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Medicine United Kingdom Technology

Human Blood Substitute Could Help Meet Donor Blood Shortfall 172

Zothecula (1870348) writes According to the World Health Organization, over 107 million blood donations are collected around the globe every year, most of which goes on to help save lives. However, while the need for blood is global, much of that which is donated is not accessible to many who need it, such as those in developing countries. And of the blood donated in industrialized countries, the amount often falls short of requirements. To help address this imbalance, scientists at the University of Essex are developing an artificial blood substitute. It would be able to be stored at room temperatures for up to two years, which would allow it to be distributed worldwide without the need for refrigeration and make it immediately accessible at the site of natural disasters.
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Human Blood Substitute Could Help Meet Donor Blood Shortfall

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  • I read about this in Wired more than 5 years ago.
    • TIL this is how the walking dead starts

    • Re:Old News (Score:5, Insightful)

      by ColdWetDog ( 752185 ) on Wednesday June 11, 2014 @08:51PM (#47218935) Homepage

      Yep, like holographic storage it's always five years away. This time it's another promising attempt. If it's like the dozen or so previous promising attempts, the substance will become less promising once it gets through further testing. Eventually it's likely that some approach will succeed - it is not at all clear that this one has any better chance than before (the TFA wasn't terribly insightful).

      But this would be a Big Deal. A really big deal if it were priced reasonably. Blood and blood products are actually pretty expensive despite it being a non profit entity in the US - testing, storage and transport all run up a pretty hefty bill. Something that was storable (especially without refrigeration) and didn't require blood typing would be a huge win.

      • Re:Old News (Score:5, Insightful)

        by Immerman ( 2627577 ) on Wednesday June 11, 2014 @10:09PM (#47219263)

        Of course they still haven't made any mention of the *most* important questions:

        Do vampires find it palatable enough to reduce their rampant predation on our species? And if so will they now leave us alone, or exterminate us as an unnecessary threat?

      • Re:Old News (Score:4, Informative)

        by Applehu Akbar ( 2968043 ) on Thursday June 12, 2014 @08:26AM (#47221427)

        This is another example of the medical cartel screwing us over. In the old days those donation centers were called "blood banks" because they functioned like actual banks. You were personally credited with each pint of blood you donated. When you needed blood after an accident or surgery, you could use any accumulated credits. You could sign credits over to a family member who needed blood. or donate them to one of those public drives for a person in need. Blood banking incentivized donations without the moral hazard of paying donors in cash.

        No longer. You have to pay for any blood you or your loved ones use, no matter how much you may have donated. Personal blood credit is used only in giving out award pins for lifetime donation totals. And we now have an ongoing donation shortfall that we never had before.

        • My favorite part was the first time I donated, when they gave me a flyer patting me on the back for it, which included a story about some guy who had needed 12 pints of blood transfused to pull through. 12 pints!

          According to their commercials, that same amount of blood could have saved up to 36 people who *weren't* spraying blood like a firehose. This is why we have a blood shortage! Priorities, people!

        • Was that before or after HIV woke us up to the need to heavily screen each and every bag of blood that comes in? Was that before or after medical malpractice lawsuits became a way of life for a huge number of leeches (which in turn, drives up liability insurance)?

          I'm actually asking, I don't know a timeline. I just know that the costs have obviously increased greatly, to a point where not paying for it might not be viable today. Even if we WERE okay with letting people who didn't have enough credits g
          • While I don't think non-donors should just be left out in the cold, I do think that donors should get priority over non-donors when it comes to receiving donations. (Exceptions for those who have never been able to donate, such as children, anemics, hemophiliacs, etc...)

          • I used to donate every other month. I stopped donating when my work hours changed to 7a-7p, and the donor group started calling & emailing weekly asking me to come in. I told the first caller I was unable to donate due to work hours. I kept getting the calls & emails. Even after asking to be removed from their calling/email lists, it continued for years. Even now that my hours would accommodate donating, I refuse to deal with that organization over their previous harassment.
    • I read about this working in a medical research lab 20 years ago.

    • I read about this in Wired more than 5 years ago.

      Specifically, an article by Wil McCarthy, here:
      http://archive.wired.com/wired... [wired.com]

  • Let gay men donate (Score:4, Insightful)

    by Noxal ( 816780 ) on Wednesday June 11, 2014 @07:46PM (#47218515)

    You know what else would help the shortage? Let gay men donate.

