The practice of using veins to inject substances essentially began in the 17th century. The first documented use of infusion therapy was administering blood as a treatment in 1492, when blood from three young boys was administered to Pope Innocent VIII (Greenwalt, 1997). It was not until 1615, however, that the concept of infusing blood from one person to another was again considered by Libavious. It would be several centuries before person-to-person transfusion became possible, and even longer before it became a safe practice.

In 1628 William Harvey’s experimental work resulted in the development of the theory of circulation, which led to an understanding of blood flow and of the presence and importance of valves. This new information about the circulatory system led others to experiment with injecting substances into the vascular system to observe the effect on the recipient. One of the earliest to document this type of experiment was Sir Christopher Wren, famed architect of St. Paul’s Cathedral in London. In 1656 he experimented with injecting opium and wine into the veins of dogs using a quill and animal bladder (Weinstein, 2007). The first successful injection into humans was accomplished in 1662 by J. D. Major. About this time, Richard Lower presented a paper before the Royal Society in England on intravenous (IV) feeding and blood transfusion in dogs. He was able to demonstrate his transfusion theory with a successful animal-to-animal transfusion (Greenwalt, 1997).

The first documented animal-to-human transfusion is credited to Jean Baptiste Denis. In 1667 Denis, a physician to the French royalty, successfully transfused 9 ounces of lamb’s blood into a 15-year-old boy suffering from madness (Cosnett, 1989 and Greenwalt, 1997). Subsequent transfusions to the boy were not successful and resulted in the first transfusion reaction. This initial success of Denis led to the promiscuous use of transfusions, with fatal results. As a result of the many fatalities, the Church and the French parliament banned the transfusion of blood from animals to humans in 1687.

Following the 1687 edict banning blood transfusions, little growth in the field of infusion therapy was noted for the next 150 years. The one significant event in the 18th century occurred in 1795, when Philip Syng Physick, from the University of Edinburgh, noted that the use of blood transfusions in obstetric hemorrhage had some success in decreasing mortality from this complication.

Infusion therapy, as practiced today, had its real beginnings in the 19th century, which was a time of rapid advancement in medicine. In 1818 James Blundell performed the first man-to-man transfusion in London (Greenwalt, 1997). In 1834 Blundell again used human blood to transfuse women who were threatened by hemorrhage during childbirth. Blundell is further credited with the correlation between blood loss and hypoxemia during hemorrhage.

One complication of early transfusions was coagulation of the blood during the transfusion. In 1821 Jean Louis Prevost, a French physician, experimented with preventing this coagulation. Prevost and Jean B. Dumas were the first to use defibrinated blood in animal transfusions (Weinstein, 2007). By 1875 Landois had discovered lysing between the serums of different animals, which later resulted in an understanding of antigen-antibody reactions.

The cholera epidemic of 1831 was an important event in the advancement of infusion therapy. Dr. William O’Shaughnessy, an Edinburgh physician, identified the significance of water and salt loss from the blood of cholera victims. In 1832 Dr. Thomas Latta of Leith, Scotland, is credited with taking this information and experimenting with administration of a saline solution to a patient. He described the patient as one who “apparently had reached the last moments of her earthly existence and now nothing could injure her. Indeed, so entirely was she reduced that I feared that I shall be unable to get my apparatus ready, ere she expire” (Cosnett, 1989). Latta was successful in resuscitating the patient initially, but the patient relapsed and eventually died. Dr. Latta wrote in Lancet of June 12, 1832, “I have no doubt the case would have issued in complete reaction, had the remedy, which had already produced such effect, been repeated” (Cosnett, 1989). The initial success of the saline injection led to further use of this therapy during the epidemic, but these efforts met with only limited success. Of the first 25 reported cases so treated, 8 recovered and there was much criticism, most often from outside the medical journals.

Further work continued and in 1853 Claude Bernard, a French physiologist, experimented with injecting sugar solutions into dogs. For the next two decades, he continued to experiment and infused not only sugar solutions but also egg whites and milk into animals, with some success.

In 1852 the importance of protein in relation to nitrogen balance, weight gain, and general well-being was observed by Bidder and Schmidt and confirmed by Voit in 1866. This correlation between protein and health led to the concept of nutritional support, although the effect of this relationship would not be fully known for another 75 to 100 years.

Major advances were made during the 1860s that would have an impact on infusion nursing and on all of medicine. Louis Pasteur developed the germ theory of disease, and demonstrated that fermentation and putrefaction result from the growth of germs. Building on this theory, Joseph Lister, Professor of Surgery at the University of Glasgow, hypothesized that microbes might be responsible for wound suppuration. He further postulated that infection could be prevented by destroying organisms and preventing contaminated air from coming into contact with the wound (Lyons and Petrucelli, 1987). Lister’s studies describing the use of carbolic acid spray as an antiseptic were published in 1867.

Many physicians began observing strict rules of cleanliness without understanding the implications. In France, surgeons continued to focus on the use of antisepsis during procedures instead of asepsis. Not until the early 1900s were the principles of asepsis fully understood. By then, it was common practice that only sterile items could contact the patient.

The use of gloves for procedures was introduced in 1889, when William Halsted of Johns Hopkins Hospital had the Goodyear Rubber Co. make a pair of rubber gloves for his operating room nurse (Weinstein, 2007). The use of gloves became popular, and by 1899 rubber gloves were being used on all clean cases. Today, gloves provide protection not only for the patient but also for the practitioner.

The last half of the 19th century also saw advances in the field of nutritional support. In 1869 Menzel and Perco of Vienna wrote a paper on the use of fat, milk, and camphor injected subcutaneously. The successful administration of a glucose solution is credited to Biedl and Krause in 1896 (Millam, 1996).

For almost 250 years, experiments in which different substances were injected into the body had yielded limited results. As with most of medicine, major advances occurred during the 20th century. By this time, the use of saline and glucose solutions was a more widely accepted practice, although they were still used only on the critically ill patient. Equipment was cleaned and sterilized between uses as a routine measure with the advent of heat sterilization in 1910, and with the medical profession’s acceptance that everything coming into contact with the patient needed to be sterile. The discovery of pyrogens in 1923 led to measures that helped eliminate them from fluids and drugs. Dr. Florence Seibert of the Phipps Institute in Philadelphia solved the serious problem of pyrogenic reactions to IV infusions in 1925, thus paving the way for safer practice (Greenwalt, 1997).