A matter of blood. Chevalier's blood affair

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Michelle Zevako

Chevalier's blood affair

An elderly man sat at the open window of a squat, unprepossessing house. The back of a carved, antique chair served as an excellent backdrop to the courageous, stern face of a gray-haired warrior who remembered the famous battles of the times of King Francis I. The gloomy gaze of the old man did not leave the gray bulk of Montmorency Castle, raising its powerful, gloomy towers to the blue sky.

Finally, the old warrior forced himself to look away, but at the same time a heavy sigh escaped from his chest.

-Where is my daughter? Where is Zhanna? – he asked the maid who was sweeping the room.

“Mademoiselle is collecting lilies of the valley in the grove,” she answered.

- Oh yes! How could I forget?.. After all, it’s spring now... Everything is blooming, everything is fragrant. Nature smiles, there is a sea of greenery and flowers all around. But the most beautiful flower is you, my Jeanne, my beloved, my chaste child!..

And against his will, his gaze again rushed to the majestic castle standing on the hill.

- Here it is, the center of evil! - exclaimed the old man. “How I hate Montmorency, whose power crushed and destroyed me—me, Señor de Pienna!” But not so long ago everything around me belonged to me... Now I am reduced to poverty, the insatiable constable has robbed me, leaving only a tiny piece of land... Woe to me, a pathetic madman! Maybe right now, at this very moment, the enemy is plotting against us, wanting to deprive us of this, our last refuge!..

The old man's eyes became moist, his face expressed despair and sorrow.

Then a man in black appeared in the room. The owner of the house turned deathly pale, and the one who entered silently bowed...

- I guessed! - the old man whispered. - These are bailiffs from the Montmorency domain!

“Messiere de Pienne,” said the man in black coldly, “the constable has just handed me a document with which I am obliged to familiarize you.” Take a look - this is the verdict of the Paris court. Yesterday, that is, Saturday, April 25, 1553, the court found that you are not the legal owner of the lands of Margency. King Louis XII had no right to grant you this estate, and now it must be immediately returned to the gentlemen of Montmorency. Please give the house, services, meadow and forest to the true owners.

Messire de Pienne listened silently to the stranger's words. He seemed petrified, and only his terrible pallor betrayed his feelings.

But the bailiff finally fell silent; then the old nobleman began to speak, his voice breaking with emotion:

- Oh, my lord Louis XII! O worthy King Francis! You are probably turning over in your graves, hearing how they humiliate a soldier who participated in forty great battles, who many times shed his blood for his sovereigns and did not spare his life for them! So now admire how the weak veteran wanders with a beggar’s bag along the roads of France!

The grief of the venerable old man threw the nobles into confusion; he hastily threw the ill-fated document on the table and flew out of the house like a bullet.

Left alone, sir de Pienne wrung his hands in despair. But only the fate of his beloved daughter scared him.

- What will happen to my dear girl? She lost everything - both shelter and a piece of bread! I curse you, villain, I curse the whole vile family of Montmorency!

The grief of the unfortunate old man was deep and genuine: the court ruling meant complete disaster for his family. Once, during the time of Louis XII, he ruled all of Picardy, but now he only has the poor estate of Margency. Ruined and humiliated, de Pienne settled here, in a poor house, standing on a piece of land, surrounded on all sides by the possessions of the powerful constable. But this was also taken away from de Pienne!.. The shame of poverty awaited the old man and his young daughter!

Zhanna was barely sixteen. Slender, gentle and very graceful, with her head set proudly, she involuntarily attracted all eyes. The girl looked like a beautiful, fragile flower, on whose petals in the first rays of the sun droplets of dew shine like diamonds. This graceful creature surprisingly resembled the spring sorceress herself!

On that fateful Sunday, April 26, 1553, Jeanne ran after lunch into a chestnut forest that grew near Margency. The girl’s heart was beating desperately, and a whisper escaped her lips, revealing the confusion of the young soul:

- But how can I confess! This evening I will definitely tell him... Yes, of course, I will... God, how afraid I am!.. But what happiness this is!..

And then Jeanne was suddenly torn from the ground by strong, gentle hands, and hot lips merged with her lips.

- I've been waiting for you, my darling!

- Oh, Francois! Darling…

– What’s wrong with you, my dear?.. Why are you trembling so much?

The slender young handsome man again attracted Zhanna to him. He had an open, kind face and a direct, bold gaze, in which restrained dignity was visible. However, the name of the young nobleman was Francois de Montmorency! Jeanne gave her heart to the eldest son of Constable Anne de Montmorency - and her lover's father had just robbed her own father of the last crumbs of his former wealth.

The young people, hugging each other, slowly walked through the meadow, full of fragrant flowers. But Zhanna could not stop trembling and often froze in fear:

- What is this?! Steps? Someone is spying on us!..

“No, it’s a bird that fluttered...” Francois gently reassured the girl.

- Oh, my love, I’m so afraid...

- Well, my dear... After all, I’m with you! Three months ago - God bless that moment - you entrusted your honor to me, and now I am your devoted protector until the end of my days. What scares you? Very soon you will become my beloved wife, and we will put an end to the feud between our families!

- Yes, my beloved, of course. But even if fate does not give me more happiness, it has already given me our love. Oh, Francois, please love me! But I know, I feel, trouble awaits us...

- Zhanna, dear, I love you more than life itself, and - God is my witness - there are no obstacles in the world that I will not overcome in order to marry you!

As soon as these words were spoken, someone laughed quietly in the bushes, but the young people did not notice anything: they were too absorbed in each other...

“If something is bothering you,” Francois whispered affectionately, “open up to me, I love you, I am your husband before God...”

- Yes, yes, definitely, come to the nurse’s house at midnight today... I have to tell you one very important news...

- Okay, meet me at midnight, my angel...

– Now you need to go!

The young man hugged his beloved tightly, and their lips merged in the last kiss. But Francois reluctantly wandered away and soon disappeared into the forest, and Jeanne, frozen, still looked after him...

But in the end, sighing heavily, she turned to go home too, and turned white with horror: next to her she saw a young man. He was about twenty years old, but such a young age did not fit with his angry, arrogant face and cold, merciless eyes. Zhanna screamed in fear:

- Lord, Henri! It is you?!

- Yes, it’s me! My appearance seemed to frighten you? But can't I chat with you just like my brother?..

Jeanne trembled, and Henri, grinning, said:

-You don't want to talk to me? However, your wishes no longer interest me. So, it's me, my dear! I heard almost everything and saw everything! Hugs, kisses... How I suffered because of you, Zhanna! After all, I swear to God, I confessed my love to you before Francois! So why am I worse than him?

