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ALFRED BLALOCK
April 5, 1899-September 15, 1964
BY A. McGEHEE HARVEY
AEFRED BLALOCK was born in Culloden, Georgia on April 5,
1899, the first son of George Z. Blalock and Martha
(Davis) B,Ialock. Blalock's father was a merchant, his mother
a "remote cousin" of Jefferson Davis. George Blalock, who
was almost thirteen years older than his wife, died in 1931.
He exercised a firm hand as head of the house, demanding
perfection of his children and laying great stress on ecluca-
tion, so that "it was a sad day when anyone brought in a
report card that left something to be clesirecI."* Alfred's sister
Elizabeth remembers hearing Alfred say "he had rather
mother use the hairbrush on him than father look at him
harcI.": His mother remembered Alfred as a conscientious
young boy who was unwilling to go to bed until his homework
had been mastered and even cried if forced to bed before he
knew every spelling worct perfectly. He was characterizes! as
having an attractive smile, a soft manner of speech, a retiring
gentle way, and an effective manner of saying clearly what
was on his mincI.
In view of his father's ill health, when Alfrec! was eleven
years of age the family movecl to Jonesboro, a town about
* Mark M. Ravitch, The Papers of Alfred Blalock (Baltimore: The Johns Hopkins
Press, 1966), vol. 1, p. xv.
tIbid.
49
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50
BIOGRAPHICAL MEMOIRS
forty miles north of Culloden where medical assistance would
be more readily available. By the age of fourteen Alfred had
completed the ninth grade at ionesboro and was granted
admission to the senior class at the Georgia Military College
at Milledgeville. He entered the University of Georgia as a
sophomore in the fall of 1915 anti gracluated from that insti-
tution with an A.B. in l91X.
Blalock dicI not consider himself to have been an exces-
sively ctiligent student either in college or medical school. His
academic record at the University of Georgia, however, re-
vealec! a satisfactory performance with most of his grades in
the 80's or 90's. The yearbook, of which he was associate
editor, listed him as secretary and treasurer of the senior class
and a member of the college debating society, the junior
cabinet, and the Gridiron Club. Election to the Gridiron Club
was considered to be the second highest honor on the cam-
pus, members being chosen for overall excellence rather than
specific academic achievement. He was a good tennis player
and entered many of the college tournaments. Dr. John P.
Campbell, Professor of Zoology at the University of Georgia,
wrote to I. Whitricige Williams, the dean at the Johns Hop-
kins University School of Medicine, regarding Blalock's acI-
mission application: "As you will see his record is not un-
usual. He went in for college activities and hacl no thought of
being a 'grind.' He only cleciclecl to take up medicine in his
senior year. One clay he came to me and sail! that he was
going to do his very best in the hope that I might feel that I
could give him a strong recommendation for Johns Hopkins.
He certainly made goocl. I have no hesitation in saying that
he is mature enough anti his habits of study are sufficiently
well formed to be acimitted. ~ hope you will take him."*
*Ibid., p. xvii.
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ALFRED BLALOCK
MEDICAL EDUCATION
51
Blalock entered the Johns Hopkins University School of
Medicine in the fall of 1918. His record in medical school was
not outstanding. Tinsley Harrison, one of Blalock's closest
friends, wrote about him as follows:
While Al Blalock was in medical school he ran the student bookstore and
from this earned a major fraction of his expenses at Hopkins. In addition
to this he was devoted to both tennis and golf, and it was our mutual
interest in these sports that first made us decide to room together and
started a friendship that meant a great deal to me throughout the years.
Also, he was very much the ladies' man and often had social engagements,
usually at Coucher, two or three evenings a week.
On the other hand, he never wasted a minute. When he was not
actively working in the bookstore or following the pursuits mentioned
above, he worked at his medical studies continually. I never saw him stop
in the living room of the fraternity house just to sit around and gossip. I
never saw him waste time as I did playing cards.
Because of these several interests, Al was not an outstanding student
when it came to grades. As I recall he ranked somewhere toward the
bottom of the upper half of the class scholastically, but I am not certain
about this. In any case he was not considered to be one of the ten or twenty
top students in the class in terms of grades.
I imagine it was because of the heavy (in my opinion excessive) reliance
on grades that he did not get the surgical internship for which he applied. *
Surgical internships at Johns Hopkins in those days were
awarcled on the basis of class standing. Although Blalock
failed to get the appointment in general surgery, he was
accepted as "house medical officer-urology" under Hugh
Hampton Young. In spite of having a nephrectomy and tem-
porary facial nerve palsy during that internship year,
Blalock's performance was sufficiently satisfactory to gain
him an assistant residency on the general surgical service for
the following year. He was turned down for a reappointment
*Ibid., p. xix.
