From the Vault: I Want a New Blood

From fictional tales of vampire thrust to to real-life medical research, the notion of synthetic blood brings with it a lot of possibilities. In this classic episode of Stuff to Blow Your Mind, Robert and Joe consider the strange history of purported blood substitutes and possible ramifications if scientists ever solve this riddle in the blood. (originally published 10/8/2020)

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Episode Transcript

Speaker 1 (00:05):
Hey, welcome to Stuff to blow your mind. My name
is Robert Lamb and I'm Joe McCormick, and it's Saturday.
Time to go into the vault for an older episode.
This one was called I Want a New Blood and
it was originally published October eight, So we're still dipping
into the Halloween last year's season. Yep, We've we've got
the fake blood on drip for this one, So let's

(00:26):
drink up. I'm imagining like a box wine, you know
in the car bood. Hey, Doc, I've been thinking I
need a new blood. Oh, the animal blood it's not working. Yeah,
I tried it. It made me crash my car, made

(00:46):
me feel you know, about three ft thick. Well, what
about true blood? Just hit the market? Headache, dry mouth,
made my eyes too red. Well, there's currently a clinical
trial for something called day Breaker. Be right there, Doc,
I got some on the black market. Made me vomit
and explode. But what exactly are you looking for? Well,

(01:07):
you know, I don't want to go crazy with hunger.
I don't want my things too long. I also don't
want it to spill or come in a pill. Now,
now you're rhyming again. Have you been taking your synthough gore,
because that's one of the withdrawal symptoms. I'm all out, doc,
and I don't imagine you have anything else around here
on tap, Welcome to Stuff to Blow your Mind, the

(01:33):
production of My Heart Radio. Hey you welcome to Stuff
to Blow your mind. My name is Robert Lamb and
I'm Joe McCormick. And here we are covered in blood.
That's right. Last year we put out a Halloween episode
titled I Drink Your Blood Type, all about blood types

(01:56):
that you know humans have, but with a vampire flavoring.
I think we did a on skit at the beginning
of that one. Um, we briefly mentioned synthetic blood in
vampire fiction in that one. I remember we did reference
true Blood as well as a nineteen thirty nine film
titled The Return of Doctor X, which I haven't seen yet.
Still haven't seen this one, but it stars Humphrey Bogart

(02:18):
as an evil doctor with this kind of like skunk
streak in his hair and round glasses who has been
brought back to life with synthetic blood. The hair suggests
Elsa Lanchester like in Bright of Frankenstein. It does. Yeah,
you definitely can see the Frannstein d na um maybe
even the lazy Frankenstein DNA in this costume design. Now,

(02:39):
in that episode, like you said, we mainly ended up
talking about natural uh properties of blood types, what evolutionary
pressures drove the development of different blood types, how that
functions in medicine, and then I think we also talked
about some pseudo scientific beliefs about blood types and personality
and psychology. But I think we only briefly mentioned in

(03:00):
the possibility of synthetic blood or using something other than
human blood in your veins. Yeah, that's right, we did.
We didn't get into the topic all that much, and
subsequently we had some listeners suggested for October twenty fair.
So here we are now, first and foremost, we should
really establish what blood literally is and maybe a little

(03:22):
bit about what it metaphorically is. So blood is technically
both a fluid and a tissue, since it's made out
of similar specialized cells suspended in a liquid matrix of plasma.
It carries oxygen and nutrients to the cells and carries
off carbon dioxide and other waste products. The heart pumps
it through the body, but it's also part of the

(03:44):
larger circulatory system. So organs like the kidney and the
lung are also important to blood. And of course, if
we lose enough blood in a short enough period of time,
we die, as we all know, yes, uh. And it's
it's amazing to stop and think how blood is not
just in your body but constantly moving throughout it, you know,
like while you're alive, it never stops. This is one

