Here we recount the tale of the origins of blood transfusions as told in the story of Antoine Mauroy one of the first people to receive one.

by Pete Moore

And so we arrive back at the night of December 19, 1667 in Henri de Montmor’s library. To the pleasure of some and the extreme consternation of others, the two physicians, Jean-Baptiste Denis and Paul Emmerey, announced that as far as they could see, Antoine Mauroy their prospective patient was stable and in good basic health. He was a perfect candidate for their revolutionary therapy. Yes, he would be the next patient to receive some transfused blood. To avoid any possible deterioration, the operation should be carried out at the earliest possible time. This, they stated was a trial of an idea. They weren’t about to look too confident in claiming any sense of certainty that the procedure would cure the poor man’s condition, though they certainly hoped to perform a wonder. Looking cautious and then claiming stunning success in a few days time was their preferred course of action.

Their hesitation was justified on practical grounds. They had never performed the operation on someone who was physically well, but had deranged behaviour. Their best guess was that they should use blood from a calf as “its mildness and strengths might possibly allay the heat and ebullition of his blood”. A time was set for the operation – six o’clock that evening, and with much fuss and elaborate bowing the assembly dissipated.

Image Courtesy Wellyn Blakeslee The artist behind this rather striking image describes this as representing the dawning of true blood science, in times when the currency of life was still widely, warily viewed as an opaque mystery. The figure, purposefully vague, might be interpreted as one of any number of the doctors and/or natural philosophers of such times.

Soon the room was empty save for the two scientists, their host and patron Montmor and the unfortunate Mauroy. His continued presence was less than voluntary as he was still tied to his chair, and had once again started to complain bitterly and vocally. As usual, Montmor was in charge. He summoned a troupe of servants and began to make arrangements to have the ‘patient’ transferred to another house, the thought of listening to his shouting for the rest of the day was just too much to be contemplated. Besides, his residence was in a fashionable part of Paris, and Montmor had no intention of bringing bad repute to his name and his house by having the neighbours making accusations that a riot was about to break out.

It is most likely that as Montmor and Denis planned the rest of the day’s details, discussing where they would obtain a suitable blood donor and agreeing the level of fees involved for all the participants, they saw this as their opportunity to stun the world and gain entry to the newly formed Académie. Becoming the first people in the world to cure mental illness would certainly do their applications for membership no harm at all.

Recording the events that followed in a letter sent initially to Montmor, a copy of which then went to Oldenburg in London, Denis said that they transported Mauroy to a “private house”, most probably Denis’ residence on the Quay des Augustins. Montmor and Denis also sent for a burley labourer to act as their ‘porter’. They needed to contain Mauroy, but Denis also wanted to reassure him. Working with calm patients is always easier, and more likely to bring about good outcomes. Who better to employ as this guardian-cum-gaoler than someone who had personally benefited from transfusion? Their choice was no muscle-man picked at random, but the man into whom Denis had transfused lamb’s blood eight months earlier; the man who Denis claimed had been so eager to receive a second dose.

Copyright 1999, Daniel Higgins, University of Illinois at Chicago. This image depicts the future of blood science, where tiny capsules much smaller than these blood cells may someday be injected into people's bloodstreams to treat conditions ranging from cancer to radiation damage.

Throughout the day a stream of people started to arrive, and Denis was pleased that among them are both physicians and churchgoers. Acting as witnesses this means that he would have people who understood what he was doing, as well as members of the public who were held in good repute. As the evening came, so too did the two scientists and a calf. In Oldenburg’s translation of Denis words, “We used what art we could to dispose the fancy of our patient to suffer the transfusion”. It is a nice turn of phrase that can quite probably be translated as “we strapped and bound the patient firmly to a solid table in the middle of the room”. He might even have been gagged to lessen his wails of protest.

Denis and Emmerey were determined not to run out of blood half way though the trial so a calf was a good choice as it would be fairly large. It would also be relatively docile. Even so, it is a fair assumption that the calf in this particular episode would have been securely tied to a table, in such a way that it was incapable of moving.

Conversation dimmed to a dull murmur as, working under the light of several lanterns, Emmerey cut into the inner thigh of the calf’s leg and revealed a bulging crimson artery. The spectators jostled gently for position, each wanting to get close, but at the same time anxious to keep out of the line of fire because, with the possible exception of Mauroy, everyone in the room was well aware that a minor slip of Emmerey’s knife would send a pulsing fountain of blood half way across the room. Observing science is interesting, but more important still, they had their clothes to think of.

With the calf vessel exposed and ready to deliver its elixir, it was time to turn to the patient. Standing over him, Emmerey cut into his right arm and revealed a vein just above the elbow joint. His work was hampered by the patient’s struggles and by the time that the incision was finished Mauroy had managed to curl himself into something resembling a fetal position, a primate act of self-protection. His arm was, however, still tied firmly to a table leg and the incision and vein were neatly exposed.

Following instruction, the tables bearing the calf and Mauroy were brought close together ready for the transfusion. But first, Emmerey wanted to make room in the patient’s body for the influx of blood. This meant that some needed to be let out first. He snicked the exposed vein and watched while blood streamed into a bowl. He waited until Denis calculated that some 10 ounces of blood had escaped and then inserted the end of a hollow quill into the vein. Quickly he cut the calf’s artery, pushed a second quill into it and watched blood spurt out of the end. With surprising dexterity he and Denis joined these two together with a series of quills, forming a complete pipe. Emmerey was excited and stretched out his fingers to relieve tension – things were going well.

Denis started counting, planning on judging the time that would be needed to let in 10 ounces of blood and replace the full volume lost in the enforced haemorrhage. It was soon clear, though, that all was not going smoothly. In their enthusiasm to witness the event, the spectators surged forward to get a better view. For a few moments it was impossible for either Emmerey or Denis to get near to their patient. Etiquette also made it difficult for these experts who came from the middle ranks of society to order their superiors back, but necessity called and they elbowed their way back to the centre of proceedings.

Mauroy’s struggles meant that he was no longer lying in a convenient position and the blood was not flowing through the tube. By the time that the two technicians had got back to their charge this lack of flow had allowed the blood to congeal in the tubes so that it was no longer transfusing from calf to human. The occasional plume of blood shot across the room while they frantically tried to change to new quills, and attempted to restore some of the flow.

By now the patient was complaining that his arm was feeling very hot, right up under his armpit. “Perceiving that he was falling into a swoon we presently stopped the blood running in, and closed up the wound”, comments Denis. The transfusion was over and Denis calculated that Mauroy had received something in the order of five or six ounces.

Denis was relieved. The transfusion had worked, but now the critical part was to keep a close watch on the patient to see what happened next. Some of the guests decided this was the time to move on and seek more lively entertainment elsewhere for the rest of the evening. Others took seats and waited, staring at the man as if they wondered whether he was about to bellow like a calf or grow horns or hooves.