“Henri, I love and respect you,” Jeanne answered in a trembling voice, “and I will always love you as a brother... the brother of the man to whom I gave my heart... I assure you, I really have the warmest feelings for you... After all, I didn’t become anything.” tell Francois...

- Yes, you just didn’t want to worry him. No, let him know that I'm crazy about you. Then he will have to challenge me to a duel.

-Are you crazy, Henri? What are you saying? After all, Francois is your brother!

– Francois is my rival. Everything else is nonsense. Think about it, my dear.

Henri shook with anger, he could hardly speak:

- So, you rejected me? Yes?.. Oh, you’re not answering me? Well! You will soon regret your decision!

- God! There is so much rage in your eyes! But I beg you - pour it out only on me!

Henri jerked as if from a blow.

- Farewell, Jeanne de Pienne! Very soon you will hear about me...” he hissed.

Hatred distorted his face, and, trembling like a wounded animal, the young man shook his head and rushed into the forest thicket.

“Let his rage be poured out only on me,” Zhanna whispered again, looking after him.

But as soon as she had time to say this, she was suddenly overcome by a new, unknown feeling, rising, it seemed, from the most hidden corner of her soul. Zhanna trembled, involuntarily covered her stomach with her hands and fell to her knees. Groaning in horror, she muttered:

- Only on me... But I no longer have the right to control myself... After all, a tiny creature also lives in me and wants to live on...

A quiet moonless night came to the Montmorency Valley. The clock in the Margency bell tower slowly struck eleven times.

Jeanne de Pienne lowered the yarn into her lap and began to count the strokes. She recalled her father's strange behavior.

– Something happened... When I returned, the priest was very alarmed. Why did he so impulsively attract me to him? And this pallor of him! However, despite my pleas, he did not tell me anything...

Jeanne turned off the lamp, threw her cloak over her shoulders, went out and headed to the peasant house, which stood not far from the house of Señor de Pienne.

The girl was walking along a hedge of blooming rose hips when she suddenly thought that someone’s shadow flashed behind the bushes.

“François!..” Jeanne called out quietly, but no one answered her. She quickened her pace, and the shadow slid towards de Pienne's house, and someone knocked several times on the lighted window.

Zhanna's father had not yet gone to bed. With his head bowed, he walked from corner to corner, oppressed by thoughts about the future of his only daughter. A sudden knock made him jump. The old man expected the worst.

Opening the door, Monsieur de Pienne looked at the uninvited guest, recognized him and could not restrain his words of curse. On the threshold stood the son of his worst enemy, young Henri de Montmorency!

The old man silently rushed to the wall on which the weapons were hung, grabbed two swords and threw them on the table with a crash. Henri shrugged his shoulders in bewilderment and entered the room. He was about to say something, but M. de Pienne pointed to the rapiers with an imperious gesture.

Henri chuckled, shook his head and took the old man’s hand:

- Enough! I didn't come here to compete with you. - The voice of young Montmorency trembled and broke; he seemed to have lost his mind. - Why do I need it? I can kill you, but there is no hatred in my soul for you. What does it matter to me that, through the fault of my father, you are on the brink of poverty! Yes, I know, I know... Through the efforts of the constable you lost all your possessions... From rich and powerful you turned into poor and outcast!..

– Do you want to hear why I’m here? Because I know: my family, the Montmorency family, is to blame for your misfortunes! Madman, I know how much you hate us all, so I came to tell you: the behavior of your daughter Jeanne de Pienne, who has long been the mistress of Francois de Montmorency, is disgusting and blasphemous!

Monsieur de Pienne staggered. The light in his eyes faded, and he involuntarily raised his hand, wanting to slap the offender in the face who had inflicted an unheard of insult on him. But Henri de Montmorency, with lightning speed, grabbed the old man’s hand and squeezed her wrist with all his might.

- Do not believe?! - he growled. “My God, right now, at this very moment, your daughter is in the arms of my brother!” Come with me and you will see it with your own eyes!

Unhappy and confused, Jeanne's father obediently followed the young man. Henri kicked open the door to the next room, and both entered Jeanne's bedroom. The girl was not there...

Monsieur de Pienne raised his hands to the sky, and in the silence of the night words of powerless despair and curse sounded. The old father with difficulty, on weakening legs, left his daughter’s room; he was hunched over and clinging to the walls with his hands. Henri, grinning, disappeared into the night.

...Jeanne de Pienne approached the peasant house. The chime of the tower clock announced midnight, and at the turn of the path, three steps from the girl, Francois appeared... She recognized him and rushed towards him. The lovers hugged each other and were silent for a long time, suffocating from the feelings that overwhelmed them.

- Darling! - François de Montmorency finally whispered. “Today we have little time: a messenger has just arrived at the castle with the news that my father is returning in an hour.” I must be home by the time the constable arrives... So tell me, my love, what is tormenting you so much? Don’t be afraid to trust me, remember that I am your husband and you should not have secrets from me...

– Husband... Oh, Francois, what a wonderful word! I even felt dizzy.

“You are my wife, Jeanne, and I swear to you this by that glorious, untarnished name that I bear!”

“Okay,” she said nervously. - So listen...

Francois leaned towards her, and the girl laid her head on his shoulder, searching for the right words...

But at that moment the silence of the night was broken by a scream: a man screamed as if death itself was looking into his eyes.

The girl escaped from the gentle arms of her lover and ran to her home. The door and window were open. Zhanna ran into the dining room and saw her father, who was groaning and whispering something hoarsely, huddled in a chair. She rushed to him and, sobbing, clasped her gray head in her hands:

- Father! Father! It's me, your Zhanna!

The old man opened his eyes and looked intently at his daughter. She involuntarily fell silent and even backed away: Monsieur de Pienne’s gaze was very eloquent. Zhanna realized that her father knew everything. Unable to hide anymore, Zhanna, looking down, said:

- Forgive me, father, forgive me! I loved him and will always love him! Don't look at me so reproachfully! Or do you want my death, do you want me to die here, at your feet, from grief and despair?! I’m not to blame for anything, I just love him... We were attracted to each other, and we could not resist this irresistible force... Ah,” father, “if you knew how much I love him!

While she was speaking, Monsieur de Pienne slowly rose to his feet and straightened up to his full height. Silently, with a face frozen with grief, he brought the girl to the threshold and, pointing his hand into the darkness of the night, said:

- Go away, I don’t have a daughter anymore!