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52
BIO GRAPHICAL M E M OIRS
to the surgical house staff (an event to which Blalock never
reconcilecl himself), and in July 1924 he began a year as
"extern in otolaryngology" uncler Samuel }. Crowe.
As a medical student, Blalock was interested in research.
In later years he often credited TinsIey Harrison with the
awakening of his interest in this area. Of his early research
experience Blalock commented:
When I was a medical student, and I think the year was 1920 or 1921,1
worked for a short while in the Hunterian Laboratory with Dr. Jay
McLean. My problem was on the lymphatics and no publications resulted.
It was at this time that Jay McLean found a heparin-like substance in the
liver, and subsequently Dr. Howell continued his work with the discovery
of heparin.
Two years following my graduation from medical school, that being
~uly1924,I spent a year as extern in otolaryngology on Dr. Crowe's service.
One of the subjects on which I worked was that of regeneration of the
recurrent laryngeal nerves of dogs. The thing that distressed me most
about the Hunterian was that I was told that I could work in it on Saturday
mornings from 10 to 12.1 had a good deal of free time and could have
gotten along better had I been allowed to work there more. Dr. Halsted
had died in 1922 else I suspect he would have given me a better opportu-
nity. *
During his early period at Johns Hopkins, Blalock pub-
lished two papers with Harrison and C. P. Wilson. The first,
"The Effects of Changes in Hydrogen Ton Concentration on
the Blood Flow of MorphinizecI Dogs," appeared in the
Journal of Clinical Investigation in 1925, and the second, "Par-
tial Tracheal Obstruction. An Experimental Study on the
Effects on the Circulation and Respiration of Morphinized
Dogs," was published in the Archives of Surgery in 1926.
In 1925 Blalock accepted the chief residency in surgery at
the newly reorganized school of medicine at Vanclerbilt.
Again Harrison was instrumental in Blalock's career. Harri-
son had interned at the Peter Bent Brigham Hospital and
*Ibid., p. xxi.
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ALFRED BLALOCK
53
returned to Johns Hopkins in the fall of 1924 as an assistant
resident in medicine. The following year he went to Vander-
bilt at the invitation of G. Canby Robinson, dean anti chair-
man of the Department of Medicine. Harrison mentioned to
Robinson that Blalock was available for the position of chief
resident in surgery. Robinson recommencled Blalock to Bar-
ney Brooks, who was moving from Washington University in
St. Louis to assume the chairmanship of the Department of
Surgery at Nashville, and Brooks offered Blalock the
. .
posltlon.
When he arrived at Vanderbilt, Blalock had hoped that
Brooks would allow him to be in charge of the surgical pa-
thology laboratory. He was initially clisappointed that Brooks
placed him in charge of the experimental laboratory, but
subsequently was pleasecl that Brooks had made this choice
for him.
Harrison and Blalock continued work in research to-
gether. Of this work Harrison wrote:
During the 192~25 year at Hopkins, and the subsequent 192~26 year,
when we were both chief residents at Vanderbilt, we managed to do a lot
of work in the laboratory together. At that time the Van Slyke apparatus
was relatively new, and the availability of a simple and accurate method for
measurement of blood oxygen made it possible to, for the first time, per-
form accurate determinations of cardiac output in the intact animal. Al-
most nothing had been done about cardiac output before that.... There-
fore Al and I became interested in studying the influence of various things
on cardiac output. After a couple of years my interest was getting more and
more toward the heart per se and Al s was moving more and more toward
problems of cardiac output that seemed to have some direct application to
the clinical problems of surgery. Therefore, we decided to split up as a
team and still help each other, but that he would work on shock and I
would work on cardiac output. Within a year after this decision he had
completed his beautiful work on hemorrhage and trauma and its effect on
the circulation of dogs. Then he came down with tuberculosis before he
had been able to complete his manuscript. He went up to Saranac for a
time, and I made the trip with him because we were afraid of a pulmonary
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54
BIOGRAPHICAL MEMOIRS
hemorrhage or something like that. All the way up on the trip he was very
unhappy because he had been forbidden to do any work of any kind and
his data for the first paper on shock were all set and ready to be prepared
for publication. I promised him faithfully that I would write the paper on
shock for him and send it to him for his approval. This I did. I have derived
a permanent satisfaction from the thought that I was able in this manner
to help a dear friend and to play a minor role in a research problem which,
looking back after 40 years, seems to have opened a lot of doors.
