Five Quarts: A Personal and Natural History of Blood

by Bill Hayes

  Seventy years later, once Bram Stoker had given himself the challenge of writing a vampire classic, he, too, borrowed a name for his villain, although he took from history, not fiction. Vlad Dracula (1431–1476) was a prince born in the Transylvania region of Romania. Dracula came from his father’s nickname Dracul, meaning “the dragon”; the added a indicated junior status. Vlad, “son of the dragon,” sometimes translated as “son of the demon,” would emerge as a leader on the Christian side of the long-standing war against the Muslim Turks. He excelled in cruelty. He concluded one battle, for instance, with the command that the thousands of captive Turkish soldiers be impaled, a slow and horrific way to die, a public butchery also meant to torment the survivors. By this point Dracula had earned a new sobriquet: Vlad Tepes, or Vlad the Impaler. Tales of his viciousness took on such life that, after he was slain by a Turkish assassin, the sultan of Constantinople ordered that Vlad’s head be staked and displayed. Come, believe your eyes, the demon is dead.

  In co-opting the name Dracula, Stoker was aiming not to model his character after the historical figure but to evoke a kindred spirit of evil. Stoker may have employed a similar tack regarding another member of Transylvanian nobility, Elizabeth Bathory (1560–1614), although here a suggestion of real-life vampirism is not out of the question. Bathory, it’s reputed, regularly bathed in human blood, which she believed would preserve her youth and beauty, as Raymond McNally details in Dracula Was a Woman (1983), a biography of the so-called blood countess. Coincidentally—or, then again, maybe not—Count Dracula, over the course of twenty-seven chapters, grows ever more youthful as he drinks his victims’ blood, a theme that hadn’t occurred in earlier vampire tales. Because this was so Bathory-like, McNally contends that Stoker had indeed been inspired by her and points out that the first account in English of the Bathory case was included in a book Stoker used as a reference, a nineteenth-century encyclopedia of the supernatural. But did Stoker, I wonder, even read this entry? Couldn’t he have just plucked the de-aging idea from his imagination? Stoker scholars and vampire enthusiasts hotly debate this question. Speculation notwithstanding, Bathory’s legend is rich in its own right. Her victims were peasant girls, preferably virgins, either hired as servants or kidnapped outright. However obtained, they all ended up in the castle cellar, the location of Bathory’s torture chamber, where they were eventually exsanguinated. Of several gruesome methods, one involved being locked inside a spike-lined spherical cage that was hoisted to the ceiling, then rocked so that the girl was pierced again and again. The countess stood naked beneath, in the shower of warm drippings.

  Portrait of Elizabeth Bathory, the so-called blood countess, at age twenty-five

  Not to excuse her behavior in any way, but some historical context might be helpful at this point. The use of blood in one’s beauty regimen was not unheard of in the sixteenth century. To prevent wrinkles, wealthy women of the Renaissance would rub their faces each morning with the Kiehl’s moisturizer of its day, the blood of doves. As for the use of virgin blood, there, too, were numerous precedents. Aztec priests in the fifteenth century, to cite one example, sacrificed virgin girls as offerings to their primary deity, the corn goddess. In Europe during the Middle Ages, it was believed that physical illness, thought to be brought on by sin, could be washed away using “innocent” virgin blood, though the donor did not need to be killed. Variants on this thinking continued as late as the fifteenth century, according to medical historians, at which time a draft of the blood of a young person, for instance, might be prescribed for the rejuvenation of the aged. I suppose it goes without saying that none of these factoids was ever brought up in Elizabeth Bathory’s defense.