Zhanna staggered, and a quiet groan escaped from her chest.

But then words were spoken that restored her strength:

- You are mistaken, sir, you have a daughter. Your son swears to you this!

And Francois de Montmorency approached M. de Pienne. Zhanna smiled faintly, and a spark of hope lit up in her eyes. However, the old nobleman, stepping back, exclaimed angrily:

- My daughter's lover! Here, in front of me!

Francois bowed with dignity, without betraying his excitement.

- Dear sir, do you agree for me to become your son?

- Son? - muttered the old man. - What he says! What a cruel mockery!

François gently took Jeanne's hand and turned again to the lord de Pienne.

“Sir, do me the honor and agree to the legal marriage of Francois de Montmorency and your daughter Jeanne,” the young man said in a clear voice.

- For a legal marriage?! You are probably delusional... But our families!..

- I know everything, sir! I will marry Zhanna, and justice will be restored. Your troubles will remain a thing of the past... I'm waiting... Zhanna's and my life and fate depend on your answer!

A wave of joy swept over the old man, and he smiled, ready to bless his daughter, but then he was suddenly struck by a terrible guess: “This man knows that I will soon die, and after my death he will laugh at the poor thing just as he is now laughing at her father.” !”

“Decide, dear sir,” insisted Francois.

- Father, don’t be silent, say something! - Zhanna begged.

“Are you really going to marry my daughter?” – the old man asked quietly.

Young Montmorency realized what was troubling a man finishing his life’s journey, and said firmly:

– I’ll marry her tomorrow!

- Tomorrow! - Monsieur de Pienne sighed heavily. “I feel like tomorrow I won’t be alive.”

- No, you are mistaken, I assure you! You will live for many more years, blessing our union.

- Tomorrow! – without listening to him, the old man repeated. - It's too late, too late! Everything is over. I'm leaving... Strength and hope have left me!

Francois looked around and saw that all the few servants had gathered, awakened by the noise, at the threshold and were watching them with curiosity. The young man shook his head decisively, motioned to two servants to seat the dying man in a chair, and solemnly said:

- Father, midnight has already passed. Your chaplain can begin the first service... So let him immediately unite the de Pienne family and the de Montmorency family!

- God! Isn't this a dream? – the old warrior whispered, and his heart completely thawed. Monsieur de Pienne's eyes filled with tears, and with a weak hand he crossed the noble scion of a family he hated.

Ten minutes later, the wedding ceremony began in the tiny Margency chapel. François and Jeanne stood in front of the altar. Behind them, in the chair in which “they brought him to the church,” sat Monsieur de Pienne, and behind them, holding their breath, stood two women and three men—servants from Margency, witnesses of this strange and tragic wedding.

The lovers exchanged wedding rings and joined their hands.

The priest said the final words of the ceremony:

– Francois de Montmorency, Jeanne de Pienne, in the name of the Living God, you are united forever...

The newlyweds turned to Monsieur de Pienne, expecting a fatherly blessing. He smiled at them with only his lips, his hands fell powerlessly on the armrests of the chair, and his head bowed to his shoulder.

Monsieur de Pienne is dead!

IN THE NAME OF GLORY

An hour later, Francois returned to the Montmorency castle. He left the sobbing newlywed in the care of a nurse, a longtime confidante of their love. Parting with Zhanna, he vowed to come in the morning, after a conversation with his father, whose arrival was expected at night.

Francois entered a spacious armory hall, decorated with huge tapestries and brightly lit by twelve bronze candelabra, in each of which burned a dozen wax candles; Heavy swords and jeweled daggers hung on the walls. In addition to a rich collection of weapons, the hall was decorated with a dozen portraits. A huge panel, just opposite the chair, depicted the famous ancestor of Montmorency, the stern warrior Bouchard, captured at the very moment when the crown of France was in his hands. The armor, cuirasses, helmets with plumes, piled against the walls, gleamed dimly, as if expecting the great ancestors of Montmorency to leave the canvases and put on armor.

Constable Anne de Montmorency had already taken his usual place in the elegant chair that stood on the dais. The old constable was clad in heavy armor; a page standing nearby held his helmet. The constable's hands rested on the hilt of a magnificent sword; the eyebrows were furrowed menacingly. Fifty officers stood motionless next to the chair.

The commander himself seemed to be the living embodiment of those warriors of antiquity who fought in legendary battles.

Beginning with the battle of Marignan, after which Francis I kissed the brave duke, and ending with the battle of Bordeaux, when the old warrior, having completely defeated the Huguenots, saved the Holy Faith and the Catholic Church, the constable mercilessly exterminated his enemies.

Two years have passed since Francois last met his father. The young man took a few steps forward. At the foot of the chair already stood pale, excited Henri, who had appeared here a quarter of an hour earlier than his brother.

Respectfully bowing before his father, François de Montmorency did not notice the cruel look that Henri gave him. The constable smiled approvingly at the sight of his stately, broad-shouldered eldest son, but did not allow himself any manifestations of fatherly feelings.

Anne de Montmorency's face again became cold and impassive, and he spoke quietly:

- So, listen to your master. You all know that Emperor Charles V suffered a crushing defeat under the walls of Metz last December. Cold and disease destroyed a gigantic army of sixty thousand people in a few days, destroying both infantry and cavalry... Many then decided that the Holy Empire had come to an end! Then we defeated the Spaniards, I defeated the Huguenots in Languedoc, and it seemed to us all that peace had come. His Majesty King Henry II organized festivities, balls and tournaments all spring... But the awakening turned out to be terrible.

The constable paused, and then, sighing, continued:

“Sometimes the elements teach conquerors a cruel lesson. It was she who took up arms against the army of Charles V. We know that the emperor sobbed, leaving positions where twenty thousand dead and fifteen thousand sick soldiers and eighty artillery pieces remained... But he long ago wiped away his tears and gathered his courage.

Yesterday, at three o'clock in the afternoon, we received news: Emperor Charles V is preparing to march on Picardy and Artois! The unbending commander is again leading a huge army towards us. At these very moments, the infantry and artillery are moving towards Terouanne in a forced march. I hope you all understand that Therouanne is the gateway to our beautiful France. The king and I made a decision: the army under my command will concentrate in the vicinity of Paris and will set out in two days. But before this happens, two thousand horsemen will go to Terouanne, take up defense there and die, but will not let the enemy through.

- We will die, but we will not miss it! – the warriors unanimously picked up.

“This dangerous expedition should be commanded by a young man and a little reckless, a man whom nothing can stop... And I know such a brave man.” Francois, my son, take command!

