Taking credit: The Canadian Army Medical Corps and the British conversion to blood transfusion in WWI

Journal of the History of Medicine and Allied Sciences

Volumn 56, Issue 3, 2001, Pages 238-277

  Pelis, Kim ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ART; ARTICLE; BLOOD TRANSFUSION; CANADA; HISTORY; HUMAN; MILITARY MEDICINE; TECHNOLOGY; UNITED KINGDOM; UNITED STATES; WAR;

BLOOD TRANSFUSION; CANADA; GREAT BRITAIN; HISTORY, 20TH CENTURY; HUMANS; MILITARY MEDICINE; PORTRAITS; TECHNOLOGY TRANSFER; UNITED STATES; WAR;

EID: 0035404425     PISSN: 00225045     EISSN: None     Source Type: Journal    
DOI: 10.1093/jhmas/56.3.238     Document Type: Article

References (166)

1. Spencie Love addresses these myths directly in One Blood: The Death and Resurrection of Charles R. Drew (Chapel Hill: University of North Carolina Press, 1996). For a concise review of Drew's actual contributions, see P. J. Schmidt, "Charles Drew, a legend in our time," Transfusion, 1997, 37, 234-36. Drew organized a large-scale system of collecting and distributing "Blood for Britain" (plasma) overseas in 1940, which became the model for U.S. collections in WWII. He died even after his doctors, who recognized him, did everything in their power to save his life.
2. Spencie Love addresses these myths directly in One Blood: The Death and Resurrection of Charles R. Drew (Chapel Hill: University of North Carolina Press, 1996). For a concise review of Drew's actual contributions, see P. J. Schmidt, "Charles Drew, a legend in our time," Transfusion, 1997, 37, 234-36. Drew organized a large-scale system of collecting and distributing "Blood for Britain" (plasma) overseas in 1940, which became the model for U.S. collections in WWII. He died even after his doctors, who recognized him, did everything in their power to save his life.
3. Despite Landsteiner's concluding remarks about the possible applications of his discovery to blood transfusion, they were generally ignored by clinicians. First, the article in which he described this discovery was a serological paper. Second, in Britain, France, Canada, and the United States, blood transfusion had fallen from medical practice, replaced by the far more simple procedure of saline infusion. Even when transfusion was reintroduced six years later, it was introduced without any awareness of blood typing. Only gradually, from around the end of WWI, was blood typing seen to be a necessary step in blood transfusion. Blood typing did not drive the early twentieth-century reintroduction of transfusion. This point has been made repeatedly; see William H. Schneider, "Blood transfusion in peace and war, 1900-1918," Soc. Hist. Med., 1997, 10, 105-26. Moreover, as Pauline Mazumdar points out, Landsteiner generally ignored his future (1930) Nobel Prize-earning work until the 19205, when it was taken up by scientists interested in studying the evolution of human races through blood types; see Pauline M. H. Mazumdar, Species and Specificity: An Interpretation of the History of Immunology (Cambridge: Cambridge University Press, 1995), pp. 303-4.
4. Despite Landsteiner's concluding remarks about the possible applications of his discovery to blood transfusion, they were generally ignored by clinicians. First, the article in which he described this discovery was a serological paper. Second, in Britain, France, Canada, and the United States, blood transfusion had fallen from medical practice, replaced by the far more simple procedure of saline infusion. Even when transfusion was reintroduced six years later, it was introduced without any awareness of blood typing. Only gradually, from around the end of WWI, was blood typing seen to be a necessary step in blood transfusion. Blood typing did not drive the early twentieth-century reintroduction of transfusion. This point has been made repeatedly; see William H. Schneider, "Blood transfusion in peace and war, 1900-1918," Soc. Hist. Med., 1997, 10, 105-26. Moreover, as Pauline Mazumdar points out, Landsteiner generally ignored his future (1930) Nobel Prize-earning work until the 19205, when it was taken up by scientists interested in studying the evolution of human races through blood types; see Pauline M. H. Mazumdar, Species and Specificity: An Interpretation of the History of Immunology (Cambridge: Cambridge University Press, 1995), pp. 303-4.
5. If historical articles mention the Canadians at all, it is to acknowledge Bruce Robertson's publication priority in Britain. They then set the Canadians aside and turn to the Americans. This pattern may be seen in the U.S. official history of blood transfusion in WWII, which opens with a review of the WWI experience: Douglas B. Kendrick, "Historical Note," Blood Program in World IVar II (Washington, D. C.: Office of the Surgeon General, 1964), p. 5. Britain's saline preference is noted by Schneider (n. 2), who goes much farther than most, giving Bruce Robertson his own paragraph and the Canadians a detailed footnote, which ends, for substantiation, with reference to Keynes's quotation about "Americans" bringing transfusion over.
6. James Blundell, "Experiments on the transfusion of blood by the syringe," Medico-Chirurgical Trans., 1818, p, 56-92. See also Kim Pelis, "Transfusion, with teeth: Re-animation and the re-introduction of human transfusion to British medical practice, 1810-1834," in Robert Bud, Barney Finn, and Helmuth Trischler, eds., Manifesting Medicine: Bodies and Machines - (Artefacts: Studies in the History of Science and Technology) (Amsterdam: Harwood Academic, 1999), pp. 1-31.
7. James Blundell, "Experiments on the transfusion of blood by the syringe," Medico-Chirurgical Trans., 1818, p, 56-92. See also Kim Pelis, "Transfusion, with teeth: Re-animation and the re-introduction of human transfusion to British medical practice, 1810-1834," in Robert Bud, Barney Finn, and Helmuth Trischler, eds., Manifesting Medicine: Bodies and Machines - (Artefacts: Studies in the History of Science and Technology) (Amsterdam: Harwood Academic, 1999), pp. 1-31.
8. At mid-century, one British obstetrician even published a statistical review of all known transfusion cases, compared them with statistics on other common surgical procedures, and concluded that blood transfusion was safe and effective. C. H. E Routh, "Remarks, statistical and general, on transfusion of blood," Med. Times, 1849, 20, 114-17.
9. See Kim Pelis, "Blood standards and failed fluids: Clinic, lab, and transfusion solutions in London, 1868-1916," Hist. Sci., 2001, 39: 185-213, and "Blood clots: The nineteenth-century debate over the substance and means of transfusion in Britain," Ann. Sci., 1997, 54, 331-60.
10. See Kim Pelis, "Blood standards and failed fluids: Clinic, lab, and transfusion solutions in London, 1868-1916," Hist. Sci., 2001, 39: 185-213, and "Blood clots: The nineteenth-century debate over the substance and means of transfusion in Britain," Ann. Sci., 1997, 54, 331-60.
11. Grace Crile, ed., George Crile: An Autobiography, 2 vols. (Philadelphia: J.B. Lippincott, 1947). See also Peter C. English, Shock, Physiological Surgery, and George Washington Crile: Medical Innovation in the Progressive Era (Westport, Conn.: Greenwood Press, 1980).
