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The motif of blood in the classic novel dracula by bram stoker

The book was published prior to the development of ABO cross-matching, so the recipient of the transfusion was fortunate to avoid a hemolytic transfusion reaction.

  • If so, perhaps those with type A blood should watch out;
  • The reason Dracula took seven years to write was that Stoker had great difficulty writing it, especially cutting through the overload of his own imaginative clutter;
  • The patient is a previously healthy young woman named Lucy who is attacked at night by the Transylvanian vampire Count Dracula.

Analyzing this case from a modern perspective allows one to review the history of transfusion medicine, the science of ABO incompatibility, and basic principles of probability. Stoker may have learned about the procedure from one of his brothers, three of whom were physicians including one who eventually became president of the Royal College of Surgeons in Ireland.

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Here we present an analysis of this fictional case of blood transfusion from Dracula as a way of reviewing basic principles of transfusion medicine and probability. Let us begin with a case description.

The patient is a previously healthy young woman named Lucy who is attacked at night by the Transylvanian vampire Count Dracula.

  1. The case has been used successfully as a teaching tool for medical students and residents. Preferential feeding success of laboratory reared Anopheles stephensi mosquitoes according to ABO blood group status.
  2. Reid M, Lomas-Francis C. Variant methods included the removal of the heart rather than its staking.
  3. Blood transfusion was a risky undertaking, and life-threatening reactions were common and poorly understood.
  4. The name was not well known outside Romania, but Stoker would make it world-famous as the historical source and embodiment of the vampire mythos. Afterwards the body may have been dug up and found alive, and from this a horror seized upon the people, and in their ignorance they imagined that a vampire was about.

Lucy quickly becomes severely anemic, and her worrisome appearance prompts a friend to summon Abraham van Helsing, a man said to know as much about obscure diseases as anyone in the world.

She tolerates all four transfusions without any side effects, regaining some vitality. Unfortunately, Dracula returns, and Lucy eventually succumbs to the vampire and joins the ranks of the undead. Reading this story from a modern perspective, one notices that Stoker makes no mention of cross-matching the donated blood. This apparent omission reflects the state of medical knowledge at the time. When Dracula was published in 1897, no one had started cross-matching donors and recipients.

Bayesian Analysis of Blood Transfusion in Dracula

Blood transfusion was a risky undertaking, and life-threatening reactions were common and poorly understood. In 1900, three years after the publication of Dracula, the puzzle was solved by Austrian physician Karl Landsteiner, who realized that there are four ABO blood types and that not all blood types are compatible.

This gene is called ABO and encodes an enzyme that adds a sugar molecule to a carbohydrate chain on red blood cells. The gene has three alleles. The A and B alleles encode enzyme variants that add different sugars, and the O allele is the A allele with a frameshift mutation rendering the protein non-functional. At a very early age, people develop IgM antibodies to A or B antigens not found on their own red blood cells because these antigens resemble polysaccharides from gastrointestinal bacteria.

These naturally occurring antibodies cause red blood cells with foreign ABO antigens to agglutinate, leading to hemolytic transfusion reactions such as those described by Blundell.

Let us now return to the case from Dracula. Lucy receives four units of blood without cross-matching from four unrelated donors.

For the sake of this analysis, let us assume that any incompatible blood would have caused a reaction. Taking the weighted average of these four values weighted by the initial probability of each blood type gives the overall probability that all four transfusions are successful. Lucy is fortunate to have avoided a hemolytic transfusion reaction. The fact that she does avoid a reaction allows us to make inferences about her blood type.

  1. Unfortunately, Dracula returns, and Lucy eventually succumbs to the vampire and joins the ranks of the undead.
  2. In the end, he wondered if the book would even be remembered. Some Dracula creation myths are easier to believe because they contain partial truths, although they quickly begin to enable improbabilities and impossibilities.
  3. Reid M, Lomas-Francis C.
  4. The history of blood transfusion prior to the 20th century—part 2. Taking the weighted average of these four values weighted by the initial probability of each blood type gives the overall probability that all four transfusions are successful.
  5. If so, perhaps those with type A blood should watch out.

This type of thinking is known as Bayesian reasoning. To understand the idea, consider someone who has tolerated one hundred non-matched transfusions from random donors.

Given this transfusion history, it is highly likely that the recipient has type AB blood, the universal recipient. Working through this analysis provides an opportunity to review basic principles of transfusion medicine and Bayesian reasoning. The case has been used successfully as a teaching tool for medical students and residents. Lucy tolerates all four transfusions, but given her low pre-test probability of being a universal recipient, her post-test probability of having type AB blood is still low.

And as a final aside, this analysis might even have implications for the genre of vampire literature as a whole. Some bloodsucking creatures such as mosquitoes are known to preferentially seek out certain blood types when it is time to feed. If so, perhaps those with type A blood should watch out. The history of blood transfusion prior to the 20th century—part 2. Am J Clin Pathol.

Reid M, Lomas-Francis C. Preferential feeding success of laboratory reared Anopheles stephensi mosquitoes according to ABO blood group status.