Part B：In the following article some paragraphs have been removed. For Questions 66 ~ 70, choose the most suitable paragraph from the list A ~ F to fit into each of the numbered gaps. There is one paragraph which does not fit in any of the gaps. Mark your answers on SHEET 1.
Does the publisher of Douglas Starr's excellent Blood--An Epic History of Medicine and Commerce actually ex-pect to sell many copies? Whoever chose the title is certain to scare off the squeamish, and the subtitle, which makes the effort sound like a dry, dense survey text, has really done this book a disservice. In fact, the brave and curious -will enjoy a brightly written, intriguing, and disquieting book, with some important lessons for public health.
66.___________________________________
The book begins with a historical view on centuries of lore about blood--in particular, the belief that blood car-ried the evil humors of disease and required occasional draining. As recently as the Revolutionary War, Bloodletting was widely applied to treat fevers. The idea of using one person's blood to heal another is only about 75 years old--although rogue scientists had experimented with transfusing animal blood at least as early as the 1600s. The first transfusion experiments involved stitching a donor's vein (in early cases the physician's) to a patient's vein.
67.___________________________________
Sabotaged by notions about the" purity"of their groups' blood, Japan and Germany lagged well behind the Al-lies in transfusion science. Once they realized they were losing injured troops the Allies had learned to save, they tried to catch up, conducting horrible and unproductive experiments such as draining blood from POWs and injecting them with horse blood or polymers.
68.___________________________________
During the early to mid-1980s, Start says, 10,000 American hemophiliacs and 12,000 others contracted HIV from transfusions and receipt of blood products. Blood banks both here and abroad moved slowly to acknowledge the threat of the virus and in some cases even acted with criminal negligence, allowing the distribution of blood they knew was tainted. This is not new material. But Starr's insights add a dimension to a story first explored in the late Randy Shilts's And the Bond Played On.
69.___________________________________
Is the blood supply safe now.'? Screening procedures and technology have gotten much more advanced. Yet it's disturbing to read Starr's contention that a person receiving multiple transfusions today has about a 1 in 90,000 chance of contracting HIV--far higher than the" one in a million" figure that blood bankers once blithely and falsoly quoted. Moreover, new pathogens threaten to emerge and spread through the increasingly high-speed, global blood-product network faster than science can stop them. This prompts Start to argue that today's blood stores are"simulta-neously safer and more threatening" than when distribution was less sophisticated.
70.___________________________________
A. The massive wartime blood drives laid the groundwork for modem blood-banking, which has saved count-less lives. Unfortunately, these developments also set the stage for a great modem tragedy--the spread of AIDS through the international blood supply.
B. There is so much drama, power, resonance, and important information in this book that it would be a shame if the squeamish were scared off. Perhaps the key lesson is this : The public health must always be guarded against the pressures and pitfalls of competitive markets and human fallibility.
C. In his chronicle of a resource, Start covers an enormous amount of ground. He gives us an account of mankind's attitudes over a 400-year period towards this "precious, mysterious, and hazardous material" ; of medicine's efforts to understand, control, and develop blood's life-saving properties;and of the multibillion- dollar industry that benefits from it. He describes disparate institutions that use blood, from the military and the pharmaceutical industry to blood banks. The culmination is a rich examination of how something as hor- rifying as distributing blood tainted with the HIV virus could have occurred.
D. The book's most interesting section considers the huge strides transfusion science took during World War I1. Medicine benefited significantly from the initiative to collect and supply blood to the Allied troops and from new trauma procedures developed to administer it. It was then that scientists learned to separate blood into useful elements, such as freeze-dried plasma and clotting factors, paving the way for both battlefield miracles and dramatic improvement in the lives of hemophiliacs.
E. Starr's tale ends with a warning about the safety of today's blood supply.
F. Starr obtained memos and other evidence used in Japanese, French, and Canadian criminal trials over the tainted-blood distribution. (American blood banks enjoyed legal protections that made U. S. trials more complex and provided less closure for those harmed. ) His account of the French situation is particularly poignant. Start explains that in postwar France, donating blood was viewed as a sacred and patriotic act. Prison populations were urged to give blood as a way to connect more with society. Unfortunately, the French came to believe that such benevolence somehow offered a magical protection to the blood itself and that it would be unseemly to question volunteer donors about their medical history or sexual or drug prac-tices. Combined with other factors, including greed and hubris, this led to tragedy. Some blood banks were collecting blood from high-risk groups as late as 1990, well into the crisis. And France, along with Canada, Japan, and even Britain, stalled approval and distribution of safer, American heat-treated plasma products when they became available, in part because they were giving their domestic companies time to catch up with scientific advances.