12. Grace Crile, ed., George Crile: An Autobiography, 2 vols. (Philadelphia: J.B. Lippincott, 1947). See also Peter C. English, Shock, Physiological Surgery, and George Washington Crile: Medical Innovation in the Progressive Era (Westport, Conn.: Greenwood Press, 1980).
13. Quoted in F. A. Simeone, "Shock, trauma and the surgeon," Ann. Surg., 1963, 158, 759-74; P. 760.
14. This was in 1895. English, (n. 7) Showk, pp. 69-71, 100; Crile, (n. 7) George Crile, I, 68-70; I, 83-85; I, 166.
15. This was in 1895. English, (n. 7) Showk, pp. 69-71, 100; Crile, (n. 7) George Crile, I, 68-70; I, 83-85; I, 166.
16. This was in 1895. English, (n. 7) Showk, pp. 69-71, 100; Crile, (n. 7) George Crile, I, 68-70; I, 83-85; I, 166.
17. This was in 1895. English, (n. 7) Showk, pp. 69-71, 100; Crile, (n. 7) George Crile, I, 68-70; I, 83-85; I, 166.
18. George Crile, "The technique of direct transfusion of blood," Ann. Surg., 1907, 46, 329-32. The year before, Crile published a preliminary article on his transfusion work, "Experimental and clinical observations upon direct transfusion of blood," Proc. Soc. Exp. Biol. Med., 1906, 4, 6-8. The monograph was Hemorrhage and Transfusion: An Experimental and Clinical Researdh (New York: Appleton & Co., 1909).
19. George Crile, "The technique of direct transfusion of blood," Ann. Surg., 1907, 46, 329-32. The year before, Crile published a preliminary article on his transfusion work, "Experimental and clinical observations upon direct transfusion of blood," Proc. Soc. Exp. Biol. Med., 1906, 4, 6-8. The monograph was Hemorrhage and Transfusion: An Experimental and Clinical Researdh (New York: Appleton & Co., 1909).
20. George Crile, "The technique of direct transfusion of blood," Ann. Surg., 1907, 46, 329-32. The year before, Crile published a preliminary article on his transfusion work, "Experimental and clinical observations upon direct transfusion of blood," Proc. Soc. Exp. Biol. Med., 1906, 4, 6-8. The monograph was Hemorrhage and Transfusion: An Experimental and Clinical Researdh (New York: Appleton & Co., 1909).
21. This is another case of a dramatic story overshadowing fact. It is repeated in Douglas Starr, Blood: An Epic History of Medicine and Commerce (New York: Knopf, 1998), pp. 31-36. Crile is demoted to having "made the procedure more accessible" (p. 41) through his adaptation of using a small metal ring to facilitate transfusion. Though he did indeed apply the ring, he did so only after having done dozens of transfusions with the Carrel technique-before Carrel used the technique to transfuse humans.
22. A. R. Kimpton and J. Howard Brown, "A new and simple method of transfusion," J. Am. Med. Assoc., 1913, 61, 117-18; Edward Lindeman, "Simple syringe transfusion with special cannulas," Am. J. Dis. Child., 1913, 6, 28-32.
23. A. R. Kimpton and J. Howard Brown, "A new and simple method of transfusion," J. Am. Med. Assoc., 1913, 61, 117-18; Edward Lindeman, "Simple syringe transfusion with special cannulas," Am. J. Dis. Child., 1913, 6, 28-32.
24. The three papers were: L. Agote, "Nuevo procedimiento para la transfusion del sangre," An. Inst. modelo clin. med., 1915; A. Hustin, "Principe d'une nouvelle méthode de transfusion muqueuse," J. Méd. Drux., 1914, 12, 436-39; Richard Lewisohn, "A new and greatly simplified method of blood transfusion," N. Y. Med. Rec., 1915, 87, 141-42.
25. The three papers were: L. Agote, "Nuevo procedimiento para la transfusion del sangre," An. Inst. modelo clin. med., 1915; A. Hustin, "Principe d'une nouvelle méthode de transfusion muqueuse," J. Méd. Drux., 1914, 12, 436-39; Richard Lewisohn, "A new and greatly simplified method of blood transfusion," N. Y. Med. Rec., 1915, 87, 141-42.
26. The three papers were: L. Agote, "Nuevo procedimiento para la transfusion del sangre," An. Inst. modelo clin. med., 1915; A. Hustin, "Principe d'une nouvelle méthode de transfusion muqueuse," J. Méd. Drux., 1914, 12, 436-39; Richard Lewisohn, "A new and greatly simplified method of blood transfusion," N. Y. Med. Rec., 1915, 87, 141-42.
27. Richard Lewisohn, "Blood transfusion by the citrate method," Surg. Gynecol. Obstet., 1915, 21, 37-47, p. 39.
28. L. Bruce Robertson, "Out with the ambulance," The Evening Telegram, 21 February 1912; a copy appears in the L. Bruce Robertson Collection, Archives of Ontario (hereafter AO), F1374-3-0-1. More biographical information on Robertson may be found in n. 48.
29. L. Bruce Robertson, "Out with the ambulance," The Evening Telegram, 21 February 1912; a copy appears in the L. Bruce Robertson Collection, Archives of Ontario (hereafter AO), F1374-3-0-1. More biographical information on Robertson may be found in n. 48.
30. In a much-cited 1918 letter to the Lancet, Moynihan claimed to have been doing transfusions for eight years. Berkeley Moynihan, "The operation of blood transfusion," Lancet, 1918, i, 826. While this may well have been true, his hospital's first recording of transfusion is in 1912: Statistical Reports of the Leeds General Infirmary, 1912, p. 27.
31. In a much-cited 1918 letter to the Lancet, Moynihan claimed to have been doing transfusions for eight years. Berkeley Moynihan, "The operation of blood transfusion," Lancet, 1918, i, 826. While this may well have been true, his hospital's first recording of transfusion is in 1912: Statistical Reports of the Leeds General Infirmary, 1912, p. 27.
32. In a much-cited 1918 letter to the Lancet, Moynihan claimed to have been doing transfusions for eight years. Berkeley Moynihan, "The operation of blood transfusion," Lancet, 1918, i, 826. While this may well have been true, his hospital's first recording of transfusion is in 1912: Statistical Reports of the Leeds General Infirmary, 1912, p. 27.
33. Crue, "Nitrous oxide anesthesia and a note on anoci-association, a new principle in operative surgery," Surg. Gynecol. Obstet., 1911, 13, 170-73. See also English, (n. 7) Shock, pp. 155-87, particularly pp. 165-67.
34. Crue, "Nitrous oxide anesthesia and a note on anoci-association, a new principle in operative surgery," Surg. Gynecol. Obstet., 1911, 13, 170-73. See also English, (n. 7) Shock, pp. 155-87, particularly pp. 165-67.
35. A copy of this article, which discusses Crile's receipt of an award for his work on shock, appears in 54:8, Series VI, Sub-series D; Folder 290, Roll 70, George W. Crue Papers, Western Reserve Historical Society (hereafter WRHS), Cleveland, Ohio. As the collection is now on microfilm, I give the roll number rather than the container number.
