The Blood Bank and the Logistics of Wartime Medicine
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Arsenal of Innovation
The Blood Bank and the Logistics of Wartime Medicine
Naveen Krishnan
July 17, 2026
Arsenal of Innovation
Arsenal of Innovation
The Blood Bank and the Logistics of Wartime Medicine
#Arsenal of Innovation
#Logistics
#Military History
#World War II
Naveen Krishnan
July 17, 2026
Editor’s note: This is the fourth article in a limited series celebrating American defense technologies born from wartime and their effects on broader national security, politics, and society. This series will run for several weeks to commemorate America’s 250th anniversary, and winners will be selected by a reader vote undertaken through our newsletter later this summer. Prior installments can be found at the Arsenal of Innovation page.Before the twentieth century gave armies antibiotics, the leading killer of American soldiers in wartime was neither enemy fire nor shrapnel. Two-thirds of the roughly 620,000 deaths in the U.S. Civil War came from diseases like typhoid and dysentery. Spread through contaminated water and crowded camps, they were eventually controlled through inoculation and field sanitation rather than the antibiotics that would not arrive until the following generation. Later in World War I, American forces lost more men to disease than to combat: 63,000 to 51,000.<br>By 1940, military medicine had largely closed that gap. Vaccines, sterile surgical technique, sulfa drugs, and organized battlefield triage meant that a soldier who could reach a surgeon had a fighting chance. But medicine could still not solve the issue of soldiers bleeding to death. A man with a survivable wound could still die in minutes, and uncontrolled hemorrhage has long been the leading cause of preventable death in combat. No army had a way to keep blood ready where the wounded fell.<br>Whole blood breaks down within weeks even under refrigeration, so it could not be stockpiled ahead of a campaign. Refrigerated railcars existed by 1940, and they could carry blood from a city to a railhead, but they did nothing for more difficult legs of the journey (e.g., from railhead to port, across an ocean, or to an aid station under fire) where there was no refrigeration at all. And whole blood had to be matched to each casualty’s blood type at the bedside, which few could do reliably in the field. Before the war, a battlefield transfusion usually meant a live donor lying beside the wounded man, giving blood directly. Across a war on three continents, that was no way to save men whose wounds were otherwise survivable.<br>An organizational breakthrough came from an American surgeon completing his doctoral research at Columbia University’s Presbyterian Hospital. Dr. Charles Drew was working on the most fundamental problem in transfusion medicine — blood preservation. While he was not the first to work on plasma preservation, he was the first to solve the problem at scale. The blood banking system that grew out of this work would help sustain the forces that won the war and then permanently integrate into American civilian life.<br>Eighty years later, militaries are confronting a modern version of this “blood problem.” A war in the Pacific would stretch supply lines across thousands of miles of ocean, and the fighting in Ukraine has already shown what happens when an enemy can hit rear areas and evacuation routes. The wounded can no longer count on a fast ride to a hospital. The answer, like the prior effort of WWII, is to push a blood product forward and keep it usable once it arrives.<br>Sign Up for Our Newsletter
From Five Hospitals to Fifty Million Americans<br>Drew’s doctoral thesis, completed in 1940 and titled “Banked Blood: A Study on Blood Preservation,” synthesized what the field had learned about storing blood. The obstacle was that red blood cells in whole blood break down quickly, and blood types are determined by those cells. Plasma, the liquid component of blood stripped of its cells, became a solution to these problems. (Plasma carries no blood type, which means it can be administered to any patient regardless of type.) Because plasma could be separated from whole blood, lyophilized (freeze-dried), reconstituted with sterile water when needed, and shipped without refrigeration, it was shelf-stable for far longer than whole blood, which keeps for a few weeks.<br>None of this was Drew’s discovery alone. The science of drying plasma had been worked out by others. At the University of Pennsylvania in the early 1930s, the bacteriologist Stuart Mudd and the engineer Earl Flosdorf developed lyophilization,...