Blood

Hemophilia: From Vitalism to Vampires

Halloween season is here! I’m already seeing decorations going up of ghosts, ghouls and… vampires. Vampires are steeped in horror lore, because they thrive on human blood. And blood has fascinated humankind throughout its history. I thought I’d run a post from almost ten years ago, about vampires, blood and hemophilia.

Dracula’s next victim!

Blood at once attracts and horrifies; it is the stuff of legends and tales, myths and medicine. I recently read the classic Dracula [read the book review below] and was amused to read how Dr. Van Helsing wanted to help the young Lucy, a victim of a vampire, by giving her a transfusion of blood. “Is it you or me?” he asks Dr. John Steward, about which one will roll up their sleeve to donate. Steward replies, “I am younger and stronger, Professor. It must be me.”

Steward offered his blood based on the concept of vitalism, that blood contains the traits of the being in which it flowed—a concept that was unchallenged for 1,500 years. Later in the book, Van Helsing says to Lucy’s fiancé Arthur, “John was to give his blood, as he is the more young and strong than me…. But now you are here, you are more good than us, old or young, who toil much in the world of thought.
Our nerves are not so calm and our blood so bright than yours!”

So Arthur becomes the better blood donor because he is calm and not scholarly! Of course, this is nonsense, but author Bram Stoker fell for the widespread belief in vitalism when he wrote his book. Dracula isn’t so picky; he pretty much would drink anyone’s blood.

Douglas Starr tells us in his book Blood* that the Egyptians saw blood as the carrier of the vital human spirit, and would bathe in it to restore themselves. Roman gladiators were said to have drunk the blood of their opponents to ingest their strength. “Our own culture attaches great value to blood, with the blood of Christ as among the holiest sacraments, blood libel as the most insidious slander, the blood-drinking vampire as the most odious demon.”*

Vampires… which are repelled by garlic and crucifixes (the two seemingly have nothing to do with one another). Yet rather than secure eternal spiritual life by consuming wine that has been transformed into Christ’s blood during Christian mass, Dracula drinks human blood to extend his physical life. 

The only thing scarier than vampires is the proliferation of teen movies about vampires!

*Starr, Douglas (2012-09-05). Blood: An Epic History of Medicine and Commerce (Kindle Locations
97-101). Knopf Doubleday Publishing Group.

Great Book I Just Read

Dracula  [Kindle]

By Bram Stoker

This classic, wonderful and visionary, has inspired an entire genre of books and movies. Jonathan Harker, a young English lawyer, is summoned to Castle Dracula in Transylvania to finalize a real estate transaction with the eerie Count Dracula, who is purchasing property in London. Harker is warned by local peasants, who give him crucifixes and other charms against evil. As a guest, Harker soon notices strange things: the Count has no reflection, is never present in daylight, and scales the castle walls downward, like a lizard. Unable to escape, Harker is soon a prisoner, until the Count reaches London, with 50 boxes of earth. The novel is told only through letters and diary entries of the main characters, including: Harker’s fiancée, Mina Murray; her friend Lucy Westenra, who is bitten by Dracula and slowly turns into a vampire; Dr. John Seward, Lucy’s doctor and once beau. Harker reappears in Budapest and eventually returns to London. Dr. Van Helsing, an expert on vampires, is called in from Holland to help save Lucy. Everyone realizes Dracula’s scheme to populate
London with the “Undead”—vampires. When Mina is bitten, and begins to turn into a vampire, the men sterilize the boxes of earth, set about London. Dracula, having no haven to stay when dawn comes, flees back to Transylvania, while the men pursue him. This is a fantastic story, though the language is not lofty or even that clever, with memorable characters, and cleverly told in letters and diaries. Perfect October reading. 5/5 stars.

The Bloody Book of Blood

Like the pages out of Ray Bradbury’s Fahrenheit 451, we’re seeing books get banned in some states. Math books, even!  Our favorite hemophilia archivist, Richard Atwood of North Carolina writes, “School libraries, and even their school librarians (can you believe it?), are under attack, with more and more books being banned for their content.” Richard provides a review below of juvenile literature that explains blood, including hemophilia, to young readers. He adds, “Kids seem to enjoy being grossed out!” And hopes it does not get banned!

