Douglas Surgenor has had a long and intimate connection with both Edwin Cohn and protein chemistry. His career advanced from a summer spent in Cohn's laboratory to a post under him in the Department of Physical Chemistry at Harvard Medical School, where he stayed until Cohn's death eight years later. He has been dean of Buffalo Medical School, president of the Center for Blood Research in Boston, and a regional director of the American Red Cross Blood Services. His project on Cohn began from a chance discovery: sitting in a seldom-used office at the Center for Blood Research, he realized that he was surrounded by a trove, as he calls it, of books and archival materials dating from Cohn's first paper of 1916 to his last, unfinished galley proofs of 1953. Surgenor knows everything about protein separation, blood fractions, and Edwin Cohn. His book resembles the kind of literary biography we have of the poets: it is a modern example of that nineteenth-century genre, the life and letters of a famous figure, in which a reading of the poems is linked to the life.
There are two intertwined books here. One is a detailed account of the [End Page 511] evolution of protein separation from a highly theoretical abstract program, understood by a small, elite group of physical chemists, to an industrial process involving pilot projects, patents, and large-scale production for military purposes in World War II. Cohn's fifty years in the protein field took it from the salting-out methods used since the nineteenth century to his own alcohol fractionation process controlled by the new Swedish machines, the Svedberg ultracentrifuge and the Tiselius electrophoresis apparatus. The combination of these sensitive methods enabled him and his group to isolate well-defined fractions containing a series of blood components, most notably in the preparation of purified albumin for use as a blood substitute on the battlefields of World War II.
The other book is an account of an extraordinarily powerful figure, a colossus who dominated not only the field of protein chemistry but also everyone with whom he came in contact—his family, his dinner parties, his colleagues, his presidents and deans, and the members of the committees on which he sat. Surgenor describes his expensive English tailoring, his walk, his formidable culture, and his position as an upper-class Bostonian: a reader can detect that the author, now elderly and distinguished, still feels something like fear of this figure who controlled his world. Interestingly, Cohn did not wish to be known as a Jew, and, like his contemporary Karl Landsteiner, he did not tell his sons that the family was Jewish. Perhaps Jewishness seemed to suggest victimhood rather than power to this powerful individual.
These themes come together in Surgenor's account of the American wartime blood program. Walter B. Cannon, a physiologist with experience of wound shock on World War I battlefields, had suggested to the National Research Council that since loss of blood volume was the most important problem, dried, reconstituted plasma might be used as a blood substitute. The idea was taken up by the army medical directorate. It was felt that plasma was easy to store and to transport, and did not require the special organization and storage of whole blood. A further suggestion came from the surgeon Owen Wangensteen: a substitute for human material might be found in bovine plasma, easily obtained from slaughterhouses. Cannon turned to Cohn, and Cohn developed a method of controlled fractionation of bovine blood, isolating and purifying the albumin in the expectation that it might prove to be immunologically inert in the human being; it was argued that human and bovine albumin were physicochemically almost indistinguishable. The bovine albumin project became Cohn's top commitment, and production was started through Armour Laboratories. At the same time, Cohn began a pilot project on human albumin.
The British army had already organized a supply of whole blood for transfusion in the field: beginning before the outbreak of war, they had set up a separate transfusion service under General Lionel E. H. Whitby. The Canadian army too had trained its medical officers and technicians in blood transfusion. The American forces, however, focused on blood substitutes and, under Cohn's steering of the Subcommittee on Blood Substitutes, went forward with the production of plasma fractions of both bovine and human blood. Other substitutes, such as gelatin and pectin, were also proposed. Although the field commanders repeatedly [End Page 512] requested whole blood, the army directorate was determined to stay with blood substitutes. Cohn, at the Harvard Plasma Fractionation Laboratory's pilot plant, was responsible for their development and production. Surgenor recounts that the strain told on him in many ways, and he became increasingly tense, impatient, and peremptory. Was the peculiar American insistence on plasma fractions at the expense of whole blood the result of Cohn's overmastering control of the field? Surgenor brings up the thought only to dismiss it. Yet he does bring it up.
Cohn's elite research had been successfully harnessed to the war effort; his fractionation program had produced several important clinical by-products, most notably gamma globulin. He emerged from the war with many honors and prizes. The adulation, however, seemed to go to his head: Surgenor suggests that the awareness of his power had a chilling effect on his colleagues, and a stultifying effect on his son; his arrogance became increasingly difficult for his family to deal with. His death from cerebral hemorrhage was reportedly linked to a pheochromocytoma, an adrenalin-producing tumor; he had impatiently refused investigation.
Edwin Cohn played a very significant part in the basic science of twentieth-century American medicine. Up till now, there has been only a single paper (by Angela Creager) written on his science or his social network. This book will clearly constitute a mine of primary sources—but beyond that, it offers a reading of both Cohn's work and his life, fearfully and intimately joined, that only a colleague could have written.
