Ludwik and Hanka Hirszfelds' Remarkable Medical Research at the Salonika Front

Doctors Ludwik and Hanka Hirszfeld in the Balkans

By James Patton

Ludwik Hirszfeld was born into a Jewish family in Warsaw, then a part of Russia, on 5 August 1884. He was educated in Łódź and Würzburg. In 1907 he became a research assistant at Heidelberg under the eminent Emil von Dungern.

The two did important work on the animal and human blood groups which had been identified by Nobel Laureate (1930) Karl Landsteiner in 1900. Hirszfeld and von Dungern discovering that the four types were not mutually exclusive, named the blood groups A, B, AB, and O, and named the agglutinins as A and B.

Hirszfeld discovered the heritability of blood groups following Mendelian rules, and with this discovery he established serological paternity exclusion. Hirszfeld was also the first to foresee the serological conflict between mother and child, which was later confirmed by the discovery of the Rhesus factor (by Landsteiner).

Doctor Ludwik Hirszfeld on the Salonika Front

While in Heidelberg, Ludwik became a Catholic, he "Germanized" his name to Herschfeld, and met and married Hanka, who was also a physician. By 1910, Ludwik’s research interest had shifted to hygiene and microbiology, and a year later he moved to the Hygiene Institute at the University of Zurich, while Hanka joined the Zurich Children's Clinic under Emil Feer (known for first identifying the effects of mercury poisoning). At Zurich, Ludwik did significant work on anaphylaxis and anaphylatoxin (complement related factors) and their relationship to coagulation of blood.

When World War I broke out, Serbia was devastated by epidemics, including typhus and bacillary dysentery. In early 1915 the Hirszfelds volunteered to be serological and bacteriological advisors on a Zurich team sent to the Royal Army Hospital in Belgrade, Serbia. Eventually they relocated to the Hospital for Contagious Diseases in Thessaloniki, Greece. While there, they continued their research. Among their microbiological discoveries was the bacillus Salmonella paratyphi C (now named Salmonella hirszfeldi).

The Ethnic Diversity of the Salonika Front

Soldiers from three continents were engaged on the Macedonian Front. Disease was rampant; epidemics were frequent. The Hirszfelds found that this diverse population presented a unique opportunity to examine the distribution of blood types in a large number of persons belonging to very different "races" (the concept of race at the time was different from today). This line of inquiry had long interested Ludwik, but he couldn’t pursue it in Heidelberg or Zurich.

They established three categories based on blood type: the "European Type," marked by a high percentage of subjects of blood group A and a low percentage of blood group B, which seemed to include the British, French, Italians, Germans, Austro-Hungarians, Serbs, and Bulgarians; the "Asian African Type," showing, on the contrary, a high percentage of blood group B and a low one of blood group A, comprising Indians, Vietnamese, Malagasy, Senegalese, and Ethiopians; and the "Intermediate Type," containing approximately equal numbers of blood groups A and B and made up of Russians, Turks, Arabs, and Jews. This graph shows the frequencies of occurrence of Types A and B in the various groups:

Click on Graph to Enlarge

The Hirszfelds expressed the ratio of agglutinin A to agglutinin B in a sample population as an index:

HBI (Hirszfeld Biochemical Index) = (A + AB) /(B + AB)

The higher the HBI of a population, the more persons with A in that population over persons with B in it; the lower, the more with B over A. The highest HBI (most A, least B) was found in the British troops (4.5); the lowest (most B, least A) in the Indian (0.5).

“The basic principle behind the evolutionary inferences drawn from the blood group results was that ‘races’ or ‘populations’ that have similar proportions of the different blood groups are more likely to share a common history than those where the proportions are very different. This sounds like common sense and it looks like a reasonable explanation for the similarities found in the different European armies. But there were also some surprises. For example, the blood group frequencies for soldiers from Madagascar and Russia were almost identical”. (Sykes, p. 37) It seemed unlikely that these two populations were related.

Click on Graph to Enlarge

The work of the Hirszfelds was simplistic in comparison to modern human genetics, but their discoveries were ground-breaking in a global way. Sykes says: “It was the use of blood groups which first launched Genetics onto the world stage of human evolution.” A secondary finding was that, contrary to then-prevailing social opinion, there is no genetically "pure race." And with their theory that Type O was the original blood type from which the others evolved (never proven), the Hirszfelds were perhaps the first genetic researchers to posit common ancestry, which has since been indicated by mitochondrial DNA research.

At the end of the war, the Hirszfelds, as patriotic Poles, went to Warsaw and established a serum research institute. In 1924 he became the head of the State Hygiene Institute and then a professor at the University of Warsaw. After the occupation of Poland by the Germans [in 1939] Hirszfeld was dismissed from the university as a "non-Aryan," and on 20 February 1941 the Hirszfeld family was forced to move into the Warsaw Ghetto. While there, the Hirszfelds organized anti-epidemic measures and vaccination campaigns against typhus and typhoid and helped run a clandestine medical school. In 1943, with the help of sympathetic colleagues, the Hirszfeld family escaped from the ghetto and were able to survive underground by moving frequently. In July 1944, they were hiding in Lublin when the Soviets flanked the city. Ludwik founded the Institute for Medical Microbiology in Wrocław in 1945, which was later re-named to honor him. In 1946 he published his autobiography, The Story of My Knowledge. He died on 7 March 1954.

Sources

British Journal for Military History, Volume 7, Issue 1, March 2021

http://self.gutenberg.org/articles/ludwik_and_hanka_herschfeld

http://n-equals-one.com/blogs/2010/10/06/archeogenetics-ii-early-blood-groupings/

The Seven Daughters of Eve, by Brian Sykes