- Yes, you, it is you who will save the king, your father and France! Two thousand horsemen are waiting for you. Come on, take up arms! You leave immediately. Hurry up, don’t stop until Terouanne, where victory or death awaits you and your warriors! You, Henri, will remain in the castle and lead its defense.

Henri bit his lip until it bled, wanting not to betray the evil joy that gripped him at this news.

“Now Zhanna is mine!” – he was convinced.

François, turning pale, stepped back:

– Father, but I... Is it really impossible to postpone the departure?

Confused, struck to the very heart, he imagined his Jeanne... his young wife, an unhappy, abandoned orphan...

- I? - he muttered. - But I can’t... It’s impossible...

The constable knitted his eyebrows:

- In the saddle, Francois de Montmorency! In the saddle!

- Father, I beg you... Give me two hours... no, an hour! I only ask you for an hour's grace!

Angered by his son's disobedience, the constable rose from his chair:

– I will not tolerate discussion of the order of the king and the commander!

“Just one hour, father, and I will gladly go to my death!”

- Strike me down if I blaspheme, Francois de Montmorency! But in the five centuries of history of our family, you are the first Montmorency who was afraid of death! Shut up, or I will order your arrest! Don't dare to stain the glorious name you bear!

Hearing this terrible insult, François straightened up proudly and flashed his eyes. He immediately forgot about everything: about love, about his wife, about family happiness.

- No one dares to say that Montmorency retreated! Father, I submit to your and the royal will and leave. But if I return, Mr. Constable, you will answer for your words. Farewell!

With a firm step, Francois walked past the nobles, shocked by this unheard-of audacity - a rebuff given to the powerful constable, and also to his father.

Everyone was sure that the old military commander would give the order for the arrest. But the constable's face suddenly lit up with a smile, and those standing nearby heard his exclamation of approval:

- True Montmorency!

Ten minutes later, Francois, having put on his armor, went down to the front yard. His horse was already saddled and was chomping at the bit impatiently. The young commander turned to the page:

-Where is my brother Henri? Let him be called!

- I'm here, Francois! – And Henri de Montmorency appeared in front of him, illuminated by the trembling reflections of the torches.

Francois grabbed his brother's hand, not noticing that he was shaking as if in a fever.

- Henri, tell me, are you devoted to me? Are you ready to prove your brotherly love?

- Do you really doubt me?

- Sorry! I'm suffering so much! Now you will understand everything... I'm leaving, maybe I won't be able to return. Lord, how hard it is for me to leave this house! Listen carefully, because my final decision depends only on you. Do you know Jeanne, daughter of the Lord de Pienne?

“Yes, of course,” Henri answered briefly.

“You see, brother, I’ve loved her for a long time!” Wait, don’t interrupt, listen to the end,” Francois continued, with a gesture stopping Henri, who was trying to say something. – We fell in love with each other six months ago, and three months later we became close. She just got married to me!..

A muffled groan escaped Henri's chest.

“Don’t be surprised,” Francois said excitedly. “I don’t have much time, and I won’t be able to tell you all the details.” Tomorrow she herself will tell you how the priest in Margency married us last night. But that is not all. Now, at these very moments, Zhanna is mourning her father. Monsieur de Pienne has died! He died right in the church! He died, and I was left as the only protector of his daughter. But that's not all! Today Margency has been returned to the constable's possession. You see, Henri, everything is going so badly, I’m leaving, and Jeanne will be all alone, helpless, without a means of support... Do you hear me?

- Yes, I hear you, continue.

- I'll finish soon, Henri. Will you fulfill my request? Please swear to take upon yourself the care of the woman whom I love with all my heart and who bears my name. Do you swear?

“I swear,” Henri answered quietly.

“If I do return from the war safe and sound, Zhanna will be waiting for me at our father’s house.” Promise me this! While I'm gone, you will become her patron and protector. Do you swear?

- I swear...

“Well, if I die, you will tell the constable everything and persuade him to fulfill my last will: let my part of the inheritance go to Jeanne, this will save her from poverty and provide her with a decent life.” Do you swear?

- I swear! – Henri repeated for the third time.

- So remember, you swore an oath! – and Francois impulsively hugged his brother.

Then François jumped into the saddle and took his place at the head of a column of two thousand horsemen. Raising his hand, he shouted in a voice that rang with despair:

- Forward! Victory or death!

In the distant chambers of the castle, the gray-haired constable must have heard the cry of his eldest son...

Finally, the old warrior forced himself to look away, but at the same time a heavy sigh escaped from his chest.

Where is my daughter? Where is Zhanna? - he asked the maid who was sweeping the room.

“Mademoiselle is collecting lilies of the valley in the grove,” she answered.

Oh yes! How could I forget?.. After all, it’s spring now... Everything is blooming, everything is fragrant. Nature smiles, there is a sea of greenery and flowers all around. But the most beautiful flower is you, my Jeanne, my beloved, my chaste child!..

And against his will, his gaze again rushed to the majestic castle standing on the hill.

Here it is, the center of evil! - exclaimed the old man. - How I hate Montmorency, whose power crushed and destroyed me - me, Senhor de Pienna! But not so long ago everything around me belonged to me... Now I am reduced to poverty, the insatiable constable has robbed me, leaving only a tiny piece of land... Woe to me, a pathetic madman! Maybe right now, at this very moment, the enemy is plotting against us, wanting to deprive us of this, our last refuge!..

The old man's eyes became moist, his face expressed despair and sorrow.

Then a man in black appeared in the room. The owner of the house turned deathly pale, and the one who entered silently bowed...

I guessed! - the old man whispered. - These are bailiffs from the possessions of Montmorency!

Messire de Pienne,” the man in black said coldly, “the constable has just handed me a document with which I am obliged to familiarize you.” Take a look - this is the verdict of the Paris court. Yesterday, that is, Saturday, April 25, 1553, the court found that you are not the legal owner of the lands of Margency. King Louis XII had no right to grant you this estate, and now it must be immediately returned to the gentlemen of Montmorency. Please give the house, services, meadow and forest to the true owners.

Messire de Pienne listened silently to the stranger's words. He seemed petrified, and only his terrible pallor betrayed his feelings.

But the bailiff finally fell silent; then the old nobleman began to speak, his voice breaking with emotion:

Oh, my lord Louis XII! O worthy King Francis! You are probably turning over in your graves, hearing how they humiliate a soldier who participated in forty great battles, who many times shed his blood for his sovereigns and did not spare his life for them! So now admire how the weak veteran wanders with a beggar’s bag along the roads of France!