36. Edward Archibald, like Crile, had studied in London, also under Victor Horsley. "Edward Archibald, 1872-1945," Can. J, Surg., 1958, 1, 167-74. Edward W. Archibald to his wife, 1 December 1914, Ace. 545, Box I, Series I, Edward IV. Archibald Collection, Osier Library, McGill University (hereafter OLM), Montreal.
37. Edward Archibald, like Crile, had studied in London, also under Victor Horsley. "Edward Archibald, 1872-1945," Can. J, Surg., 1958, 1, 167-74. Edward W. Archibald to his wife, 1 December 1914, Ace. 545, Box I, Series I, Edward IV. Archibald Collection, Osier Library, McGill University (hereafter OLM), Montreal.
38. "The transfusion of blood," Br. Med. J., 1907, ii, 1006.
39. Both the British Medical Journal and the Lancet ignored transfusion between their respective reviews of Crile's work and 1916.
40. Both the British Medical Journal and the Lancet ignored transfusion between their respective reviews of Crile's work and 1916.
41. Geoffrey Keynes, The Gates of Memory (Oxford: Oxford University Press, 1981), p. 124.
42. As Hans Zinsser observed in 1934, "Until they actually suffered from dirt, lousiness, fatigue, terror, disease, or wounds, most men enjoyed the last war." Hans Zinsser, Rats, Lice and History (Boston: Little, Brown, 1934 [1903]), p. 151.
43. As Hans Zinsser observed in 1934, "Until they actually suffered from dirt, lousiness, fatigue, terror, disease, or wounds, most men enjoyed the last war." Hans Zinsser, Rats, Lice and History (Boston: Little, Brown, 1934 [1903]), p. 151.
44. See John S. G. Blair, In Arduis Fidelis: Centenary History of the Royal Army Medical Corps (Edinburgh: Scottish Academic Press, 1998) and Anthony Cotterell, R.A.M.C. (London: Hutchinson & Co., 1943). For an excellent, detailed study of the structure and function of the RAMC during the Great War, see Ian R. Whitehead, Doctors in the Great War (Barnsley, South Yorkshire: Leo Cooper, 1999).
45. See John S. G. Blair, In Arduis Fidelis: Centenary History of the Royal Army Medical Corps (Edinburgh: Scottish Academic Press, 1998) and Anthony Cotterell, R.A.M.C. (London: Hutchinson & Co., 1943). For an excellent, detailed study of the structure and function of the RAMC during the Great War, see Ian R. Whitehead, Doctors in the Great War (Barnsley, South Yorkshire: Leo Cooper, 1999).
46. See John S. G. Blair, In Arduis Fidelis: Centenary History of the Royal Army Medical Corps (Edinburgh: Scottish Academic Press, 1998) and Anthony Cotterell, R.A.M.C. (London: Hutchinson & Co., 1943). For an excellent, detailed study of the structure and function of the RAMC during the Great War, see Ian R. Whitehead, Doctors in the Great War (Barnsley, South Yorkshire: Leo Cooper, 1999).
47. I use the term "wound shock" anachronistically and with strong qualification. The term was only coined, to my knowledge, in 1917. However, it does serve as a convenient way to differentiate the kind of shock experienced by war wounded from surgical shock and the ever-popular shell shock. Although I define the term only briefly in this essay, it is a central component in the longer monograph on shock and transfusion in the Great War which I am currently writing.
48. Sir Anthony Bowlby, an eminent surgeon at London's St. Bartholomews Hospital, was named surgical advisor to the front lines in 1916 and was the author of the chapter, "The development of Casualty Clearing Stations and front-line surgery in France," in W. G. Macpherson, A. A. Bowlby, Cuthbert Wallace, and Crisp English, eds., Official History of the War - Medical Services - Surgery of the War, 2 vols. (London: HMSO, 1922), 1, 208-47. See also Whitehead, (n. 24) Doctors, pp. 195-208.
49. Sir Anthony Bowlby, an eminent surgeon at London's St. Bartholomews Hospital, was named surgical advisor to the front lines in 1916 and was the author of the chapter, "The development of Casualty Clearing Stations and front-line surgery in France," in W. G. Macpherson, A. A. Bowlby, Cuthbert Wallace, and Crisp English, eds., Official History of the War - Medical Services - Surgery of the War, 2 vols. (London: HMSO, 1922), 1, 208-47. See also Whitehead, (n. 24) Doctors, pp. 195-208.
50. "The position of casualty clearing stations," Br. Med. J., 1915, ii, 834-36 (see the triangle-shaped diagram on p. 834).
51. For a review of the debate over medical innovation in war, see Roger Cooter, "War and modern medicine," in W. F. Bynum and Roy Porter, eds., Companion Encyclopedia of the History of Medicine, 2 vols. (London: Routledge, 1993), 1, 1536-73.
52. Keynes, (n. 22) Gates, p. 144. There are several studies on the significance of efficiency at this time. See, for example, Steve Sturdy and Roger Cooter, "Science, scientific management, and the transformation of medicine in Britain c. 1870-1950," Hist. Sci., 1998, 36, 421-66.
53. Keynes, (n. 22) Gates, p. 144. There are several studies on the significance of efficiency at this time. See, for example, Steve Sturdy and Roger Cooter, "Science, scientific management, and the transformation of medicine in Britain c. 1870-1950," Hist. Sci., 1998, 36, 421-66.
54. This CCS, Britain's No. 3, would become the home to the Third Army's model "shock centre" a year later. The term "resurrection ward" (misspelled with one middle "r" missing) is found on a sketch of the plan for the CCS, attached to its "war diary" entry of September, 1916. War Diary, No. 3 CCS, September, 1916, WO 95/412, Public Records Office (hereafter PRO), London, England.
55. The exact proportion of shock victims is impossible to determine because "shock" was not a medically reported category for statistical surveys. Instead, soldiers were listed as having died of abdominal wounds, crush wounds, and so on. In his excellent review of transfusion and wound shock in WWI, A. G. Butler cites an estimate from the Australian Corps that 2-3% of CCS arrivals suffered shock significant enough to need active resuscitation (and 5-8% required urgent surgery). The number of shock cases doubled in 1918; see A. G. Butler, The Australian Army Medical Services in the War of 1914-1918, 3 vols. (Canberra: Australian War Memorial, 1940), 11, 783, note 19, and p. 957. Unfortunately, this same limitation holds true for the number of transfusions performed during the war.
56. As Archibald wrote in his 1917 review of shock in wartime, "shock is seen to an extent unparalleled in the experience of any surgeon at home." Edward Archibald and W. S. McLean, "Observations upon shock, with particular reference to the condition as seen in war surgery," Ann. Surg., 1917, 66, 281-87. In fact, "W. S." McLean was "W. L." - Walter Leonard, who appears in publications as "W. S." "W. A.," and "W. L."; his surname, too, shifts between McLean and MacLean. McLean holds a potentially important, though still (and perhaps forever) vague, place in the story of the wartime treatment of shock. See his Personnel File, RG 150, Ace. 1992-93/166, Box 7054 - 19, National Archives of Canada (hereafter NAC), Ottawa, Ontario.