(04:06):
of those ideas that sometimes makes me feel the you know,
the flame run under my skin. It's it's just a
little too creepy thinking about how even when I'm sitting
perfectly still and perfectly at rest, the blood is still going.
It's rushing through every inch of me. And that's true
for all of us, of course. And so one thing
I was wondering actually is how long does it take

(04:27):
for each red blood cell to circulate all the way
through your body and make it back to the heart. Uh.
I was reading an interesting Q and A by the
Naked Scientists where they worked out the math on this,
and I thought this was pretty cool. So it depends
on a number of factors, but their estimate was that
for most people, the body performs a complete blood circuit

(04:47):
roughly every minute. And they found this because the average
adult has you know, roughly five leaders of blood in
the body. The average heart pumps about seventy milli leaders
of blood every time it beats, and the average rest
sting a heart rate is something like seventy beats per minute.
And if you multiply all these together, you find that
the heart circulates about four point nine are close to

(05:08):
five leaders of blood every minute. So on average, it
probably takes about one minute for your heart to circulate
your entire blood volume. And it does this minute after
minute after minute until you die. Isn't that crazy the
longer you look at it. Yeah, this idea of this
endless river of blood just circulating through your body. Now, blood,

(05:30):
of course, also has taken on various uh additional connotations,
connotations of heredity, class, race, violence, sacrifice, and more. I
was reading an article titled bio Securitization, the Quest for
Synthetic Blood and the Taming of Kinship by Cath Weston.
The author gets gets a bit deeper into the connotations

(05:52):
that will be discussing today, but there were several aspects
worth highlighting. First of all, just the idea of royal
blood and the divine right of kings. The idea that
there's like literally, there's something in the bloodline. UM. The
idea of blood is a signifier of kinship, the idea
of the idea that your relatives are your blood relatives, etcetera.
And UH. An interesting thing that Weston points out to

(06:14):
is a historical tidbit is that blood transfusion UH, during
its history has been objected to for both religious reasons
and we'll get into an example of that in a bit,
but also for reasons steeped in racist ideologies. UM. And
so the you know that the metaphorical idea of blood
has often seemed to muddy our biological understanding of blood.

(06:35):
I think what this comes down to is that in
many ways blood is seen as some kind of essence.
That it's not just a part of the body that
plays a particular role in um in energy and the
oxygenation of tissues and the removal of waste products and
the circulation of chemicals, hormones and things throughout the body,
but it also is somehow the soul of the thing.

(06:57):
It There are properties inherent rent to the animal or
the human that are represented by or borne through the blood.
In particular. Yeah, it gets kind of weird. When you
think about the fact that, like, on one hand, to
think that the blood is not us, that the blood
is just this this oil that we run on, like
that's that's not completely correct. Like the blood we we

(07:20):
are blood. The blood is part of our body again,
it's it's tissue and a liquid. But on the other hand,
we're not just the blood. It's not like if you
drained our blood out and put us in a jar,
that's not us in the jar and an empty shell
over here. Like I'm I'm reminded of of myths, for instance,
that involve something like blood in other beings, like the

(07:40):
episode we did on Tallos the Bronze automaton and the
idea that he had this I core in his body
that was like the magical substance that that made him function,
and that that reveals a lot about how blood was
was considered in prior ages. Yeah, it's like the oil
and the car engine. But it's also the it's somehow magical,

(08:01):
it's somehow bearing the properties of godhood. And when you
take out the plug and allow all of the eye
cord to drain, now that you just kind of comes
to a halt. Yeah. So indeed, like the idea of
taking the blood from one person, the blood that is
part of that person, in putting it into another person.
You know that that that opens up the door for
a lot of you know, I guess, uh, you know,

(08:22):
metaphorical ideas about what that means. What does it mean
that that person is now in me um or what
orient in the when there is an injury? What does
it mean that a lot of me is now like
on the pavement. That sort of thing. Now, that brings
us to what we're mainly going to be talking about today,
the idea of blood transfusions. Again, if you lose too
much blood in a short period of time, you can die.