    • Agreed. The only reason they were ever banned from donating is the fear of disease. A fear that's bigoted and unfounded. Just force all blood donors to get tested for infection, regardless of orientation, then give the clean ones a certfification with expiry. Re-test as required to continue donating.
      • by _merlin ( 160982 )

        Well it comes down to statistics. In Sydney, there's now supposedly greater than 20% HIV infection rate amongst gay men. It's quite high, and much higher than the HIV infection rate amongst the general population. This probably isn't the case everywhere, but in Sydney, a randomly selected gay guy is far more likely to be carrying HIV than a randomly selected person from the rest of the population.

        In Sydney the HIV infection rate amongst prostitutes is actually very low. However in Hanoi it's supposedly

      • Agreed. The only reason they were ever banned from donating is the fear of disease. A fear that's bigoted and unfounded. Just force all blood donors to get tested for infection, regardless of orientation, then give the clean ones a certfification with expiry. Re-test as required to continue donating.

        Wrong. Gay men and/or people with HIV/AIDs should not be discriminated against but lets not pretend there is no difference in contraction rates.

        Your chance of contracting HIV is 18x higher if you're having anal sex. Gay men are far more likely to be having anal sex though not always (I have a gay friend that hates it an only does Oral... strange as that may be, he says its a common preference.) When those rules were put in place there was no test for HIV. Now testing is easy and cheap so the rules are pret

        • If you've got a lethal or debilitating pathogen lurking around in your blood, you should be discriminated against with respect to donating blood. That's why I propose that all donors should be tested, no matter what their sexual orientation is. You're right, testing is easy and cheap now. So do it to everyone and certify the clean donors.
          • by QQBoss ( 2527196 ) on Wednesday June 11, 2014 @10:52PM (#47219457)

            All donors ARE tested for HIV (at least in USA, Canada, and China), but the test is post-donation and not pre-donation. Donated blood is tested for far more than just HIV, as well, and failing that post-donation test can result in a temporary or permanent ban from future donations. Prescreening of donors reduces the cost of testing relative to acceptable donations, which is a useful tool for keeping the cost of the existing donor supply lower than it would be otherwise. The American Red Cross revisits this policy about every 5 years, IIRC, and goes through the math of where the percentage breakpoints are for breakeven results- when any population crosses that line the wrong way, a new question goes on the prescreening survey. Homosexually active men are no more discriminated against than people who got tattoos or ear piercings within a certain time period, or who lived in certain countries (don't be from Cameroon or Nigeria, for example). [ncsucr.org] Want to change that? Try changing the incidence of disease in the indentifiable community below that break point, because manipulating only the math doesn't turn out well in any scenario.

            Giving a blood test for all the possible BBPs (blood borne pathogens) and other issues prior to donating is not cheap if the number of donors goes up by any significant amount of people who wouldn't qualify, so a prescreening survey is going to remain the most cost effective way of dealing with these issues and keeping the number of people who would dilute the quality of the blood supply low.

            If you don't qualify to pass the written prescreening test, and you still want to donate blood, at least in the USA you can do that. There is a box you can check to indicate that you want your blood disposed of after donation. This is most commonly used by drug users and homosexuals who are donating in the presence of family, co-workers, or friends who the donor feels are not aware of their situation. It wastes staff time and some property (collection bags, etc...), but allows an individual to maintain their privacy for a lower cost than a prescreening blood test would cost.

      • disagreed. the fear of disease is quite justified, the percentage of gay men with AIDS is very high, CDC says 20%.

      • then give the clean ones a certification with expiry. Re-test as required to continue donating.

        Certification shmertication. Test every single damn time. That's what they do up here in Canada. When you donate blood, they take a half-dozen additional vials of blood specifically for testing along with the unit itself.

      • Just force all blood donors to get tested for infection, regardless of orientation, then give the clean ones a certfification with expiry. Re-test as required to continue donating.

        Back in the 80's, one of the things we learned from the opening stages of the AIDS epidemic is the possibility that a new disease agent will enter the human population, sight unseen. If such a new virus were to appear, it could spread silently for years before being identified (just has HIV did).

        It is this risk which had led to the exclusion of the gay population. The elevated risk for HIV infection in that population serves as a marker -- it demonstrates that they have the epidemiological risk characteri

      • It's statistically founded and if they had the balls they'd reject African American males who have crazy high infection rates.

