Blood Work

Very many maintain that all we know is still infinitely less than all that still remains unknown.

—William Harvey,
De motu cordis
(1628)

Blood is a juice of a very special kind.

—Johann Wolfgang von Goethe,
Faust, Part 1
(1808)

Note on Translations

Dramatis Personae

Prologue

Chapter 1
THE DOCTOR AND THE MADMAN

Chapter 2
CIRCULATION

Chapter 3
THE AGE OF VIVISECTION

Chapter 4
PLAGUE AND FIRE

Chapter 5
PHILOSOPHICAL TRANSACTIONS

Chapter 6
NOBLE AMBITIONS

Chapter 7
“HOW HIGH WILL HE NOT CLIMB?”

Chapter 8
THE KING'S LIBRARY

Chapter 9
THE PHILOSOPHER'S STONE

Chapter 10
THE BLOOD OF A BEAST

Chapter 11
THE TOWER OF LONDON

Chapter 12
BEDLAM

Chapter 13
MONSTERS AND MARVELS

Chapter 14
THE WIDOW

Chapter 15
THE AFFAIR OF THE POISONS

Chapter 16
CHIMERAS

Epilogue

Blood Transfusion: A Chronology

Acknowledgments

Notes

Bibliography

Illustration Credits

In all circumstances, I have first relied on period translations of the original foreign-language texts cited. In the absence of a period translation, the remaining translations are my own. The source of the quote (printed translation or translated original) is indicated in the notes that accompany the text. Minor changes have been made to regularize spelling or typography, but these do not impact the original meaning.

O
n December 14, 1799, America's first president awoke with a sore throat, which was soon accompanied by a fever. At six that morning, George Washington's doctors agreed it was time for a bloodletting. Eighteen ounces of blood later, the patient's condition had not improved, and he was bled twice more. Not long after, Washington was unable to breathe—medical historians believe that he suffered from an infection of the epiglottis—and a tracheotomy was performed. A fourth round of bloodletting followed, to no avail. Washington gasped for breath like a drowning man and died late that evening, around ten o'clock.
¹

Though we will never know whether Washington died of his illness or of the severe bloodletting he suffered during his “treatment,” many historians would bet on the latter. His body was laid out in the family's formal parlor so that prominent visitors could pay their respects. Yet as the nation prepared to mourn its first president, others wondered if there was a way to bring him back to life.

When Washington's granddaughter, Mrs. Thomas Law, arrived the next morning, she brought with her a man who suggested the unthinkable. Dr. William Thornton, best known as architect of the U.S. Capitol, speculated that the president could be revived if both blood and air were returned to his corpse. Dr. Thornton suggested that Washington be warmed up “by degrees and by friction” so his blood might be coaxed to move once again through his body. Then Thornton proposed to “open a passage to the lungs by the trachea, and to inflate them with air, to produce artificial respiration, and to
transfuse blood into him from a lamb.
”
²

Thornton's idea of transfusing the dead president was swiftly rejected by Washington's family. They did not quibble with the doctor as to whether resurrection by transfusion could be possible. Instead they declined on the grounds that it was better to leave the memory of George Washington's legacy intact as “one who had departed full of honor and renown; free from the frailties of age, in full enjoyment of every faculty, and prepared for eternity.”
³
Death was preferable to any extraordinary attempt to resurrect the president using animal blood.

Thornton was not the first to propose blood transfusion as a miraculous cure, nor was he the first to consider animals as donors. More than 130 years earlier, between 1665 and 1668, all of Europe was abuzz with excitement over the possibility of blood transfusion. French and English scientists were locked in an intense battle to master blood's secrets and to perform the first successful transfusion in humans. Members of the British Royal Society began by injecting any number of fluids into the veins of animals: wine, beer, opium, milk, and mercury. Then they turned their sights on transfusions between dogs—large ones to small ones, old ones to young ones, one breed to another. The French Academy of Science followed suit with its own canine transfusion experiments but to its dismay was unable to replicate English successes.

