Flesh and Blood: Organ Transplantation and Blood Transfusion in Twentieth-Century America (review)

In her latest work, Flesh and Blood, medical historian Susan E. Lederer offers detailed accounts of the transfer of body parts and fluids, particularly in the United States. This is an astonishing accomplishment, given that Lederer packs an extraordinary amount of historical data into a volume that is scarcely over two hundred pages long. The work is simultaneously informative and lucid, and interested scholars will inevitably earmark nearly every page. The book is arranged into eight compact chapters addressing such topics as skin grafts (ch. 1), blood transfusion (ch. 2, 4 –7), forms of body “banking” (ch. 3), racialized blood typing (ch. 4 –6), and religious perceptions on the transfer of blood and organs (ch. 7,8). Lederer regularly challenges assumptions that the medical transfer of flesh and blood between bodies is new, or that such efforts are confined primarily to the twentieth century. She also regularly questions assertions that novel medical interventions generate apprehension and disgust, culling medical and legal texts and the mass media (namely newspapers, feature films, and fiction) to expose a lively public interest in and an enthusiasm for practices spanning several centuries. Flesh and Blood is marked by good humor, too.

Lederer’s concern is the “surgical imaginary” (pp. ix, 212), and she begins her first chapter by referencing H. G. Wells’s 1896 novel, The Island of Doctor Moreau, about a surgeon exiled from London who performs radical human–animal experiments on a South Sea island. Wells’s macabre tale facilitates Lederer’s exploration of other weird experiments within the history of medical practice. Early forms of skin grafting were clearly informed by agricultural practices, as donor and patient were temporarily sewn together until the graft took (as is exemplified in a range of illustrations). Dogs were sewn to children, and pigs and even frogs were attached to adult patients. In other quarters, coworkers, friends, and, to a lesser extent, kin, lined up to donate small patches of skin to those injured in industrial accidents. Early blood transfusions similarly required the temporary suturing together of bodies. These forms of “surgical wizardry” (p. 25) inevitably required pronounced forms of intimacy, as marked not only by the particular categories of people who offered parts of themselves to others but by the intimate proximity that these modes of healing required. Public zeal for these procedures was widespread during the early decades of the twentieth century, as is illustrated by the hundreds of stories to emerge in the popular press (p. 52).

This theme of intimacy provides a powerful unifying theme for the majority of the chapters. Whereas the first three expose an optimistic, public passion for skin and blood transfers, chapters 4 –6 focus on institutional interests and responses as framed by blood collection, banking, and redistribution. As Lederer asserts, increasingly sophisticated understandings of blood typing and donor–recipient compatibility were guided by racialized understandings of difference, contamination, and danger. A particularly striking example involves the efforts of the American Red Cross during World War II. When Americans participated in the “Blood for Britain” campaign, the racial origins of blood products were irrelevant; once the United States entered the war, however, blood donated by blacks and whites was segregated (as were troops). Anxieties over blood purity persisted in the postwar era, when blood banks, hospitals, and medical schools (hardly confined to the South) regularly labeled blood’s origins. Lederer argues that associations of syphilis with American blacks informed such “Jim Crow blood policies” (pp. 117, 133), and as new categories of blood typing emerged (such as the Rh factor) they, too, were incorporated into the racialized schema.

In chapter 6, Lederer addresses the (somewhat underdeveloped) theme of “medicalizing miscegenation,” involving the transfer of organs (from testicles to hearts) across racial and species barriers. Still other racialized anxieties emerge here. Lederer then returns to the theme of blood in chapter 7, where she explores a range of religious...