        HIV testing isn't cheap and forcing it on everyone would shrink the donor pool dramatically not increase it.

        Seriously, can we just having an equal opportunity to have your blood stolen stay off the agenda for the moment?
        • HIV testing isn't cheap and forcing it on everyone would shrink the donor pool dramatically not increase it.

          Sure it is. Canadian Blood Services tests every single blood donation for HIV (also Hep C, West Nile, and others). The testing is done after the fact, so there's no waiting or anything. They just take a half dozen vials of blood in addition to the unit.

    • by JMJimmy ( 2036122 ) on Wednesday June 11, 2014 @08:01PM (#47218629)

      And develop better screening tests - they rejected me and told me never to donate again because I have a protein in my blood that triggers a false positive on the cheap HIV test. A proper, more expensive, test works just fine though.

      That was a fun letter to get... starts off saying (paraphrasing) "Thank you for your donation, unfortunately your blood tested positive for HIV and cannot be accepted"... at this point most sane people might start freaking out and stop reading. When you do read on it explains it but I wonder how many people started calling people or crying before reading on.

      • Is there a half-life on Creutzfeldt-Jakob disease?

        They won't let "mad cows" from Britain donate here in Australia. But the outbreak over there was a couple of decades ago.

        • Actually Mad Cow randomly pops up now and again. Aggressive testing though limits it's affect to a couple dozen cattle as opposed to whole herds.

        • Is there a half-life on Creutzfeldt-Jakob disease?

          CJD has an insanely long incubation period. It can be over 50 years between infection and the onset of symptoms and they could be infectious for a significant portion of that.

        • by sjames ( 1099 )

          It is thought that it can take several decades to become symptomatic in some cases.

    • by Anonymous Coward on Wednesday June 11, 2014 @08:06PM (#47218659)

      The reason that gay men typically aren't allowed to donate isn't because they're gay. Rather, it's because the sexual practices they often engage in, namely anal sex, happen to readily transmit HIV and other STIs. The higher prevalence of such carriers within the gay community further increases the risk of contaminated blood.

      How do you propose this be dealt with? Clearly allowing tainted blood to be used is not an option. It does no good to have large amounts of unusable blood available.

      • If you're going based off rate of infection then those from Florida, New York, and Louisiana should not be allowed to donate either since they're more than twice as likely as someone from Virginia and more than 18 times more likely than someone from Vermont.

        The fact is that they test all the blood for HIV/AIDS and a bunch of other things because if they don't they've got some hefty liability to deal with. What they are likely worried about is freshly infected individuals who are not diagnosed yet and won't

        • If you're going based off rate of infection then those from Florida, New York, and Louisiana should not be allowed to donate either since they're more than twice as likely as someone from Virginia and more than 18 times more likely than someone from Vermont.

          Shouldn't you specify a baseline infection rate if you're going to throw around "twice as likely" and "18 times more likely"?

          There's a difference between a base rate of 0.0001% going up to 0.0018%, and 1% going up to 18%.

          • If you're going based off rate of infection then those from Florida, New York, and Louisiana should not be allowed to donate either since they're more than twice as likely as someone from Virginia and more than 18 times more likely than someone from Vermont.

            Shouldn't you specify a baseline infection rate if you're going to throw around "twice as likely" and "18 times more likely"?

            There's a difference between a base rate of 0.0001% going up to 0.0018%, and 1% going up to 18%.

            No, because the point was that looking at subgroups based on single factors was rather narrow sighted. One looks at MSM (men having sex with men) and you see a higher rate of infection there compared to non-MSM and say it's more than twice as likely but then even within MSM the numbers are wildly varied by different sub-groups. Hispanic MSM are half as likely as Black MSM. So should hispanic MSMs be allowed to donate? My point was the absurdity of it. Vermont has 1.3 aids cases per 100,000 people, New

      • No, the reasons they're not allowed to donate are outdated reasons. [wikipedia.org] It made sense when there was no test, or when the tests were less reliable. Today, we obviously have tests, every donation is tested. The false negative rate is 0.03% [wikipedia.org]. So it's pretty safe to take a negative as a negative.