57. See Peter Kurt Bamburger, "The adoption of laparotomy for the treatment of penetrat-ing abdominal wounds in war," Mil. Med., 1996, 161, 189-96.
58. See Bamberger (n. 33), p. 194, and Gordon Gordon-Taylor, "Abdominal and thoracoabdominal injuries," in Zachary Cope, ed., Surgery (London: HMSO, 1953), particularly pp. 94-95.
59. Cuthbert Wallace, "The early operative treatment of gunshot wounds of the alimentary canal," Lancet, 1915, ii, 1336-46, especially p. 1340; Edward Archibald, "Abdominal wounds as seen at a Casualty Clearing Station," Can. Med. Assoc. J., 1917, 7, 298.
60. Cuthbert Wallace, "The early operative treatment of gunshot wounds of the alimentary canal," Lancet, 1915, ii, 1336-46, especially p. 1340; Edward Archibald, "Abdominal wounds as seen at a Casualty Clearing Station," Can. Med. Assoc. J., 1917, 7, 298.
61. "Odds and ends picked up at No. 10 and No. 17 Cas. Clg., Remy, Jan. 29-Feb 2 1916," Acc. 545, Box 3, Series 4: 1915 (3) - 1917, Edward IV. Archibald Collection, OLM. This is a collection of notes, which seems to have become the basis of his article on abdominal surgery. A month earlier, Meyer and Taylor had published on their abdominal work. See W. C. B. Meyer and D. C. Taylor, "Penetrative wounds of the abdomen: A list of the first fifty consecutive cases operated upon at the 17th Casualty Clearing Station in the field, Flanders," Lancet, 1916, i, 8-15. In their case list, 17 of 50 died; of these 17, 13 are listed as having died of shock and/or hemorrhage (primary or secondary). Moreover, another 41 cases were not operated upon, "because patients were moribund, because no perforation was suspected, or because conservative treatment was considered advisable" (p. 9).
62. "Odds and ends picked up at No. 10 and No. 17 Cas. Clg., Remy, Jan. 29-Feb 2 1916," Acc. 545, Box 3, Series 4: 1915 (3) - 1917, Edward IV. Archibald Collection, OLM. This is a collection of notes, which seems to have become the basis of his article on abdominal surgery. A month earlier, Meyer and Taylor had published on their abdominal work. See W. C. B. Meyer and D. C. Taylor, "Penetrative wounds of the abdomen: A list of the first fifty consecutive cases operated upon at the 17th Casualty Clearing Station in the field, Flanders," Lancet, 1916, i, 8-15. In their case list, 17 of 50 died; of these 17, 13 are listed as having died of shock and/or hemorrhage (primary or secondary). Moreover, another 41 cases were not operated upon, "because patients were moribund, because no perforation was suspected, or because conservative treatment was considered advisable" (p. 9).
63. Another important component in lessening shock was the widespread adoption of the Thomas splint for immobilizing fractures. See Roger Cooter, Surgery and Society in Peace and War: Orthopaedics and the Organization of Modern Medicine, 1880-1948 (Basingstoke: Macmillan in association with the Centre for the History of Science, Technology, and Medicine, University of Manchester, 1993).
64. Archibald and McLean (n. 32), p. 282; E. M. Cowell, "The initiation of wound shock," J. Am. Med. Assoc., 1918, 69, 607-10.
65. "Imagine a man with a wound bad enough to incapacitate him from moving, lie him in pouring rain for several hours on a wet night till he is soaked, plaster him with thick adhesive clay-mud all over hair, face, hands, tunic, breeches, putties, and boots, add a mass of dressings and bandages saturated with blood - scoop him up with a stretcher used as you would a trowel for getting it full of earth, and then cart him ten miles in an ambulance, and you will have an idea of the picture presented by the great majority of our stretcher cases." Henry Wynyard Kaye, diary entry, 26 September 1915, p. 194, RAMC 739/7, Box 149, RAMC Collection, Wellcome Archives (hereafter WA), London.
66. The first part of this quotation is from a letter written by Archibald in December 1915 (the first page of which is missing), in Ace. 545, Box 1, Series I, Edward W. Archibald Collection, OLM; the second part is from Archibald and McLean (n. 32), p. 282.
67. Cowell repeated and extended these experiments with American physiologist Walter B. Cannon after the United States entered the war. In a "cover note on Research Work of ist Army," 24 Oct 17, from the DMS (First Army) to the DGMS, it is explained that Cowell had been conducting his studies on wound shock for "twelve months" (War Diary, DMS First Army," WO 95/197, PRO).
68. Cowell, "Wound shock in front line areas," in Macpherson et al., eds., (n. 26) Official History, 1, 58-78.
69. Paul Fussell, The Great War and Modern Memory (London: Oxford University Press, 1975 [1977]), p. 29.
70. Conscription was discussed during 1915 and implemented for all single men between 18 and 40 in January 1916. Universal conscription was introduced in May that same year.
71. Cowell (n. 42), p. 59. The following year, C. Gordon Watson, consulting surgeon to the Second Army, described the effects of saline as "too often transitory - a flash in the pan - followed by greater collapse than before" (quoted in L. Bruce Robertson, with a note by C. Gordon Watson, "Further observations on the results of blood transfusion in war surgery," Br. Med. J., 1917, ii, 679-83; p. 683).
72. An alternative to blood was offered at about the same time by British physiologist William Bayliss, who proposed a gum acacia solution as a substitute for saline. W. M. Bayliss, "Methods of raising a low arterial pressure," Proceedings R. Soc. Lond., 1917, 89, 380-93. Bayliss submitted this paper in August 1916.
73. L. Bruce Robertson, "The transfusion of whole blood: A suggestion for its more frequent employment in war surgery," Br. Med. J., 1916, ii, 38-40.
74. L. B. Robertson was born in Toronto to parents of Scottish descent in 1885. He studied Arts at the University of Toronto before turning to medicine. Following his medical graduation in 1909, he held a succession of important internships. The first of these was at the Toronto Hospital for Sick Children, which his uncle John Ross Robertson, a noted Canadian newspaper publisher and philanthropist, had helped expand into a major medical facility in 1891. He subsequently held an 18-month internship at Bellevue Hospital in New York and a 6-month post in Boston at the Children's Hospital. He then returned to Toronto's Sick Children as assistant surgeon. See Clarence L. Starr, "Obituary: Lawrence Bruce Robertson," Can. Med. Assoc. J., 1923, 13, 216-17;
75. Edward W. Gallie, "Address before the Academy of Medicine, Toronto," ms. in F 1374-5, L. Bruce Robertson Collection, AO. The Finding Guide prepared by the Archives of Ontario for the Robertson collection also includes a biographical sketch by Sally Gibson.
76. While making final revisions on this manuscript, I learned of a new article on Robertson: Peter H. Pinkerton, "Canada's transfusion medicine pioneer: Lawrence Bruce Robertson," Transfusion, 2001, 41, 283-86.