(08:44):
One way that we know that that can be prevented
today is by adding more blood, assuming it is the
correct sort of blood. When a blood transfusion is done correctly,
can save lives. It's you know, this is I think
something that most of us are familiar with. H And
as we detailed in last year's episode, which I think
we recently reran uh in our feed UH. One does

(09:07):
have to get it just right to respect the different
blood types. And this was a significant hurdle to overcome
in medical science totally. But the idea of synthetic blood
or a blood substitute, you know, the idea of there
being something other than blood that you could fill one
up with when you're you're facing a life threatening shortage. UM.

(09:27):
The key argument here would be, you know, something could
be manufactured ahead of time and to some degree kept
on a shelf for use in times of emergency. So
this was, you know, just decreasing to some extent the
reliance on blood and tissue donation. UM. I think it's
also been argued that this would be ideal if you
were dealing with a very far flung situation. You can't

(09:48):
have a proper blood bank on hand, but perhaps you
have some sort of short term substitute that can be
used instead. But of course, the other side of the
scenario is that such blood would be a product not
unlike true blood from the v show that we mentioned earlier.
We'll discuss where we are in our quest for a
true blood substitute, but first we want to explore some

(10:08):
of the earliest and really some of the weirdest and
grossest ideas for synthetic blood. It's really a wonderfully bizarre
bit of history. So one of the sources I was
Looking at Here is titled Artificial Blood by Suma and Sarkar,
and it was published in two thousand and eight by
the Indian Journal of Critical Care Medicine. And in this

(10:29):
the author points out that the notion of artificial blood
has pretty much stirred in the human mind for as
long as people have bled to death from their injuries.
Like we've we've realized that there's something and and this
can get kind of I think, kind of vague and
magical as to the you know, the idea that blood
is important and if we lose it we can die,

(10:49):
and hey have its loss means death. Perhaps it's uh
to add blood is to add life or to restore it. Now,
certainly there's a there's a mix of magic and and
early medicine here. Uh Sarkar points to ink and folklore
depicting something arguably like blood transfusion. I've also seen it
pointed out elsewhere that Odysseus temporarily resuscitates underworld shades by

(11:14):
offering them um blood sacrifice in the Odyssey. The idea
of blood as if not a biological underpinning of life,
you know, something tied up with our conception of the
life force. That that passage in the Odyssey is pretty stirring.
I was looking at a Robert Fagel's translation of it,
and basically, Odysseus is instructed to um to to flay

(11:37):
and then burn these um the the the animals and
sacrificial rams or what have you, in order to like
draw in the spirits of the dead so that he
can commune with them. And then of course later on
he does it. Uh. And it's it's it's actually really
rather creepy. Yes, And I would say one reason is
that it contains this older Greek view of the afterlife,

(11:57):
sort of the pre Platonic view of the afterlife in
Greek thought, which is less the idea of you know,
places of possible reward or punishment, and more the idea
that everyone who dies just dwells forever. In this miserable,
confused dungeon of shades. All right, on that wonderfully spooky note,
We're gonna take a quick break, but we'll be right

(12:18):
back with tales of early blood transfusions. Thank alright, we're
back now in talking about substitutes for human blood that
can be hooked up to your veins. One of the
easiest places you know, you can imagine people would have looked,
is to the blood of other animals, that's right, yeah,

(12:40):
and uh and at this at this point, we're gonna
we're gonna move to around uh sixteen sixteen, because that's
when a man by the name of William Harvey described
blood circulation, which is going to be key, just a
better understanding of like what's actually going on with blood.
And in the following years, numerous substances were tried out
as a stand in for human blood. And the list

(13:01):
provided by Sarkar in that article I cited earlier is
pretty horrific. It includes beer, urine, milk, plant resins, and
of course sheep blood. Now, sheep's blood is at least blood, right,
so at least it has that going for it. And
and this is known as zeno transfusion. The first documented

