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blood transfusion in a time of war
The development of blood transfusion techniques is based on
a long period of experimentation along the 19th Century. Through
this century, two blood transfusion procedures were tried,
direct or indirect, which had supporters and detractors, with
none of them being able to prevail due to technical difficulties
(problems related to conservation, coagulation and infection)
and the high rate of accidents. Experimentation, however,
went on its path: physicians carrying out autologous, heterologous
and homologous transfusions; instrument builders improving
all mentioned procedures. While indirect transfusion was based
upon the theory of blood stirring or defibrillation, prior
to injection, as a homogenizing method for the size of red
cells, homologous direct transfusion embodied the advances
on risks and loss of properties of conserved blood. Both techniques
prevailed in the context of the development of the experimental
basis created by the European war conflicts of the beginning
of the 20th Century.
The instruments illustrating this section record the persistence
of both techniques in the Spanish context of the 1930s. In
fact, if the definition of “blood groups” (1901)
supported direct transfusion to facilitate prior determination
of compatibilities, the arrival of a key element in indirect
transfusion, the finding of a stable anticoagulant, with low
toxicity and preservative properties, sodium citrate, opened
the door for new devices and the possibility to create blood
banks. On the one hand, the syringe designed by the French
physician Louis Jubé (1927) constitutes one of several
methods of the period for direct transfusion of pure or fresh
blood, non citrated, from arm to arm. On the other hand, the
technical solution tried by Catalan physician Frederic Duran
Jordà (1937), during the Spanish civil war, based upon
a serum glass ampoule, which he adapted to store plasma, after
determining the blood group, filtered, citrated and vacuum-packed
in aseptic conditions. The number of donations made evidence
the success possibilities of Duran’s methodology and
the quantity of plasma conserved, carried on refrigerated
trucks and transfused both at the front and at the rearguard.
And also through the creation on the front of the Transfusion
Service of Barcelona, which allowed to consolidate the blood
bank. An experience that served as a model for England in
the 1940s. In Barcelona, Norman Bethune learned the techniques
that shortly afterwards practiced in Madrid and later on in
China, thus showing the usefulness of storing up great amounts
of plasma as a therapeutic resource. That is, fundamental
elements for the transfusion therapy developed in the 1950-1960s,
based upon the substitution of glass flasks for plastic bags
and the specific use of the distinct blood constituents.
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© Official Medical Association of Barcelona 
