Blood & Money

Blood: An Epic History of Medicine and Commerce

by Douglas Starr
Knopf, 441 pp., $27.50

Human history is full of blood, and it has not only been spilled on battlefields and in dark alleys. Blood itself has had an active part in world events. In his fascinating book Blood: A History of Medicine and Commerce, Douglas Starr explains, among other things, how American expertise in blood banking helped the Allies win World War II in Europe and how controversy over a shady plasma bank in Managua, known locally as the casa de vampiros, sparked the Nicaraguan civil war in the 1970s.

Blood, the book, contains many images of squeamish fascination: about “sixteen million gallons of blood and plasma are collected annually worldwide,” Starr informs us, “the equivalent of thirty-two Olympic-size swimming pools.” Later, he describes how a doctor “sliced through the skin with a scalpel, snipping through a layer of glistening pink connective tissue and exposing the tiny vein, matchstick thin with a reddish-blue tinge.”

If these images make you queasy, you are not alone. Fear of blood is a common reaction, an ancient, evolved response to threat, and red is the universal symbol of danger. There is nothing irrational about this. We have every reason to be afraid of it. Starr’s book is the story of blood, but it is also the story of money, and the dance of death the two of them have lately been doing.

The story really begins in the seventeenth century when William Harvey discovered how circulation works, and how the heart pumps blood in one direction, from arteries through capillaries to veins and back to the heart. It would be some time before the real function of blood, to carry oxygen and other nutrients around the body and to help defend it against disease, was clearly and widely understood, and even longer before anything useful could be derived from this knowledge. This did not stop physicians from at least trying to use blood to treat a variety of afflictions, both physical and spiritual. Bloodletting, for example, is perhaps the most ancient and international medical art. Starr tells us it

originated in the ancient civilizations of Egypt and Greece, persisted through the medieval, Renaissance, and Enlightenment periods, and lasted through the second Industrial Revolution. It flourished in Arabic and Indian medicine….

Doctors bled patients for every ailment imaginable. They bled for pneumonia, fevers, and back pain; for diseases of the liver and spleen; for rheumatism; for a nonspecific ailment known as “going into a decline”; for headaches and melancholia, hypertension and apoplexy. They bled to heal bone fractures, to stop other wounds from bleeding, and simply to maintain bodily tone…. And yet there was never any evidence that bloodletting did any good.

One of the most famous American practitioners of bleeding was Benjamin Rush, a signer of the Declaration of Independence and a great, although misguided, humanitarian. It was during a yellow fever epidemic in Philadelphia in 1793 that he became convinced of how well bloodletting worked. He went from house to house with his…

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