77. This was the standard pattern. Canadian medical institutions were modeled after and partnered with the British, were subordinated to British command, and took in all Allied casualties. See Andrew MacPhail, Official History of the Canadian Forces in the Great War, 1914-1919: The Medical Services (Ottawa: F. A. Acland, 1925); J. George Adami, War Story of the Canadian Army Medical Corps (Westminster, SW: Colour Ltd., 1918). Though Adami's book is listed as "volume é," no second volume was ever published. Adami's working files for the book are in RG9, III, vols. 3745-54, NAC.
78. This was the standard pattern. Canadian medical institutions were modeled after and partnered with the British, were subordinated to British command, and took in all Allied casualties. See Andrew MacPhail, Official History of the Canadian Forces in the Great War, 1914-1919: The Medical Services (Ottawa: F. A. Acland, 1925); J. George Adami, War Story of the Canadian Army Medical Corps (Westminster, SW: Colour Ltd., 1918). Though Adami's book is listed as "volume é," no second volume was ever published. Adami's working files for the book are in RG9, III, vols. 3745-54, NAC.
79. The details of No. 2 Canadian CCS are taken from the War Diary of OC J. Edgar Davey until November, 1917; WO 95/346, PRO. Copies of the CAMC war diaries are also held at the NAC. Originals are in RG9; microfilm copies are also available. The two sets are not always identical.
80. Personnel Files of the CEF, Edward W. Archibald, RG 150, Acc. 1992-93/166, Box 211 - 35, NAC. Archibald seems to have depleted most of his savings to stay as long as he did. The details are laid out in his correspondence with his father and, to a lesser extent, his wife. See, for example, Archibald to his father, 16 January 1916, Ace. 545/1, Edward W. Archibald Collection, OLM.
81. In focusing on the Western front, I will be dealing only briefly with the contribution of two more CAMC medical officers: Alexander Primrose and E. S. Ryerson. The two were on the staff of Toronto's Hospital for Sick Children, where Robertson had taught them syringe transfusion. During the war, they were stationed in Salonika, where they presented the details of their transfusion work to the Salonika Medical Society in the spring of 1916. This presentation became the basis for their own article, "The direct transfusion of blood: Its value in haemorrhage and shock in the treatment of the wounded in war," Br. Med. J., 1916, ii, 384-86. In the biographical sketch "Alexander Primrose," the comment is made that "this paper had a wide influence on British practice." D'Arcy Power, continued by W. R. Fanu, Lives of the Fellows of the Royal College of Surgeons of England, 1930-1951 (London: RCSE, 1953), pp. 648-49, p. 649.
82. In focusing on the Western front, I will be dealing only briefly with the contribution of two more CAMC medical officers: Alexander Primrose and E. S. Ryerson. The two were on the staff of Toronto's Hospital for Sick Children, where Robertson had taught them syringe transfusion. During the war, they were stationed in Salonika, where they presented the details of their transfusion work to the Salonika Medical Society in the spring of 1916. This presentation became the basis for their own article, "The direct transfusion of blood: Its value in haemorrhage and shock in the treatment of the wounded in war," Br. Med. J., 1916, ii, 384-86. In the biographical sketch "Alexander Primrose," the comment is made that "this paper had a wide influence on British practice." D'Arcy Power, continued by W. R. Fanu, Lives of the Fellows of the Royal College of Surgeons of England, 1930-1951 (London: RCSE, 1953), pp. 648-49, p. 649.
83. Robertson (n. 47), p. 39. The second patient, suffering a secondary hemorrhage from the stump of his amputated leg, improved significantly after an early-November transfusion, but died of sepsis a week later. The third patient improved after a first transfusion, but died after a second, apparently from hemolysis. Despite this failure, Robertson did not assert that typing was always necessary.
84. Archibald published two articles on transfusion by the citrate method in British medical journals in 1916. The shorter version appeared as "A note upon the employment of blood transfusion in war surgery," Lancet, 1916, ii, 429-31; and the full version, which he gave the same title, appeared in the J. R. Army Med. Crops, 1916, 27, 636-44. In both, he mentioned Major Hill and the four 1915 transfusions.
85. Archibald published two articles on transfusion by the citrate method in British medical journals in 1916. The shorter version appeared as "A note upon the employment of blood transfusion in war surgery," Lancet, 1916, ii, 429-31; and the full version, which he gave the same title, appeared in the J. R. Army Med. Crops, 1916, 27, 636-44. In both, he mentioned Major Hill and the four 1915 transfusions.
86. Archibald arrived at No. 1 Canadian CCS in late December 1915 and remained with the unit until late April 1916, when he returned to No. 3 Canadian General Hospital. Robertson's CCS was located in the converted prison formerly occupied by Archibald's CCS. There is no evidence that the two men met. War Diary, No. 2 Canadian CCS, 18 January 1916, T 10922, NAC.
87. Whitehead explains that W. G. Macpherson, Director of Medical Services of the First Army, had not initially followed Bowlby's lead in advancing the CCS. Whitehead, (n. 26) Doctors, p. 197.
88. It is unclear what transfusion work Robertson did between February and October of 1916. Primrose and Ryerson commented that Robertson had been conducting transfusions at the CCS level; these, however, are not recorded in any of Robertson's publications; Primrose and Ryerson (n. 52), p. 386. Their article appeared on 16 September 1916, suggesting, but not proving, that Robertson was indeed transfusing at the CCS level that spring.
89. Edward Archibald to his father, 15 April 1916, Ace. 545/1, Edward W. Archibald Collection, OLM.
90. Edward Archibald, "A brief survey of some experiences in the surgery of the present war," Can. Med. Assoc. J., 1916, 6, 775-95.
91. Archibald and McLean, (n. 32). McLean was born in 1885 in McLeod, Alberta, Canada, and graduated from Dalhousie Medical School in 1908. The co-authored paper on shock seems to have been his only publication; however, in the CAMC Official History, he is mentioned for his work on chest wounds, trench fever, and "disorderly action of the heart" (MacPhail, [n. 49] Official History). See also "Obituary of the war. Walter Leonard MacLean, MD," Lancet, 1917, 11, 952.
92. Archibald and McLean, (n. 32). McLean was born in 1885 in McLeod, Alberta, Canada, and graduated from Dalhousie Medical School in 1908. The co-authored paper on shock seems to have been his only publication; however, in the CAMC Official History, he is mentioned for his work on chest wounds, trench fever, and "disorderly action of the heart" (MacPhail, [n. 49] Official History). See also "Obituary of the war. Walter Leonard MacLean, MD," Lancet, 1917, 11, 952.
93. War Diary, No. 2 Canadian CCS, 14 April 1916, WO 95/346, PRO. OC J. Edgar Davey would later hold up Robertson's role in bringing blood to the British during his oration at Robertson's funeral. See "Dr. Bruce Robertson," Can.J. Med. Surg., 1923, 195-98. Davey's comments, which were reported in the Daily Telegram, are on p. 197. Archibald (n. 54), Lancet.
94. War Diary, No. 2 Canadian CCS, 14 April 1916, WO 95/346, PRO. OC J. Edgar Davey would later hold up Robertson's role in bringing blood to the British during his oration at Robertson's funeral. See "Dr. Bruce Robertson," Can.J. Med. Surg., 1923, 195-98. Davey's comments, which were reported in the Daily Telegram, are on p. 197. Archibald (n. 54), Lancet.
