Halsted's interest in transfusion led him to focus his efforts on a common condition of the day, illuminating gas poisoning. The first residential electric lights became available in New York City in 1882, but consumers had to be within a one-mile radius of Thomas Edison's direct-current generating plant on Pearl Street in order to receive service. It would be another decade before alternating current, which could transmit current farther, became generally available. Meanwhile, homes, businesses, and streets continued to be illuminated with gas, and a by-product of burning gas was carbon monoxide. Workers exposed to illuminating gas were often acutely poisoned by it, particularly in confined spaces like the gaslit night boats plying the rivers. In the emergency ward at the Chambers Street Hospital, Halsted devised a procedure called centripetal transfusion, in which the patient's blood was removed, aerated, and returned to the donor. Aeration removed carbon monoxide from its combination with hemoglobin and allowed the hemoglobin to combine with oxygen from the air. Halsted believed it was preferable to retransfuse the blood into an artery rather than a vein, so that it would go "against the stream and not mix with other blood and cause gangrene of the extremity." Whether arterial retransfusion was of any particular value is debatable, but the blood's renewed ability to carry oxygen cleared the acute toxicity and patients recovered rapidly.
Friday, April 30, 2010
From Genius on the Edge by Dr. Gerald Imber (pages 43-44):