History of Blood Transfusion

William Harvey's 1628 account of circulation (De motu cordis) made blood a fluid moving in a closed system, and it invited the question of whether blood could be moved from one body to another. In 1665 the English physician Richard Lower performed the first recorded animal-to-animal transfusions, between sheep and between dogs, and published the results in De sanguinis circulatione.

In June 1667 the French physician Jean-Baptiste Denis, physician to Louis XIV, transfused sheep's blood into a fifteen-year-old boy, with the help of the surgeon Paul Emmerez; the boy survived. A transfusion into a man followed in 1668. The results were mixed and alarming: a patient died after injections of calf's blood, Denis was accused of murder and acquitted of malpractice, and the experiments were abandoned. French authorities restricted transfusion after 1668, and the practice faded for more than a century.

The failures were not mere bad luck. Practitioners could not explain immune incompatibility (the destruction of transfused red cells), could not control dose reliably, and had no way to prevent clotting or infection. These episodes show why a plausible physiological idea was insufficient: transfusion became dependable only when compatibility, collection, anticoagulation, storage, sterility, and clinical indication could be managed together.

1. 1628: Harvey publishes his account of blood circulation.
2. 1665: Richard Lower performs the first recorded animal-to-animal transfusions.
3. 1667: Denis transfuses sheep's blood into a boy in Paris; the boy survives.
4. 1668: A transfusion into a man follows; deaths and a murder accusation end the experiments.
5. After 1668: French authorities restrict transfusion, and the practice falls out of use.

In 1818 the obstetrician James Blundell, working at Guy's Hospital in London, performed human-to-human transfusion to treat women dying of postpartum hemorrhage, and published his experiments in the Medico-Chirurgical Transactions. His 1834 book, An Attempt to Transfuse the Blood of One Person into Another, argued that human recipients required human blood. The 1818 timeline entry examines the episode and the care needed around "first" claims.

Blundell's apparatus moved blood directly from donor to recipient, so a willing donor had to be present and the procedure performed quickly before the blood clotted. Without blood groups, crossmatching, anticoagulation, or sterile technique, mortality remained high, and transfusion stayed a desperate maneuver rather than a routine treatment. It also belongs to the history of obstetrics and midwifery, where postpartum hemorrhage was a leading cause of maternal death, and to hospital history, because later blood banks and emergency systems changed what operations and trauma care could safely attempt.

In 1900–1901 the Austrian pathologist Karl Landsteiner showed that human blood falls into groups (later named A, B, AB, and O) according to the substances on the red cells and the antibodies in the serum, and that incompatible combinations agglutinate. He published the finding in 1901 in the Wiener klinische Wochenschrift and received the Nobel Prize in Physiology or Medicine in 1930. Typing, and later crossmatching — mixing a sample of donor and recipient blood before transfusion — shifted safety from guesswork toward laboratory control.

Levine and Stetson described an important human blood incompatibility in 1939, and Landsteiner and Alexander Wiener reported a related factor from experiments with rhesus-monkey blood in 1940. The resulting "Rh" terminology was historically influential, although the human and monkey antigens were later shown not to be identical. Rh incompatibility between mother and fetus caused hemolytic disease of the newborn, a condition recognized in the 1940s and later largely prevented by Rh immunoglobulin, licensed in 1968.

In 1914 Albert Hustin in Brussels and Luis Agote in Buenos Aires independently used sodium citrate to keep donated blood from clotting. Richard Lewisohn established a safe citrate concentration in 1915, and Peyton Rous and J. R. Turner developed a citrate-glucose preservative in 1916. These advances made it possible to collect blood in advance, and refrigeration, containers, and expiry rules then allowed blood to be stored and transported instead of passed directly vein to vein.

The first organized transfusion services appeared in the 1930s: during the Spanish Civil War, Federic Durán-Jordà set up a transfusion service in Barcelona in August 1936, followed by one in Madrid in December 1936. In 1937 Bernard Fantus established a hospital service at Cook County Hospital in Chicago and popularized the term "blood bank." Reuben Ottenberg had earlier helped establish pre-transfusion compatibility testing.

Dried plasma, developed in the late 1930s, could be shipped without refrigeration and used for shock. In Britain, Janet Vaughan helped organize the Emergency Blood Transfusion Service, while the British physician P. L. Mollison studied blood storage and transfusion practice during the war. In 1940 Charles Drew directed "Blood for Britain," which collected plasma in the United States for use in Britain, and he helped organize an early American Red Cross blood programme.

The same years exposed the social side of the new system. The American Red Cross initially excluded Black donors and later segregated their blood into separate supplies, a policy Drew condemned as unsupported by biological evidence. That episode links transfusion to medical ethics and to the wider history of military medicine.

After the war, national services took over the infrastructure built for fighting: in 1946 the British Ministry of Health established the National Blood Transfusion Service. Preservatives such as citrate-phosphate-dextrose (CPD) extended storage in the 1950s, plastic bags replaced glass bottles in the 1970s, and component separation allowed one donation to be divided into red cells, platelets, and plasma matched to different needs. Apheresis, in which a single donor's platelets are collected by machine, was developed in the 1960s and 1970s.

The second great safety problem was infection. Donor screening began with hepatitis B in Australia in 1971, then HIV in 1985 and hepatitis C in 1990, and nucleic acid testing in the early 2000s shortened the window in which an infection could be missed. Safety now depends on every link in the chain — donor selection, sterile collection, testing, labeling, traceability, and reaction investigation — rather than on a single test.

Blood services recruit donors, judge eligibility, test for infections, label components, preserve traceability, investigate reactions, and maintain supply for unpredictable emergencies. A blood service is therefore an institution as much as a technique: it only works when recruitment, laboratory, logistics, and clinical teams function together.

Donor rules have also reflected prejudice and political assumptions. Programmes have segregated blood by race or excluded groups through categories that did not always distinguish evidence-based risk from stigma, as the wartime "colored blood" policy shows. Reform requires both recipient safety and fair treatment of donors.

Access remains geographically unequal because blood expires and requires regular donation, refrigeration, laboratories, trained staff, and rapid transport. The ability to transfuse is therefore a measure of health-system capacity as well as a medical technique.

Start with the 1818 first successful blood transfusion and the blood circulation timeline entry, then the profiles of William Harvey and Charles Drew.

Continue with surgery through the ages, military medicine, obstetrics and midwifery, and medical ethics. The NHS Blood and Transplant history provides an institutional chronology of blood groups, anticoagulation, storage, banks, and screening.