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Karl Landsteiner: Blood on His Mind
Richard Bauman
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Karl Landsteiner, who won the Nobel Prize in 1930, saw himself
as simply a scientist doing what he liked best--investigating
blood and the human body.
Click image to enlarge.
For more than forty years, Karl Landsteiner had blood on his mind. Not with evil or criminal intent, but with scientific curiosity. He studied blood, broke it down into its component parts, learned about it and how it worked in the human body. In doing so, he changed the medical profession's fundamental understanding of blood and its life-giving, life-sustaining role. The worth of his research reached beyond medicine. It influenced criminal investigations, helped solve crimes and even settle domestic disputes. He learned that polio was caused by a virus, and believed a vaccine could be developed to prevent it nearly fifty years before the first polio vaccine was actually created.
Blood transfusions are a commonplace and generally safe medical procedure today. Barring hidden diseases in the donor's blood or some mistake during the process, there's minimal risk in receiving another person's blood. In the late 1800s and early 1900s, however, transfusions were hardly routine procedures. They were fraught with danger and could take the life they were intended to save. Basically, they were a "last resort" option.
That changed when Landsteiner, an Austrian immunologist, started studying blood. Through his exhaustive research in the late nineteenth century, he discovered three of the four basic blood types, and then urged other doctors to use transfusions to save lives.
Karl was born in June 1868 in Vienna, Austria. His father, Leopold, was a well-known journalist and expert on law, but he died when Karl was just six years old. Karl's mother, Fanny Hess Landsteiner, saw to it that he received a strong education. Karl was a brilliant student and when he was just seventeen years old he was accepted at the University of Vienna to study medicine. Six years later he received his degree in medicine.
Modern medicine was in its infancy at the time. Louis Pasteur, in France, had discovered the principles of vaccines just sixteen years before, and in 1885 he had used his treatment for rabies in a human being for the first time. Landsteiner saw the future of medicine lay in greater knowledge of the human body through scientific research. He became a medical research scientist rather than a practicing physician.
To strengthen his knowledge of medicine and research techniques, he spent five years in Zurich and Munich studying organic chemistry and scientific techniques. Then he returned to the University of Vienna as an assistant to Max von Gruber in the department of hygiene. There he became fascinated with the nature of blood and antibodies.
The prevailing medical thinking in late 1800s and early 1900s concerning blood was that every person's blood was the same--yet somehow different, too. Doctors at that time knew blood transfusions were possible, but fraught with danger. A transfusion could take the life of the person it was meant to save. Sometimes they were successful, but sometimes when recipient and donor bloods mingled, rather than flowing together the blood cells agglutinated or "clumped." The "clumping" typically caused shock and jaundice and was usually fatal.
If all blood is the same, and the blood transfusion procedure is performed properly, Landsteiner reasoned, then there should be no complications. While most medical professionals thought the clumping had to do with blood pathology, Landsteiner thought differently. He hypothesized differences in blood makeup existed from person to person, which would explain why transfusions often failed.
Landsteiner's notion of different blood characteristics became the starting point for his research and ultimate discoveries. His preliminary experiments were simple enough. He took blood samples from several dozen patients in the Vienna University Hospital. In his laboratory separated red corpuscles from the basic blood serum of each sample. He then spent hundreds of hours cross testing samples of red blood cells the samples of blood serum.
He discovered that in some instances red cells from one person's blood would "clump" in some of the serum samples, but in other samples there was no adverse reaction when blood serum and red cells came together. He spent months hunched over a microscope, eyes straining, muscles aching to determine what caused the clumping and deciphering the complex structure of blood. It took an entire year of exhaustive testing and cross testing before he confidently announced his discovery of different human blood types.
Landsteiner had discovered that red blood cells typically had one of two distinct molecules on their surface. He called one type of molecule "A" and the other molecule "B." In some blood samples neither "A" nor "B" molecules were present. Such blood was classified as "O." (Two of his colleagues, a year later, identified a fourth blood type, "AB.") He also learned that all of the red cells in a person's blood are the same type. Thus, through simple microscopic examination of a few drops of a patient's blood, and knowing what to look for, it became possible to determine a person's blood type.
He also discovered why certain blood types could mix without harming the patient, but others could not. When incompatible blood types mingle, the recipient's blood releases antibodies to fight off the "invaders" and clumping of cells is the result.
Even though his experiments were duplicated and verified by other scientists between 1901 and 1903, the medical profession was slow to accept the information, and even slower in using it to benefit patients. Dr. Reuben Ottenberg, at New York's Mt. Sinai Hospital, performed the first modern blood transfusion using blood type testing--in 1907--four years after Landsteiner's discovery was made public. And between 1907 and 1913, less than fifty transfusions took place each year in New York hospitals. By 1915, however, Landsteiner's findings were gaining acceptance--barely in time for the start of World War I, where battlefield transfusions took place on a large scale thanks to his research.
The discovery of blood types saved lives in hospitals and on battlefields, and it also helped catch criminals. He and Max Richter discovered a way to determine blood type in dried blood samples, such as those found at a crime scene, or on the clothes of suspects. His work gave police another tool to help solve crimes.