The grief of the venerable old man threw the nobles into confusion; he hastily threw the ill-fated document on the table and flew out of the house like a bullet.

Left alone, sir de Pienne wrung his hands in despair. But only the fate of his beloved daughter scared him.

What will happen to my dear girl? She lost everything - both shelter and a piece of bread! I curse you, villain, I curse the whole vile family of Montmorency!

But how can I confess! This evening I will definitely tell him... Yes, of course, I will... God, how afraid I am!.. But what happiness this is!..

And then Jeanne was suddenly torn from the ground by strong, gentle hands, and hot lips merged with her lips.

I've been waiting for you, my darling!

Oh Francois! Darling…

What's wrong with you, my dear?.. Why are you trembling so much?

The young people, hugging each other, slowly walked through the meadow, full of fragrant flowers. But Zhanna could not stop trembling and often froze in fear:

What is this?! Steps? Someone is spying on us!..

No, it was a bird that fluttered... - Francois gently reassured the girl.

Oh, my love, I'm so afraid...

Well, my dear... After all, I’m with you! Three months ago - God bless that moment - you entrusted your honor to me, and now I am your devoted protector until the end of my days. What scares you? Very soon you will become my beloved wife, and we will put an end to the feud between our families!

Yes, my beloved, of course. But even if fate does not give me more happiness, it has already given me our love. Oh, Francois, please love me! But I know, I feel, trouble awaits us...

Zhanna, dear, I love you more than life itself, and - God is my witness - there are no obstacles in the world that I will not overcome in order to marry you!

As soon as these words were spoken, someone laughed quietly in the bushes, but the young people did not notice anything: they were too absorbed in each other...

If something is bothering you, - Francois whispered tenderly, - open up to me, I love you, I am your husband before God...

Yes, yes, definitely, come to the nurse’s house at midnight today... I must tell you one very important news...

Okay, see you at midnight, my angel...

Now you need to go!

Lord, Henri! It is you?!

Yes, that's me! My appearance seemed to frighten you? But can't I chat with you just like my brother?..

Jeanne trembled, and Henri, grinning, said:

You don't want to talk to me? However, your wishes no longer interest me. So, it's me, my dear! I heard almost everything and saw everything! Hugs, kisses... How I suffered because of you, Zhanna! After all, I swear to God, I confessed my love to you before Francois! So why am I worse than him?

Henri, I love and respect you,” Jeanne answered in a trembling voice, “and I will always love you as a brother... the brother of the person to whom I gave my heart... I assure you, I really have the warmest feelings for you... After all, I didn’t tell anything Francois...

Yes, you just didn’t want to worry him. No, let him know that I'm crazy about you. Then he will have to challenge me to a duel.

You're crazy, Henri! What are you saying? After all, Francois is your brother!

Francois is my rival. Everything else is nonsense. Think about it, my dear.

With hereditary blood diseases, in particular hemophilia, providing patients with the drugs they need on time and in sufficient quantities is a matter of health and life. However, as # President of the Republican Association of Hemophiliacs Gulnara Huseynova said, this year in Azerbaijan, people with hemophilia faced a shortage of blood clotting factor concentrate.

“The problems were observed for several months, and in September the patients were left without this drug, which they needed. If people with hemophilia are not given this concentrate in time, they may begin to bleed - for one reason or another or without it. Thus, due to a shortage of drugs, some patients experienced hemorrhages in the joints. With such hemorrhages, the rehabilitation process is very complex; it requires time, a therapeutic approach and additional doses of concentrate. The joint in which the hemorrhage occurred is called the target joint, since later it is there that there is a high probability of repeated hemorrhages,” she noted.

According to our interlocutor, the Ministry of Health resumed supply of the drug after some time. But for now it is not enough, we must hold out until February, when a new batch arrives. No explanation was given as to why there was a failure in the supply of concentrate. Last year, the insufficient quantity of the drug was explained by inflation, due to which it was purchased in smaller quantities. The shortage of the drug was also explained by unplanned surgical operations, as a result of which a lot of concentrate was wasted. However, this point had to be foreseen. In general, as G. Huseynova said, in recent years there has been a sad downward trend in the amount of the drug dispensed.

“All over the world there is a practice of calculating the required number of units of blood clotting factor concentrate per capita. At a minimum, there should be 4 units per capita, but this year we had only 1.1 units, that is, three times less than the permissible minimum.

However, the Ministry of Health assured us that in 2019 the situation will change for the better, and the drug will be provided in sufficient quantities. By the way, certain improvements are already noticeable, since after a month without the drug, the patients were given a newer, third-generation drug. We hope that the course towards safer and higher-quality treatment will be continued,” said G. Huseynova.

She noted that today there has been a breakthrough in the treatment of hemophilia in the world. Thus, the drug Emicizumab was recently patented, which is now being administered to seriously ill patients in Europe. It is done not intravenously, but intramuscularly, and not three times a week, but once a month. This is a great relief for patients, and the president of the Association expressed hope that such a drug will soon be used in Azerbaijan.

Speaking about the situation with providing hemophilia patients with drugs in the regions, G. Huseynova said that if the situation was difficult in Baku, then everything was much worse there.

“But, as the Ministry of Health notes, next year the situation in the regions will improve markedly. Now children from the regions are forced to come to Baku for treatment, covering a long distance several times a year. But it is planned that next year children will be able to receive the help they need locally. Now the process of improving doctors is underway,” she said.

The expert noted that she expects positive changes in the lives of patients with hemophilia in the foreseeable future, but does not yet have complete information about all the upcoming changes.

If we talk about positive aspects, this year, according to G. Huseynova, two regional and Baku hemophilia centers were equipped with the necessary physiotherapeutic equipment to help prevent disability in patients with hemophilia. These are new multifunctional and portable devices.

She said that, according to the hematology department at the Republican Clinical Hospital, there are a total of 1,620 patients in the country suffering from bleeding, including patients with hemophilia. This figure is higher than last year. In general, according to the Hemophilia Center, there are 40-60 more patients every year. The increase, according to the expert, is largely due to increased awareness of the population; people know that such diseases can be treated and one can live normally with them.

“Another reason for the increase is the lack of normal family planning. That is, for example, there is a child with hemophilia in a family, and the parents decide to have a second child without consulting doctors or geneticists. If there are people in the family with hemophilia, then there is a possibility of having children suffering from this disease. What matters here is whether there are women in the family who are carriers of the hemophilia gene. Let me remind you that only women can be carriers of this gene, and in the vast majority of cases men suffer from hemophilia,” G. Huseynova noted.