Then, seemingly out of nowhere, a young physician named Jean-Baptiste Denis surprised the scientific world when he performed the first animal-to-human blood transfusion to great acclaim—and even greater controversy. On a cold day in December 1667, Denis transfused lamb's blood into the veins of a fifteen-year-old boy. The result was stunning: The boy survived. But fate would not be kind to Denis for long. Flushed with success, Denis tried his next, and last, round of transfusions—this time on a mentally ill, thirty-four-year-old man named Antoine Mauroy. The doctor cut open the vein of a calf and rigged a rudimentary system of goose quills tied together with string. He then transfused just over ten ounces of calf's blood into Mauroy's arm. By the next morning signs looked promising that the experiment was going to work—or, at the very least, not be fatal. Several days and several transfusions later, however, Mauroy was dead. And Denis was soon accused of murder.

In a dramatic turn of events, a Paris judge cleared Denis of all accusations on April 17, 1668. Still, the madman's death signaled an end not only to Denis' career as a transfusionist but also to transfusion entirely. In its judgment the French court mandated that no future human transfusion could be performed without prior authorization from the Paris Faculty of Medicine. And this was very unlikely to happen, given that the medical school had made no secret of its hostility toward the procedure. Two years later, in 1670, the French parliament banned transfusions altogether; transfusion experiments were also stopped in England, Italy, and throughout Europe, not to be taken up again for 150 years.

 

T
his book views the story of the Denis trial through two different lenses. First, it is a microhistory that traces the little-known and captivating tale of the rise and fall of the transfusionist Denis, and blood transfusion more generally, over a period of about five
years during the seventeenth century. But, perhaps more important, it is also a macrohistory that traces the confluence of ideas, discoveries, and cultural, political, and religious forces that made blood transfusion even thinkable in this era before anesthesia, antisepsis, and knowledge of blood groups. This story is, then, as much about the scientific revolution—its greatest minds and most calculating monarchs—as it is about blood transfusion itself.

The term “scientific revolution” has long been a matter of debate among historians, and I should pause briefly here to explain the use of it in my subtitle and at various moments throughout the book. Beginning in the late 1940s with the work of such legendary historians as Alexandre Koyré and Herbert Butterfield, the scientific revolution was understood as the unequivocable birth of modern science—the decisive moment at which science heroically supplanted superstition and never looked back. This is not how I use the term. Instead I join more recent historians who have worked diligently to nuance our understanding of the scientific revolution as, explains Steven Shapin, “a diverse array of cultural practices aimed at understanding, explaining, and controlling the natural world, each with different characteristics and each experiencing different modes of change.”
⁴
If we can be certain about one thing when it comes to the scientific revolution, it is that there were no easy answers, no clear consensus. Natural philosophers—as scientists were called then—tussled with one another to unlock nature's truths, and more often than not they disagreed, sometimes violently.

The early chapters of this book begin across the Channel, in England, where the foundations for the Frenchman's history-making transfusions were laid. Here, men like Christopher Wren, Robert Boyle, and Robert Hooke performed experiments to test William Harvey's recent discovery of blood circulation. This
foray into the larger, international context of early science—fascinating and drama-filled in its own right—lays the foundation for what was, in the end, a showdown between France and England in the fight for scientific dominance.

At the core of this battle lay the race to solve enigmas about both earthly and divine worlds that were as complex as they were controversial. In the early decades of the seventeenth century, Harvey turned understandings of the human body upside down when he announced his discovery of blood circulation. René Descartes had also made his radical pronouncement, “Cogito ergo sum [I think therefore I am],” claiming that the mind—and the soul—were independent from the body, which he argued was little more than an ingenious machine. In a Europe still recovering from the ravages of religious wars, natural philosophers tried to make sense of the broad implications of these and other theories that had so unsettled traditional understandings of science and the body.

A perfect storm had been brewing in Europe, between France and England, Catholics and Protestants, and, especially, science and superstition. And transfusion sat at the heart of it all. It is through this larger cultural and political narrative that Denis' experiments must be told. The early story of transfusion is not just about an ambitious man whose efforts met with resounding failure; it is the story of a world undergoing radical transformation as science and society changed at a pace never before imagined.

As novelistic as this world of early science may seem, however, this book is a work of nonfiction. My narrative approach to history frames what is, above all, a study of historical documents, manuscripts, medical manuals, personal letters, and illustrations—some well known and many esoteric, even obscure. Still, to research and to write about history also means coming face-to-face with any number of conundrums, contradictions, and archival
gaps. Confronted by those moments, I have relied on what I know intimately about the time period, its actors, and its power structures as a professor of early medicine and culture. Yet, as imperfect as our knowledge about any moment in the past necessarily is, the lines between fact and fanciful speculation must nonetheless be firmly drawn. In this regard I am indebted to cultural historians such as Carlo Ginzburg, Natalie Zemon Davis, Robert Darnton, and David Kertzer, whose scholarship guided my own efforts to make history's stories come alive—responsibly and in ways that breathe life into a chapter of early science that might otherwise be lost to general readers.