95. War Diary, No. 2 Canadian CCS, 14 April 1916, WO 95/346, PRO. OC J. Edgar Davey would later hold up Robertson's role in bringing blood to the British during his oration at Robertson's funeral. See "Dr. Bruce Robertson," Can.J. Med. Surg., 1923, 195-98. Davey's comments, which were reported in the Daily Telegram, are on p. 197. Archibald (n. 54), Lancet.
96. Malcolm Brown, The Imperial War Museum Book of the Somme (London: Pan Books, 1997), PP. 92, 252.
97. Robertson, "Blood transfusion in the Casualty Clearing Stations and Base Hospitals," unpublished 1918/19 ms., p. 2, Publications file, Academy of Medicine Library, Toronto.
98. All quotations in this paragraph from Robertson (n. 47), p. 38.
99. Ibid., p. 38.
100. Before Robertson presented his four case histories, his article extended to three-and-a-half columns; his review of blood's powers filled most of the first of them.
101. It should be noted, however, that he was frank about the death of one of his patients from hemolysis and cited Rous and Turner's paper on rapid blood typing. This, and the above quotations, are from Robertson (n. 47), p. 38.
102. "It is with slight modifications the method popularized by Lindeman of New York, who has placed it on its present basis of efficiency." Ibid., p. 38.
103. Archibald, (n. 54) Lancet, p. 429. Archibald seems to have assumed that the difficulty of transfusion operations alone hindered its more widespread use. Though there is some truth in the assumption, it does not wholly explain the British resistance to blood.
104. Ibid., pp. 429, 430.
105. Primrose and Ryerson, (n. 52). The article indicates that Primrose and Ryerson had been in touch with Robertson during the war-they had even discussed the details of their transfusion work-but were unaware of Robertson's article when they submitted their own. See the Note at the end of the article, p. 386.
106. Ibid., p. 384.
107. Ibid., p. 386.
108. In February 1916, for example, the CCS only treated 155 cases (War Diary, No. 2 Canadian CCS, WO 95/346, PRO). In the summer of 1917, on the other hand, the (expanded) surgical teams at No. 2 Canadian performed 150 operations in one day. Robertson, handwritten manuscript, p. 8, F1374-2-0-1, L. Bnice Robertson Collection, AO.
109. War Diary, No. 2 Canadian CCS, May 1916 "Comments," WO 95/346, PRO.
110. It is suggestive that, by the spring of 1917, No. 22 was among the first of the CCSs to set aside part of its serious surgical ward for the active resuscitation of soldiers with wound shock. They were also transfusing blood by January of 1917. War Diary, No. 22 CCS, WO 95/253, PRO. The Boulogne base was a hub for MRC research. T. R. Elliott was stationed there; in 1918, it would be the home of gum acacia production.
111. This was one in a series of serious illnesses Robertson was to endure in his short life. Personnel Files of the CEF, Lawrence Bruce Robertson, RG 150, Ace. 1992-93/166, Box 8363 - 21, NAC. War Diary, No. 2 Canadian CCS, 17 November 1916, WO 95/346, PRO.
112. One of the difficulties faced by CCS surgeons, for instance, was the de facto separation between care at the front and care back at the lines of communication. CCS surgeons who were experimenting with abdominal surgery, amputations, sepsis treatment, and even transfusion, had a hard time learning how their patient responded after leaving the CCS. Robertson attempted to bridge this gap by providing patients with return-addressed envelopes, which he asked them to fill with news of how they had gotten on. Robertson kept a whole stack of these patient letters. One patient even wrote, "I should like to know Sir, if the patient, (I acted as blood donor for,) is recovering alright." Letter from F. Birditt to Robertson, 22 July 1917, "Correspondence, 1915-1918," F1374-1-0-1, L. Bruce Robertson Collection, AO.
113. Robertson tried transfusion with sodium citrate on four occasions (the first recorded was on IO December 1916); in the end, he held to the more complex syringe method, believing unaltered blood was therapeutically superior to the citrated variety. Further, it was easier to stop the transfusion in the event of a reaction; Robertson, (n. 45). The first citrate case is detailed on p. 680.
114. Robertson lists seven cases of shock/hemorrhage that were transfused that winter. Ibid.
115. Lt. Col. Wingate, OC of No. 17 CCS, commented on one such transfusion that "the change in the patient was most marked" (War Diary, No. 17 CCS, 19 May 1917, WO 95/343, PRO).
116. The blueprint of No. 1 Canadian CCS's layout is dated 26 March 1917. The only copy I have ever seen of it is contained in J. G. Adami's files, which he compiled for his book on the CAMC (n. 49). Neither the NAC nor the PRO versions of No. I's War Diary include this blueprint.
117. "Collective surgical experiences at the front and at the base," in U.S. Surgeon General's Office, The Medical Department of the United States Army in the World War, 17 vols. (Washington, D.C.: Government Printing Office, 1921-1929), XI, 130-65. The survey indicating the blood preference of surgeons is on pp. 153-65.
118. The visit is recorded in the war diaries of both CCSs. I have looked at over half the extant CCS war diaries and have yet to find a British resuscitation ward that predates the Canadian plans. Further, it is possible that No. 2 Canadian did have its own resuscitation ward, before No. 1; I have found no evidence for or against this possibility. Ascribing credit to events taking place in wartime, when leaving paper trails was of fairly low priority and possibility, can be difficult.
119. War Diary, No. 2 Canadian CCS, plan enclosed at the end of the May, 1917 diary, WO 95/346, PRO; manuscript, hand-written by Robertson around 1918, outlining work done at a CCS, p. 6; in "Medical Papers: Notes," F1374-2-0-1, L. Bruce Robertson Collection, AO.
120. War Diary, No. 2 Canadian CCS, 3 June 1917, WO 95/346, PRO. George Gask, one such luminary, remained with No. 2 Canadian CCS until November 12.
121. Anthony Bowlby and Cuthbert Wallace, "The development of British surgery at the front," Br. Med. J., 1917, i, 705-721, and reprinted in Abstracts of War Surgery (St. Louis: C.V. Mosby, 1918), p. 56.
122. Anthony Bowlby and Cuthbert Wallace, "The development of British surgery at the front," Br. Med. J., 1917, i, 705-721, and reprinted in Abstracts of War Surgery (St. Louis: C.V. Mosby, 1918), p. 56.
123. Crile, (n. 7) George Crile, I, 287. This is quoted as a diary entry. The British and Canadians tended to call their hopeless wards "moribund," rather than "moratorium."
124. I am not arguing that the Canadians were the first to do transfusions in France; rather, that they were the ones who actively and initially worked to persuade the British of blood's benefits. Indeed, Crile helped organize the American Ambulance, in which rotating groups from top U.S. hospitals treated the wounded in Paris from early 1915. Staffed by "neutral" Americans, it was not involved with treating casualties near the front. Crile's Lakeside unit was the first of these groups, arriving in January 1915. Crile most probably did a few transfusions at that time (this is his claim in ibid., p. 256). Further, when the Harvard Unit took over in April 1915, Beth Vincent not only did transfusions in Paris, but also at Alexis Carrel's hospital in Compiègne (Elliott Carr Cutler, A Journal of the Harvard Medical School Unit to the American Ambulance Hospital in Paris, Spring of 1915 [New York : Evening Post Job Print. Off., 1915?], pp. 30, 38). The French, too, tried transfusion early but abandoned it. None of these early efforts were recorded in British journals, and there is no evidence that the individuals doing transfusion had any impact on British practices; indeed, they seem to have been more connected to French than to British medical staffs.
