Jaundiced Students Contribute Blood To Dampen Effects of Atomic War

The separation of blood components would be of vital importance in the event of an atomic bomb blast. Dr. Shields Warren, of the New England Deaconess Hospital in Boston and a member of the medical team that visited Nagasaki in September 1945, has cited three distinct and separate problems in the treatment of radiation victims:

How to meet infection; how to control hemorrhage; and how to "supply sufficient oxygen-carrying capacity to the organism as a whole."

Warren pointed out the advantages in using instead of whole blood or plasma, the cellular elements themselves and thus meeting "the needs that exist at the time those particular needs arise."

The after-effects of an atomic bomb blast would probably he lessened because of current research by Harvard's "blood man," Dr. Edwin J. Cohn. Even though men can't preserve whole blood, Cohn has learned how to preserve many blood components individually, and the separation of blood would be of vital importance in the event of an atomic blast.

Radiation affects the bone marrow, where the red cells are produced, and it is some weeks before the victim's system can take over again. White cells are manufactured in the marrow and lymph glands, which are also affected by radiation. The effects are delayed until about a week after a blast.

Blood separation could answer the radiation problems with oxygen bearing red cells, disease-fighting white cells, and homorrhage-controlling platelets. No longer would doctors have to "scrap a whole jeep when only a part is needed" by using whole blood instead of a plasma fraction.

Rejected Students Give Blood

This month marked the first anniversary of the University. Institution of Applied Biology in Jamaica Plain. Inside the old Victorian building lies the modern Blood Characterization and Preservation Laboratory where revolutionary new blood processing equipment--to collect blood from donors and simultaneously separate it into its component parts is being developed.

This work, under the direction of Cohn, who is Higgins University Professor, requires donors and in its experimental phases is taking jaundice sufferers who were refused by the Red Cross in the December PHH drive. These men have been going over to contribute there, where their permanent reject classification is discounted.

Cohn has repeatedly stressed that blood economy demands transfusing only such blood components as a particular patient needs. Thus all available blood would be used most effectively in surgery it is often necessary to replace blood lost during an operation with whole blood, but in most clinical conditions only a part of the blood is deficient and need be supplied.

Blood fractionation, however, evolved from the still continuing search for non-human blood substitutes. Twenty-five years ago Cohn started to study hemoglobin in red cells, but the first real fruit came in the spring of 1940 when the German offensive had already begun on the continent and blood was needed for casualties.

History of Project

Cohn was asked to investigate to determine whether animal plasma could be safe for human transfusion. New methods for the fraction of plasma were therefore rapidly developed during the spring and summer of 1940. Techniques to yield undenatured products of great stability resulted. These methods had been applied successfully on a large scale, and studies were available demonstrating the value of such products in the treatment of shock.

Before the end of the year, however, Cohn was convinced that the problem of freeing animal material of the possibility of antigenic reactions might prove insoluble, and that in any case, the animal plasma project could not be completed in a short time. He thus recommended that only human products be used.

Throughout World War II Cohn studied blood and blood derivatives under contract with the Office of Scientific Research and Development. Nationwide blood collection made possible the study and clinical use of human blood on a scale never previously conceivable. Donors' blood was supplied to the Pilot Plant week by week and the products of fractionation were studied and tested.

As practical procedures were developed, capable of use in large-scale production, the methods evolved in the Pilot Plant were used on a steadily expanding scale in seven pharmaceutical firms under Navy contracts.

This work resulted in the production of serium albumin, gamma globulin, fibrin products for brain surgery, and other parts of the coagulation mechanism for chemical and clinical study.

After the war there was a return to fundamental research, and out of it, in October 1950, Cohn came up with his first mobile blood fractionation plant that could go to the donors. It was housed in a 32-foot trailer-truck so this refrigerated lab could go along with Red Cross Bloodmibiles processing could start within a few moments after collection. By November the truck was rendered obsolete by the development of the newer methods.

