Dr. Alexander S. Wiener (1907-1976), was an outstanding leader in the fields of Forensic Medicine, Serology, and Immunogenetics. His pioneer work led to discovery of the Rh factor in 1937, along with Dr. Karl Landsteiner, and subsequently to the development of exchange transfusion methods that saved the lives of countless infants with hemolytic disease of the newborn. He received a Lasker Award for his achievement.
At first, Dr. Wiener and Dr. Lansteiner did not understand the full significance of their discovery. They were enagaged in identifying a range of factors, such as the M factor, which proved to have much less significance. Dr. Wiener named the Rh factor after the Rhesus monkeys used as test subjects. However, by the time he and Dr. Landsteiner published in 1940, Dr. Wiener was able to demonstrate the role of Rh sensitization as a cause of intragroup hemalytic reactions, thus increasing the safety of blood transfusions.
Also, in conjunction with Dr. Phillip Levine's separate work which helped identify the Rh factor as a major cause of erythroblastosis fetalis, or Rh disease, he was able to help solve a major cause of infant fatality. He created the first medical procedure to combat the problem, which he called an exchange transfusion. It consisted of a complete blood transfusion for the affected baby. The method was further refined by Dr. Harry Wallerstein, a transfusionist.
Since then, less extreme methods have been found to deal with erythroblastosis fetalis. However, at the time, the procedure was able to save over 200,000 lives.
A lot of Dr. Wiener's later work involved examining the genetics of the Rh factor. In the process, he became embroiled in controversy, as an alterate theory (CDE), which was somewhat simpler to understand, was also proposed. Although Dr. Wiener's theories on the genetics of the Rh factor have ultimately proven correct, there are still many who have adopted the CDE notations, because of their greater simplicity.
Dr. Wiener's theory is that Rh inheritance is controlled as follows:
There is one Rh locus at which occurs one Rh gene, but this gene has multiple alleles. For example, one gene R1 produces one agglutinogen (antigen) Rh1 which is composed of three "factors": rh', Rh(o), and hr' '. The three factors are analogous to C, D, and e respectively in the CDE nomenclature. The d gene does not exist in Wiener's theory, and, in fact, has been proven not to exist at all.