(13:22):
zeno transfusion was conducted by French physicians Jean Baptiste Duni
and Paul Imarez in sixteen sixty seven, and it apparently
was successful between a fifteen year old boy and a lamb. Uh. Yeah,
so this first one was largely reported as successful. I
think that could be defined in a number of ways,

(13:42):
depending on what you what you call success. At least
it was reported that the fifteen year old boy felt
good afterwards. But this whole saga of Jean Baptiste Ani
is actually I started looking into this a little bit deeper,
and the more I looked, the weirder and weirder of God.
So I want to take a digression here to talk

(14:03):
about Denny and his his historical context. So one of
the papers I want to look at is by Benjamin H.
Chin Ye and I. N. H chin Ye published in
the Canadian Bulletin of Medical History in two sixteen, called
Blood Transfusion and the Body and Early Modern France. Now,
a lot of this paper is concerned with what medical

(14:25):
worldview guided the work of late seventeenth century physicians like
Denny and Denise contemporaries, and the authors argued that the
physicians of France in this time did not really have
a unified system of anatomical theory guiding their work, but
rather a somewhat contradictory patchwork of contemporary natural philosophy and

(14:46):
anatomical research with a received background of galenic humoralism. So
this is the system that you're probably pretty familiar with
by this time that views health issues as largely related
to the balance and status of the four humors blood, flim,

(15:07):
black bile, and yellow bile. This is received from UH,
not invented by, but sort of shaped and received by
the Roman physician Galen. Now, the authors of this paper
tell the story of the first documented Zeno transfusion with
some quotes from the report at the time. As you said,
the patient was a fifteen year old boy, and he

(15:29):
had already been through twenty rounds of blood letting. This
was in order quote, to assuage the excessive heat that
was a result of the boy's violent fever. And in
galenic theory, blood is associated with heat and excitation. This
is part of the place we get the idea of

(15:49):
being sanguine, right, you know, having an excess of blood
makes you sort of a brilliant and excited and energetic.
But this could be bad in in UH, in galenic thinking,
by causing fevers, by causing mania, and that sort of thing.
So they let this guy's blood twenty times, and after
the twenty bleedings quote, his wit seemed wholly sunk, his

(16:13):
memory perfectly lost, and his body so heavy and drowsy
that he was not fit for anything all right. So,
so basically a situation where the bathtub was too hot. Uh,
let some of the bathwater out. Now it seems a
bit too cold. Right. The problem is that, yeah, he's
he's appearing sluggish. That seems something is wrong with his brain.

(16:33):
Maybe he doesn't have memories or much energy. Uh. So
Denny counters this by starting a transfusion. He draws blood
from the carotid artery of a lamb, and then that
blood goes into the vein in the boy's arm. Ultimately,
the boy received about nine ounces of lamb blood and
then Denny wrote that quote afterwards, he hath no longer

(16:57):
that slowness of spirit nor heaviness of body, which before
rendered him unfit for anything. He grows fat visibly and
in brief is a subject of amazement to all those
that know him and dwell with him. So Denny concludes, Yeah,
it seems like he's doing good. Uh. And this was
on June sixteen sixty seven. But blood transfusions can be unpredictable.

(17:19):
There can be wildly different reactions and different patients depending
on often how the host's immune system in particular responds
to what's being put into the veins and as we've
been talking about. Despite being on the cutting edge of
seventeenth century anatomy and new surgical techniques, Denny was also
still in the grip of Galenism, which had been, you know,

(17:41):
a dominant force in European medicine since the Roman Empire,
and which attributed the bulk of medical pathologies to imbalances
or corruptions in the four humors. And Deny himself, he
agreed with this. He believed, quote, the greatest part of
our diseases are but results of the distemper and corrupt
of the blood. Now he doesn't say quite every disease,