How the Donor Sees It

By looking in a mirror suspended above his head, a donor can watch the small apparatus that is the object of all this research. Only about six-cubic feet in size, this transparent-walled blood fractionator will be the pilot model for future production.

Through a non-wettable plastic tube, which avoids damage to delicate formed elements, heretofore caused by collecting with glass or rubber tubing, the blood flows into a column of resinous beads (called an ion exchange column). Here calcium is removed to prevent clotting. On this resin are collected platelets, tiny disk-like formed elements of the blood which initiate the clotting process, obtained in this machinery for the first time in substantial yield.

By passage through a heat-exchange unit the blood is next rapidly cooled to the optimum temperature for its preservation. It then passes into a centrifuge where the plasma red and white cells are separated from each other. The heavier red cells pass through a high-density solution of salts and sugars and remain in the centrifuge bowl.

The Complicated Process

The white cells pass through and are carefully collected in a second centrifuge. Meanwhile the plasma--the liquid medium in which the cells are suspended--flows into a mixing vessel where zinc salts are added to precipitate the gamma globulins of the blood and certain other plasma proteins.

Gamma globulins, the immunity-bearing proteins of the blood, have come into general use for protection against measles. The possibilities both of the effectiveness of these globulins against other diseases and of their further separation to yield specific antibodies pose a challenge to chemist and oltnician alike.

The components not precipitated by the zinc salts form a Stable Plasma Protein Solution which passes through a second ion exchange column to remove the sine. This solution has been successfully injected into soldiers and civilians during and after World War II.

At the dedication ceremonies a year ago Cohn pointed out that "neither alcohol, very low temperature, drying equipment, nor radiation equipment for virus sterilization is necessary" to produce Stable Plasma Protein Solution which, he believes, "will replace serum albumin, dry plasma, and wet plasma."

Both dry plasma and scrum albumin were used in World War II in the treatment of shocks and burns, this function being the replacement and maintenance of fluids lost from the blood streams.

Thus within a matter of minutes after a donation, the removal from the blood of its unstable components and its separation into its major fractions is accomplished. Speed is essential in blood processing: deterioration starts as soon as the blood is drawn from the donor's veins.

Cohn's Administrative Polices

Clotting is only one of the primary risks in delay. However, even if gross clotting in whole blood is avoided, the chemical interactions leading up to it have begun so that it is impossible to bank human blood in the state in which it circulates in the body.

Cohn runs the Lab with octopus-like efficiency and inspires his helpers to work long hours by his own almost tireless example. He seems to exert direct control over almost all of the lab, including the design of pamphlet covers. Believing that scientific information should be released to scientists first, he refuses to give press interviews or allow members of his staff to be quoted on scientific matters.

The Wandering Botanists

Most of his helpers have great admiration for him, though some complain that he overorganizes. He does most of this work in luncheon-conferences (to save time)--which range from two and three day gatherings to his "round tables" of his Formed Elements Group. At the latter, experts in fields related to blood separation and preservation gather once or twice a month to munch sandwiches and discuss recent progress. These are tape-recorded for future reference.

The University Laboratory itself is housed in the Harvard Medical School, while its Blood Preservation Laboratory, site of development work arising from fundamental research--and where donors blood--in the Bussey Institution of Applied Biology in Jamaica Plain.

Formerly--about 1896--an applied science school for "estate managers," the latter also contains the State Wasserman Laboratory, the State Diagnostic Laboratory, and certain activities of the Botany Department. The botanists emerge in force in the summer, but they have been squessed for the most part into the greenhouse and the basement.

Cohn's Lab boasts the impressive title, "University Laboratory of Physical Chemistry Related to Medicine and public Health, Harvard University." Formerly secretaries were required to answer the phone and repeat the complete title. A new era has come, however, and if you should call Jamaica 4-0456 to offer your blood, the answering voice will say: "Blood Preservation Laboratory.