125. Grace Crile, (n. 7) George Crue, I, 300. Butler (n. 31) in his Australian Army Medical Services, used that other gothic monster for his description, calling the Great War, "that vampire" (II, 950). Moreover, to counterbalance the image, Butler appealed to blood transfusion for wound shock as a valuable lesson the monster had taught.
126. Grace Crile, (n. 7) George Crue, I, 300. Butler (n. 31) in his Australian Army Medical Services, used that other gothic monster for his description, calling the Great War, "that vampire" (II, 950). Moreover, to counterbalance the image, Butler appealed to blood transfusion for wound shock as a valuable lesson the monster had taught.
127. Original ms. diaries, 7 June 1917, hand-numbered page 12, 54:8, Series IV, Subseries A, File 256, Roll 62, George W. Crile Papers, WRHS.
128. That Robertson's ward was up and running, and not merely a paper plan, is substantiated by case notes he included in his next article: "Case 18. Lce.-Cpl. A., admitted June 7th, 1917; wounded the previous day. Perforating wounds of both legs, severing both posterior tibial arteries. Practically moribund condition; inoperable. Anti-shock measures were carried out in the resuscitation ward with little effect" (emphasis added). They transfused the patient several hours later. Robertson (n. 45), p. 681.
129. Granted, the resuscitation ward at No. 17 seems to have been far less sophisticated than the one at No. 2 Canadian. However, the name was there, attached to a facility that actively treated shock.
130. Crile is supposed to have written this about June 1917: "It was a great surprise to me that no plans whatever had been made for the use of transfusion in the English or French armies. ... Ed Lower and I introduced the use of blood transfusion in the British line where it became so obvious a method for the prevention and treatment of shock and for compensating hemorrhage, that before the end of the war blood was gathered from the wounded and stored at the casualty clearing stations." Crile, (n. 7) George Crile, I, 281.
131. This typed transcription is located with the collections "Family Memorabilia," 54: 7, Series III, George W. Crile Papers, WRHS. Occasionally, the dating on the handwritten diary is confusing; thus, I checked the dates of the handwritten against the typed versions for the resuscitation case. Both were included under the "7 June" entry.
132. Crile, (n. 7) George Crile, I, 284-85.
133. English, (n. 7) Shock, chapter 10.
134. A. Eisenbray, "The Moratorium (renamed the Resuscitation Ward)" p. 9, in 54:7; Series III, Roll 32, George W. Crile Papers, WRHS.
135. George Crile, "Shock," lecture given at the sanitary school in Langress, 1 June 1918, 54:7, Series I, Sub-series A, Folder 13, Roll 3, George W. Crile Papers, WRHS.
136. That Crile saw transfusion as "his" is evident in the memoir, as well as in letters to Grace.
137. Cowell, (n. 42) in Macpherson et. al., (n. 26) Official History, I, 60.
138. Quoted in Robertson (n. 45), p. 683. Cowell taught a course on wound shock at the First Army RAMC School, held in January 1918, at No. 22 CCS (War Diary, No. 22 CCS, January 1918, WO 95/253). Courses were repeated. O. H. Robertson specifically trained shock teams in the autumn of 1918: "we have a class of about a dozen M.O.'s every week and teach them for three days. These men then go up to the front as 'shock teams' - each team consisting of an M.O., a nurse and an orderly." O. H. Robertson to Peyton Rous, 4 November 1918, in file, "Rous-Robertson Correspondence," B R77.r, Peyton Rous Collection, American Philosophical Society Archives (hereafter APSA), Philadelphia.
139. On Cannon's work, see Saul Benison, A. Clifford Barger, and Elin L. Wolfe, "Walter B. Cannon and the mystery of shock: A study of Anglo-American co-operation in World War I," Med. Hist., 1991, 35, 217-49.
140. On Oswald Hope Robertson, see William C. Hanigan and Stuart C. King, "Cold blood and clinical research during World War I," Mil. Med., 1996, 161, 392-400; J. R. Hess and P. J. Schmidt, "The first blood banker: Oswald Hope Robertson," Transfusion, 2000, 40, 110-13.
141. On Oswald Hope Robertson, see William C. Hanigan and Stuart C. King, "Cold blood and clinical research during World War I," Mil. Med., 1996, 161, 392-400; J. R. Hess and P. J. Schmidt, "The first blood banker: Oswald Hope Robertson," Transfusion, 2000, 40, 110-13.
142. Oswald H. Robertson, "A method of citrated blood transfusion," Br. Med. J., 1918, i, 477-79. O. H. Robertson does not appear to have been aware of Archibald's earlier work in this publication.
143. "Second Report issued by the Surgical Shock Committee of the Third Army" (hand-dated "BEF, 5/3/18" - either 5 March or 3 May, depending on the country dating the manuscript), signed by H. M. W. Gray, O. H. Robertson Papers, B: R546, APSA . The reasons for the U.S. citrate preference are detailed in the pamphlet, A Report Upon Transfusion of Blood for the Recently Injured in the United States Army (Paris: Medical Division of the American Red Cross Society in France, 1918).
144. "Second Report issued by the Surgical Shock Committee of the Third Army" (hand-dated "BEF, 5/3/18" - either 5 March or 3 May, depending on the country dating the manuscript), signed by H. M. W. Gray, O. H. Robertson Papers, B: R546, APSA . The reasons for the U.S. citrate preference are detailed in the pamphlet, A Report Upon Transfusion of Blood for the Recently Injured in the United States Army (Paris: Medical Division of the American Red Cross Society in France, 1918).
145. O. H. Robertson drew blood into a bottle containing a sterile solution of sodium citrate, dextrose, and distilled water, then packed the bottle in ice. After about five days, when the red cells settled at the bottom, he removed most of the supernatant fluid and stored the remainder on ice. He found that the cells kept well for at least three weeks. Oswald H. Robertson, "Transfusion with preserved red blood cells," Br, Med. J., 1918, i: 691-95. Walker and Gordon-Taylor described the process in some detail, but concluded that it "was not generally adopted because of the greater simplicity of other techniques." Kenneth Walker and Gordon Gordon-Taylor, "Blood transfusion," in Macpherson et al., (n. 26) Official History, I, 108-33; P. 123.
146. O. H. Robertson drew blood into a bottle containing a sterile solution of sodium citrate, dextrose, and distilled water, then packed the bottle in ice. After about five days, when the red cells settled at the bottom, he removed most of the supernatant fluid and stored the remainder on ice. He found that the cells kept well for at least three weeks. Oswald H. Robertson, "Transfusion with preserved red blood cells," Br, Med. J., 1918, i: 691-95. Walker and Gordon-Taylor described the process in some detail, but concluded that it "was not generally adopted because of the greater simplicity of other techniques." Kenneth Walker and Gordon Gordon-Taylor, "Blood transfusion," in Macpherson et al., (n. 26) Official History, I, 108-33; P. 123.