When the Great War ended in 1918, much of Europe was in political and economical chaos. Landsteiner moved to The Hague, in Switzerland where he took a job doing routine lab tests at a small hospital. While the job was routine and he was over-qualified for it, it gave him a place to continue his research in his spare time. As a result, he made preliminary discoveries about the relationship between blood, antibodies and allergies.
Because so much of his time was spent doing research he had little social contact other than with his research colleagues. In 1916, however, he met the love of his life, Leopoldine Helene Wlasto. He was forty-eight years old when they married, and in April 1917, the couple's only child, Ernst Karl Landsteiner was born.
In 1922 Karl, Leopoldine and Ernst moved to the United States, when he accepted a research position at the Rockefeller Institute for Medical Research in New York. His work in the United States, as it had in Europe, focused on blood. He made further discoveries about human immunity and allergies, and blood's influence on them. By 1927, he and Dr. Philip Levine had discovered additional blood groups: "M," "N," and "P," resulting in even better testing and control of blood used for transfusions. Those blood groupings also helped settle more than a few lawsuits since they were often the deciding evidence used in paternity suits.
In 1930, Landsteiner won the Nobel Prize ($48,000) for Medicine and Physiology for his discovery of blood types in the early 1900s. It might seem that an inordinate amount of time passed between his discovery and receiving the prize, but it actually wasn't uncommon. Alexander Fleming, for instance, discovered penicillin in 1927, but didn't receive the Nobel Prize until 1945. In both cases it took scientists and doctors decades to totally appreciate the huge benefits of Fleming and Landsteiner's discoveries.
After winning the Nobel Prize, Landsteiner continued researching human blood. He and other scientists puzzled over why dangerous and sometimes fatal reactions occur in a small percentage of persons receiving transfusions. Although donor and recipient blood types had been carefully matched, the recipient's blood would fight against the new blood as if it were diseased.
Reviewing the medical histories of patients who had this extraordinary reaction, Landsteiner and co-researcher, Dr. Alexander Wiener, made an intriguing discovery. All of the victims they studied had either previously had a successful transfusion, or they were women who were pregnant or who had been pregnant at sometime during their lives. This led directly to Wiener and Landsteiner discovering the Rh factor in human blood.
About eighty-five percent of the human population has the Rh factor in their blood. Such persons are termed Rh positive. The rest of the population doesn't have Rh factor and are deemed Rh negative.
Landsteiner and Wiener learned that if persons with Rh-negative blood receive more than one transfusion of Rh-positive blood, their blood develops anti-factors, similar to those found in the blood of a person who has had a disease such as mumps or chickenpox. By identifying the Rh factor and proving its effect on Rh-negative persons, transfusion protocols were changed so Rh-negative persons no longer received Rh-positive blood.
They discovered, too, the Rh factor was responsible for infant disease erythrublastosis fetalis. It occurs when the mother and the fetus have incompatible blood types and as a result the mother's anti-bodies injure the fetus.
Incidentally, Landsteiner and Wiener called it the "Rh" factor because it was first discovered in the blood of a Rhesus monkey.
Though Landsteiner's research centered on human blood, he didn't confine himself to just that area. In 1905, for example, he researched the venereal disease, syphilis. He and fellow scientist Viktor Mucha developed the technique of dark-field miscroscopy. They used it to study and identify the organisms that caused syphilis.
Doing research on polio in 1908, he learned a virus, not bacteria, caused it. He predicted a vaccine could be found for it, but it would be difficult to produce. He was right: Nearly fifty years passed before Jonas Salk produced the first effective polio vaccine.
Landsteiner became a U.S. citizen in 1929. Ten years later he officially retired at age seventy-one. His retirement was in name only--he kept right on working. On June 24, 1943 he was in his laboratory at the Rockefeller Institute, when he suffered a massive heart attack. He died two days later.
Even before winning the Nobel Prize, Landsteiner had disliked publicity, and disliked being called the world's foremost authority on the mechanics of immunity. He saw himself as simply a scientist doing what he liked best--investigating blood and the human body. He seldom gave interviews to reporters, and rarely made speeches even though he was constantly being asked to do so.
He was extraordinarily protective of his privacy and his family, not only in America but relatives in Europe, too. He feared the Nazis would win the war and conquer the world. His fear might have been well grounded. He was born Jewish, though he and his mother converted to Catholicism when he was a youth. Nonetheless, he desperately tried to hide his Jewish heritage, even going to the extreme of trying to prevent it being made public. Interestingly, his death in 1943 wasn't published in Germany or Austria until 1947--two years after the defeat of Nazism.
Many researchers and scientists never have the opportunity to see the result of their life's work. Landsteiner did. Many researchers and scientists labor for years without making a single significant discovery. Landsteiner made dozens of discoveries. Many researchers and scientists want their names to be readily recognized--he didn't--and consequently his name isn't as well known as that of Fleming, Sabin or Salk. Nonetheless, his contributions to human wellness are every bit as meaningful--some might argue even more so.
Richard Bauman is a freelance writer from West Covina,
California. He is the author of Awe-Full Moments:
Spirituality in the Commonplace (iUniverse, 2000).
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