Do not get me wrong. I had nothing whatever to do with the concep-
tion or planning of the work on shock. This was entirely Al's own. I did take
his data and wrote the paper for him without a true realization on my own
part of the importance of the work. This was done purely to help out a
friend in distress.*
After spencling a year ~1927) at the Trudeau Sanatorium,
Blalock went abroad for a few months where he worked in
the Department of Physiology in Cambridge under G. V.
Anrep and Sir Joseph Barcroft. When he returned to Van-
derbilt in the latter part of 192S, he continued to work prodi-
giously in the laboratory, doing essentially all his own work,
making his own animal preparations and doing his own bloocl
gas determinations. He had students working with him from
the first ant! to be chosen by him for a summer's work was
considered to be a real plum. His younger collaborators then
and later remember the method of writing joint papers.
When a project was completed Blalock took the experimental
tiara and rough notes for a clinical paper anti, shortly, often
by the next morning, wouIcl have written the entire paper,
longhand, in very close to final form, frequently placing the
names of his associates before his own.
In January 1930 Vivien Thomas, a young black who was
forced for lack of funds to leave his first year of college, came
to work for Blalock in the laboratory. At that point Blalock's
increasing obligations were cutting into the time he could
spend in the laboratory and he neecled someone to free him
*Ibid., p. xxii.
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ALFRED B LALOC K
55
from the more routine chores. A more fortunate choice could
not have been macle. Vivien Thomas learned to perform the
surgical operations and the chemical determinations needler]
for their experiments, to calculate the results, and to keep
precise records; he remained throughout Blalock's career as
an invaluable associate. As time went on Blalock and Thomas
worked together so closely that it was enough to suggest to
Thomas the experimental preparation ant! the measure-
ments to be made. Thomas often contributed his own ideas
in developing the operative and manipulative techniques.
RESEARCH AT VANDERBILT
In 1928 Blalock began studies, with the air! of Hubert
Bradburn, in which the oxygen content of blood withdrawn
from veins in various parts of the body was determined dur-
ing shock produced by different methods, including the in-
. . ,% . . . .
pectin ot . histamine in some cases anc . trauma to an extremity
in others. The difference in the results led to the following
statement by Blalock:
These observations suggest a local accumulation of blood at the site of
trauma to a large area such as the intestinal tract or an extremity, and are
evidence against the action of a histamine-like substance that produces a
general bodily effect. The (earlier) prevailing theory . . . was that traumatic
shock was due to a toxin, possibly histamine. The strongest evidence that
had been put forward in favor of the toxic theory was derived from the
experiments of Cannon and Bayliss, in which they found that shock result-
ing from trauma to an extremity of the cat could not be accounted for on
the basis of the local loss of whole blood and plasma. In brief, they trauma-
tized one posterior extremity and, when shock resulted, they amputated
the two posterior extremities and determined the difference in the weight.
After completing the studies on blood gases, I repeated the experiments of
Cannon and Bayliss using anesthetized dogs. It was noted that the swelling
extended to a higher level than the uppermost limit of the trauma and
suggested that the two physiologists had not performed their amputations
at a sufficiently high level. In my experiments the posterior part of the
animal was bisected and the difference in the weights of the traumatized
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56
BIOGRAPHICAL MEMOIRS
and non-traumatized parts was determined. A comparison of this differ-
ence with the results of other experiments in which shock was produced by
the slow withdrawal of blood showed that the trauma resulted in a suffi-
cient loss of whole blood and plasma to explain the development of shock.
In my paper published in 1930, entitled "Experimental Shock, The Cause
of the Low Blood Pressure Produced by Muscle Injury to Dogs," it was
stated: "The experiments which are presented in this paper offer no evi-
dence that trauma to an extremity produced a toxin that caused a general
dilatation of capillaries with an increase in capillary permeability and a
general loss of fluid from the bloodstream."*
An important paper that originated in Blalock's labora-
tory describecI a method for transplanting the acirenal gland
of the dog with reestablishment of its blood supply. This
successful transplantation of the adrenal to the neck of the
clog, apart from such early trials as Carrell and Guthrie's, was
the first successful transplantation of an endocrine organ by
direct anastomosis of its vascular supply. The most important
aspect, however, was the success of the vascular suture tech-
niques that lecT Blalock to suggest to his laboratory associates
that the central ens! of the divicled subcIavian artery be con-
nected to the pulmonary artery to see whether this would
result in pulmonary hypertension. The results of this investi-
gation were reported in the Journal of Thoracic Surgery in ~939
in a paper entitled "Experimental Observations on the Ef-
fects of Connecting by Suture the Left Main Pulmonary
Artery to the Systemic Circulation." Blalock was to use this
operation in 1944 for the relief of the Tetralogy of Fallot. It
is a measure of his breadth as a physiologist that he was
interested in pulmonary hypertension, a physiological prob-
lem that was not to attract the attention of other surgeons or
cardiologists until almost two decades later.
