In 1881, doctor William Halsted rushed to help his sister Minnie, who was hemorrhaging after childbirth. He quickly inserted a needle into his arm, withdrew his own blood, and transferred it to her. After a few uncertain minutes, she began to recover.
1881 年, 威廉·哈斯泰德醫生趕著 要去幫助他的妹妹米妮, 她生完孩子之後大量出血。 他很快地將一根針插入他的手臂, 將他自己的血液抽出來輸送給她。 經過充滿不確定性的 幾分鐘之後,她開始恢復。
Halsted didn’t know how lucky they’d gotten. His transfusion only worked because he and his sister happened to have the same blood type— something that isn’t guaranteed, even among close relatives.
哈斯泰德並不知道他們有多幸運。 他的輸血能夠成功, 只因為他和他妹妹 剛好血型相同—— 即便是很親的親人, 也無法保證血型一定會相同。
Blood types hadn’t been discovered by Halsted’s time, though people had been experimenting with transfusions for centuries— mostly unsuccessfully. In 1667, a French physician named Jean-Baptiste Denis became the first to try the technique on a human. Denis transfused sheep’s blood into Antoine Mauroy, a man likely suffering from psychosis, in the hopes that it would reduce his symptoms. Afterward, Mauroy was in good spirits. But after a second transfusion, he developed a fever, severe pain in his lower back, intense burning in his arm, and he urinated a thick, black liquid.
在哈斯泰德的時代, 還沒有發現血型, 不過數世紀來 人類一直在試驗輸血—— 大部分都沒成功。 1667 年,法國醫生尚巴蒂斯特·迪尼 是第一在人類身上 測試輸血技術的人。 迪尼把羊血輸給安東·苗瓦, 可能得了精神病的病人, 希望輸血能減輕他的症狀。 之後,苗瓦的精神很好。 但在第二次輸血之後, 他開始發燒, 他的下背劇烈疼痛, 手臂有嚴重的灼燒感, 還尿出了黑色的濃稠液體。
Though nobody knew it at the time, these were the signs of a dangerous immune response unfolding inside his body. This immune response starts with the production of proteins called antibodies, which distinguish the body’s own cells from intruders. They do so by recognizing the foreign proteins, or antigens, embedded in an intruder’s cell membrane. Antibodies latch onto the antigens, signaling other immune cells to attack and destroy the foreign cells.
當時沒有人知道, 但這些都是徵兆,表示他體內 開始出現了很危險的免疫反應的。 這種免疫反應一開始會產生 一種蛋白質,稱為抗體, 抗體能將身體本身的細胞 和入侵細胞區別開來。 它們的做法是從 入侵細胞的細胞膜中 辨視出外來的蛋白質或抗原。 抗體會抓住抗原, 通知其他免疫細胞 去攻擊並摧毀外來細胞。
The destroyed cells are flushed from the body in urine. In extreme cases, the massive break down of cells causes clots in the bloodstream that disrupt the flow of blood to vital organs, overload the kidneys, and cause organ failure. Fortunately, Denis’s patient survived the transfusion. But, after other cross-species transfusions proved fatal, the procedure was outlawed across Europe, falling out of favor for several centuries.
被摧毀的細胞會 透過尿液被沖出身體。 在極端的案例中,細胞大量崩解 會造成血流栓塞, 阻斷送往重要器官的血液, 導致腎臟負荷過重, 因而造成器官衰竭。 幸運的是,迪尼的病人 撐過了這次輸血。 但,證明跨物種輸血會致命之後, 這種療法在歐洲各地被法律禁止, 失寵了數個世紀。
It wasn’t until 1901 that Austrian physician Karl Landsteiner discovered blood types, the crucial step in the success of human to human blood transfusions. He noticed that when different types were mixed together, they formed clots. This happens when antibodies latch on to cells with foreign antigens, causing blood cells to clump together. But if the donor cells are the same blood type as the recipient’s cells, the donor cells won’t be flagged for destruction, and won’t form clumps.
直到 1901 年,奧地利醫生 卡爾·蘭德施泰納發現了血型。 這是人對人輸血 能夠成功的關鍵步驟。 他注意到當不同的血型 混合在一起時就會形成凝塊。 當抗體抓住有外來抗原的細胞時 就會發生這個現象, 造成血細胞凝結成塊。 但,如果捐血者的血型 和接收者相同, 捐血者的細胞不會被標記為 摧毀目標,因此不會形成凝塊。
By 1907, doctors were mixing together small amounts of blood before transfusing it. If there were no clumps, the types were a match. This enabled them to save thousands of lives, laying the foundation for modern transfusions.
到了 1907 年, 醫生會在輸血之前 先將少量的血液混合。 如果沒有凝塊,血型就相符。 這讓他們得以拯救數千條人命, 為現代輸血奠定基礎。
Up to this point, all transfusions had occurred in real time, directly between two individuals. That’s because blood begins to clot almost immediately after coming into contact with air— a defense mechanism to prevent excessive blood loss after injury.
一直到這個時點, 所有的輸血都要即時進行, 直接由一個人輸給另一個人。 那是因為只要血液一接觸到空氣, 幾乎馬上就會凝結—— 這是一種防禦機制, 預防受傷時大量失血。
In 1914, researchers discovered that the chemical sodium citrate stopped blood coagulating by removing the calcium necessary for clot formation. Citrated blood could be stored for later use— the first step in making large scale blood transfusions possible. In 1916, a pair of American scientists found an even more effective anticoagulant called heparin, which works by deactivating enzymes that enable clotting. We still use heparin today.
1914 年,研究者發現 化學物質檸檬酸鈉 能夠將形式凝塊所需要的鈣 除去,阻止血液凝結。 加入檸檬酸的血液可以 儲存起來,後續再使用—— 這是讓大規模輸血 成為可能的第一步。 1916 年,兩位美國科學家 發現了更有效的抗凝血劑, 叫做肝磷脂,它能夠將 促成凝結的酵素去活性化。 現今我們都還在用肝磷脂。
At the same time, American and British researchers developed portable machines that could transport donor blood onto the battlefields of World War I. Combined with the newly-discovered heparin, medics safely stored and preserved liters of blood, wheeling it directly onto the battlefield to transfuse wounded soldiers.
同時, 美國和英國的研究者 開發出了攜帶式的器材, 能夠將捐血者的血液運送到 第一次世界大戰的戰場上。 結合新發現的肝磷脂, 軍醫便能夠安全地儲存 和保存數公升的血液, 用車運送到戰場上, 輸血給受傷的士兵。
After the war, this crude portable box would become the inspiration for the modern-day blood bank, a fixture of hospitals around the world.
戰後,這種簡陋的可攜式盒子 變成了靈感來源, 後來才會出現全世界醫院 必備的現代血庫。