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There Shall Be Blood

Mary O’Doherty

A History of Haematology: From Herodotus to HIV, by Shaun R McCann, Oxford University Press, 246 pp, £39.99, ISBN: 978-0198717607

There are few things of more vital interest than blood. Professor Shaun McCann has brought us on “a wonderful journey” – as he terms his own career – tracing the evolution of haematology from hieroglyphics indicating cupping in ancient Egypt in 3500 BC to its present-day establishment as a relatively new specialty in medicine.

As this is an early volume in the series of Oxford Medical Histories that are written by doctors and with doctors, in particular, as their readership, this reviewer is something of an interloper, with no background in science or medicine ‑ a librarian rather, whose home is the humanities, and who has worked in the history of medicine for the last thirty years. The example of a much-loved celebrated Irish physician is apt: when a lecturer to First Med students was told that what was being written on the blackboard couldn’t possibly be read from the back of the classroom, he replied “I’m sure it’s all correct, carry on.”

In this comprehensive survey of all that led to haematology becoming a distinct specialty many diverse developments, especially in the last twenty-five years, are covered and seemingly disparate issues alluded to. Mentions of blood across the millennia are cited and the role of the microscope in the study of blood is recounted from the discovery of the lens itself through to early developments in its manufacture. Likewise the application of ever more powerful technology is covered and how automation and digitisation have changed and enhanced the work of haematologists in a shrinking global community. The key role of genetics is elucidated and it is a source of national pride to find Irish pioneers in this and other related branches of medicine. Irish surnames, many as a result of the diaspora, are notable too, as authors in the hundreds of papers referenced in this volume. Molecular medicine, the understanding of disease mechanisms and the quest for its remediation are the means and goal of those engaged with haematology. Critical too has been the endeavour to set international standards, and the role of agencies to provide safeguards for the public. Fascinating indeed is the reaction to, and the various modes of, the establishment of haematology as a specialty from country to country around the world. This unexpected aspect no doubt mirrors the ways in which branches of knowledge may or may not be accepted as distinct entities — an aspect of contentious debate throughout the world of learning. 

Underlying all the developments leading to haematology recounted by Professor McCann are the perennial issues of ethics and justice: what might not be for sale? The poor go without available treatments. In the preface Professor McCann writes that he has “always been fascinated by the phenomenon of people being ‘written out of history’”. This he rectifies where he can. War too has led to advances in the study, storage and use of blood, especially in transfusion.

Whither medicine? Professor McCann passionately emphasises that the person who is the patient must be at its heart. He is adamant that “the main tenets of medicine, for thousands of years, have been careful history taking, a complete physical examination, and then appropriate investigations”. McCann, a doctor in the humane tradition of Osler — which the profession and patient lose at their peril — states that haematologists are often mistakenly referred to as scientists, when, in fact, they are primarily doctors.

Professor McCann tells us in the preface that he has ‘thoroughly enjoyed writing this book.’ And it shows. Painstakingly researched, highly detailed, rigorously referenced and meaningfully illustrated, with an enticing cover, James Cogan’s cartoons, and separate name and subject indexes, History of Haematology: From Herodotus to HIV fulfils exacting critical criteria: it is both useful and enjoyable. Practitioners in the field of haematology and beyond have much to look forward to in this publication.

As a footnote, it is edifying to learn that “the first volunteer panel of blood donors in 1921” was set up by Percy Lane Oliver, a London librarian, whose idea ultimately led to the formation of the national Blood Transfusion Service.

Mary O’Doherty is Heritage Collections Librarian at the Royal College of Surgeons in Ireland.

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