COLD BLOOD AND CLINICAL RESEARCH DURING WORLD-WAR-1

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.