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Spain Bleeds

The Development of Battlefield Blood Transfusion during the Civil War

Linda Palfreeman is Lecturer in Journalism at the University of Cardenal Herrera, Elche, Spain. Her research on local aspects of the Spanish Civil War and of the International Brigades’ Medical Service resulted in ¡Salud! British Volunteers in the Republican Medical Service during the Spanish Civil War, 1936–1939 (2012), followed by Aristocrats, Adventurers and Ambulances: British Medical Units in the Spanish Civil War (2013). Spain Bleeds, the final book in this informal trilogy, continues to provide long unavailable information on health care and medical assistance during wartime.

War is sometimes mistakenly construed as the chief impetus for medical innovation. Nevertheless, military conflict obliges the implementation of discoveries still at an experimental stage. Such was the case with the practice of blood transfusion during the Spanish Civil War, when massive demand for blood provoked immediate recourse to breakthroughs in transfusion medicine not yet integrated into standard medical practice.

The Spanish Civil War marked a new era in blood transfusion medicine. Frederic Duran Jordà and Carlos Elósegui Sarasoles, directors, respectively, of the blood transfusion services of the Republican Army and of the insurgent forces, were innovators in the field of indirect blood transfusion with preserved blood. Not only had they to create transfusion services, almost from scratch, capable of supplying campaigning armies with blood in wartime conditions, they also had to struggle against the medical establishment and to convince their medical peers of the value (not to mention the scientific significance) of what they were doing.

The Blood Transfusion Service of the Republic was a truly international effort, with medical volunteers from all over the world carrying out transfusion work in primitive and often dangerous conditions. All took their lead from one man – the young Catalan haematologist, Frederic Duran Jordà, the indisputable pioneer of civil war blood transfusion medicine. From humble beginnings at the outbreak of war, blood transfusion services were created in Spain that would later become crucial in the treatment of casualties during the Second World War and would shape the future evolution of blood transfusion medicine throughout the developed world.

Published in association with the Cañada Blanch Centre for Contemporary Spanish Studies
and the International Brigade Memorial Trust


Hardback ISBN: 978-1-84519-717-9
Hardback Price: £50.00 / $64.95
Release Date: June 2015
Paperback ISBN: 978-1-84519-718-6
Paperback Price: £22.50 / $34.95
Release Date: March 2016
Page Extent / Format: 200 pp. / 229 x 152
Illustrated: YES


Series Editor’s Preface by Paul Preston

Introduction: Blood on the Battlefield

Chapter 1 A brief history of blood transfusion

Chapter 2 Techniques and methods

Chapter 3 Republican Services at the outbreak of war: Frederic Duran Jordà

Chapter 4 Norman Bethune arrives in Spain

Chapter 5 Reg Saxton, British transfusionist

Chapter 6 Cadaveric blood transfusion

Chapter 7 Insurgent services at the outbreak of war: Carlos Elósegui Sarasoles

Chapter 8 A life of commitment: Dr. Duran, before and after the Spanish Civil War

Conclusion: Between death and life – The response of a people


The book presents the original technologies developed in Barcelona by Frederic Duran Jordà and their influence on Norman Bethune’s initiatives in Madrid when creating what became the Instituto Hispano-Canadiense de Transfusión de Sangre. It is a valuable description of a blood transfusion network in the republican side, integrated in the framework of the Republican Health Service. Challenging the huge demand for blood transfusions on the war front, these collaborative connections, despite conflicts and rivalry, developed an efficient system based on donor recruitment, innovative methods of preservation of the blood, and complex systems of transport to the war front.
Reviewed by Josep L. Barona, University of Valencia in European History Quarterly

From a composite review of Mark Derby, Petals and Bullets: Dorothy Morris New Zealand Nurse in the Spanish Civil War. And the trilogy by Linda Palfreeman, Salud!: British Volunteers in the Republican Medical Service During the Spanish Civil War; Aristocrats, Adventurers and Ambulances: British Medical Units in the Spanish Civil War; Spain Bleeds: The Development of Battlefield Blood Transfusion During the Civil War, published in conjunction with the Cañada Blanch Centre for Contemporary Spanish Studies, London School of Economics

These books are both well-written, and Derby is a skilled stylist. The richness of the picture of wartime life that emerges provides a trove of detail on the bureaucracy and invention that comprised the life of a relief worker in modern war. These books ought not to be read for engagement with the historiography of humanitarian relief, for this the reader might turn to others in the Cañada Blanch/Sussex Academic Press stable, such as the trilogy on Spanish relief written by Linda Palfreeman. Rather, these are documentary histories, staying close to the source material of diaries and letters, and their value rests in their contribution to the social history of relief work. Nevertheless, in exposing some of these two women’s aspirations, they demonstrate Palfreeman’s conclusions on the need to be attentive to the spectrum of relief workers’ motivations and of the dangers of too arbitrary a separation of humanitarianism from politics. Gertrude and Dorothy’s accounts show the contingencies of daily practice—Gertrude and her Quaker colleagues felt drawn to provide a canteen for soldiers, which was not quite according to FWVRC custom — and demonstrate that the Red Cross model of neutrality was one only of a range of humanitarian positions. Dorothy’s aid work, for example, was an act of political solidarity with the Republican cause, and she was contemptuous of the British government’s policy of non-intervention for upholding an unjust status quo. Had she been aware of it, she may well have castigated the impartiality of the British Red Cross Society, which made a grant to the medical services of each side of the conflict but declined to intervene. These books can also be read for the light they shed on the growing specialisation of relief work in war, and for an insight into women’s adoption of such new professional roles, fashioned both in word and deed.
Reviewed by Rebecca Gill, University of Huddersfield, in Quaker Studies

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