This text on blood in Kelly Regan Barnhill’s  2010 book, The Bloody Book of Blood, is classified as juvenile literature. Hemophilia is included among the numerous blood topics. Hemophilia is explained in the section “Blood Disorders” that is accompanied with a photograph of a bruise on page 22. The text states: “Hemophilia is a rare, but serious blood disorder. This disease keeps a person’s blood from clotting properly. Patients with hemophilia need to be extra careful. A cut can bleed for days, and it may never heal completely. Even a small bruise can be a big problem. The extra blood pools under the skin, causing the bruise to grow to a huge size.”

Hemophilia is defined in the glossary, along with a pronunciation guide. The text states: “hemophilia (hee-muh-FIL-ee-uh) — a health condition in which blood does not clot normally.”

This is an educational book, part of The Amazingly Gross Human Body series that includes texts on blood, vomit, spit, snot, sweat, and… pee. This short book with a large font includes one page for a glossary, one page for an index, one page for “read more” and internet sites, 16 illustrations, and 4 “gross facts.” Michael Bentley, a professor of biology at Minnesota State University, Mankato, acted as a consultant.

“The author simplified the definition of hemophilia appropriately for juvenile readers, yet a simple note on proper treatment, and maybe genetics, would be beneficial,” Richard adds.

Kelly Regan Barnhill.  2010. The Bloody Book of Blood. Mankato. MN: Capstone Press. 32 pages.

Texts That Protect

If something big were happening, you’d want to know about it right away, especially if it concerned the factor you or your loved one uses. The Patient Notification System (PNS) is a free service that will notify you about any withdrawals, recalls or warnings concerning your specific product, and even ancillaries. Are you signed up with it?

Launched in 1998 by the Plasma Protein Therapeutics Association (PPTA), a group that is supported by manufacturers of plasma-based products and recombinant products, this system has diligently sent out hard copy, telephone and email notices of any changes in your prescription drugs.

There was a time in the early 2000s when these were frequent, as there were shortages, plant shut-downs, recalls, products taken off line, and more. You can imagine that the specter of the mass HIV infections in the blood supply in the 1980s led to this unique and vital service.

There’s good news now: stringent manufacturing practices, better donor screening and genetically-engineered products means that notices of safety concerns are almost a thing of the past.

Are you signed up? You should be. It’s free, confidential, and now fast! Just recently, the PNS added notifications by text, probably the fastest route these days.  You will want to be up to date on any changes in the product you use.

Sign up for the PNS at www.patientnotificationsystem.org or call 888-UPDATE-U.

The Bloody Ban


According to the CDC, 4.9 million Americans require a transfusion of blood or blood products daily. Is our blood supply safe enough to infuse into them?

That’s the debate raging right now. At issue? Whether gay men can be allowed to donate blood. The FDA has a policy that men who have had sex with another man (MSM), even once, since 1977 are deferred indefinitely from donating blood. On June 11, an advisory committee to the Department of Health and Human Services, composed of health experts from around the country, voted 9-6 to maintain that bans. Is this fair, unfair, discriminatory, accurate?

Mark Skinner, president of the World Federation of Hemophilia, and a lawyer, believes the ban should be upheld. He writes in an article in US News & World Report (posted July 26, 2010), “Recent CDC data indicate that while U.S. HIV infection rates are falling in heterosexuals and intravenous drug users, they are rising among men who have sex with other men and are 44 times that of other men. Additionally, other pathogens that might also be transmitted through high-risk sexual behavior are not fully understood.” Mark stresses that the safety of a recipient of a blood donation comes first. Looking at the scientific data only, the rise in HIV rates and their pattern, the ban should stay for now.

Alternatively, some believe the ban is unfair, needless and discriminatory. Representative Mike Quigley, Democrat from Illinois who sits on the House Committee on Oversight and Government Reform, voices this concern in a counter piece to Mark’s. The ban was put into place during the HIV contamination of the nation’s blood supply in the 1980s. Yet, a man who has had sex with an HIV-positive woman can donate after waiting a year. Fair? Quigley is concerned that there is not enough blood to be donated, and that the gay community represents a willing source of blood donations. Quigley wants a way to separate the high risk gay donors from the low risk, so that at least some in the community can participate.

