BORIS BURDA: what is written on the doors of racing cars

Valentin Spivak. Weekdays (excerpt), 2021 / Facebook, «Sil-Sol»

 

ATTENTION — QUESTION!

 

Crew members of multiday races are not allowed to swap places in a car on the track. What is written on each door of such a car?

 

ATTENTION — RIGHT ANSWER!

 

The blood type of the competitor who sits near the door. In case of an accident, there won’t be time to determine it…

 

FROM THE DEPTHS OF TIME

 

Long ago, people realized that blood is an essential fluid for life. The loss of large amounts of blood led people and animals to imminent death. It was natural to assume that if the body’s loss of blood was so harmful, replenishing it with blood was beneficial. But how to do it?

The simplest way is obvious — if something is useful, you have to drink it or eat it. An injured person has lost a lot of blood? Let him drink someone else’s blood to compensate for the loss. Flocks of sheep were following the Egyptian army in order to give their blood to the wounded warriors. This procedure did not make the wounded man any worse. What did not make it better — was not noticed immediately…

The temptation to give blood a sacred meaning was great. For the first time, something similar was described, perhaps, in Homer’s «Odyssey.» In order for the dead summoned from Hades to speak to Odysseus, they must drink the blood of sacrificial rams — a liquid not just medicinal, but precisely sacral, magical.

There were even recipes for the use of blood against specific diseases. Hippocrates believed that crazy people would be helped by drinking the blood of mentally normal people. And the famous fake «Constantine’s Gift» says that Emperor Constantine fell ill with leprosy and was prescribed baths of children’s blood, but Pope Sylvester cured him in another way. Now, obviously, this is a phony…

 

BLOOD FLOW

 

Attempts to use blood as a mixture continued (Pope Innocent VIII was said to have tried to restore youth by drinking the blood of three boys, but to no effect, and so be it). But after 1616, when the English doctor Harvey discovered the circulatory system, new ideas arose — what if we inject healthy blood into this system of the patient?

Already in 1665, Harvey’s fellow countryman Richard Lower released a lot of blood from a dog’s vein, and when the dog started convulsions, he injected the blood of another dog into the same vein. The poor animal recovered and lived on without noticeable consequences of this atrocity. A little over a year later, French surgeon Jean-Baptiste Denis transfused the blood of a lamb to a man.

The patient survived, and Denis decided to continue. There was no one willing to do it, so he offered volunteers a lot of money. The poor laborer was flattered, gave blood, and it was a success! The workman was enthusiastic and again offered his own blood for transfusion. Let’s remember him — he was probably the first donor in history!

However, Denis’s fourth patient died in agony, and this impressed not only doctors but also lawyers. Denis was even sued for murder but was acquitted — no law prohibited such a thing. Then, in 1668, the French Parliament banned the transfusion of animal blood to humans, and soon, British lawmakers joined the ban. Transfusions stopped for a century and a half.

 

 

 

FROM PERSON TO PERSON

 

The law ended the transfusion of animal blood. The results were depressing: at that time, they even made an unkind joke about the fact that this operation required not one ram but three — one gives blood, and the second transfuses this blood to the third. But these laws did not forbid transfusing to a person the blood of another person rather than an animal…

One of the first doctors who believed in this idea was English obstetrician James Blundell. A typical complication of childbirth is blood loss. And in 1818 Blundell tried to save a woman with postpartum hemorrhage by transfusing her with a syringe of her husband’s blood from vein to vein. She was saved, and Blundell made several more such experiments.

 

 

The results were controversial — about half of the women recovered, even though the threat to their lives was high. But the other half died — and it seems that it was the transfusion of other people’s blood that caused the sudden deterioration. Blundell even tried taking the laboring woman’s own blood, lost in uterine bleeding, for transfusion — successfully, by the way…

Others, inspired by Blundell’s partial successes, also tried transfusing human blood for blood loss. Sometimes, it saved hopeless patients; sometimes, it killed those who, perhaps, would have had a chance… This treatment began to be compared with the same time «Russian roulette» appeared — whether you are lucky or not…

Not only blood was transfused. Some doctors suggested that everyone would benefit from milk — a food created by nature. But milk, it turns out, should have been drunk, not injected into a vein. They did not see any benefit from it but a lot of harm. However, the saline solution of table salt, which was transfused to the patient Albert Landerer in 1881, clearly helped and certainly did not hurt.

 

WE ARE NOT ALL OF THE SAME BLOOD

 

The logical explanation for what was happening was the assumption that there are different kinds of blood, and some people’s blood is compatible, and some are not. Since fatal transfusion accidents happen often but not all the time, there must not be very many of these factors. But what are these factors, and how are they determined?

They were not found for a long time, although the enthusiasm of doctors did not decline — there is information that from 1820 to 1870, blood was transfused at least 75 times. But it did not become a mass phenomenon — with a double-digit percentage of fatalities, it was hard to expect such a thing. And the most frustrating thing was that it was not possible to understand what the outcome of the transfusion depended on.

The decisive breakthrough in solving this problem occurred in Vienna — that’s how, with a capital letter, the medicine of Austria-Hungary was not in vain honored. Karl Landsteiner, a Viennese doctor, in 1900 took blood from himself and five of his staff volunteers, separated the red blood cells from the serum by centrifugation, and began to mix the red blood cells of one donor with the plasma of another.

 

 

It turned out that sometimes, when mixed, the serum of one blood agglutinates (that is, glues and precipitates) the red blood cells of the other, and sometimes it does not. At first, Landsteiner identified three blood groups, and two years later, his colleagues Alfred de Castello and Adriano Sturley found another. These groups were named O, A, B, and AB.

 

NEW SUCCESSES AND NEW CHALLENGES

 

Erythrocytes did not agglutinate when transfused with blood of the same type as the recipient, the blood recipient. But this was not the only safe option. Type O blood could be transfused to carriers of any blood type without risk. And people with blood type AB could be transfused with any blood type without risk.

Unfortunately, medics did not immediately realize what a powerful tool Landsteiner had given them. The first transfusion, taking into account the blood groups of the donor and recipient, was only in 1907 in the United States. Soon, they invented methods of preserving donor blood, allowing it to be stored (in particular, using sodium citrate), and transfusion began to be used more confidently.

But in 1928, the director of the Moscow Blood Transfusion Institute, Bogdanov (by the way, a famous Marxist who argued with Lenin himself), tried to cure a patient by exchanging blood transfusion. They had the same zero group, complications should not have arisen, but Bogdanov died. Obviously, the blood group was not the only risk factor.

 

 

In 1940, the same Landsteiner and his students found a new factor. At its discovery, they used the blood of Rhesus macaque because it was called the Rh factor. It turned out that Rh-positive blood cannot be transfused to Rh-negative people, and vice versa. It is possible that this is what Bogdanov did not take into account — then, it was simply not known.

Now donor blood is also tested for viruses — first because of hepatitis, and then because of the threat of AIDS transmission (for example, the famous writer Isaac Asimov died this way). And there are many more blood groups — there are already 44 of them (fortunately, not all of them are so important). And the value of blood has only increased — especially now when the war is going on.

There are enough new solutions, too. There is already artificial blood that can be transfused to everyone. More and more often, transfusion is not the whole blood but just those components that are necessary. But it all started with a brilliant solution by Viennese physician Karl Landsteiner, who was able to understand what kind of blood could be used for safe transfusion.

 

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