        Gay men are also more likely to have had an HIV test than most people, and they would self-exclude themselves if positive. Given that gay men could already simply lie, it's not like a whole lot would change there.
    • by Thiez ( 1281866 )
      While one might argue that forbidding them from donating is unfair, or has a basis in incorrect assumptions, let us not pretend that allowing gay men to donate blood would make a significant difference if a shortage exists. What percentage of the population is a homosexual male? Perhaps 3%?
    • Re: (Score:3, Insightful)

      by Anonymous Coward

      I'm sorry, but this is just politically correct feel good bullshit.

      Things that preclude you from donating blood:
      Intravenous drug use
      Promiscuous Sex (Yeah, that's right, all those people who say prostitutes can donate are wrong!)
      Having recently traveled to certain parts of the world
      Having recently received a piercing from a place other than a certified clinic (read piercing or tattoo parlor)
      If you've recently had a cold (and in fact, if you come down with a cold a few days later, they ask you notify them so

    • by HJED ( 1304957 )
      Or English people. (Yes you read that right, in Australia you can't donate blood if you lived in the UK before 1996)
    • Why can't generally happy dudes give blood?
    • As righteous as this sounds, there are two counterpoints to make:

      1) do homosexual men *really* account for such a high number of rejected donors that it would make up for the shortfall? Somehow, I doubt it.

      2) they aren't rejected (only) on the unfounded stigma of increased AIDS susceptibility, but on the *legitimate* basis that anal sex is damaging to extremely sensitive tissue, making it vulnerable to increased infections in general.

  • Religious Objections (Score:5, Interesting)

    by Anonymous Coward on Wednesday June 11, 2014 @07:54PM (#47218571)

    I know some people reject blood transfusions based on religious beliefs - if any of those are here, would you have an objection to artificial blood?

    • If it is made entirely of non-blood components I would have no objection. Same goes for non-blood volume expanders such as Haemaccel, Saline, Ringers Lactate, Dextran, etc.
    • by rgmoore ( 133276 )

      I expect it would depend on the details. People have experimented with at least two classes of blood substitutes: hemoglobin based and fluorocarbon based. I assume people with religious scruples would be OK with fluorocarbon-based substitutes. Hemoglobin-based substitutes would probably be classified as processed blood still be off limits, unless the hemoglobin were actually recombinant and not extracted from blood.

    • by tepples ( 727027 ) <.tepples. .at. .gmail.com.> on Wednesday June 11, 2014 @09:23PM (#47219057) Homepage Journal
      Jehovah's Witnesses readily accept expanders [jw.org] not made from human blood. I used to associate with Jehovah's Witnesses but stopped about a year ago after discovering contradictions in the denomination's other doctrines. My own personal interpretation of "the life is in the blood" (Genesis 9:4, Leviticus 17:11, 17:14, Acts 15:29) means I'd reject red and white blood cells, but platelets and plasma are acceptable in a pinch because those aren't living cells.
      • by chooks ( 71012 )

        I hate to break it to you, but platelets have mitochondria, consume energy, have cellular processes, activation/deactivation signals, etc..., so not quite sure that classifying them as "not living cells" is accurate.

        On another note, you found contradictions in a Christian religion's doctrines? Shocking! Excuse me while I head to my fainting couch...

        • by tepples ( 727027 )
          I guess you're right: platelets are more alive than I thought. But what does that say about plasma?
          • by chooks ( 71012 )

            Plasma is primarily water with a collection of proteins (performing a variety of opposing functions) and should contain no viable cells. There is probably a chance of contamination with viable cells (probably more common in plasma derived from whole blood, but I have no data/sources to back this up) but this may also depend on the type of plasma (e.g. frozen vs liquid -- but again I have no data at the moment to indicate risks on one versus the other).

  • It sounds like they just got awarded funding to do the research, which is nice and all. If money was the solution to all of the world's medical problems, surely we would have solved all sorts of issues by now, but science just doesn't work that way. Now don't get me wrong, I hope they succeed in producing a blood substitute, but I'll get excited when they have an available product.

    • by slew ( 2918 )

      FWIW, they apparently have a paper [nih.gov] and a website [haemo2.com]...

      As I understand it, although many previous hemoglobin substitutes have been tried and tested, the hemoglobin tends to eventually becomes toxic. Their new approach is to re-engineer the hemoglobin molecule to attach tyrosine which apparently has the effect of allowing some natural cleaning processes in the blood to reduce toxic build up before it gets to bad (in theory)...