(18:03):
but you can imagine he thinks most of them. So like, oh, no,
you've got arthritis. Uh, your problem is you've got bad blood.
Or you know, you've got, oh a fever. I think
that's that's a blood issue. We've got to get some
of that blood out. And so, as a result, he believed,
quote the speediest and commonest remedy they have in practice
is to evacuate the same by phlebotomy. Phlebotomy means blood letting,

(18:28):
or else refresh it and cool it by julips. Uh So,
in other words, if you know, for most diseases. The
cause is bad blood and the best treatment is to
drain the blood out or possibly to give the patient julips.
The paper doesn't explain what julips means here, so I
tried to look this up. I think what julips refers
to here is a flavored drink, for example, rose water

(18:52):
sweetened with sugar syrup. All right, so this is when
we talked to say about a mint julip. This is
the same word. Yeah. I think it was later on
that julip came to often have alcoholic connotations. I think
at this time it just would have meant a flavored drink,
not necessarily with alcohol in it. I don't know why
that is thought to deal with corruption of the blood,
but that is amazing, you know. Can you imagine you

(19:13):
show up at the hospital with dingay fever or whatever
and they're like, we could use some rose water. Yeah,
Or if the or the two possible treatments on the
table are bleeding or a sweet drink, it's like, yeah,
essentially you're gonna have kool aid or they're going to
drain you into a bucket. Well, it seems like between
the two, Dennis kind of favored one over the other.

(19:33):
It seems like he was a bleeder. And yeah that
that kid had not had twenty julips prior to the
lamb blood. To be fair, I don't know how many
julips he had, but they did bleed him twenty times. Uh,
maybe you got a julip every time. Who knows. It's
like the brownie they give you and the when you
go to donate blood, you know you get brownies. Oh man,

(19:53):
I get um like peanut better crackers. Sometimes I get
what is it that's a special tree? Oh, nutter butters
sometimes there I've seen the Nutter butters. Yeah, that confirmed
in my experience, Like it forces me to equate peanut
butter with the blood. Like basically, you know, we're thinking
about the same thing here. It's like, well I lost

(20:14):
some blood, gotta get some peanut butter in there. That
taste of the Nutter butter or the what is it's
I was trying to remember the name of the little
brownie that's got the colorful sprinkle on top that they
give you sometimes and Seth chimed in there called cosmic brownies.
We think, yeah, I've never heard of that. I mean
like space brownies. I believe Seth space cakes. But I

(20:35):
don't think you should have one of those after blood donation.
You should have some space shrimp cocktail after blood donation.
But anyway, okay, So, so bleedings, bleedings, all those bleedings
obviously that Denny loves. They can really take a toll.
As described, you know what happened to this fifteen year old.
So Denise saw blood transfusion from animals as a perfect

(20:57):
compliment to blood letting. In his words, it's quote the
old and corrupt being first evacuated, could then make room
for the new and pure. So in the case of
the June sixteen sixty seven transfusion, this teenage boy, he's
blood twenty times to bring down his fever. He's pretty
low after that, and then Lamb's blood is used to
revive him with a fresh, clean, non corrupted supply. But

(21:22):
Denny did not stop there with the xeno transfusions. Later
that same year, Denny also transfused sheep's blood into the
veins of a healthy forty five year old Sedan chairman.
Now that means he was one of those guys who
carries fancy people around in the litter, you know, so
if you're fancy and you don't want to get your
boots wet. You can ride in a box where four

(21:42):
guys carry you on poles. So you have to imagine
if if this guy is a professional sedan chairman, he's
probably pretty fit. Right, Yeah, he's got to be kind
of a hoss. And for that reason, I've seen this
case and the idea that there's no identified cause for it.
It seems like this was maybe a negative control role,
just like seeing what a transfusion does into a healthy guy.

