188 



ON THE TIIANSFUSION OF MILK. 



[1855. 



On the Transfusion of Milk, as practised in Cholera, at the 

 Cholera Sheds, Toronto, July, 1854. 



By jAMug BovELL, M.D., Trin. Coll., Toronto. 



{Read before the Canadian Institute, January llth, 1855.) 



Mk. President. 



As I am quite aware that the Council of the Institute, as 

 well as many of its members, wish to confine within proper 

 limits the introduction of purely professional matters at the usual 

 evening meetings, I have endeavoured to divest the subject 

 which I purpose to bring before you this evening, as much as 

 possible, of what you might consider its technical features; and 

 instead of presenting to the Society a Report on the Cholera of 

 1854, I now venture to claim your attention to a single fact 

 connected with that visitation, — one which I believe will be 

 received by the members of the Institute with interest. 



The possibility of saving human life by the transfusion of 

 new blood into the system is not of very ancient date, and I 

 beheve that the records of antiquity furnish us with no 

 instance of the introduction of blood into the system by 

 operation. It was however practised, says Dr. Ehamsbotham, 

 " hy some in the last century; and some physiologists contend 

 that the operation of transfusing medicated fluids, and blood 

 itself, into the system of man, is of very remote origin ; and 

 they ground their supposition on some passages in the ancient 

 poets." Thus G.v!d represents Medea as renewing the youth 

 CEson by injecting the juice of herbs into his veins. 



"Quod simul ac vidit, stricto Medea reoludit 

 Ense senis jugulum : veteremque exire cruorem 

 Passa replet succis. Quos postquam combibit CEson 

 Aut ore acceptos, aut vulnere, barba, comceqiie 

 Canitie posita, nigrum rapuere calorem." 



This is no warrant for such a belief; and the probability is, 

 that the fancy originated, not in any practice then pursued, 

 but merely in an adventurous flight of poetry. It has been 

 even supposed that in these early times blood was actually 

 transmitted from one person to another, and a second passage 

 in the same author, where he describes Medea's fiend-like 

 deception practised upon the unsuspecting daughters of Pelias, 

 has been quoted in proof. 



Quid nunc dubitatis inertes ? 



Stringite, ait, gladios, veteremque haurite cruorem 



Ut repleam vacuas juvenili sanguine venas. 



Lib. vii. — 5. 



That these lines will not bear any such interpretation, the 

 whole context, and the pretended sanitary preparations she 

 makes, abundantly testify. 



My relative. Dr. Leacock, in his Inaugural Thesis, published 

 at Edinburgh, in, I think, 1816, again directed the attention of 

 physicians to the real benefits which might be expected from the 

 employment of such means for the restoration of life ; and his 

 opinions meeting with a warm advocacy from the justly celebrated 

 Dr. Blundell, the operation of transfusion received an impress 

 which it has never entirely lost. Various physiologists have, since 

 the re-introduction of transfusion by Dr. Leacock, performed on 

 the lower animals experiments, with the view to ascertain how 

 far the blood of one animal may be substituted for that of 

 another. As might have been expected, it was soon discovered 

 that it was impossible to so far pervert the laws of physiology 

 as to build up tis,sues from blood formed for the support of 

 structures typically distinct ; accordingly the law has been 

 established, that an animal can only be restored to health by 

 the introduction into its veins of blood taken from one of its 

 own species. But intelligible fis this law is, it is, neverthe- 



less, found, that many conditions contribute to its successful 

 vrorking. Constituted as blood is, possessing a highly complex 

 organisation, consisting of many parts — organized solids and 

 fluids, and inorganic salts, wonderfully and inseparably joined 

 together, living very quickly and dying as instantly, in obedi- 

 ence to laws which govern its origin and death- — blood cannot 

 be for any appreciable time removed from the circulatory con- 

 dition without undergoing change. It is a completed orga- 

 nism when withdrawn from the body of the animal; already 

 has it lived out more than half its time, and all its tendencies 

 are not to live on, but to die out: hence experiment has shewn 

 that even with the blood of the same animal the effects of its 

 transfusion have not been invariably satisfactory, and various 

 propositions have been made to modify the introduction of the 

 blood, in order to render it better fitted for the end in view. 

 Thus the French philosophers have endeavoured to show that the 

 de-fibrination of the blood was more likely to secure the benefits 

 sought to be obtained, than when the whole organized compound 

 was employed. Be this as it may, it is quite certain, that in 

 case of epidemic visitations, which cut down, not an individual 

 here and there, but which decimate a population, be transfu- 

 sion never so successful, yet it would be an impossibility to 

 employ it on a general scale, since the physician would not be 

 justified in depriving the as yet unattacked man, of blood, every 

 drop of which he may require shortly himself, even if it were 

 possible to induce the disaffected to part with what is really 

 under such a condition to them " their life's blood." 



The appreciation of this truth evidently led our authorities to 

 introduce other menstrua, and as Animal Chemistry pointed 

 out in the destroying discharges the presence of the saline con- 

 stituents, it was thought advisable to inject into the system a 

 supply of similar matei ial to fill up the place of that drained away. 

 That this plan has been occasionally successfid experiment fully 

 attests ; but it is nevertheless admitted, that it has not fulfilled 

 the expectations of its originators. In the firet place, this doc- 

 trine fails to take cognizance of that portion of the blood which 

 remains in the vessels; it fails to recognise the prime fact that 

 the senim and salts of the blood are drained away, not so much 

 in consequence of changes which have ensued in the vascular 

 canals, as from a tendency in the blood itself to separate into 

 its constituent parts — in short, to die. The introduction, 

 therefore, of the saline ingredients into the body is not a 

 restoring to the blood that which it had lost, but it is a restor- 

 ing to the system of a part only of its usual circulating pabu- 

 lum, the thick, black decaying blood-corpuscles being altogether 

 unfit to carry on the vital processes requisite for the mainten- 

 ance of the animal fabric. Thus reasoning, the thought sug- 

 gested itself that nature herself provided us with the means of 

 accomplishing the renovation of the blood, and that we had 

 prepared ready for our use a liquid possessing the requisite 

 qualities of a blood forming fluid, and, above all, that which no 

 art or power of man could bestow, viz., vitality — a compound 

 mixed in the great laboratory of life. 



The experiments performed by M. Magendie were, however, 

 not very encouraging, and tended rather to throw a shade of 

 doubt over the utility of milk as an agent in transfusion. This 

 distinguished physiologist injected various substances into the 

 arterial system of dogs, and amongst them milk, the results of 

 which was by no means satisfactory. 



In Mr. Hassall's very excellent work on the Microscopic 

 Anatomy of the Human Body, in the chapter on the blood, tne 

 following remarkable observations, cited from M. Donne's 

 Papers, occurs :— 



" Now, with regard to actual experiments with milk, we have 