      Of course they'll have to test it eventually. Hopefully it won't be a *opt-out* proce

  • Then i found outnhow much blood banks were making selling donated blood to hospitals and other places that nneded blood or plasma. It was discusting, not to mention the huge salaries that were supported basted on these fees. I think one story was based on the Central Florida Blood Bank. I think NPR's Planet Money did a show on this also. Do not believe all those " our reserves are low, donate now". Sorry, it was Radio Lab - http://www.radiolab.org/story/... [radiolab.org]
    • by kuhnto ( 1904624 )
      Please excuse my misspellings, as I am in the bathtub.
    • by mysidia ( 191772 ) on Wednesday June 11, 2014 @08:25PM (#47218775)

      Then i found out how much blood banks were making selling donated blood to hospitals and other places that nneded blood or plasma.

      Then donate to the red cross. They are not selling it for a profit. People who won't donate for some perception of money changing hands -- should remember, that one day you may be on the other side of this equation, and dependent on some stranger to make a blood donation, as vital to your own survival.

      The fewer donated units are available, the more expensive it will get, and the more people that may die, because the supply or money wasn't there to get them the transfusion they needed.

      By law, all the blood donations in the US have to come from volunteers -- donors are not allowed to sell blood.

      It is very expensive to administer a blood bank; there are a lot of costs involved in getting the product, maintaining the product, ensuring the safety of the product, and distributing the product.

      Red cross says they do not charge for the blood itself --- but they do recover costs from hospitals for each unit distributed which they say are the costs of recruiting donors, screening potential donors, collection of blood by trained professionals, processing, storing, labelling, and the testing of each unit of each blood unit in state of the art laboratories.

      • by rgmoore ( 133276 )

        Then donate to the red cross.

        Or directly to a hospital that collects its own donations. Even non-profits like the Red Cross add extra layers of bureaucracy.

      • Bullshit. There is a clinic that would pay people 40 bucks a pop per "plasma" donation. I used to go there back when I was making minimum wage and flip an ounce of my plasma into a silver bullion coin once every week. That's almost 3 pounds of silver a year just to be at 90% strength for a few hours instead of 100. They would also test your blood for infection, your sugar / protean levels and what not, so it was a way to monitor your health and actually get paid for it.
        • by mysidia ( 191772 ) on Thursday June 12, 2014 @12:43AM (#47219829)

          Plasma donation is likely not for transfusion into a patient; the plasma itself is valuable to pharmaceutical companies for putting together various protein products and treatments for disease. A fractionation process can be used on plasma to derive various components, such as the immunoglobins, coagulation factors, and albumin solutions.

          The components of plasma are absolutely vital for the creation of certain vaccines and treatment of certain disease, such as factor VIII and factor IX proteins which may be administered in the hospital to hemophiliacs, or people suffering from liver disease or anticoag overdose.

          There is a much larger market for these products than for transfusions, and there is commercial interest in obtaining the plasma needed to derive these products.

      • A "non-profit" that pays the CEO a million dollars.
        • by mysidia ( 191772 )

          A "non-profit" that pays the CEO a million dollars.

          I would encourage you to avoid libelous assertions. The American Red Cross' published financials show the CEO makes less than $600,000; which is less than 0.01% of the American Red Cross's annual expenses; ~90% of which are spent on programs, and ~4% are administrative overhead costs such as administrative staff.

          By the way.... if the CEO moved to a for-profit company, they could expect a minimum of about $10 million a year plus stock options. I

      • By law, all the blood donations in the US have to come from volunteers -- donors are not allowed to sell blood

        Then fix the law. I'll give my blood away for free when everyone working at the blood bank and the hospital start working for free as well. Until then, my O-Neg blood is staying where it is. Frankly, it takes balls to ask me to donate when everyone else in the system is in there for the money. Pay people for blood and the shortages will disappear. At least in the US. 3rd world countries may ha

        • by mysidia ( 191772 )

          Then fix the law. I'll give my blood away for free when everyone working at the blood bank and the hospital start working for free as well.

          Unless you are promising to spend 4 hours a day 7 days a week of your life continuously donating blood, then you are insisting that these people be treated unfairly. As is, they receive low pay working for a non-profit.

          These people need to eat as well.

