Blood Trials: Transfusions, Injections, and Experiments in Africa, 1890–1920: Table 1

Abstract

From about 1880 to 1920, a culture of medical experimentation promoted blood transfusion as a therapy for severe anemia in Europe, which was applied in German East Africa in 1892 for a case of blackwater fever, a complication of malaria afflicting mainly Europeans. This first case of blood transfusion in Africa, in which an African's blood was transfused into a German official, complicates the dominant narrative that blood transfusions in Africa came only after World War I. Medical researchers moreover experimented with blood serum therapies on human and animal subjects in Europe and Africa, injecting blood of different species, "races" and ethnicities into others to demonstrate parasite transmissibility and to discover vaccines for diseases such as malaria, sleeping sickness, and yellow fever. While research in German colonies is highlighted here, this was a transnational medical culture that crossed borders and oceans. This research is of interest as a possible early pathway for the epidemic spread of HIV and other zoonoses in Africa and the world, which biomedical researchers have identified as emerging in West-Central Africa sometime around the turn of the twentieth century.

Cerebral Malaria: Clinicians, Extracellular Vesicles, and Therapeutically-Rational Exchange (T-REX)

“…In 1892, in sub-Saharan Africa (SSA), a military physician (Emil Steudel) successfully rescued a white European scientist with life-threatening CM and blackwater fever by deciding to transfuse the blood of a Black donor who had lived and worked in, and off the coast of, malaria-endemic East Africa [54]. A review of the context suggests Dr. Steudel felt this inter-racial transfusion was prudent because he suspected the blood from a Black African would be therapeutically superior to the blood from the patient's white colleagues.…”

“…[4] Interestingly, thoughtful, prudent donor RBC selection is consistent with the inter-racial blood transfusion used in 1892 in SSA to rescue a CM patient. [54]. That is, clinicians have been stressing the concept "for cell therapies, the cells matter."…”

Therapeutically‐rational exchange (T‐REX) of Gerbich‐negative red blood cells can be evaluated in Papua New Guinea as “a rescue adjunct” for patients with Plasmodium falciparum malaria

“…Simple transfusion has been used adjunctively to treat malaria patients since 1892. 20 Since 1974, conventional exchange transfusion has been used to rescue severely ill Pf-malaria patients. 21 Now, to optimize exchange-formalaria, we have recommended that T-REX be evaluated.…”

“…16 Of course, even simple transfusion can successfully rescue some Pf-malaria patients, as noted since 1892. 20 Regarding exchange transfusion, although journals often insist authors submit only new and unique findings, for 40 years, clinicians-presumably feeling compelled-have repeatedly published remarkably similar case reports describing how exchange transfusions dramatically rescued their near-death Pf-malaria patients. [21][22][23][24][25][26][27][28][29][30] Unfortunately, "standard issue" transfusions do not always rescue Pf-infected patients.…”

“…In addition to explaining how sequestration of Pf ‐infected RBCs within the microvasculature of the brain and “hemostatic dysfunction” seem linked to CM, O'Sullivan et al noted “development of adjunctive therapies that can attenuate CM progression clearly represents a major unmet need” 16 . Of course, even simple transfusion can successfully rescue some Pf ‐malaria patients, as noted since 1892 20 . Regarding exchange transfusion, although journals often insist authors submit only new and unique findings, for 40 years, clinicians—presumably feeling compelled—have repeatedly published remarkably similar case reports describing how exchange transfusions dramatically rescued their near‐death Pf ‐malaria patients.…”