Blood has long played a central part in our mythologies and religions, from the Last Supper to tales of blood-sucking vampires. Sharing or swapping blood retains a strong symbolic significance, from little boys making themselves blood brothers by mingling blood from scratches, to Angelina "Lara Croft" Jolie and her husband Billy Bob Thornton wearing vials of each other's blood as jewellery. Strange then to realise that in European medicine, blood transfusion has a very recent history.
It is only 100 years since Karl Landsteiner identified the blood group system. His work opened the way to safer transfusion and many of the medical practices we take for granted today. Landsteiner discovered how antigens and antibodies present in the different groups can cause death if donor and recipient are incompatible. Before his research, transfusions were a hit-and-miss affair. The first experiments involved animals, but in 1667 an audience of British scientists watched a volunteer have a quantity of sheep's blood injected into his veins. He survived, but apparently went slightly mad.
The "humours" played a large part in 17th-century medical theory. Blood was credited with carrying the emotions around the body, so people who were mild and timid were transfused with blood from a strong, aggressive animal, such as a bull, while their more bellicose counterparts were given lamb's blood to calm them down. Such thinking was still current in the 19th century, when women who suffered haemorrhages in childbirth received transfusions of their husband's blood. The theory was that if they were emotionally compatible, so should their blood be.
However, it was a big step from Landsteiner's discovery to blood transfusions becoming standard medical practice. Demand grew in the First World War, especially after a means was found to stop blood clotting, allowing blood to be stored for two weeks. But when the war ended, demand fell. There were only four "panels" of volunteer donors in the country, all in London, and the majority of transfusions were person to person, a tube connecting donor and recipient.
The system of donation only survived through the determination and ingenuity of volunteers. They raised money to keep them going, in one instance by persuading local cinema owners to introduce a Sunday tax that went directly to the service. The Blitz pushed the service forward, with panels set up nationwide to cope with the many civilian casualties. After the war, a national blood collection and processing service was created alongside the new National Health Service.
Blood features in the biology curriculum from key stage 3 onwards. In the days before Aids, there was nothing lower school biology students enjoyed more than pricking their fingers to explore the mysteries of their blood. Studying a smear of red on a slide through the microscope and finding out their blood groups was a lesson all remembered. Now, school labs are blood-free environments, and the drama of those lessons is past. Students are familiar with, and fascinated by, blood in its violent guise from their favourite films, but it is much harder for teachers to interest them in the scientific aspects.
Nick Attoe, biology teacher at Aylward School in north London, takes GCSE students to the Wellcome Galleries at the Science Museum in London. The numerous exhibits and dioramas inform and "appeal to those with a gory sense of humour". Although some schools still do whole-animal dissection, most students count themselves lucky if they get to dissect a sheep's heart. This is partly due to pressure on teachers' time covering the national curriculum yet, as Nick Attoe says, "younger students get a lot of enjoyment out of the idea of getting hands-on experience. By Year 12 they're very interested in looking at how it works". This is where the blood services can help.
Throughout the UK they are keen to recruit new donors and come into schools to give talks. They are happy to respond to teachers' needs, so talks can be geared to a particular aspect of study. Moira Carter of the Scottish National Blood Service finds that students across key stages are interested. "We can talk to children of any age," she says, "but you have to watch out for the teenagers. They're the ones who faint." Students may handle empty blood bags and learn about the donation service from start to finish. SNBS also holds teachers' summer schools at a fractionation plant. Fractionation has been identified as an area students find hard at AS-level.
An NBS video, Blood Simple, covers donation to transfusion, but in England students aged 16-plus can also visit blood-processing centres. The sights and machinery supply a memorable experience. They will see how the blood is separated into its component parts, starting in the centrifuge system room, while something that looks like a vending machine with rocking shelves extracts platelets to be given to cancer patients whose own have been destroyed by chemotherapy. Microbiologists test the samples for diseases, and robotic machines test for further blood groups.
It is a working laboratory, part-factory, part-warehouse, that can open students' eyes to careers in applied science. Of course the pay-off for the blood services is increased awareness about the need for donations. With medical advances more blood is needed. Around 20 per cent of us will need a blood transfusion during our lives. We take it for granted the blood will be available, yet only 6 per cent of the population donate.
MORE INFORMATION Contacts for details of talks, visits and summer schools: Mid, south and west Wales: Trudi Evans, donor recruitment officer, tel: 01443 622088.
Northern Ireland: Stella Madden, campaigns officer, schools and universities, tel: 028 9053 4662.
Scotland: Moira Carter, national donor services manager, tel: 0131 536 5401.
England: contact your nearest National Blood Service Centre - telephone numbers are on the national website www.blood.co.uk Information online: www.blood.co.uk is the most student-friendly with interactive quizzes, and facts from Nick Arnold's 'Horrible Science' books, all gorily illustrated, as well as information aimed at older surfers.
www.scotblood.co.uk is aimed at donors www.snbts.org.uk has more scientific information including bone and tissue transplants, and research.
www.welsh-blood.org.uk has a step-by-step guide to a donor session, human-interest stories and FAQs.
www.n-i.nhs.ukniblood has online donor registration, human-interest stories and information about the work of the service.