(22:03):
And reportedly this guy was fine. And then after that,
Denny performed a transfusion of Calf's blood on a Swedish
and nobleman who was dying of an unspecified illness in Paris,
and the first transfusion this guy got seemed to sort
of enliven him, bringing him back a bit, freshen him up,
But then he died while in the middle of receiving
his second transfusion. We don't know why he died. But

(22:26):
then finally the authors tell the story of how Denny
performed again a similar operation on a thirty four year
old man named Antoine Moroy in an attempt to treat
a supposed mental illness. I read this case described more
fully in another paper by James G. Chandler, Teresa L. Chin,
and Max V. Wool Hour called direct blood Transfusions in

(22:49):
the Journal of Vascular Surgery from and I was having
trouble finding out exactly what Moroy's symptoms were. The main
report about him, The main symptom that has described is
that he would quote intermittently disappear from his suburban home
to indulge in paris Is sensual pleasures. I'm not sure

(23:10):
if that's actually a symptom of an illness, but right,
I mean, because certainly that that could go along, that
could certainly be the practice of one who's suffering from
a true mental illness. But you know, this could also
just this could also be a case of sexual addiction
or that, or it could just be, you know, merely
this person had a very you know, exciting sex life,
and whether they decided to treat medically, yeah, so I

(23:33):
don't know, but it is widely reported at the time.
Everyone says he was a known madman. So without any
other we just have to assume that there is something
else going on with him, I guess so. Denny, of
course attributed this supposed insanity to humorl imbalance. Denise solution, Well,
you've got to remove this man's blood and replace it

(23:53):
with calf's blood, and did he believed that the sweetness
and freshness of the calf's blood would temper the ardor
and the boiling of the man's existing blood. So Denny
tries this out. They bled him of two d ninety
milli leaders of his own blood, and then they put
about a hundred and seventy five milli leaders of blood

(24:14):
from a calf's femoral artery into a vein in Moroy's arm,
and it was reported that his temperament became more subdued
by the process. So it was repeated in the presence
of a number of observing physicians a few days later,
and the second transfusion did not go as well as
the first one. Maroy reacted first by he said he

(24:35):
had lumbar pains, a pain in the lower back, and
tightness in his chest, and he presented an irregular pulse.
And then the next day this progressed into vomiting and
a nosebleed, and maybe most alarmingly, uh to quote from
Denise report, he produced a tall glass of urine as
black as if it had been deluded by my fireplace.

(24:59):
I want to be clear here that it may sound,
it may come through a little bit like I'm I'm
purely laughing on my side, but um, this is I'm
feeling an immense sense of revulsion here. This has just
giving me the all over. Oh yeah, god. Uh So
you would think this would suggest the transfusion was a
bad idea, right, that this guy's he's experiencing chest pain,

(25:20):
back pain, he's vomiting, his nose is bleeding, and he's
peeing black. But Denny considered it a success. And the
reason he considered it a success was he interpreted the
results according to humorl theory. He believed that the black
urine was an evacuation of excess black bile from the body,
which he wrote, is known to send vapors up into

(25:42):
the brain which disrupt its function. So, according to Deny,
he had been mistaken that the problem was too much
corrupted blood. Instead, the problem was too much corrupted black bile,
and the transfusion had caused the body to evacuate it all.
And Denny believed that his transfusion had some what succeeded
in curing moroy. Oh, it's such The the history thus

(26:05):
far is is very fascinating because you know, if you're
not familiar with it, and you hear about okay, the
first blood transfusion and it's going to involve a human
and um and and lamb, you just assume it's going
to end and just disaster and just end in death,
and that that will be a stumbling block. But then
it's not, or seemingly not. And then in this case,

(26:26):
something that seems like a firm warning, um, do not proceed,
rethink what you were doing, is interpreted as a success. Yeah, exactly,
though not by everyone, I should note, because the paper
by chin Ye and chin Yee notes that there was
a rival Parisian physician named guyom Lamie who he disagreed,
and he argued that the black urine was a negative

(26:48):
reaction to the calf's blood. But the reason, he said
was that it was indicative of the body's attempt to
purge the contamination of a substance that was against its nature,
which sounds kind of close. But I think this opposition
is being infused with, you know, ideas of sort of
like spiritual essential is um that are not really proper