          There is also not a sufficient supply of qualified individuals that volunteers working just a few days a week wo

    • I know several people who would be dead if not for you. Hate me if you like, but hospitals pay because insurance pays because people don't understand the value of insurance.

      Hospitals charge because people don't pay.

      People don't pay because insurance does.

      Consider to whom you donate, but please do consider donating to someone.

      Tell me to donate and shut up if you like, but I cannot. I can only remind you that people, flawed as they may be, deserve more than your cynicism.

      • by dave420 ( 699308 )
        Or you could fix the joke that is the US health industry. Civilised countries don't have such issues, and donation is not a money-spinning endeavour for everyone involved.
  • immediately accessible at the site of natural disasters.

    ...So a nutcase decides to start the new revolution by blowing up a park, or an incompetent building contractor builds an apartment complex that collapses... but the victims do not get the precious artificial blood, because their disaster was unnatural.

    Engineers do not play well with appeals to emotion.

  • ... sell the naming rights to HBO
  • It's incredibly ridiculous that people are asked to donate blood as a charitable act, while every other person and organization along the line, makes a hefty profit on processing and selling your donated blood, at astronomical rates, to people who have no alternative but immediate death.

    If they offered even a trivial amount of money ($5 per pint) the numbers would be shored up in short order. Those with major reservations wouldn't suddenly run to the blood bank, but those who were thinking about it, anyway

    • You need to read that book.

      Taking money for blood might have the opposite effect on the supply. In the book from the title, Swiss were asked if their community would be willing to host a nuclear waste storage facility for the good of the country. Many Swiss were on board with it--for the good of their country. A subset of Swiss from the same community were asked if they'd store the waste for $. Those Swiss said NO WAY. The good of their country was far more motivating for the Swiss than $.

      And take me for example. $5 is in no way compensation for the enduring the needle stick and the time involved. I doubt $20 would motivate me. Maybe not even $100. However, I've donated 2 gallons or more. I do it because of this thought: one small needle stick for me, and a bit of time, and maybe someone gets to live.

      And I'm the least-risk group of donors, selected partly by my lack of $ motivation. I don't need money for drugs because I don't take them. D'you really want to give drug addicts motive to donate blood to get money? Sometimes there isn't time for blood to be exhaustively screened before use.

      Also, recent experience shows that the most powerful motivator for blood donation is solidarity. Blood donation went through the roof after 9/11 and other disasters. They literally couldn't stick people with needles and drain 'em fast enough.

      I really think that if we want more blood supply, we need to beat the solidarity drum, and make it really convenient for people to donate.

      Best,

      --PeterM

      • by tepples ( 727027 )

        I don't need money for drugs because I don't take them. D'you really want to give drug addicts motive to donate blood to get money?

        That depends on to what extent health insurance covers drugs.

        • by dave420 ( 699308 )
          Or if you live in a decent country where drug addicts get free treatment, including free drugs if required, meaning they don't even consider donating blood to be a good thing to do.
      • I'm well aware of such counter-effects, but they are very unlikely to overwhelm the gains. As I said, this is used for plasma donations quite successfully.

        we need to beat the solidarity drum

        They have been... quite extensively... and are still coming up short.

      • An Army for free
        Working to help industry;
        That profit from thee.
  • i remember reading a harvard business case study about a similar product called biopure in the mid-00s - that didn't end well if i remember right

  • http://www.smithsonianmag.com/innovation/a-romanian-scientist-claims-to-have-developed-artificial-blood-180947565/?no-ist
  • I can't speak for other countries where things may be different, but the US rules on exclusion that the Red Cross uses get more and more exclusionary every year and are now a bit nuts in my opinion. I was a regular blood donor and they used to call me and tell me that they liked to get my blood because it was "unusually clean" and was very suitable for giving to infants. Early this year I tried to donate and they deferred me for a year. Want to know why? It's because I rode on a train for no more than 6
  • Are dark, sparkling Foldger's Crystals [jt.org] rich enough to keep these patients alive and well?

    Spokesman: How do you feel?

    Patient #1: Fine, thank you.

    Spokesman: Did you know that we've replaced all of your blood with Foldger's Crystals?

    Patient #1: An instant?

    Spokesman: That's right.

    Patient #1: I can't believe it. I feel great. I'm full of Foldger's Crystals, really?

    Spokesman: Yes, and so are all the other patients in this intensive care unit. How do you all feel?

    [ The other patients show reactions of approval ]

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