The studies in shock, however, were the principal occupa-
tion of Blalock's laboratory in Nashville. He and his group
*A. Blalock, "Reminiscence: Shock After Thirty-four Years," Review of Surgery,
2 1(1964):231.
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ALFRE D B LA LO C K
57
carefully explored every facet of the problem and compiled
the evidence that clearly connected shock with the loss of
fluid outside the vascular bed and with the resulting decrease
in blood volume. His experiments were simple and direct; his
discussions and conclusions concerning the results were
straightforward, forceful, and convincing. Other investiga-
tors, of course, were reaching the same conclusion, particu-
larly Phemister in Chicago, but the massive amount of data
that Blalock accumulated on the characteristics of hemor-
rhagic and traumatic shock, his carefully planned experi-
ments that eliminated one possible cause after another of the
then current explanations of shock, and the clarity with
which he put forth his views, based on sound experimental
work, led to a new understanding of this important problem.
The firm recognition of the need for volume replacement
was corroborated in the treatment of the wounded during
World War II. Large quantities of blood, blood substitutes,
and plasma expanders were used, which resulted! in the sav-
ing of many lives. Blalock himself considered his best work to
have been that on traumatic shock.
On October 25, 1930 Blalock married Mary Chambers
O'Bryan of Nashville. They tract three children: William Rice,
Mary Elizabeth, and Alfred Dandy.
THE BALTIMORE PERIOD
In 1938 Dean DeWitt Lewis, then chairman of the Depart-
ment of Surgery at Johns Hopkins, resigned because of ill-
ness. The committee to select a successor recommencled
several prominent surgeons in the country who turned the
position down for one or another reason. One of those who
declined was Evarts A. Graham, the distinguished chairman
of the Department of Surgery at Washington University.
Graham strongly recommended Alfred Blalock to President
Bowman of Johns Hopkins. When the offer was macle to
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58
BIOGRAPHICAL MEMOIRS
Blalock, he accepted without hesitation and assumed the
position in ~ 94 ~ .
Establishing himself in Baltimore proved somewhat diff~-
CUlt for a variety of reasons, but Blalock successfully disposed
of the numerous problems that arose. He began at once to
operate daily anti to be actively concerned in the training of
the resident staff and in the teaching of medical students. His
Friday noon clinics rapidly developed into masterpieces of
clinical instruction. George Duncan, an assistant resident in
surgery at Vanclerbilt, was brought to Baltimore to continue
the experiments on shock.
At the time of Blalock's arrival in Baltimore, A. McGehee
Harvey, the medical resident, ancI I. L. Lilienthal, Jr., were
studying the physiology anti pharmacology of myasthenia
gravis. It was their conclusion that there might be a circulat-
ing substance, similar to curare, responsible for the neuro-
muscular blockade and the resulting muscular weakness. The
well-known changes in the thymus glancI, consisting of hyper-
trophy of that organ as well as the occurrence of tumors,
macle this structure the most likely source of such a substance.
Harvey and Lilienthal had cliscussecI their evidence on nu-
merous occasions with Frank Forct, who was the senior neu-
rologist of the hospital, ancI it was clecided that a trial of total
thymectomy in patients with this disease, regardless of
whether there was tumor or simple hypertrophy, was indi-
catecI. ForcI agreed to present this proposal to Blalock. While
in Nashville Blalock had successfully removed a thymic
tumor from a patient with myasthenia gravis. The decision
was made to do a total thymectomy in a series of patients with
myasthenia. The patients were operated on by Blalock anti
their pre- and postoperative care anti study was managed by
Harvey and Lilienthal. In the early cases the results were
highly encouraging, and objective evidence was obtained for
the first time of a function of the thymus gland in man from
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ALFRED BLALOCK
71
effects on cardiac output and blood pressure. An experimental
study. Arch. Surg., 19:725-34.
Oxygen content of blood in patients with varicose veins. Arch.
Surg., 19:898-905.
With Hubert B. Bradburn. The relationship of changes in blood-
flow through an extremity to (1) changes in temperature of
tissues, (2) differences in oxygen content of the arterial and
venous blood, and (3) cardiac output. Am. J. Physiol.,
91:115-22.
1930
With Hubert B. Bradburn. Distribution of the blood in shock. The
oxygen content of the venous blood from different localities in
shock produced by hemorrhage, by histamine and by trauma.
Arch. Surg., 20:26-38.
With P. N. Harris and Bentley Cox. Observation upon the exterior-
ized appendix of the dog. Surg. Gynecol. Obstet., 50:572-77.
Experimental shock. The cause of the low blood pressure produced
by muscle injury to dogs. Arch. Surg., 20:959-96.