According to her, many people believe that the main reason for the birth of children with hemophilia is consanguineous marriages, but this is not so. Yes, the probability in this case may be higher, but there are many families in which the parents are not related to each other, and, nevertheless, they have children with hemophilia. The President of the Association stated that it is necessary to create a genetic laboratory in the country in order to prevent the birth of children with this hereditary disease.

- How much blood do they take?
- Yes, like half a liter.
- Take it while it flows!
This is a dialogue in line to donate blood to victims of the explosion on Pushkinskaya. The line laughs, but somehow nervously. We have been waiting for about an hour, and it is unknown when they will call us - we are invited to donate blood only after checking our health, and preference is given to professional donors (about whom doctors already know everything) and men of large build - it is believed that they tolerate this procedure better. After half an hour, it begins to seem to everyone else that they will never get into this operating room, and all their noble impulse will be in vain. Jokes in the spirit of medical jokes keep morale up at least a little.
But, although everyone at the St. Vladimir Children's City Clinical Hospital is indeed slightly tense, this is nothing compared to the queue at Sklif, where in the morning many of those present had to stand in the heat for several hours: first registration, then tests, then delivery... By 10 By the hour, more than a hundred people wishing to donate blood had already gathered in the courtyard of the institute: although several addresses of hospitals were named, the majority came to Sklif. He is more widely known, and easier to find. As a result, a huge number of people gathered at the famous institute, and almost no one arrived at the other blood collection points, for example at the city station, in the morning.
The doctors tried to explain all this to the citizens, but they listened poorly. After long hours in the heat, emotions are more difficult to contain and spill out on the doctors. A woman of about 50, standing in front of me, was simply indignant to the point of white heat - she has been standing here since 8 in the morning, and came yesterday, and is it really difficult to organize everything quickly?! “The bureaucracy has been scammed,” said a man nearby. The situation became very tense, but then the doctors offered a new option - register now, make lists and come on any convenient day later. But this solution seemed to suit few people: almost everyone turned out to be working people, and no one wanted to skip out again. Then doctors began to suggest that those who were especially impatient go to other hospitals, where blood was also needed. Many, after listening to the doctors and looking at the queue, decided to do so.
The St. Vladimir Children's Hospital is not so far from Sklif - a few metro stops in Sokolniki. But no matter how much I was in a hurry, about 10 people got there earlier. There were no relatives and friends of the victims here - no one was brought to this hospital from Pushkinskaya. Apart from a few full-time donors, everyone here is volunteer. You no longer have to stand here—there are sofas in the reception area—and people’s spirits have lifted. As soon as I entered, several people immediately turned and said at once:
- Shoe covers!
After these words, my face apparently became quite surprised, since they immediately explained to me that I was supposed to wear rag “shoe covers” on my shoes - sort of like in a museum - so as not to carry dirt from the street. I filled out the form and read about the contraindications – by the way, there are quite a few of them: from the usual “Mantoux” to mental illness and deaf-muteness. Viral hepatitis and stomach ulcers are also mentioned - those who have suffered from them cannot be a donor at all, regardless of the timing. They will also not accept blood from an alcoholic or drug addict.
While I, under the guidance of my comrades from the queue, am filling out a form and trying to remember which of the things listed on the list I have ever been sick with, a new face appears, and everyone turns to him:
- Shoe covers! - we shout in one voice and I already observe, not without pleasure, the expression on the newcomer’s face - it, just like mine, becomes confused.
The mood of those waiting rises again, and the newcomer - and this is a very elderly man with an honorary donor certificate - is explained what's what. But after a few minutes it becomes clear that he came in vain, despite his “crusts”: according to the new rules, you cannot donate blood even if you are drug-free. For some time, grandpa tries to prove his rights, but leaves with nothing.
It’s strange to observe, but what those present are most worried about is not the donation itself - although 500 milliliters of blood is actually taken from donors - but they are afraid that they won’t be allowed to donate. In my presence, one of the young people was found to have a so-called exemption - a ban on donating blood. He left the office in a rage. Another student arrived with a friend - a full-time donor, but she was not allowed to donate - it turned out that she was not yet 18 years old. Some – what’s even more offensive – simply forgot to bring their passport – and without this, no one is allowed to take the test.
Meanwhile, there were not just a lot of people at the hospitals, but a lot of them - from Sklif to the children's hospital of St. Vladimir they began to bring people on a special bus in an organized manner. The reception area became very noisy and crowded. But there is no longer any hostility; everyone, on the contrary, is trying to help each other. Remind them not to forget to drink a cup of hot sweet tea with cookies (a mandatory procedure in this hospital before donating blood).
- Tell me, do you have lists of victims? – the girl still doesn’t know what happened to her friend, whether she was even at the scene of the explosion. But there are no lists here, you have to call the editor to clarify the lists of victims.
- What is your friend’s last name?... There are no such people!
The girl’s heart is clearly relieved; she noticeably stops being nervous. And then we are called into the operating room. I know my blood type, so a preliminary test is not needed... Did you eat? Yes, but, as expected, more than four hours ago...
New donors emerged from the walls of the hospital with brightened faces and without hiding their bandaged elbows. It’s very funny to watch from the outside - they gave half a liter of blood and are happy. But in return, many volunteers acquired a long-forgotten feeling of belonging to something very important and good... A good feeling, by the way.

Tatiana Gomozova
photo - REUTERS

The method of replacing blood with a rejuvenating decoction was described in Ovid’s Metamorphoses, but even then hardly anyone perceived it as anything other than a fairy tale. Both in ancient and more enlightened times, doctors thought more not about magical blood substitutes, but about saving the wounded and women in labor and tried to develop a way to safely transfuse blood.

Such attempts most often ended in failure - until 1901, when the Austrian immunologist Karl Landsteiner discovered the existence of blood groups (in 1930 he received the Nobel Prize for this). And after in 1914, the Russian doctor Vadim Yurevich (and at the same time his Belgian and American colleagues) proposed preserving blood with a solution of sodium citrate, blood transfusion became an ordinary medical procedure.

With the development of transfusiology, the problem of blood substitutes has become urgent. It's not even a question of a shortage of donor blood - now it exists only in poor countries. In Russia there is no shortage as such, and moments of some tension (as a rule, in cases of terrorist attacks or natural disasters) arise not because of a lack of donors, but because of poor organization of blood procurement.

Sometimes clinics do not have enough blood of certain types. However, in critical cases, all patients with the same Rh factor can be transfused with blood of group I (0) (its carriers are called “universal donors”). Patients with the rare group IV(AB) - “universal recipients” - can be transfused with blood of any group.