  Arrested on December 30, 1610, the fifty-year-old countess was charged with committing what a panel of judges called “an almost unbelievable number of murders.” Through surviving court documents from her two trials, it’s possible to sift a handful of facts from the voluminous legend that has since engulfed Elizabeth Bathory. The countess was not present at either trial (she’d been placed under house arrest in her castle), but her four closest servants, charged as accomplices, were brought before the judges. Previously tortured, the servants, one by one, ratted out their boss. The body count was thirty-six, thirty-seven, or fifty-one girls, depending on whom you believed. Another witness, not charged, claimed the number was much higher. She testified to what she’d heard secondhand: A castle servant had found among Bathory’s possessions a handwritten list of victims, 650 in all. This smoking gun, however, was never introduced into evidence. Neither was a word said regarding Bathory’s bloodbathing. Nonetheless, snippets of the transcript remain chilling: “The countess stuck needles into the girls.” “She bit out individual pieces of flesh . . . with her teeth.” She “attacked the girls with knives” and “beat them so hard that one could scoop up the blood from their beds by the handfuls.” If the servants had been hoping for leniency, they were sorely disappointed. Three were sentenced to execution—one was beheaded; two were burned alive after being de-fingered—and the fourth to life in prison. Bathory, too, was given a life sentence, though, as a concession to her noble lineage, this meant confinement to a small room in her castle, the windows and doors of which were bricked in, save for a slot for food. Till her death three years later, she maintained her innocence.

  In terms of sheer villainy, one can easily imagine how the stories of Vlad and Elizabeth may’ve inspired Bram Stoker’s Dracula. But to tap into that essential cringe factor, the novelist turned to the animal kingdom. To the Desmodus rotundus in particular—the vampire bat. That Stoker pored over a description in the 1823 edition of Anecdotes of the Habits and Instincts of Animals prompted my own poking into present-day sources. Apart from its repellent appearance—the beady eyes, horsey ears, and piggish snout—what makes the vampire such a nauseating bat is its signature mode of feeding: A nighttime hunter, it lands on the ground a few feet from its victim, usually a sleeping cow or horse, and skitters forward on all fours. It’s said that sleeping human beings are sometimes its prey, so you may want to splurge on the extra-strength mosquito netting next time you’re in Central or South America, the species’ native habitat. Powerful hind legs aid the sparrow-sized mammal in scaling a dangled arm, leg, or tail. The bat then sinks its razor-sharp canine teeth into a fleshy area such as the neck, having first licked soft the spot. Its saliva, which contains an anti-clotting enzyme, keeps the blood flowing while the vampire sucks. (So potent is this superdrool that scientists have synthesized the anticoagulant into a powerful blood-thinning medication called Draculin, appropriately enough.) A good thirty minutes of nightly feeding meets a bat’s necessary daily intake; the vampire survives wholly on blood. The bat’s bite can also spread disease (rabies, for instance), and although Stoker doesn’t expressly say so, this is also how Dracula transmitted his contagion. Vampirism is an infectious disease in which evil is the pathogen. With each new bite, one’s essence is overwhelmed, one’s blood overpowered.

  BRAM STOKER TOOK GREAT CARE TO CLOAK HIS VAMPIRE TALE IN THE guise of realism. The more authentic and contemporary his fictional world, he rightly believed, the more genuine the reader’s fright. Hence his characters used such newly invented devices as a recording phonograph (an early-model tape recorder), a portable typewriter, and a Kodak camera. Likewise, a trip to Transylvania taken by one of the book’s heroes followed actual train timetables. Elsewhere, landmarks and locations were drawn from real life, as were certain events. A ship that had beached near where a vacationing Stoker wrote portions of Dracula, for example, found its way into the plot. When he was uncertain of details, he turned to experts—to his older brother, Thornley, for instance. A prominent surgeon in Ireland, Thornley Stoker vetted the final manuscript before Bram sent it to the typesetter, double-checking the blood transfusion scenes, in particular, to make sure of their accuracy.

  Whereas Stoker wrapped his myth in truths, modern-day scientists have worked to expose the truths behind the myth, posing, fo
r instance, the fascinating question, Might there have been a medical basis for the allegorical disease of vampirism? The answer is a resounding yes. It’s a blood disorder called porphyria.