With John C. Burch and Tinsley R. Harrison. A comparison of the
effects of hemorrhage under ether anesthesia and under spinal
anesthesia. Arch. Surg., 21:693-97.
Observations upon the blood flow through skeletal muscle by the
use of the hot wire anemometer. Am. J. Physiol., 95:55~60.
1931
Trauma to the intestines. The importance of the local loss of fluid
in the production of low blood pressure. Arch. Surg., 22:
3 14-24.
Experimental shock. IV. The probable cause for the reduction in
the blood pressure following mild trauma to an extremity.
Arch. Surg., 22:598-609.
Experimental shock. VII. The importance of the local loss of fluid
in the production of the low blood pressure after burns. Arch.
Surg., 22:610-16.
With l. W. Beard. Experimental shock. VIII. The composition of
the fluid that escapes from the blood stream after mild trauma
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72
B I OGRAPH I CAL ME MOI RS
to an extremity, after trauma to the intestines, and after burns.
Arch. Surg., 22:617-25.
With George S. Johnson. Experimental shock. IX. A study of the
effects of the loss of whole blood, of blood plasma and of red
blood cells. Arch. Surg., 22:626-37.
With P. N. Harris. Experimental shock. X. Observations on the
water content of the tissues of the body after trauma and after
hemorrhage. Arch. Surg., 22:638~8.
Stab wound of heart. Ann. Surg., 93: 1278-79.
With I. W. Beard and Virginia Butler. A study of the effects of
division of the cervical esophagus of the dog. Surg. Gynecol.
Obstet., 53: 169-75.
With Virginia Butler and I. W. Beard. Experimental shock. ~I. A
study of the alterations in the volume of blood and in the water
content of blood and of muscle that are produced by histamine.
Arch. Surg., 23:848-54.
With G. S. Johnson. Experimental shock. XII. A study of the effects
of hemorrhage, of trauma to muscles, of trauma to the in-
testines, of burns and of histamine on the cardiac output and on
blood pressure of dogs. Arch. Surg., 23:855-63.
With }. W. Beard and G. S. Johnson. Experimental shock. A study
of its production and treatment. I. Am. Med. Assoc., 97:
179~97.
1932
With I. W. Beard. Intravenous injections. A study of the composi-
tion of the blood during continuous trauma to the intestines
when no fluid is injected and when fluid is injected continu-
ously. J. Clin. Invest., 11:249-65.
With I. W. Beard and Charles Thuss. Intravenous injections. A
study of the effects on the composition of the blood of the
injection of various fluids into dogs with normal and with low
blood pressures. J. Clin. Invest., 11:267-90.
With J. W. Beard, Harwell Wilson, and B. M. Weinstein. A study of
the effects of hemorrhage, trauma, histamine and spinal anes-
thesia on the composition of the blood when no fluids are in-
jected and when fluids are introduced intravenously. I. Clin.
Invest., 11:291-309.
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ALFRED BLALOCK
73
With I. W. Beard. The effects on the composition of the blood of
the subcutaneous injection of normal salt solution into normal
dogs and into dogs subjected to intestinal trauma. Graded
hemorrhages and histamine injection. T Clin. Invest., 11:
311-25.
The effects of complete occlusion of the thoracic aorta. An experi-
mental study. I. Thorac. Surg., 2:69-76.
1933
With l. W. Beard and Harwell Wilson. Effects on composition of
blood of physiologic solution of sodium chloride when intro-
duced by intraperitoneal injection and by stomach tube in the
presence of low blood pressure. Arch. Surg., 26: 122-33.
With Harwell Wilson, B. M. Weinstein, and J. W. Beard. Loss of
protein from the blood stream. Effects of the injection of solu-
tion of pituitary and of epinephrine. Arch. Surg., 26:330-34.
Exposure of the heart to atmospheric pressure. Effects on the car-
diac output and blood pressure. Arch. Surg., 26:516-21.
With W. M. Raymond. Studies on bronchial occlusion by the
method of Adams and Livingstone. Surg. Gynecol. Obstet.,
56:779-81.
With R. A. Daniel, fir., and S. E. Upchurch. The absorption from
traumatized muscles. Surg. Gynecol. Obstet., 56:1017-20.
Peritonitis. Effects on the administration of salt solution on the
amount of fluid that accumulates in the peritoneal cavity. Arch.
Surg., 26:1098-1102.
Effects of primary shock on cardiac output and blood pressure.
Proc. Soc. Exp. Biol. Med., 31:36-37.
1934
With G. V. Anrep and A. Samaan. The effect of muscular contrac-
tion upon the blood flow in the skeletal muscle. Proc. R. Soc.
