Blood supply

“ If there is a failure of renewal—that is, a disease—we shall generally find an abnormal condition of the blood. The distribution of the blood is controlled by the heart, a great four-chambered pump. One chamber drives the blood to the lungs, a mass of fine porous membranes, where it comes into contact with the air, and gives off the poisons which it has accumulated in its course through the body, and takes up a fresh supply of oxygen. By another chamber of the heart the blood is then sucked out of the lungs, and by the next chamber it is driven to every corner of the body. ”

“ The Red Cross also operates its Blood Services, which collects and processes half of the supply of blood needed by the Nation's medical facilities. Red Cross is continuously seeking new and more economical uses for blood and blood products. ”

“ And clinical triumphs have confirmed scientific views, which find their reasonable explanation partly in our knowledge of the normal life of the elements, partly in the morbid changes they are subject to. Transfusion of blood has sometimes served as an heroic remedy for arterial hæmorrhages, and losses of blood occurring after confinement. In these situations there is no injury to the elements of the nervous tissues, the glands and muscles; thus the supply of new blood restores life to them ”

“ The effect of the blood upon the body depends, thirdly, upon its circulation or distribution. The first involves the nature, quantity, and digestion of the food which nourishes; the second, the ventilation, cleanliness, &c., which purify; the third, the various exercises which aid to distribute.
As the blood is continually being expended in the nourishment of the body, so it must as constantly be renovated by supplies from without—by food. Evidently, then, this food must supply to the blood every material required by the body; [Pg 526] otherwise there can be no proper nourishment. ”

“ Circulation of the Blood.—Nothing is more important for the health or healing of any organ or part of the body than a good supply of arterial blood. Venous blood, collected by the veins after it has done its work all over the body, or blood stagnating in congested organs, is useless for growth and healing. To promote a vigorous circulation of blood in any part we wish to cure is, then, of great importance ”

“ First, the blood is incessantly transmitted by the action of the heart from the vena cava to the arteries in such quantity that it cannot be supplied from the ingesta, and in such a manner that the whole must very quickly pass through the organ; second, the blood under the influence of the arterial pulse enters and is impelled in a continuous, equable, and incessant stream through every part and member of the body, in much larger quantity than were sufficient for nutrition, or than the whole mass of fluids could supply ”

“ Today every ship in the United States Navy carries a large supply of dried blood plasma. Liquid plasma, ready for immediate use, is a must in every naval hospital. Every hospital corpsman, at battle stations, carries a first-aid kit which contains syrettes of morphine to be administered to all gravely injured and a supply of blood plasma and sterile needles for prompt intravenous therapy.
Blood plasma is human blood from which the blood cells have been removed. It has the advantage over whole blood in that it does not require typing. ”

“ We may just mention that as a general rule he approves of bleeding after any accident. He disapproves of bleeding both at the onset and the crisis of a disease. In constitutions requiring bloodletting he holds that spring is the best season for it. Even in cases in which there is a deficiency of blood, but there is congestion in some particular part, he permits blood to be abstracted, in order to produce revulsion, the patient’s strength being recruited afterwards by a nourishing diet. ”

“ The bleeding must be steadily repeated as the symptoms recur until relief [296] has been obtained, or until it becomes evident that the powers of the patient cannot resist the inroads of the disease and of the efforts made for its cure. The quantity of blood that may be lost in two or three days by powerful, healthy men is sometimes enormous, amounting to 100, 150, and even 200 ounces, with the happiest effect. ”

“ The blood is collected in a glass or plastic graduated container and stored under refrigeration. The study of blood donors has, incidentally, given insights into the physiology of bloodletting since the volume customarily removed from a donor is about the same in volume as that taken by a bleeder (one pint or 500 cc) . [86]
The annual physical examination today includes taking a small amount of blood from the finger or a vein in the elbow. This blood is then analyzed for the presence of biochemical components of such diseases as diabetes, anemia, arteriosclerosis, etc. ”

