As preparations ramped up for possible U.S. involvement in World War II, isolating a blood substitute for transfusion became a military priority.
To address this need, in 1940, Walter Cannon, HMS Class of 1900, then head of the National Research Council’s Committee on Transfusions, called on Edwin Cohn, head of the Department of Physical Chemistry at HMS. Cohn and his lab were ready, having laid the groundwork through their work on the physicochemical properties of protein components, including serum albumin and serum globulin. Cohn’s work for the Army coincided with the American Red Cross’s campaign to establish a national blood donation program for the war effort. His lab and the Red Cross developed a symbiotic relationship: in 1941 a group of Red Cross volunteers began making weekly blood donations that were delivered to Cohn’s lab. These donations provided the raw material to develop what became known as the Cohn process for fractionation—extracting albumin and other clinically usable products from plasma while maintaining the structural and functional integrity of the protein.
Half a world away and a couple of years later, Edward Churchill, HMS Class of 1920, in his role as Consultant in Surgery, Fifth U.S. Army, in North Africa, observed the effects of overreliance on plasma in cases of shock, and, in a report to the surgeon general in the region, wrote, “there is a need for whole blood transfusions in the treatment of a significant proportion of wounded. Plasma is not an adequate substitute in these cases.”
Churchill set up “live-blood” banks in Tunisia, which recruited donors from troops not actively engaged in combat or recovering from injuries. Reporting this story in August 1943, the New York Times noted that “blood is taken only from volunteers at present.” In his memoir, Surgeon to Soldiers, Churchill wrote that “the Red Cross’s and the National Research Council’s commitment to plasma and plasma fractionation reflected a huge vested interest [which] had been built up starting from assumptions and erroneous thinking.”
Images: John Soares. Objects courtesy of the Warren Anatomical Museum at the Francis A. Countway Library of Medicine; triage tags and transfusion kit donated by Edward Churchill’s son, Frederick.