Ser. B. 114:223~5.
Shock. Further studies with particular reference to the effects of
hemorrhage. Arch. Surg., 29:837-57.
Influence of exposure to cold and of deprivation of food and water
on the development of shock. Arch. Surg., 29: 1055-68.
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74
BIOGRAPHICAL MEMOIRS
1935
Experimental studies on the effects of the perforation of peptic
ulcers. Surg. Gynecol. Obstet., 61:2~26.
The effect of total pneumonectomy on the position of the esoph-
agus. Proc. Soc. Exp. Biol. Med., 32:1552-55.
With Sidney Burwell. Thoracic duct lymph pressure in concretio
cordis. An experimental study. I. Lab. Clin. Med., 21:296-97.
With Gunnar Nystrom. Contributions to the technic of pulmonary
embolectomy. I. Thorac. Surg., 5:169-88.
1936
With R. S. Cunningham and C. S. Robinson. The experimental
production of chylothorax by occlusion of the superior vena
cave. Ann. Surg., 104: 359-64.
With Morton F. Mason. Observations on the blood flow and gas-
eous metabolism of the liver of unanesthetized dogs. Am. l.
Physiol., 117:328-34.
With Tinsley R. Harrison and Morton F. Mason. Effects on blood
pressure of injection of kidney extracts of dogs with renal
hypertension. Proc. Soc. Exp. Biol. Med., 35:38-40.
1937
With Sanford E. Levy. Fractionation of the output of the heart and
the oxygen consumption of normal unanesthetized dogs. Am. }.
Physiol., 118:368-71.
With Sanford E. Levy, Morton F. Mason, and Tinsley R. Harrison.
The effects of ureteral occlusion on the blood flow and oxygen
consumption of the kidneys of unanesthetized dogs. Surgery,
1 :238~2.
With Morton F. Mason and Tinsley R. Harrison. The direct deter-
mination of the renal blood flow and renal oxygen consumption
of the unanesthetized dog. Am. I. Physiol., 118: 667-76.
With Sanford E. Levy. The effect of hemorrhage, intestinal trauma
and histamine on the partition of the blood stream. Am. I.
Physiol., 118: 734-38.
With C. S. Robinson, R. S. Cunningham, and Mary E. Gray. Exper-
imental studies on lymphatic blockage. Arch. Surg., 34:
1049-71.
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ALFRED BLALOCK
75
With Morton F. Mason and Ray Evers. Renal oxygen utilization of
dogs with experimental hypertension. Proc. Soc. Exp. Biol.
Med., 36:819-20.
With Sanford E. Levy. The effects of obstruction of the common
bile duct on the portal blood flow and oxygen consumption.
Surgery, 2: 33-36.
With C. S. Robinson, R. S. Cunningham, Mary E. Gray, and B. Carl
Rogers. Chylous effusions produced by experimental ligation of
the superior vena cave. Chemical and cytologic studies. Arch.
Pathol., 24:3,03-14.
With Tinsley R. Harrison, Morton F. Mason, and John R. Williams,
fir. Relation of kidneys to blood pressure. Effects of extracts of
kidneys of normal dogs and of dogs with renal hypertension on
blood pressure of rats. Arch. Int. Med., 60: 1058-68.
1938
With C. Sidney Burwell. Chronic constrictive pericarditis. Physio-
logic and pathologic considerations. }. Am. Med. Assoc., 110:
265-71.
With Sanford E. Levy and Rudolph A. Light. The blood flow and
oxygen consumption of the kidney in experimental renal hyper-
tension. Am. I. Physiol., 122: 38~2.
With Sanford E. Levy. The effects of unilateral nephrectomy on the
renal blood flow and oxygen consumption of unanesthetized
dogs. Am. I. Physiol., 122:609-13.
With Sanford E. Levy. Experimental attempts to prevent or abolish
the hypertension that is associated with renal ischemia. Surgery,
3:899-903.
With Sanford E. Levy and Charles S. Robinson. The effect of alter-
ing the renal blood pressure and blood flow on the glomerular
filtration of a transplanted kidney in unanesthetized dogs. Am.
J. Physiol., 123: 383-87.
1939
With Sanford E. Levy. A method for transplanting the adrenal
gland of the dog with re-establishment of its blood supply. Re-
port of observations. Ann. Surg., 109: 84~98.
With Sanford E. Levy. Gradual complete occlusion of the coeliac
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76
BIOGRAPHICAL MEMOIRS
axis, the superior and inferior mesenteric arteries with survival
of animals: Effects of ischemia on blood pressure. Surgery,
5: 175-78.
