by people, Rockefeller invested in the establishment of Rockefeller Research Center to change the world's impression of its group, which is simply a "windfall" for the newly established Rockefeller Research Center. This letter was immediately forwarded to major newspapers, causing a great sensation, and Karel soon became famous. The vascular anastomosis he founded suddenly became an imitated technical means in blood transfusion treatment, although it was difficult to master. To this end, some auxiliary devices have even been invented to help surgeons perform vascular anastomosis.
Karel (right) and pilot Lin Bai, and their devices for supporting organs through cardiopulmonary bypass. Time Weekly, 1938 June 13 cover.
While cheering Karel's achievements in Europe and North America, a scientific research that has made a revolutionary contribution to blood transfusion therapy has been completed, but it is unknown. 190 1 year, the young Viennese pathologist Karl Landsteiner discovered human blood type. This has to start with 1900. In a study, Steiner found that when blood is mixed between different people, blood cells sometimes aggregate. For this reason, he wrote a paper to discuss whether this phenomenon is caused by bacterial pollution or individual differences. Then he designed a series of ingenious experiments, taking blood from himself and his assistant and letting them stand until the plasma and red blood cells were separated. Then in a series of test tubes, the plasma is mixed with all other people's red blood cells and the results are observed. Steiner found that the experimental results can be divided into three situations. Plasma labeled as group A can coagulate red blood cells labeled as group B, and vice versa. Although the plasma labeled as group B can coagulate the red blood cells of group A, Lansteiner's red blood cells will not coagulate after mixing with the plasma labeled as group A and group B, but his plasma can coagulate both red blood cells of group A and group B. At first, he called the third type C, and later, for some reason, he renamed it type O. This is the origin of ABO blood group system, and almost everyone knows it today. Two years later, Lance Turner's colleagues discovered AB blood group in a larger cross experiment, and the research on the most basic blood group system of human beings came to an end.
Lanstner
Steiner realized the so-called transfusion syndrome-patients who receive blood transfusion sometimes have fever, chills, severe kidney pain, black urine and even death. It is precisely because human blood types are different, and some blood types are incompatible with each other, which leads to all this. He wrote this in his research paper. However, Steiner is introverted, and almost no one in the surgical field knows this great achievement. Only Dr. Reuben Otternberg of new york took the lead in matching before blood transfusion after reading his paper, thus avoiding transfusion syndrome. Although Ottenberg strongly advocated blood type matching, only a few doctors responded. It was not until another revolutionary blood transfusion treatment technology appeared that blood transfusion, a big and difficult operation, was transformed into an operation that any rural doctor could do, and blood type matching was really taken seriously.
Blood transfusion treatment is very difficult because once blood is isolated, it is very easy to coagulate. Karel's vascular anastomosis can avoid this problem, but his technique has great defects. First, it has great potential damage to the donor's hand. Second, it is impossible to know how much blood the blood donors have exported, and even sometimes the blood donors have lost too much and almost died. In this case, few people are willing to donate blood, and not all relatives are willing to take such a big risk for their loved ones. In view of this, the two doctors invented two systems, by drawing blood or directly drawing blood with a needle and then quantifying it, and then losing it to the recipient. The use of these systems greatly reduces the risk and pain of blood donors. Of course, in order to prevent blood coagulation, doctors need to act quickly and need many assistants. At this time, Ottenberg's colleague, Dr. Richard Levithorne, began to attack coagulation, and found in 19 15 that 0.2% citric acid can prevent coagulation and is harmless to human body. This key discovery turned the blood transfusion that used to require experts into an ordinary minor operation. Therefore, blood transfusion therapy has developed rapidly in all hospitals. Therefore, the incidence of transfusion syndrome has increased dramatically. After numerous painful lessons, cross matching became the standard operation before blood transfusion at 1920. At this point, the three obstacles of blood transfusion have been overcome one by one. With the appropriate blood transfusion equipment, the safe cross-matching of blood and citric acid to prevent coagulation are ensured. 1930, Steiner also won the Nobel Prize in Physiology or Medicine, which is well deserved.