Therapeutic transfusion was not a common procedure at the turn of the
century, Although its safety was enhanced by the discovery of blood gr
oups and preinfusion testing in the decade prior to World War I, techn
iques and indications remained cumbersome and clinically naive, By 191
6, a stable Western Front, an efficient line of transport, and the ope
rative requirements of a large number of wounded demonstrated the futi
lity of pharmacotherapy or saline infusion for traumatic shock, In the
same year, Rous and Turner at the Rockefeller Institute developed a p
reservative solution for whole blood, Rous' student, Dr. O.H. Robertso
n, arrived in France with Base Hospital 5 in June 1917 during a period
of growing recognition by military surgeons that transfused blood was
an effective therapy, although a practical delivery system was not av
ailable, Over the next 8 months, Robertson clinically tested a transfu
sion technique using preserved blood in glass jars carried to the fron
t in specially designed cases. The method was accepted immediately, an
d by the Armistice transfusion was used frequently on the front line o
r during the perioperative period, The accessibility of preserved bloo
d with an efficient transfusion system reinforced the introduction of
''resuscitation teams'' attached to Casualty Clearing Hospitals for th
e specialized management of traumatic shock, Robertson's success at te
chnical innovation during World War I associated with a large clinical
population resulted in the development of the indications and procedu
res for modern transfusion therapy.