Autohemotherapy Saved My Brother

In 1940, my older brother, Albert, was born prematurely, with a severe case of ichthyosis (skin with scales like fish.)

Due to Albert’s prematurity, at birth his entire body fit in the palm of my father’s hand. Albert had no suckling reflex, and so the pediatrician said there was nothing that could be done to save him. The newborn was doomed.

Based on the above information, I would place the baby’s fetal development at roughly 2/3rds of the way through the second trimester, perhaps at 22 weeks, close to a pound in weight and at most eight inches from the top of his head to his rump. He would have been below the now standard 24 week “age of survivability.” Survival at that stage of prematurity was unlikely.

Dr. Albert S.J. Clarke, an orthopedic surgeon, was my Dad. The infant at risk was Dad’s first child, named after him (Albert Sidney Johnston Clarke III.) Being a physician, Dad was not going to give up on his son without a fight.

Due to Albert’s small size, and the condition of his skin, they were unable to start an I.V., which is the standard of care in today’s medical world. So, as my Mother explained it, as a last resort, Dad withdrew his own blood and injected it into the gluteal muscles of the baby. That blood carried nutrition and sustenance to Albert; e.g., water, minerals, protein, sugar.

That was not as crazy as it seems, since Autohemotherapy was used in the early 20th century to treat dermatological cases, starting in 1913. The following abstract is an example of a 1928 article after the method gained some medical acceptance.

Quoting from the abstract, “Autohemotherapy, first used in dermatologic conditions by Ravaut (1913), closely followed by Spiethoff (1913), consists in the withdrawal of blood … and its injection into the patient’s gluteal muscles, preferably.”

By the 1940’s, Dr. Clarke was no doubt aware of the questionable therapeutic efficacy of the old method, but as a means of delivering fluid and nutrition to an infant otherwise shut-off from the world, there was nothing to lose. Their blood types matched, so in theory, a blood injection would not hurt.

Although the Rh factor was just discovered that year (1940), Albert’s odds of survival were likely assured by the fact that most people are Rh positive.

At the beginning of the 20^th century, there was virtually no standard of care for premature infants. Julius H. Hess (1876–1955) published the first book on the subject of medical care for the premature infant in 1922.

In that book, Hess described tube feeding, or gavage, as in the illustration below. However, in the following years, infants often died from aspiration pneumonia induced by early feeding after birth, and early-applied gavage fell out of favor.

A year after my father successfully salvaged my brother, Hess amended his guidance in his 1941 text, writing “Small premature babies (those weighing under 1200 g) were not fed for 24–48 h …. During this time the premature baby receives physiologic salt solution, subcutaneously in the thighs, one to three times daily.”

Obviously, physiological saline solution avoids the risk of incompatible blood reactions, but in the case of that baby and his father-physician, God had blessed them with fully compatible blood types.

I don’t know if Hess had been made aware of my Dad’s lifesaving treatment conducted a year before Hess made his latest recommendation, but that is certainly possible.

I never discussed with Dad the details of his saving intervention, but from what I’ve read about babies with ichthyosis, my brother’s survival and thriving until age 73 is a bit of a miracle. His pediatricians gave him zero chance of surviving his first days. They didn’t know just how determined my Father could be.

Due to my brother’s genetic skin disease, he shed skin in large flakes; his bed sheets were always covered in them. He had to be lathered in Vaseline to keep his brittle skin from cracking too deeply, and bleeding. He also had very poor tolerance to heat because he had few if any functioning sweat glands.

In spite of his disability, Albert was one of the nation’s first Respiratory Therapists. He trained other Respiratory Therapists in west coast colleges, and ran several Respiratory Therapy Departments in hospitals across the country.

With unlimited medical research libraries at his disposal, he discovered on his own that a drug used for treating psoriasis helped him control his own skin condition. As a result, his quality of life in his last decades greatly improved. He fulfilled a dream of remarrying, all made possible by a determined physician willing to take a chance when the “experts” had given up hope.

Dr. A.S.J. Clarke, M.D. in his later years.

Today, thanks to advances in the medical management of premature infants, autohemotherapy is medically unnecessary. In fact, many doubters question its efficacy. However, I have the physical scars from growing up with a rambunctious big brother to prove that, in at least one case, it was a lifesaver.