DISCOVERY 



105 



that had been lost by injecting a solution of 

 conunon salt in water into the circulation, and some- 

 times this served to tide the patient over a critical 

 period. But often the effect was transient, the water 

 that was injected being rapidly removed from the 

 circulation and excreted. The immediate effect of 

 blood transfusion upon a patient who is dying from 

 loss of blcod is one of the most gratifying sights that 

 a surgeon can ever hope to see. The patient may have 

 been hterally within a few minutes of his death, but 

 very soon after the beginning of the transfusion he 

 begins to show signs of returning hfe. His breathing, 

 from being a series of deep sighs, becomes normal, his 

 pulse, previously very rapid and almost, if not quite, 

 imperceptible, becomes slower and stronger, and his 

 grey, drawn face regains its natural colour. The 

 transfused blood, though probably not equal in amount 

 to that which had been lost, has nevertheless served 

 to turn the scale in favour of life, and the process has 

 ensured that the patient shall, at any rate, not die 

 from lack of blood. .\ blood transfusion canied out 

 during the war was sometimes done under difficulties, 

 and was apt to be a real race with death with a very 

 brief margin of time ; but however intense the effort, 

 the result was nearly always an adequate reward. 

 There was never any difficulty in obtaining volunteers 

 for the office of blood donor. A number of men in 

 hospital were usually tested for their blood groups 

 before a battle, and the suitable ones chosen out. 

 Most men took a genuine pleasure in saving the Ufe 

 of a comrade, and sometimes the rescue was effected 

 under their very eyes. The donor was usuedly not 

 ill-pleased to find afterwards that he was to get in 

 addition three weeks' leave in England. 



Towards the end of the war it was found that citrated 

 blood could be kept unchanged for twenty-four hours 

 or more, and in some hospitals the blood was drawn 

 off from si.x or more donors when a battle was expected, 

 and held in readiness ; but even with this improvement 

 it was still impossible during a long battle to carry 

 out all the transfusions that were necessary. Physio- 

 logists in England therefore did much research in an 

 attempt to discover a fluid which could be used as a 

 substitute for blood and prepared beforehand in large 

 quantities. It was necessary to find a non-poisonous 

 solution which had approximately the same " viscosity," 

 that is to say, the same physical properties, as blood, 

 and would consequently not be removed so rapidly 

 from the circulation as was the salt solution previously 

 used. It was thought by some authorities that the 

 corpuscles of the transfused blood were not important 

 from the point of view of their special function as 

 oxygen carriers, but that the maintenance of an ade- 

 quate blood volimie was the chief thing to be aimed 

 at. Doubt has even been expressed whether the cor- 



puscles of the transfused blood really carry out their 

 proper functions in the recipient ; but it has recently 

 been shown that the visiting corpuscles can remain 

 in the circulation for more than thirty days, and it 

 is therefore almost certain that they can be as useful 

 to the recipient as if his own corpuscles had been 

 put back into his veins. Normally an adult person 

 has approximately fifteen thousand million miUions of 

 corpuscles circulating in his body, and it is not difficult 

 to beUeve that this number might be considerably 

 reduced without ill effect. It was accordingly an- 

 nounced in 1918 that a satisfactory substitute for 

 blood had been found in a specially prepared solution 

 of gum-acacia, and it was used at once with high hopes 

 of success ; but it was found in France not altogether 

 to justify the claims that had been made for it, and 

 blood continued to be used whenever conditions per- 

 mitted of it. 



It is improbable that blood transfusion will ever be 

 used on a large scale in civil practice, but it has 

 already been found of great value for resuscitating 

 patients who have undergone certain severe surgical 

 operations ; it has also been used with good effect in 

 various diseases of the blood, such as pernicious anaemia, 

 and has saved the lives of the unfortunate people known 

 as " bleeders," whose blood, being deficient in the 

 power of coagulation, continues to flow almost in- 

 definitely after even a trivial injury. The injection of 

 another blood gives the blood of the recipient, at any 

 rate temporarily, an increased coagulabihty, so that 

 the bleeder's wound is stanched. This effect is not 

 spoilt by the admixture of citrate, although this is 

 used as an anti-coagulant outside the body — a physio- 

 logical paradox which has yet to be explained. 

 Transfusion can also be used for cases of severe loss 

 of blood due to accidental wounds. It is to be hoped 

 that in hospitals it will always be possible to give a 

 blood transfusion at very short notice ; but the pro- 

 vision of blood donors is not so simple a matter in 

 civil Ufe as it was in the army. Already in America 

 professional blood donors are to be found, who for a 

 moderate fee are willing to sell a pint or more of blood 

 several times a year; but Nature would not tolerate 

 the letting of blood at intervals frequent enough to 

 provide an adequate income, were this to be the donor's 

 only means of hvehhood. It is more probable that a 

 suitable volunteer will have to be found for each case 

 as the necessity arises. 



We hope to deal in the next issue with the following 

 interesting books published by the Wireless Press : — 

 The Wireless Transmission of Photographs, by Marcus 

 J. Martin ; and Wireless Telegraphy and Telephony, by 

 H. M. Dowsett. 



