LET IT FLOW: After researchers discovered that sodium citrate could prevent the coagulation of blood for many hours—some claimed for as long as 48 hours, though transfusions were typically performed on the same day as the blood extraction—doctors would put a small amount of the substance in a glass flask and add blood collected directly from the arm of a donor. The blood was then transfused into a patient from the flask. This image was published in a review of the technique by one of its many pioneers, Richard Lewisohn, a surgeon at Mount Sinai Hospital in New York, who helped identify the appropriate dosage of sodium citrate that would keep the blood liquid without being toxic to the recipient. THE BOSTON MEDICAL AND SURGICAL JOURNAL, 190:733-42, 1924.In a dramatic and widely publicized feat in 1908, French surgeon Alexis Carrel, working at the Rockefeller Institute for Medical Research in New York City, demonstrated the relatively new technique of direct blood transfusion. To save a baby’s life, he connected the artery of a surgeon’s arm with a vein in the leg of the surgeon’s infant daughter. The method, which he and others had been developing for the past couple of years, circumvented the problem of coagulation that had long challenged blood transfusion efforts. As soon as blood is exposed to air, it begins to coagulate; directly connecting the vessels of donor and recipient avoided contact with air altogether.
“Blood could actually flow from individual to individual and really bring people back from death itself,” says Susan Lederer, a professor of medical history and bioethics at the University of Wisconsin School of Medicine and Public Health.
But the technique required great skill, limiting its implementation to only the most accomplished surgeons, such as transfusion pioneer George Washington Crile, who was one of the first to adapt Carrel’s techniques at the St. Alexis Hospital in Cleveland. Among transfusion practitioners, there was a push to discover a compound that could prevent coagulation enough to support indirect transfusion, without causing excessive bleeding or introducing toxins to the blood.
Various compounds in solution were already used for other anticlotting purposes. Jewish butchers, for instance, used salt solutions to ...
