The intertwined relationship of blood and money developed as the practice of Western medicine became more scientific, especially during the 20th century. Like so many efforts to better the human condition, the story of blood research and development is a tale of tragedy as well as triumph. Blood is a gripping, fast-paced medical thriller with protagonists drawn from real life. Starr's journalistic background - he is a former newspaper reporter and science editor for the PBS series Bodywatch and currently teaches and coordinates the graduate Program in Science Journalism at Boston University - is of prime importance. His deft handling of plot and character impart a feeling of "you are there" immediacy to his narrative. His set-piece episodes, such as the World War II development of blood plasma, are skillfully woven into the broad scheme of medical and social trends.

There are many heroes in the story of how blood evolved from a mystical substance to a mainstay of the health sciences. Yet there is no one figure, no dominant individual like Louis Pasteur or Jonas Salk who can be placed on a pedestal and proclaimed the discoverer of blood. Instead, the protagonists of Starr's account represent the progressive, incremental course of modern scientific discovery.

Blood is a body product rather than a healing substance drawn from nature or discovered in a laboratory. But the process that has transformed blood into "nearly a score of injectable substances" capable of "saving lives all over the world" is largely unfamiliar territory, especially for the general public. Blood plasma, for instance, saved hundreds of thousands of lives during World War II, but does not figure as prominently in historical texts as magic bullets like penicillin.

Starr begins his story in characteristically dramatic style with the 1667 experiment by French physician Jean-Baptist Denis, who transfused 10 ounces of calf's blood into the veins of an emotionally disturbed patient. The experiment was a radical departure from contemporary practice, given the universal belief that bleeding was the proper course of action to relieve an imbalance of bodily humors. In another sense, Denis acted in accordance with the ancient belief known as "vitalism," whereby the essence of an animal's characteristics - in this case a calf's tranquillity - could be transfused into an ailing human.

Regardless of whether Denis was a visionary or a quack, his experiment ended in the death of his patient. Attempts to transfuse human blood during the 19th century showed more promise, but primitive equipment and a lack of real knowledge into the composition of blood resulted in many fatalities. Karl Landsteiner's discovery of blood types in 1900 and the development of anticoagulants by Richard Lewisohn were the crucial steps toward the establishment of safe transfusion and blood banks.

The escalating demand for blood created by the huge casualties of World War II led to the next major development - and to bureaucratic wrangling as well. Because of the delicate nature of whole blood, the U.S. launched a massive effort, orchestrated by Edwin Cohn of Harvard University, to produce blood products such as dried plasma. This was a major breakthrough because it allowed plasma to be taken directly into the battle zone. But it was soon discovered that exclusive use of plasma deprived the bloodstream of needed oxygen. When the U.S. Army surgeon general still balked over sending whole blood to the front, surgeons initially had to rely on blood donated by the troops.

Like oil, blood was refined into new and useful products during the war. When peacetime came, however, the refining process continued but the patriotic zeal to donate blood did not. To maintain supply and profits, blood banks had to develop new strategies, such as tapping the blood of the poor in the U.S. and Latin America, as well as that of prison convicts and alcoholics.

By the time the AIDS crisis struck in the early 1980s, the blood-products industry was already in crisis. Use was skyrocketing as the factor VIII clotting formula was hailed as a salvation in the treatment of hemophilia. Unfortunately, contamination of the blood supply by hepatitis-infected donors was rising, too. This should have sounded alarm bells with the emerging threat of HIV/AIDS. As Starr reveals, the alarm did sound, but it was ignored by many medical authorities around the world. The continued use of AIDS-contaminated blood supplies after the danger was recognized completes this sad and sinister chapter in medical history. The imperatives of profit-seeking, largely as a result of national policy agendas, clouded the decisions of medical authorities in the U.S., France, Japan, and elsewhere. Starr deals cogently and with a measure of restrained passion in recounting the erosion of ethical standards during the AIDS crisis. But the subject does not make for easy reading.

Blood fills a gap in the history of medicine by stressing the importance of transfusion and its pioneers. Of equal importance, Starr's book is a powerful warning of what can occur when blood is typed in terms of dollars, yen, or pounds sterling rather than as A, B, AB, or O.