With Ralph D. Cressman. Experimental traumatic shock. Further
studies with particular reference to the role of the nervous
system. Surg. Gynecol. Obstet., 68:278-87.
With Ralph D. Cressman. Experimental hypertension. Effects of
kieselguhr injection and of splanchnic stimulation. Proc. Soc.
Exp. Biol. Med., 40:258-60.
With Sanford E. Levy and Ralph D. Cressman. Experimental
hypertension. The effects of unilateral renal ischemia combined
with intestinal ischemia on the arterial blood pressure. I. Exp.
Med., 69:833-46.
With Sanford E. Levy. Experimental observations on the effects of
connecting by suture the left main pulmonary artery to the
systemic circulation. I. Thorac. Surg., 8:525-30.
With Morton F. Mason, Hugh I. Morgan, and S. S. Riven. Myasthe-
nia gravis and tumors of the thymic region. Ann. Surg., 110:
554-61.
1940
With George O. Wood and Morton F. Mason. Studies on the effects
of the inhalation of a high concentration of oxygen in experi-
mental shock. Surgery, 8:247-56.
With Morton F. Mason and C. Sidney Robinson. Studies on the
renal arterial blood pressure and the metabolism of kidney tis-
sue in experimental hypertension. J. Exp. Med., 72:289-99.
With A. S. Minot. Plasma loss in severe dehydration, shock and
other conditions as affected by therapy. Ann. Surg., 112:
557-67.
1941
With James R. Dawson and Ralph D. Cressman. Experimental
hypertension and pregnancy in dogs. Am. J. Pathol., 17:31-38.
With Morton F. Mason. Blood and blood substitutes in the preven-
tion and treatment of shock: With particular reference to their
uses in warfare. Ann. Surg., 133:657-76.
With George O. Wood. Effects of uncomplicated hemoconcentra-
tion (erythrocytosis) with particular reference to shock. Arch.
Surg., 42:1019-25.
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ALFRED BLALOCK
77
With Morton F. Mason. A comparison of the effects of heat and
those of cold in the prevention and treatment of shock. Arch.
Surg., 42: 1054-59.
Tumors of the thymic region and myasthenia gravis. Am. I. Surg.,
54: 149-50.
With Sidney Burwell. Chronic pericardial disease. Report of
twenty-eight cases of constrictive pericarditis. Surg. Gynecol.
Obstet., 73:433-61.
With A. McGehee Harvey, Frank R. Ford, and Joseph L. Lilienthal.
The treatment of myasthenia gravis by removal of the thymus
gland. Preliminary report. I. Am. Med. Assoc., 117:1529-33.
1942
With Mark M. Ravitch. An evaluation of blood and blood sub-
stitutes. Surg. Gynecol. Obstet., 74:348-52.
A comparison of the effects of local application of heat and cold in
the prevention and treatment of experimental traumatic shock.
Surgery, 11:356-59.
With George Duncan. The uniform production of experimental
shock by crush injury. Possible relationship to clinical crush
syndrome. Ann. Surg., 115:684-97.
With George W. Duncan. Shock produced by crush injury. Effects
of the administration of plasma and the local application of cold.
Arch. Surg., 45: 183-94.
1943
Effects of lowering temperature of an injured extremity to which a
tourniquet has been applied. Arch. Surg., 46: 167-70.
Effects of morphine in experimental shock due to hemorrhage.
Arch. Surg., 47 :326-28.
1944
With Edwards A. Park. The surgical treatment of experimental
coarctation (atresia) of the aorta. Ann. Surg., 119:445-56.
A comparison of the effects of continuous and of intermittent ap-
plication of a tourniquet to a traumatized extremity. Arch.
Surg., 48:489-90.
Thymectomy in the treatment of myasthenia gravis. Report of
twenty cases. I. Thorac. Surg., 13:316-39.
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78
BIOGRAPHICAL MEMOIRS
With William P. Longmire, fir., and George W. Duncan. The use of
venous tourniquets as an aid to the diagnosis of incipient trau-
matic shock. Surg. Gynecol. Obstet., 79:434-37.
The utilization of oxygen by the brain in traumatic shock. Arch.
Surg., 49:167-69.
1945
With Helen B. Taussig. The surgical treatment of malformations of
the heart in which there is pulmonary stenosis or pulmonary
atresia. }. Am. Med. Assoc., 128:189-202.
1946
Operative closure of the patent ductus arteriosus. Surg. Gynecol.
Obstet., 82:113-14.
Effects of an artificial ductus arteriosus on experimental cyanosis
and anoxemia. Arch. Surg., 52:247-52.
The surgical treatment of congenital pulmonic stenosis. Ann.
Surg., 124: 879-87.