“ When this can be done with a lancet, it is to be preferred to any other method; but where a vein cannot be found, recourse must be had to leeches or cupping.
The quantity of blood to be let must always be regulated by the strength, age, constitution, manner of life, and other circumstances relating to the patient. It would be ridiculous to suppose that a child could bear to lose as much blood as a grown person, or that a delicate lady should be bled to the same extent as a robust man. ”

“ Another objection to bleeding in the inflammatory state of consumption, is derived from the apparent and even sensible weakness of the patient. The men who urge this objection, do not hesitate to take from sixty to a hundred ounces of blood from a patient in a pneumony, in the course of five or six days, without considering that the debility in the latter case is such as to confine a patient to his bed, while, in the former case, the patient's strength is such as to enable him to walk about his house, and even to attend to his ordinary business. ”

“ Transfusion of blood is accomplished, in case of wounds by accident, without inconvenience to the one supplying the life-fluid, or danger to the recipient, while effective tonics bring about the rapid replacement of the amount of blood abstracted in the emergency. ”

“ The amount of blood used in transfusion is usually a very few ounces, sometimes only one or two drachms—rarely ten or more ounces; a small quantity is safer. The blood of a different species of animal is considered dangerous when used in large quantity. Venous blood is preferred, and may or may not be defibrinated. ”

“ It is possible the inhabitants of European countries and cities, may so far have passed the simple ages of inflammatory diseases, as never to exhibit those symptoms on which I have founded the indication of blood-letting. I suspect moreover that in most of the southern states of America, the inflammatory action of the arterial system is of too transient a nature to admit of the repeated bleedings in the consumption which are used with so much advantage in the middle and northern states. ”

“ An added force is given to all these illustrations of the universal belief that transferred blood has a vivifying power, by the conclusions of modern medical science, concerning the possible benefits of blood-transfusion. [233] On this point, one of the foremost living authorities in this department of practice, Dr. Roussel, of Geneva, says: “The great vitality of the blood of a vigorous and healthy man has the power of improving the quality of the patient’s blood, and can restore activity to the centres of nervous force, and the organs of digestion. ”

“ Receiving new blood as a means of receiving new life, seems to have been sought interchangeably, in olden time, in various diseases, by blood lavations, by blood drinking, and by blood transfusion. It is recorded that, in 1483, King Louis XI., of France, struggled for life by drinking the blood of young children, as a means of his revivifying. ”

“ It is the more necessary to caution people against bleeding in this disease, as there is generally at the beginning an universal stricture upon the vessels, and sometimes an oppression and difficulty of breathing, which suggest the idea of a plethora, or too great a quantity of blood. ”

“ Some physicians, and many of the laity, think that repeated bleedings tend to the development of fat. For my part, the fact is indisputable, both theoretically and as the result of experience. Bleeding removes a portion of the blood, which is flesh in a fluid state, having for its object not only the nutrition of the several organs, but also the stimulation of the heart's movements, and thus the maintenance of life. Taking a little blood, is taking a little of that which maintains life, and is therefore a weakening of every organ of the body. ”

“ Thus too, a single glass of wine will often produce delirium in a fever in a man, who, when in health, is in the habit of drinking a bottle every day, without having his pulse quickened by it.
An ignorance of the quantity of blood which has been drawn by design, or lost by accident, has contributed very much to encourage prejudices against [332] blood-letting. Mr. Cline drew 320 ounces of blood in 20 days from a patient in St. Thomas's hospital, who laboured under a contusion of the head. ”

“ After death the amount of blood sometimes seems to be increased, and sometimes, as in “pernicious anaemia,” it is certainly diminished. But the high counts of red corpuscles which are occasionally reported as evidence of plethora or increase of the total blood are really only indications of concentration of the fluid except in certain rare cases. It is necessary, therefore, in examining blood diseases, to confine ourselves to the study of the blood-unit, which is always taken as the cubic millimetre, without reference to the number of units in the body. ”