The sword of Damocles for both doctors and patients is the possibility of transmitting infectious diseases with donated blood. But this problem also concerns mostly developing countries, where tests are still not always carried out even for HIV or hepatitis B and C viruses.

Blood groups

The blood type is determined by the glycoproteins contained in the membrane of red blood cells - protein-carbohydrate complexes - A and B (they are called agglutinogens, from the word agglutination - clumping). There may be two types of antibodies to these antigens in the blood plasma - agglutinins, a (anti-A) and I (anti-B). When the interaction of the same agglutinogens and agglutinins (A and a, B and I) occurs, gluing (hemagglutination) and destruction of red blood cells occurs. The figure on the right shows four blood groups - combinations of the presence or absence of these four factors in plasma and red blood cells. When transfusing blood, the Rh factor must also be taken into account. The combinations of proteins and antibodies that determine it are much more complex, but the result is simpler: 85 percent of people (those with positive Rh, Rh+) have a specific protein in their red blood cells, the rest (with negative Rh, Rh-) do not. But the blood type diet is pure quackery. True, there is almost no harm from this (not counting the costs of “research”). There may even be some benefit: having received a list of meaningless prohibitions like “instead of turkey - chicken +, asparagus - lettuce +” on eight sheets with a hologram, you can’t help but think - isn’t it time to stop eating sandwiches on the run and eat three times a day?

In Russia, all donated blood undergoes mandatory testing for HIV, hepatitis B and C, and syphilis (although the pale spirochete dies very quickly outside the body and it is impossible to become infected with syphilis through a transfusion of canned blood). Of course, this is far from the ultimate dream.

In the USA, for example, an analysis is also carried out for antibodies to human T-lymphotropic viruses of types I and II and PCR analysis of nucleic acids for latent infection with human immunodeficiency viruses, hepatitis C and West Nile fever. In our country, studies for the presence of lymphotropic virus and West Nile encephalitis virus in the blood are not carried out, since these infections, fortunately, are not common in our country. Unfortunately, testing for nucleic acids of other viruses is also not mandatory in Russia, but its implementation is included in the development plans of the transfusion industry for the near future.

To improve the safety of blood products in rich countries, various methods of virus inactivation are used, such as treatment with detergents (polysorbitol, Triton X100, sodium thiocyanate), pasteurization and other heating modes, ultra- and nanofiltration. The most universal method for purifying plasma is the latter method, in which the molecules of serum proteins, without being deformed, pass through special filters that retain not only viruses, but also prions, which are considered the cause of the development of Creutzfeldt-Jakob disease - the human analogue of the notorious “mad cow disease”. In Russia, methods of viral inactivation are also gradually beginning to be introduced into practice.

For now, unfortunately, the 100% absence of viruses in donor blood cannot be guaranteed, since it is impossible to detect the presence of the virus using immunological methods immediately after infection. However, the likelihood of such an infection is very low. According to statistics, the probability of contracting HIV infection through a blood transfusion today is approximately one chance in a million.

Blood composition

Approximately 50% of the five liters of blood circulating in the average human body are made up of cells: red blood cells (erythrocytes), white blood cells (leukocytes) and platelets (platelets). Red blood cells are responsible for supplying tissues with oxygen, white blood cells are responsible for protecting the body from infectious pathogens and other foreign objects penetrating into it, and platelets are for blood clotting and stopping bleeding.

Blood plasma contains water and organic and mineral compounds dissolved in it: proteins - including albumins, globulins (including antibodies - immunoglobulins), fibrinogen and other proteins of the blood coagulation system, as well as nutrients (in particular, glucose and fats) , hormones, vitamins, enzymes, metabolic products and inorganic ions.

Another problem is the limited shelf life of blood components. Red blood cells are stored at -4°C for up to 35 days with 70% viability, platelets - only five days. Frozen blood plasma has the longest shelf life (2 years). There is a method for deep freezing blood cells and storing them for a long time in liquid nitrogen at a temperature of -196°C, which theoretically can be used to create banks where biomaterial of everyone would be stored. However, this is not economically feasible and is recommended for preserving one’s own blood only in cases of threat of massive blood loss.

Ideal substitute

It is impossible to completely imitate all the properties of blood, therefore there is no blood substitute in the full sense of the word and, most likely, there will not be.

The portrait of an ideal blood substitute looks something like this: it is non-toxic; does not cause immune or other adverse reactions; has a viscosity similar to blood; has buffering properties, that is, it maintains a constant level of blood acidity; is able to circulate in the body for a long time without losing its properties; does not interact with plasma components and cells; stored at room temperature; has a long shelf life; inexpensive, and most importantly, it transports and releases oxygen and carbon dioxide like hemoglobin.

The first mortal danger with massive blood loss is a drop in blood pressure: so little fluid remains in the vessels that the heart is unable to pump it. The lack of fluid can be replenished with ordinary saline (0.9% NaCl), replacing up to 30% of the blood. This will normalize the pressure for a couple of hours, but will subsequently cause tissue swelling. Colloidal blood substitutes based on gelatin, hydroxyethyl starch, dextran (a polymer of glucose synthesized by some bacteria) or polyethylene glycol can help avoid swelling.

To restore blood volume, donor plasma or human serum albumin solution can be transfused. However, they are expensive, cause a number of adverse reactions and do not exclude the transfer of viruses and prions.

The second possible cause of death due to blood loss may be insufficient oxygen supply to tissues. In this case, it is necessary to introduce red blood cells or oxygen-carrying substitutes. Red blood cells have all the typical disadvantages of donor blood: the possibility of lack of the drug of the required group, the possibility of infection and adverse reactions that often develop even when cells of the desired group are transfused.

The development of synthetic oxygen-carrying blood substitutes is carried out in two directions: solutions of modified hemoglobin and perfluorocarbon emulsions. These substances do not require selection according to group, Rh factor and other tissue compatibility systems, do not tolerate infections, have a long shelf life, they can be accumulated in large quantities and used immediately. They fall short of the ideal only in terms of price and time of existence in the body: donor red blood cells circulate in the recipient’s blood for up to three months, and synthetic ones - no more than a day. But they carry oxygen no worse than whole blood.

Such drugs are especially necessary in emergency situations: a set of packages with precious and perishable red blood cells of different groups cannot be carried in an ambulance just in case. And even when the victim is taken to the hospital, it is better to start transfusion with a blood substitute as soon as possible, and only then administer plasma or red blood cells.

