Book Review: Blood and justice: the seventeenth-century Parisian doctor who made blood transfusion history.

Using similar image-evoking language to that of Edgar Allen Poe's Auguste Dupin adventures, Pete Moore has also created a tantalizing tale of mystique and macabre. Unlike Poe's account, however, Moore's tale is true. The plot that he reveals scene by scene is that of Jean-Baptiste Denis being called forth in 1667 to perform a blood transfusion in a human subject. Helpful to the wide audience for which this work is intended (and deserves), the author introduces a cast of over 150 characters before his opening chapter. Readers are then carried into the world of seventeenth-century Europe with sufficient detail to feel that they are present at each of the settings Moore eloquently describes. Such attention to detail is important in delineating this little known history of a significant medical discovery. Denis, a mathematician and astronomer with a passionate interest in medicine, together with the respectable surgeon Paul Emmerey, were called to the Hotel de Montmor, home of a fashionable patron of experimental science to perform a blood transfusion into Antoine Mauroy. Mauroy, a local servant widely known for suffering bouts of insanity that provoked outrageous public acts, had been restrained in a chair in the audience-filled room before Denis arrived. A local calf had been secured as the blood donor. Since blood was believed, at the time, to be “an essential component of who you are” (p. 10), it was reasonable for Denis to adopt contemporary medical thinking that purifying the blood of the ill was a pathway to cure. But instead of letting blood, as had been practised for centuries, Denis was the leading advocate in France for transfusing good, healthy blood into diseased patients. Such procedures, the mathematician noted, had an advantage over blood-letting in that the overall blood volume could be maintained. The fact that the donor was non-human was of little consequence to Denis. To establish the context surrounding medical wisdom of the period, Moore summarizes pertinent elements of Cartesian and Harveian philosophy as well as the new experimental philosophy that was being espoused by England's Royal Society and emulated by France's Academie Royale des Sciences. We gain a glimpse of the channels through which men like Denis advocated innovative experimental procedures in order to gain favour, thereby accelerating their societal rise. The rivalries so typical in histories of England and France are played out here in the claim of priority over which nation's natural philosophers had first uncovered the benefits of blood transfusion. Denis transfused some five or six ounces of the calf's blood into Mauroy through a series of quills that he had connected into one continuous pipeline. Although not the first time he had performed such a transfusion into humans, it was his first time for using this technique in attempt to cure a patient who was deemed physically well, but mentally deranged. What initially appeared as an “incredible cure” (p.154), soon took a deleterious pathway upon which, after three transfusions over a series of weeks, Mauroy died and Denis was indicted for murder. Using the documentary evidence from the trial and contemporary European medical writings, Moore sets up a debate between all of these authorities in a manner similar to Walter Cronkite's ‘You Are There’ US innovative television series of the 1950s. Although this setting is admittedly fictitious, it is believable as it is based solely upon accurate, contemporary accounts. At the conclusion of this scintillating scene, we find that Denis was acquitted, but the magistrate's decision that “no transfusion should be made upon any human body without the approval of the physicians of the Parisian Faculty [of Medicine]” (p. 205) dealt a death knell to such experimentation in the ensuing decades. Indeed, the need to gain consensus from such a divisive professional body prohibited further attempts at transfusion for 150 years. Some readers may be bothered by Moore's readiness to skip forward within his chapters, filling the readers with more up-to-date information of the subsequent findings about blood and transfusion. Indeed, it was a bit disconcerting to jump into twentieth-century blood typing and incompatible transfusion knowledge in the midst of his chapter on ‘Denis' route to the top’. Perhaps such information should have been relegated to an epilogue or added to the otherwise helpful timeline of seventeenth-century blood transfusion at the close of the book. Doing this towards the final pages would reinforce the timeliness of a history of blood transfusion. It would also have allowed the author to include references leading curious readers to more thorough histories of the importance of blood and modifications of blood transfusion over time. An index would also have been of immense help. Upon reflection, I am left craving more medical and scientific history to be delivered in such a lively manner. Perhaps BBC television should be thinking how best to feature Moore's important historical writing before an even wider audience, one that it clearly deserves.