(27:10):
in medicine. Uh It sounds to me like Muroy was
probably suffering from what is now called an acute hemolytic reaction,
which is a widely known rare side effect of a
blood transfusion, I guess, more common if it is not
a properly controlled blood transfusion. And this is where the
recipient's immune system interprets the donor red blood cells as

(27:33):
invasive pathogens and attacks them hemolysis in in the name
acute hemolytic reaction, hemallysis means the destruction of red blood cells,
and then the red blood cells under attack releases substance
into the blood that the body has to try to purge,
and this substance can cause severe damage to the kidneys.

(27:54):
And this will sound pretty familiar now. Symptoms of an
acute hemolytic reaction include, among their things, chest and lower
back pain, nausea, and dark urine. But then there is
an even stranger epilogue to the Moroy story. Uh So,
picking up with what's covered in the Chandler at All Paper, Denny,
of course considered Moroy somewhat cured, and I guess this

(28:17):
meant that he was no longer a seeker of sensual pleasures,
at least at first after what happened. And the authors
here say that at first Maroy behaved as his wife wished,
but then he became truculent again, and they say this
was quote prompting her to insist on another transfusion. Moroy
refused to cooperate and received no blood, so he was
going to get a third transfusion, but it didn't go forward,

(28:40):
and then quote he died that evening, and his wife,
perhaps with the encouragement of some physician critics, accused Denny
of killing her husband. Denny was tried for manslaughter but
exonerated when it was discovered that Mrs Moroy was poisoning
her husband with arsenic and then the following year, the
French parliament enacted a ban on transfusion of blood into humans.

(29:04):
So he tries to do this third transfusion, uh doesn't
work out. Maroy dies, his wife is found to have
been poisoning him, or at least is believed to have
been poisoning him, and then we get a ban on
on transfusions in France. But it also doesn't stop there
because while you can imagine it's common enough for a
person to be murdered by a spouse. The story gets

(29:25):
even more complicated. I was reading about a book by
a Vanderbilt University historian named Holly Tucker that argues the
case for a conspiracy of rival physicians to intentionally murder
Antoine Moroy and framed Denny for causing his death. Now,
I haven't read this book that it sounds extremely interesting,

(29:47):
but I want to give you the gist, mostly based
on a review in the Journal of Clinical Investigation by
Neil Blumberg. So, to start, we know that Denise gillina
humor theory was hopelessly misguided. Right, this is not a
good basis for medical intervention. There is no reason to
think that blood from a docile lamb will treat mania
and humans mental illness doesn't work that way, and there's

(30:10):
no way to predict or prevent which of these would
result in a severe, life threatening rejection of the donor blood.
But despite how misguided and dangerous Denise treatments were, denise
rivals opposed them for almost equally misguided reasons. A lot
of these I think some were probably just sort of
motivated by ambition, you know, they were kind of temporal

(30:33):
and political rivalries but many of Denise opponents had extreme
religious and conceptual opposition to blood transfusions. For example, some
of them believe that the transfusion of blood from an
animal could turn a human into a type of chimera
or some kind of animal human hybrid. You might become
a subhuman ware lamb or a ware calf, which is

(30:57):
very Gary Larson. Yes, and some also believed that the
ingestion of foreign blood through transfusion was a slippery slope
to cannibalism. I'm not quite sure how you get there,
but that at least was was argued. Yeah, because it's
I mean, it's not like the humans we're talking about
here weren't already eating meat, right, Yeah, I would think

(31:19):
that the eating of meat would more likely give way
to cannibalism than the transfusion of blood from animals. Yeah. Yeah,
And this might sound kind of outlandish, like, well, how
could you get to that? You know, how could you
have this kind of opposition to blood transfusions? But uh,
I know the cases made in Holly Tucker's book, and
Bloomberg himself brings up as a point of comparison that quote.