In the spring of 2007, an international group of researchers led by Dane Henrik Clausen developed a way to remove antigens A and B from the surface of red blood cells. For this, highly effective enzymes isolated from bacteria are used Elizabethkingia meningosepticum And Bacteroides fragilis. This does not solve the problem of antibodies in blood plasma, but red blood cells purified from antigens will be suitable for transfusion to recipients with any group.

Due to their small size, perfluorocarbon particles and hemoglobin molecules can deliver oxygen to tissue cells even through narrowed capillaries. This is especially important in case of brain injuries, heart attacks and strokes, when the blood supply to tissues is disrupted, and every preserved cell is priceless. Oxygen-carrying blood substitutes are suitable for saving donor blood during planned operations, and for preserving organs and tissues in transplantology, and even in cases where the patient refuses a transfusion of blood and its components for religious reasons.

Blue blood

In the mid-1960s, scientists tried to use the ability of perfluorocarbons to dissolve up to 50 volume percent oxygen and up to 190 volume percent carbon dioxide to create liquid breathing mixtures. But they received practical application as the basis for blood substitutes.

Japanese and American scientists were actively involved in work in this direction, but after the introduction of experimental drugs, animals often died from blockage of blood vessels. The reason was the relatively large (even in second-generation drugs - about 0.2 microns) droplet size of perfluorocarbons, which stuck together into even larger structures, which led to blockage of small vessels.

The Russian drug Perftoran, developed in the 1970-1980s at the Institute of Biophysics of the USSR Academy of Sciences under the leadership of Felix Fedorovich Beloyartsev, which was called “blue blood” because of its bluish color, is devoid of this drawback. The size of the particles included in its composition is 0.04-0.07 microns (the diameter of an erythrocyte is 7 microns). The ability of small particles of the emulsion to penetrate through compressed capillaries and thus restore blood microcirculation makes it possible to break the vicious circle of functional disorders associated with impaired blood supply to tissues. When there is a lack of oxygen, cells switch from glucose oxidation to a backup energy supply route - glycolysis, the breakdown of glucose into lactic acid. When the environment becomes acidic, the capillaries shrink even more, and even less oxygen enters... Perfluorocarbon particles, which smuggle oxygen to the cells, are able to reverse this process.

Tests of Perftoran on animals, and then in the clinic, demonstrated its exceptional effectiveness. With the help of the then experimental drug, it was possible to save several patients who were considered absolutely hopeless and more than a dozen seriously wounded soldiers in Afghanistan. Perftoran turned out to be not only an excellent blood substitute, but also an effective means for relieving fatal cerebral edema that develops during traumatic brain injuries, for preventing fat embolism - blockage of blood vessels by droplets of fat that enter there from the bone marrow during severe injuries and wounds, as well as for transportation intended for organ transplantation.

Unfortunately, behind-the-scenes games, the struggle for titles and money, as well as the ambitions of certain influential personalities led to the suicide of Professor Beloyartsev, who could not withstand pressure from the KGB, and temporarily suspended work on Perftoran (the details of this sensational dirty story can be found in Simon Shnol’s book “ Heroes and villains of Soviet science"). However, after some time, Beloyartsev’s followers continued the work he had begun, and now in the town of Pushchino near Moscow, the world’s only and truly excellent blood substitute is produced. American Oxygent and Japanese Fluosol-DA were inferior to Perftoran in all respects and are currently not produced.

Natural hemoglobin

Free hemoglobin as an oxygen carrier has a number of advantages over whole red blood cells from donor blood. It does not cause an immune response, which eliminates the need to select a drug for compatibility, provides better oxygen delivery to tissues due to the small size of the molecules, and can be stored frozen for 2-3 years without loss of activity.

The first attempts to transfuse hemoglobin solutions led to the development of severe renal failure, which was caused, as it turned out later, by the presence of fragments of cell membranes in the preparations. In 1970, for the first time it was possible to obtain purified hemoglobin that was non-toxic to the kidneys.

In addition to the difficulty of purifying impurities, free hemoglobin preparations have another significant drawback. Hemoglobin is removed from the body by the kidneys within a few hours after administration, which, given the rather high cost, makes its use economically unfeasible. An alternative is to use cattle hemoglobin, the characteristics of which are even better in some respects than those of humans, but it can become a source of causative agents of spongiform encephalopathy - the Creutzfeldt-Jakob disease mentioned above.

To improve the characteristics of hemoglobin solutions, various methods can be used to stabilize its molecules: polymerization, cross-linking of molecules into dimers, combination with large molecules, and packaging in liposomes.

The Russian drug Gelenpol, based on polymerized hemoglobin from donor blood, successfully passed clinical trials and received a state license in 1998, but its industrial production is still a matter of the future. The one developed by an American company is at approximately the same stage. Biopure a drug Hemopure from polymerized bovine hemoglobin. Their price is much higher than that of donor blood, and their activity in the body lasts less than a day, which significantly reduces the rationality of their use (Perftoran “works” about twice as long).

The sum of the parts is greater than the whole

Transfusing whole blood is not only unnecessary, but also a dangerous luxury. Blood is a complex system of cells and proteins that, when transfused, trigger a response from the patient's immune system. Today, transfusiologists have practically abandoned whole blood transfusions and switched to the use of individual blood components. For several decades now, donor blood has been separated by centrifugation into 3-4 components: plasma, from which various proteins (clotting factors, albumin and gamma globulin), red blood cells and platelets, and, if necessary, leukocytes are isolated. With anemia, the body needs only whole red blood cells, with leukemia - mainly platelets, with hemophilia - protein blood clotting factors isolated from plasma. Red blood cells are transfused in case of massive blood loss (for an adult of average height - 1.5 liters or more). And for the most common indication for transfusion—blood loss after injury or surgery—plasma or artificial blood substitutes are usually sufficient.

Other versions of domestic and foreign drugs based on modified hemoglobin are at various stages of development or preclinical testing.

Other options

There are several other approaches to creating blood substitutes. For example, attempts are being made to grow blood cells from the patient's own stem cells. This option would completely remove the issues of immunological incompatibility and transmission of infections, but the process itself - at least now - is very labor-intensive and expensive. Attempts are also being made to synthesize analogues of human or very effective crocodile hemoglobin using transgenic microorganisms.

Just a decade ago this was bordering on science fiction. However, given the dizzying speed of development of biotechnology and genetic engineering, it is quite possible that in the near future a vial of donor red blood cells will cause us much more surprise than it does now - a reusable glass syringe. Why not?