1947
The use of shunt or bypass operations in the treatment of certain
circulatory disorders including portal hypertension and pul-
monic stenosis (Churchill Lecture). Ann. Surg., 125:129~1.
With Helen B. Taussig. Observations on the volume of the pulmo-
nary circulation and its importance in the production of cya-
nosis and polycythemia. Am. Heart J., 33:413-19.
The technique of the creation of an artificial ductus arteriosus in
the treatment of pulmonic stenosis. J. Thorac. Surg., 16:
244-54.
1948
With C. Rollins Hanlon. Complete transposition of the aorta and
the pulmonary artery. Experimental observations on venous
shunts as corrective procedures. Ann. Surg., 127: 385-97.
With C. Rollins Hanlon. Interatrial septal defect. Its experimental
production under direct vision without interruption of the cir-
culation. Surg. Gynecol. Obstet., 87:183-87.
With R. l. Bing, }. C. Handelsman, I. Campbell, and H. Griswold.
The surgical treatment and the physiopathology of coarctation
of the aorta. Ann. Surg., 128: 803-24.
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ALFRED BLALOCK
1949
79
With Mark M. Ravitch. Aspiration of blood from pericardium in
treatment of acute cardiac tamponade after injury. Further ex-
perience, with report of cases. Arch. Surg., 58:463-77.
1950
With C. Rollins Hanlon. The surgical treatment of complete trans-
position of the aorta and the pulmonary artery. Surg. Gynecol.
Obstet., 90:1-15.
With Henry T. Bahnson. Aortic vascular rings encountered in the
surgical treatment of congenital pulmonic stenosis. Ann. Surg.,
133:356-62.
With Richard C. Clay. Congenital arteriovenous fistulas in the man-
dible. Surg. Gynecol. Obstet., 90:543~6.
With Richard F. Kieffer, {r. Valvulotomy for the relief of congen-
ital valvular pulmonic stenosis with intact ventricular septum.
Report of nineteen operations by the Brock method. Ann.
Surg., 132: 496-516.
With Ray Heimbecker and Vivien Thomas. Experimental reversal
of capillary blood flow. Circulation, 4: 116-19.
1953
With Henry T. Bahnson and Robert D. Sloan. Splenic-portal ve-
nography. A technique utilizing percutaneous injection of
radiopaque material into the spleen. Johns Hopkins Hosp.
Bull., 92:331-45.
With {erome Harold Kay and Vivien Thomas. The experimental
production of high interventricular sentry clefectc. Ally (~.vne-
col. Obstet., 96:529-35.
1954
~ A,
With Thomas N. P. Johns. Mitral insufficiency: The experimental
use of a mobile polyvinyl sponge prosthesis. Ann. Surg.,
140:335~1.
1955
Our obligations and opportunities (Presidential address, American
College of Surgeons, November 19, 1954~. Bull. Am. Coll.
Surg., 40:83-86.
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80
BIOGRAPHICAL MEMOIRS
1956
The nature of discovery (Presidential address, American Surgical
Association). Ann. Surg., 144:289-303.
With Robert A. Gaertner. Experimental coarctation of the ascend-
ing aorta. Surgery, 40: 712- 17.
1957
With David C. Sabiston, Jr., and Jean P. Fauteux. An experimental
study of the fate of arterial implants in the left ventricular myo-
cardium. Ann. Surg., 145: 927-38.
1958
With David C. Sabiston, Jr. Experimental ligation of the internal
mammary artery and its effect on coronary occlusion. Surgery,
43:906-12.
With David C. Sabiston, Jr. Physiologic and anatomic determinants
of coronary blood flow and their relationship to myocardial
revascularization. Surgery, 44:406-23.
1959
With David C. Sabiston, Jr., J. L. Talbert, and L. H. Riley. Mainte-
nance of the heart beat by perfusion of the coronary circulation
with gaseous oxygen. Ann. Surg., 150:361-70.
1961
With James L. Talbert, Lee H. Riley, Jr., and David C. Sabiston, Jr.
An evaluation of gaseous oxygen perfusion as a method for
maintaining renal viability during periods of complete ischemia.
Surg. Gynecol. Obstet., 112: 593-99.
With David C. Sabiston, fir. Coronary thromboendarterectomy for
angina pectoris. Postgrad. Med., 29:439-50.
1963
With David C. Sabiston, Jr., and Gary W. Archer. Fate of cells in
passage through lymphatics and lymph nodes. Ann. Surg.,
158:570-80.
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ALFRED BLALOCK
1964
81
With Lazar I. Greenfield. Effect of low molecular weight dextran
on survival following hemorrhagic shock. Surgery, 55:684-86.
Reminiscence: Shock after thirty-four years. Rev. Surg., 21 :231-34.