HEMATOLOGY

also spelled Haematology, branch of medical science concerned with the nature, function, and diseases of the blood. The first step toward scientific knowledge of the composition of the blood was taken in the 17th century by a Dutch microscopist, Antonie van Leeuwenhoek, who, using a primitive, single-lens microscope, observed red corpuscles and compared their size with that of a grain of sand. In the 18th century an English physiologist, William Hewson, amplified the description of the red corpuscles, studied the lymphatic system, and demonstrated the role of fibrin in the clotting of blood. The 19th century saw the recognition of bone marrow as the site of blood-cell formation and the clinical description of pernicious anemia, leukemia, and a number of other disorders of the blood. The introduction of a method of staining blood inaugurated the morphologic phase of the science. In the first quarter of the 20th century the changes in the morphology of the blood in disease engaged the attention of most students. The century opened with the discovery of the blood groups O, A, B, and AB, which made possible the transfusion of blood from one person to another without the serious ill effects that ensue when incompatible blood is given. The study of the anemias gained impetus from the introduction of the hematocrit, a centrifuge for determining the volume of red corpuscles in the blood as compared with the volume of plasma, and the introduction, in 1932, of a simple method of measuring the volume and hemoglobin content of these cells. (Hemoglobin is the substance in the red cells that transports oxygen to the tissues.) Another era in hematology, which has been called the physiologic phase, began about 1920 with the systematic investigation of the role of food substances in the production of red blood cells. This led to discovery of the beneficial effects of liver extract in treating pernicious anemia and, ultimately, to the discovery of vitamin B12, the anti-anemic principle of liver. Parallel discoveries in nutrition, biochemistry, and the use of heavy and radioactive isotopes helped to show how hemoglobin is produced and aided in the recognition of changes that take place in disease. After World War II the field of hematology broadened. Hematological studies of sickle-cell anemia revealed that variation in a normal protein at the molecular level can be the underlying cause of a whole chain of clinical and laboratory abnormalities characterizing a disease. Simultaneous advances in techniques of protein and enzyme chemistry permitted recognition of a large number of disorders of hemoglobin synthesis the existence of which had not been suspected before. These were shown to be under genetic control. The work on heritable anemias, in particular, provided anthropologists with important genetic markers. Other research since World War II has made use of electron microscopy and advances in biochemistry to explore the role of radiation, various chemical agents, and viruses in leukemia and the lymphomas, to investigate more closely the structural changes involved in the synthesis of blood cells, and to study blood platelets and the process of coagulation.