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Alexander S. Wiener (March 16, 1907 Brooklyn, New Yorkmarker; - November 6, 1976 New York Citymarker), a lifelong resident of New York City, was recognized internationally for his contributions to medicine. He was an outstanding leader in the fields of forensic medicine, serology, and immunogenetics. His pioneer work led to discovery of the Rh factor in 1937, along with Dr. Karl Landsteiner, and subsequently to the development of exchange transfusion methods that saved the lives of countless infants with hemolytic disease of the newborn. He received a Lasker Award for his achievement in 1946.

Blood "fingerprinting"

Dr. Wiener began working with Dr. Landsteiner at the age of 23, shortly after beginning his work at Brooklyn Jewish Hospital, where Dr. Wiener remained for the rest of his life. Much of their initial work revolved around the M Factor, which they discovered was actually five different, distinct blood factors.

This encouraged them in their quest to create a blood "fingerprint," a unique blood profile that could be used in legal and criminal matters. Indeed, Dr. Wiener pioneered much of the type of blood testing that has now become commonplace in the age of DNA. Along with his work in his Brooklyn lab, Dr. Wiener also did a considerable amount of work in a Manhattan lab where he concentrated on forensics, assisting the police in numerous investigations by analyzing the blood (or related fluids) of those involved.

Numerous articles and chapters of books with real life crime stories were written about Dr. Wiener's work in criminology. Along with his father, George Wiener, a lawyer. Dr. Wiener helped draft a new set of laws addressing the recent scientific advancements in blood identification. He was a member of the American Medical Association legal committee that sponsored blood test laws in all states, and he was the co-author of its 1935 report. His work in the genetics of the blood factors also allowed him to be of assistance in many paternity cases.

He was eventually made an honorary member of the Mystery Writers of America for his work.

Rh factor

When Wiener and Landsteiner discovered the Rh factor in 1937 (named after the Rhesus monkeys used as test subjects), they did not immediately realize its significance. It was seen as yet another factor, not much different from the M, N, or P factors--useful for "fingerprinting," but not having much more extended implications. However, Wiener soon realized that the new blood factor they had discovered was associated with problems in blood transfusions. Although the first time Rh positive blood is transfused into someone with Rh negative blood, it may not cause any harm, it does cause the creation of antibodies which make a second such transfusion very dangerous. By the time he and Dr. Landsteiner published in 1940, Wiener was able to demonstrate the role of Rh sensitization as a cause of intragroup hemalytic reactions, thus increasing the safety of blood transfusions.

Also, in conjunction with Phillip Levine's separate work which helped identify the Rh factor as a major cause of erythroblastosis fetalis, or Rh disease, he was able to help solve a major cause of infant fatality. Dr. Wiener created the first medical procedure to combat the problem, which he called an exchange transfusion. It consisted of a complete blood transfusion for the affected baby. The method was further refined by Harry Wallerstein, a transfusionist.

Since then, less extreme methods have been found to deal with erythroblastosis fetalis. However, at the time, the procedure was able to save over 200,000 lives.

Nomenclature and genetics

A lot of Dr. Wiener's later work involved examining the genetics of the Rh factor. In the process, he became embroiled in controversy, as an alterate theory (CDE), which was somewhat simpler to understand, was also proposed. Although Dr. Wiener's theories on the genetics of the Rh factor have recently proven to be closer to the actual DNA structure of the genes (though the truth lies somewhere between the two theories), there are still many who have adopted the CDE notations.

Dr. Wiener's theory is that Rh inheritance is controlled as follows:

There is one Rh locus at which occurs one Rh gene, but this gene has multiple alleles.For example, one gene R1 produces one agglutinogen (antigen) Rh1 which is composed of three "factors": rh', Rh(o), and hr' '. The three factors are analogous to C, D, and e respectively in the CDE nomenclature. The d gene does not exist in Wiener's theory, and, in fact, has been proven not to exist at all.

In fact, it has recently been proven that there are two connected genes, one of which has multiple specificities, as Wiener theorized. So although he was incorrect to theorize that there was only one gene involved, the principle that a single gene can have multiple alleles, a revolutionary idea at the time, has proven true.

References

  • Alexander S. Wiener Rh-Hr Blood Types
  • Landsteiner K, Wiener AS. An agglutinable factor in human blood recognized by immune sera for rhesus blood. Proc Soc Exp Biol Med 1940;43:223-224.
  • Addine Erskine The Principles and Practices of Blood Grouping
  • Pauline M. H. Mazumdar Species and Specificity
  • David R. Zimmerman, Rh: The Intimate History of a Disease and Its Conquest Macmillan (1973) ISBN 0-02-633530-1.
  • Edward Radin, Twelve Against Crime Specifically Chapter 8, "Master of Invisible Clues."


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