“ Little impression can be made on an acute disease by the slow removal of even a large quantity of blood, as the organs have time to accommodate themselves to the loss, which might, for any good it will do, as well be dispensed with. Either bleed rapidly or not at all. The nearer the commencement of an ailment, in which you employ bleeding, the operation is resorted to, the greater the chance of its doing good; no time ought, therefore, to be lost in using the lancet, when once it is known to be required. ”

“ In civilian life, however, such inducements cannot be held out, and it will be found that many a man “does not like the idea” of parting with a pint of blood, even though the sacrifice may save another’s life. Often, however, a near relative of the patient may happen to be willing and suitable, or, failing [98] this, in a hospital ward there will usually be some young man who has been admitted for a slight operation, such as the radical cure of a hernia, and will accede to a request for blood if the procedure, its object, and its harmlessness to himself be briefly explained. ”

“ The effect of a transfusion on the coagulating power of the patient’s blood more than compensates for the risk attending a rise in blood pressure. Now only is lost blood replaced, but also the clot plugging the damaged vessel is made more secure. The patient is tided over the immediate danger to his life, and surgical treatment is made possible. ”

“ Articles advocating bloodletting continued into the 1920s and 1930s. [83]
Bloodletting is currently being tested as a treatment for those suffering from angina or heart attacks. Blood is removed on a scheduled basis to maintain the hematocrit (the percentage of red blood cells in the blood) at a specified level. Keeping the hematocrit low has provided relief to those being tested. [84] Other benefits of removing blood, including the lowering of blood pressure, can be obtained by the use of antihypertensive drugs. ”

“ But I trust that we have facts enough to establish it as a certainty, 1st, That the black blood after the interruption of the chemical functions of the lungs, continues for some time to circulate, and 2dly, That it penetrates into the organs, where it replaces the red blood; these circumstances explain the reason, why on opening the body we always meet with black blood even in the vessels which are destined for the circulation of arterial blood. ”

“ It is a still more difficult matter for obvious reasons to estimate how much blood a man can lose and yet remain alive. This will depend partly on the power of physiological accommodation possessed by the individual in his vaso-motor system and tissue fluids and partly on the rapidity with which the bleeding takes place. Clinical observations have shown that after a moderate hæmorrhage, such as the withdrawal of 800 cc. of blood from a donor, the blood volume may be restored to normal within an hour. ”

“ The most direct way in which diseased blood produces disease in the parts to which it is conveyed, is by communicating to them its own condition. Even foreign substances, which have no natural connexion with the body, may, in this way, be conveyed in the blood, and deposited in the organs of the body. ”

“ Does not the restoration of the blood from its disorganized state, by means of bleeding, suggest an idea of a similar change being practicable in the solids, when they are disorganized by disease? And are we not led hereby to an animating view of the extent and power of medicine?
2. Blood of a scarlet colour, without any separation into crassamentum or serum, indicates a second degree of morbid action. It occurs likewise in the malignant state of fever. It is called improperly dense blood. It occurs in old people. ”

“ Another mode of stimulating or exciting the whole system is, by putting into it a larger quantity of blood than it naturally contains. This is entirely similar to the breathing of oxygen; especially if arterial blood be used, which has already imbibed its spiritous part from the atmosphere. In the last century the transfusion of blood was proposed not only as a mode of curing diseases, but of restoring old people to youth ”

“ What more there was of the blood than enough to repair the present damages of the machine, must not be lost, but should be returned again to the heart; and for this purpose the venous system is provided. These requisites in the animal explain the circulation of the blood, a priori. [1]
All this provision, however, would not be sufficient; for the store of blood would soon be consumed, and the fabric would break down, if there was not a provision made by fresh supplies. These, we observe, in fact, are profusely scattered round her in the animal and vegetable kingdoms ”