History books rarely mention early transfusion, primarily because it does not fit at all neatly into the larger narrative of the “revolutionary” triumphs of science in the seventeenth century. As one scholar wrote, “It is probably fortunate that blood transfusion took a nap for over one and a half centuries. Ignorance of antisepsis, asepsis, and immunology would have resulted in countless disasters.”
⁵
This is likely true. The few historians who have studied early transfusion argue that the procedure was outlawed in France, England, and Italy in the wake of the Denis trial because it was too deadly.
⁶
And when I first learned about the Denis case several years ago, I was inclined to agree. However, the more I researched contemporary accounts of the experiments and the court case that followed, the less this argument held up.

It does not take an advanced degree in immunology to imagine how transfusing animal blood into human veins could be dangerous, or even lethal. But surely if mortality concerns alone were at the heart of the initial prohibitions against transfusion, many other procedures would also have been banned. Bladder stones, for example, were frequently removed through penile extraction or by cutting so deeply into the perineum that the barber-surgeon could reach his whole hand into the patient's body. The
operation was so painful that the Renaissance surgeon Ambroise Paré explained that it took four strong men to hold his patients down during the operation. The procedure was also notoriously fatal—so much so that the English diarist Samuel Pepys put his stone on display and celebrated each anniversary of his own procedure, exceedingly grateful that he was still alive.
⁷

Similarly, no formal limits were imposed on what was arguably the most emotionally and ethically fraught of operations: cesarean sections. In the absence of effective anesthesia, cesarean sections were excruciatingly painful and often resulted in the death of a new mother in an act that was meant to save the life of a child whose own survival was anything but certain. In 1668, the same year as the Denis trial, the surgeon Jacques Mauriceau called the procedure “a great excess of inhumanity, of cruelty, and of barbarity.”
⁸
Still, neither the courts nor the medical faculties ever put formal restrictions on these and other horrifically painful and dangerous procedures.

The more I dug into the Denis case, then, the more questions I had—and doubly so after I learned the outcome of the trial. While much of the court record surrounding the Denis trial has been lost to history, all existing seventeenth-century accounts do agree on one thing: Mauroy was poisoned—not by the animal blood that may or may not have flooded his veins—but by arsenic. All accounts also agree that several doctors, whom Denis would later call “Enemies of the Experiment,” were directly implicated in the death. But over the centuries, oddly enough, the names of these men have been relegated to the dusty shelves of history. To date no study has attempted to unveil the identities of the doctors who feared transfusion so much that they would resort to murder. Who could they have been? And what could have been their motivations to kill?

The truth, as they say, is sometimes stranger than fiction.
“Enemies of the Experiment” lurked everywhere, it turns out, and their reasons for wanting to put an end to transfusion are as strange as they are fascinating: It was the moral and religious implications of mixing the blood of different species, rather than the medical safety or well-being of the patient per se, that put a stop to the first transfusions.

Some seventeenth-century physicians and power brokers feared that science was toying with forces of nature that it did not understand—and very dangerous ones at that. In early Europe the borders between science and superstition were as fluid as the blood with which natural philosophers were experimenting. Detractors compared doctors who practiced transfusion to alchemists. Just as alchemists worked tirelessly to transmute base metals into gold, transfusionists risked transforming bodies and minds by transfusing animal qualities into human veins. Would humans now bark? Or dogs begin to speak?

In early European minds the potential for species transmutation via transfusion was real—and terrifying. Monstrous hybrid creatures loomed large in the early European imagination. Sea dragons put the fear of God into the hearts of New World explorers; sailors returned from their travels with tales of kingdoms ruled by dog-headed men and islands inhabited by mermaids who were neither fully human nor fully fish. For some the risk that science could create monsters—or worse, corrupt the entire human race with foreign blood—was simply too much to bear. Transfusion needed to be stopped, and it was, for well over a century and a half after the Denis trial.