  In its mildest symptomatic form, porphyria is not at all vampiric—at worst, an extra sensitivity to sunlight may cause your skin to blister. But in rare cases an untreated victim may indeed look like one of the undead: Your coloring takes on a deathly pallor due to severe anemia; your lips erode and gums recede, making your teeth—the eyeteeth, in particular—appear longer, more fang-like; and sunlight turns your affected flesh caustic, causing your facial features to dissolve and fingers to be eaten away. The lesson you learn quickly is, daylight is deadly. That undiagnosed cases of porphyria may’ve first planted suspicions of vampirism hundreds of years ago, perhaps as far back as the twelfth century, was originally suggested by a Canadian biochemist in 1985. Little could Dr. David Dolphin have imagined as he stepped up to the conference podium that day in May the media monster he’d unleash. What assured he’d grab headlines was his matter-of-fact contention that victims may have been driven to drink blood to relieve their symptoms. After an initial fireball of attention, Dr. Dolphin’s hypothesis has since taken on a life of its own, especially on the Web, not unlike the legend of Elizabeth Bathory.

  Porphyria is triggered by a flaw in the cellular machinery for producing heme, a crucial element of the blood’s oxygen transporter, hemoglobin. One of the steps in assembling heme involves the introduction of dark red pigments called porphyrins (from the Greek for “purple”). When the system is flawed, you end up with too much porphyrin and not enough heme. The porphyrin pigments backlog, building up in the skin, teeth, bones, and organs, causing a host of symptoms depending on where the accumulations occur. Your teeth may turn a dirty brown, for instance, and pain may settle into your limbs and back. (That sufferers can be extremely sensitive to sunlight made more sense once I learned that porphyrins are an ancestral sibling to chlorophyll, though, of course, the light-activated process of photosynthesis in plants isn’t destructive.) While toxins such as drugs, alcohol, or chemical poisoning can bring on porphyria, the illness is mainly hereditary in origin.

  It’s now known that the infamous British king who reigned during America’s war for independence, George III (1738–1820), suffered from acute intermittent porphyria (AIP), one of eight distinct forms of the disease. As is typical of AIP, the king’s illness manifested most notably in neurological symptoms: seizures, hallucinations, and bouts of mania and paranoia that would last for days or weeks at a time, then vanish, with long remissions in between. That his malady was porphyria, not “madness,” as was believed during and long after his reign, would be unknown today were it not for a peculiar fact of royal life: As the monarch, George was subject to daily visits by physicians, who chronicled his every symptom. From these surviving documents, modern-day British researchers have gleaned conclusive evidence for a posthumous diagnosis of AIP. Aside from jottings regarding the characteristic mental paroxysms, which began when George was in his twenties, the clincher was this notation: “His Majesty has passed . . . bloody water,” by which was meant discolored urine, elsewhere described as “bluish,” dark and “bilious,” and having left “a pale blue ring” around the specimen flask. All are telltale signs of excessive porphyrin production, as are severe abdominal pain and muscle weakness. The medical records also show how royal protocol must have frustrated the doctors, who could never speak unless first spoken to. When King George was at the peak of his delirium, entire visits passed in silence, as on one day in January 1812: “His Majesty appears to be very quiet this morning, but not having been addressed we know nothing more of His Majesty’s condition of mind or body than what is obvious in his external appearances.” Perhaps this explains the preoccupation with the kingly pee.

  Having exonerated George III of madness, the British researchers then posed the next logical question: Since AIP is always hereditary, who else in his bloodline carried the disease? By combing through historical accounts and medical records—a search abetted, once again, by the fastidious description of urine samples—they were able to trace the disorder through thirteen generations, spanning more than four hundred years. Among his ancestors, fifteen were identified as sufferers and/or carriers, beginning with his father and going back to Mary, Queen of Scots (1542–1587), where the porphyria paper trail ended. As with George, retrospectively diagnosing Mary with the illness allows for a radically revised view of her reign. Mary, whom the researchers called “one of the great invalids of history,” was so sick so often that her opponents accused her of using hypochondria, to borrow the modern term, as a political ploy. Conversely, her enemies were accused on one occasion of poisoning her, an episode now ascribed not to foul play but to the fickleness of genetics.

