James Blundell

This Month in Medical History: The bloody history of James Blundell

September 13, 2011
by Joanna Padovano, Reporter
This report originally appeared in the September 2011 issue of DOTmed Business News

English obstetrician and physiologist James Blundell noticed that many women were dying during childbirth due to a significant loss of blood, so he decided to perform one of the first transfusions of human blood into another human.

The life-saving medical practice of blood transfusions first began hundreds of years ago. Initial efforts involved animal-to-animal transfusions, which were later followed by animal-to-human transfusions, and then eventually human-to-human transfusions. It has been said that early attempts at blood transfusions involved misguided methods such as having the patients drink the donor’s blood. As has been the case with other medical procedures in the past, many people opposed the concept of blood transfusions and it was even banned in some areas.

In September 1818, the first well-documented human-to-human blood transfusion was performed at Guy’s Hospital in London, England, by Dr. James Blundell, who had first practiced the procedure on dogs. Using a syringe Blundell injected a woman suffering from a severe postpartum hemorrhage with four ounces of her husband’s blood. Although she died, Blundell continued to perform blood transfusions on approximately ten additional patients, about half of whom survived.

Through the years Blundell published his work and wrote about the importance of preventing air from getting into a patient’s veins and avoiding coagulation of the blood. He also developed instruments to aid in the transfusion of blood, such as the Impellor, which provided blood under pressure to the recipient; and the Gravitator, a gravity feed device.

In those days, blood transfusions were typically given to patients who were experiencing conditions such as postpartum hemorrhage, extreme malnutrition, ruptured uterus, and cancer of the pylorus, among others. Due to a lack of knowledge about the different blood types, transfusions were a dangerous endeavor that frequently led to the recipient’s death.

During the early 1900s, Karl Landsteiner, an Austrian physicist, documented three out of the four main human blood types—A, B, and O. Shortly after that AB, a fourth blood group, was identified by A. Decastrello and A. Sturli. This discovery allowed doctors to recognize that the blood given to a patient needs to be compatible with their own blood type in order to increase their chance of survival. Doctors eventually realized that people with blood type O are universal donors and people with blood type AB are universal recipients.

As for Blundell, later in his career he worked with Samuel Lane, an English physician who used blood transfusions to treat people with hemophilia. Blundell also contributed to improvements in the fields of gynecology, obstetrics, and abdominal surgery. In 1838 he became a Fellow of the Royal College of Physicians; he died four decades later.

Since then doctors have continued to make advancements in the practice of blood transfusions. During the 1970s it became possible to separate the different components of blood, including red blood cells, white blood cells, platelets, and plasma, using a process called apheresis. More recently, tests were developed to detect viruses, such as HIV and Hepatitis B, in donated blood.

Although the once controversial procedure is now extremely common, there are still certain groups today, who do not support the concept of donating or accepting blood due to personal beliefs.

Religious beliefs aside, no one can deny that blood transfusions are extremely beneficial in the world of medicine and have saved countless lives over the years, thanks in part to the pioneering work of James Blundell in the nineteenth century.