Not good enough for Mark Skinner, who puts the focus on the recipient’s safety. But he bridges the debate by adding, “While many perceive a disconnect between leading gay rights and end-user patient organizations, these groups have more in common than recent discourse reflects. Both have been disproportionately impacted by the HIV epidemic and for most of the past quarter-century have worked toward shared goals including preventing the virus’s spread. Both share a strong commitment to a safe national blood supply.”

There’s no right or wrong answer at this point, but you can read more about this by Googling “blood donor ban.” If anything, it’s a great exercise in tolerance, science, altruism and politics. I wonder if anyone has interviewed the recipients about how they feel?

Great Book I Just Read
Undaunted Courage by Stphen E. Ambrose

Christopher Columbus may have put America on the map, but Meriweather Lewis put a map to America. One of the great adventure stories of all time, the amount of courage needed by this 30 year old, setting out to discover what lay beyond the Mississippi River, was immense. A close confident of Thomas Jefferson, who had unbridled expansionist plans, he set out in 1803 to find the fabled water passage to the Pacific Ocean. There was none, but Lewis (and Clark!) had an adventure like no other. From Philadelphia to St. Louis through Idaho and eventually Oregon in two years, they charted and mapped the US under the most primitive of circumstances, and discovered new species of plants and wildlife. They met and negotiated with the Indians, the most terrifying of which were the Sioux. A great study in leadership and courage, it has a sad outcome for Lewis in the years following his celebrity status. An amazing American hero. Four stars.

The Beginnings of Transfusions


This week I am off to the National Hemophilia Foundation meeting in San Francisco, and I thought an historical look at blood might be in order. I can’t think of a better story about blood than one that starts with a madman running naked through the streets of Paris in the 17th century. True.

Chapter 1 of the wonderful book Blood by Douglas Starr starts with poor Antoine Mauroy, who suffered “phrensies.” From time to time, he would take off his clothes, run through streets and set fires. Eventually, doctors experimented on him to try to cure him. Mauroy became the guinea pig in an experiment that forever changed medicine. In 1667 Jean-Baptitste Denis, physician to king Louis XIV, transfused half a cup of blood from a calf into Mauroy. He hoped the “gentleness” of the calf would infuse as well. Despite the discoveries of the Renaissance and the advances made in science, doctors still believed the blood somehow carried the characteristics of the creature, a concept known as “vitalism.” For example, a stag’s blood carried courage; a calf gentleness. Since the ancient Greeks, the body was not yet viewed as a system, and doctors knew nothing of hormones, genes or viruses. It would be 200 more years before they discovered that water transported disease! In the 17th century, doctors believed that in the “humors”: phlegm, choler, bile, blood. The Greeks believed that good health meant maintaining a balance of the humors in the body, so draining blood and purging digestive system should help. This is where blood-letting as a medical treatment evolved.

Blood– it has a colorful past! And worth reading about. Be sure to read Blood by Douglas Starr.

Other doctors and researchers dabbled in finding out the secrets of the blood. William Harvey found valves in blood vessels, which led him to think that the body might be a system, more mechanical. Christopher Wren (the famous architect whose beautiful cathedrals I just glimpsed when I was in London last week) and Robert Boyle, founder of modern chemistry, dabbled in circulation. Richard Lower tried transfusing blood from one dog to another: he discovered how to transfuse from an artery into a vein and it worked.

What happened to our madman? Antoine Maury died from the procedure. What doctors didn’t know is that proteins in the blood from one animal–even from another person– are not always accepted by the body. The immune system may attack the foreign proteins. Dr. Denis was accused of murder. He in turn sued Antoine Mauroy’s widow in 1668 for slandering his reputation. Turns out Mauroy actually died from arsenic poisoning– by his wife! Still, the French Parliament’s banned all transfusions involving humans. Similar actions follow in England and Rome. And 150 years would pass before it was tried again.

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