  Such a rare disease as porphyria would never have manifested in so many family members were it not for the strict controlling of the bloodline through intermarriages, a phenomenon not unique to royal dynasties. A similar kind of inbreeding occurred within isolated and remote communities during the Dark Ages, for example, and, in these shallow gene pools, recessive traits could flourish. Hence, as biochemist and medical writer Nick Lane postulates, a type of porphyria that is among the rarest today—congenital erythropoietic porphyria (CEP), the disfiguring, vampiric form of the disease described earlier—may’ve once been relatively common in spots of Eastern Europe now recognized as the cradle of vampire myths, the valleys of Transylvania. Assuming this to have been the case, it’s easy to imagine how the corpse-like appearance and odd behavior of sufferers may have given rise to whispers of vampirism; how, within these enclaves, certain folk remedies would’ve been embraced; and how, over time, the rumors and remedies would have gradually evolved into legend. Garlic is a good example. It’s now well known that certain chemicals in garlic can exacerbate porphyria symptoms, a lesson that Transylvanian sufferers may have had to learn through painful experience. Little agility is needed to make the next leap, to imagine how a sufferer’s way of averting a flareup could mutate into a superstition among the healthy for preventing the disease and then into a means of warding off a vampire attack. Likewise, the genuine need to avoid the sun could have transmuted into the dramatic literary convention of the bright light of day turning a vampire to toast.

  In view of all this, the hypothesis put forth by David Dolphin doesn’t sound so far-fetched: that, hundreds of years ago, victims of this most heinous form of porphyria may have self-medicated by drinking human blood. In a sense, this is evocative of earlier thinking, such as the belief in ancient Rome that a swallow of gladiator blood could cure epilepsy. Provocative, yes, but scientific, no. In Dr. Dolphin’s theory, however, science concedes. The severe anemia caused by CEP leaves sufferers with dangerously low levels of heme in their circulatory systems. In medical terms, a heme deficiency is an iron deficiency, which is why the modern treatment for this rare form of porphyria is regular transfusions of blood. Though not recommended, a patient could instead be given a straw. The heme molecule is robust enough to survive digestion and will make its way into the bloodstream.

  When I consulted a nutritionist on this final notion, I was so preoccupied by the repulsive thought of ingesting blood that I was startled when she stated the obvious: “We eat blood all the time. It’s in our meat, in all the animals we kill for food.” Mary Kay Grossman is a registered dietician and coauthor of the bestseller The Insulin-Resistance Diet. “In our culture,” she continued, with the exception of kosher diets, “we don’t drain the blood off. If you cook it, it’s not unhealthy to eat blood, and it doesn’t lose its nutritional value.” In fact, Grossman explained, some cultures, such as the Masai of Kenya and Tanzania, subsist entirely on blood and milk—cow’s blood, that is. “They milk the cows, then puncture the throat, and drain the blood off.” (The cows survive, by the way.) The Masai then mix the two and drink it fresh, she added, or give it a few days to ferment. “They live in an extremely dry climate where it�
��s almost impossible to grow anything, so the blood supplies iron and the milk is a major source of protein.”

  Raw animal blood is a central part of the diet of other pastoral groups in eastern Africa, I later learned, including the Karimojong of Uganda, but, globally, cooked animal blood as a main ingredient in traditional dishes is far more common. The Inuits with their seal’s blood soup, for example. The Tibetans with yak’s blood cubes, a snack of reduced yak’s blood served with sugar and hot butter. And the English with their black pudding, a baked then fried concoction of pig’s blood, bread cubes, skim milk, beef suet, barley, oatmeal, and mint. You can even taste your way through every region of France through local interpretations of boudin noir, “blood sausage.” Larousse Gastronomique, the classic French encyclopedia of Continental cuisine, describes sixteen variations, following the basic recipe of equal parts onions, pork fat, and pork blood.