147. Kenneth Walker, co-author of the aforementioned chapter on transfusion for the British official history, worked with O. H. Robertson on transfusion with preserved red cells; he reported on their forward work in Walker and Gordon-Taylor (n. 107), p. 127.
148. Though Archibald disappears from transfusion history after WWI, he may well have been indirectly involved in the application of blood banking in the Spanish Civil War. In the early 19305, his surgical assistant at Montreal's Queen Victoria Hospital was Norman Bethune.
149. McLean was at No. 36 CCS on the evening he was wounded; he died early the next morning. War Diary, No. 1 Canadian CCS, 9 November 1917, T 10921, NAC.
150. Robertson's archives hold the letters from Robertson making the request, from Davey asking that it be denied, and from the director of medical services, CAMC, denying it. F1374.-5, L. Bruce Robertson Collection, AO. The exchange is from October 1917.
151. Unsigned letter to J. G. Adami, 20 May 1918, F1374-1-0-1, L. Bruce Robertson Collection, AO.
152. L. B. Robertson, "A contribution on blood transfusion in war surgery," Lancet, 1918, i, 759-62.
153. Walker and Gordon-Taylor (n. 107).
154. Guiou had gone to France as a senior medical student in 1915, but returned to Canada to finish his degree. He returned to France only in 1917. The following passage is all he includes of Robertson: "Captain D.E. Robertson of the First Canadian Division had done a blood transfusion in the 3rd Field Ambulance Main Dressing Station at Albert on the Somme in the fall of 1916. He had used a citrate bottle made by Professor Brodie and sent to him by Dr. Gallie of the Toronto General Hospital" (p. 29). That this was indeed Bruce Robertson is strongly suggested by the Gallie connection in Toronto. Gallie, who spoke at Robertson's funeral, was a friend and colleague. Norman Miles Guiou, Transfusion: A Canadian Surgeon's Story in War and Peace (Yarmouth, Nova Scotia: Stoneycroft, 1985).
155. During his long career, Sir Geoffrey (he was knighted in 1955) also did important work on breast cancer and myasthenia gravis. He was medical advisor to the influential Red Cross Blood Transfusion Service in the 1920s.
156. Geoffrey Keynes, Blood Transfusion (London: Henry Frowde, 1922).
157. Keynes, (n. 22) Gates, p. 144.
158. Keynes, (n. 117) Blood Transfusion, p. 17.
159. L. B. Robertson to Geoffrey Keynes, 8 November 1922, Ace. 562/30; Book I, "Red Cross Blood Transfusion Service Scrapbook," British Red Cross Archives, Guilford, Surrey, England. Bruce Robertson is cited by Keynes, but only in relation to his later work on exsanguination transfusion in children [Keynes, (n. 117) Blood Transfusion, pp. 135-36]. It was Robertson's exsanguination work that captured the popularizing imagination of Paul de Kruif, who described it in his 1930 article, "A News reel of death-fighting: Recent discoveries in the great struggle against disease. " The article appeared in the September 1930 volume of the Ladies' Home Journal (pp. 16-17) as well as in the Readers' Digest, October 1930 (pp. 506-7). An archival copy is located in F1374-2-0-3, L. Bruce Robertson Collection, AO.
160. L. B. Robertson to Geoffrey Keynes, 8 November 1922, Ace. 562/30; Book I, "Red Cross Blood Transfusion Service Scrapbook," British Red Cross Archives, Guilford, Surrey, England. Bruce Robertson is cited by Keynes, but only in relation to his later work on exsanguination transfusion in children [Keynes, (n. 117) Blood Transfusion, pp. 135-36]. It was Robertson's exsanguination work that captured the popularizing imagination of Paul de Kruif, who described it in his 1930 article, "A News reel of death-fighting: Recent discoveries in the great struggle against disease. " The article appeared in the September 1930 volume of the Ladies' Home Journal (pp. 16-17) as well as in the Readers' Digest, October 1930 (pp. 506-7). An archival copy is located in F1374-2-0-3, L. Bruce Robertson Collection, AO.
161. L. B. Robertson to Geoffrey Keynes, 8 November 1922, Ace. 562/30; Book I, "Red Cross Blood Transfusion Service Scrapbook," British Red Cross Archives, Guilford, Surrey, England. Bruce Robertson is cited by Keynes, but only in relation to his later work on exsanguination transfusion in children [Keynes, (n. 117) Blood Transfusion, pp. 135-36]. It was Robertson's exsanguination work that captured the popularizing imagination of Paul de Kruif, who described it in his 1930 article, "A News reel of death-fighting: Recent discoveries in the great struggle against disease. " The article appeared in the September 1930 volume of the Ladies' Home Journal (pp. 16-17) as well as in the Readers' Digest, October 1930 (pp. 506-7). An archival copy is located in F1374-2-0-3, L. Bruce Robertson Collection, AO.
162. L. B. Robertson to Geoffrey Keynes, 8 November 1922, Ace. 562/30; Book I, "Red Cross Blood Transfusion Service Scrapbook," British Red Cross Archives, Guilford, Surrey, England. Bruce Robertson is cited by Keynes, but only in relation to his later work on exsanguination transfusion in children [Keynes, (n. 117) Blood Transfusion, pp. 135-36]. It was Robertson's exsanguination work that captured the popularizing imagination of Paul de Kruif, who described it in his 1930 article, "A News reel of death-fighting: Recent discoveries in the great struggle against disease. " The article appeared in the September 1930 volume of the Ladies' Home Journal (pp. 16-17) as well as in the Readers' Digest, October 1930 (pp. 506-7). An archival copy is located in F1374-2-0-3, L. Bruce Robertson Collection, AO.
163. L. B. Robertson's memorial tablet, erected at St. Andrew's Presbyterian Church in Toronto, reads: "he first introduced into the British army in this period, a practicable method of blood transfusion."
164. See English, (n. 7) Shock.
165. Geoffrey Keynes, ed., Blood Transfusion (Bristol : John Wright & Sons Ltd., 1949), p. 37. A nice example of Keynes's influence on the transfusion narrative, including its fallacies, is contained in Kenneth Walker's The Story of Medicine (New York: Oxford University Press, 1954). He wrote of WWI, "A Canadian medical officer, Oswald Robertson, did a great deal to popularize this technique and there can be no doubt that thousands of lives were thereby saved" (p. 203).
166. Geoffrey Keynes, ed., Blood Transfusion (Bristol : John Wright & Sons Ltd., 1949), p. 37. A nice example of Keynes's influence on the transfusion narrative, including its fallacies, is contained in Kenneth Walker's The Story of Medicine (New York: Oxford University Press, 1954). He wrote of WWI, "A Canadian medical officer, Oswald Robertson, did a great deal to popularize this technique and there can be no doubt that thousands of lives were thereby saved" (p. 203).