(31:40):
One might consider that current disagreements about stem cell therapies
are similar in nature, as some find it impossible to
separate considerations of religious belief and scientific approach. So even
today we certainly do have, you know, bioethical debates that
are largely prompted by religious belief. That's that's true. I mean,

(32:02):
you know, I certainly think to any number of um
of chimerical um uh studies that have come out, you know,
there's always going to be that that voice of criticism
that's going to raise the specter of some sort of
uh uh you know, man goat hybrid or whatever the case.
Maybe this is against nature, this is a perversion. Yeah, yeah,
the shadow of Frankenstein there. At the same time, it's

(32:25):
interesting looking at all this and thinking about like the
sort of spirit that the spiritual and religious ideas that
are kind of attributed to the idea of first and foremost,
you know, the draining of the blood, the bleeding of
the patient, but then the idea of well it looks like, uh,
looks like your treatment didn't take You're still running, trying
to run off to Paris. We need to replace that
blood again. It reminds me of some of the criticisms

(32:48):
leveled at so called young blood transfusion that we've uh
we we've seen in in in recent years, you know,
the idea that an an older person could receive the
transfused blood of a younger person, uh with some sort
of health benefits. And I believe this is this is
largely seen as pseudo scientific um. But but but I

(33:09):
can I can see some of the same energy in
young blood transfusion that you see kind of attributed to
the the you know, the poorly understood nature of blood
transfusion at the time and the uh, the seventeenth century. Yeah,
I can totally see that, like this view of there's
some kind of unholy experiment that's being done in in

(33:29):
dark rooms that we don't have access to. And by
the way, anyone who watched the television series A Silicon
Valley you might remember the the the young blood um
thing being a part of the plot as the the
Hoholy founder A. Gavin Belson at one point has a
quote unquote blood boy who is responsible for providing him
blood transfusions to UH as as a as a I

(33:51):
believe in like a life hack to keep him on home. Man. Well,
it's interesting again to compare to the case of Danny
and his rivals. I mean, well, maybe I should finish
it first and then say this. So in the end,
Holly Tucker's book makes the argument that it was Denise opponents,
especially a physician named Henri Martin de la Martiniere, who

(34:13):
arranged the murder of the patient of Antoine Moroy by
giving arsenic to Moroy's wife and encouraging her to poison him. Ultimately,
she argues this was in an attempt to discredit Denise
medical theories, and it's a it's a case where there's
really no good guys because if you know, if Holly
Tucker's theory is correct, and they really did this, it

(34:35):
was a case of two camps that were both entirely wrong, Uh,
fighting over this conceptual biomedical space. Oh wow, this is
such a wonderful bit of a bit of history. I
wonder if this has been adapted in any kind of
historical drama, because it should perfect for that sort of thing. Yeah,
absolutely so. Anyway, that that is the very weird story

(34:57):
of early zeno transfusion in sixteen sixties France. Now, xeno
transfusion is technically still on the table today, but it's
generally not practiced with humans today because generally human blood
is much more forthcoming. Um but uh, but yeah, this
the strange history of of of blood, not just as

(35:19):
zeno transfusion, but again thinking of the idea of like
deer and urine or or milk being used. Uh, this
brings to mind the various alternative bloods you often encounter
in humanoid beings in sci fi and fantasy. You know,
I instantly think of the milk white blood in Ridley
Scott's Various Androids, or the yellow blood that you see
in Phantasms the Tall Man, or in the The Androids

(35:42):
of Halloween three, one of my favorites. Yeah. Um, Now,
on the subject of milk, Sarkar rites that indeed, in
eighteen fifty four, milk was injected into the veins of
patients with asiatic cholera, thinking that it would help regenerate
white blood stulls. Oh maybe is it like a color
match thing? I know, that's what it sounds like. Now.

(36:05):
The thing is enough patients survived that they kept trying it.
They're like, well, nobody's dying. It seems like they're eventually
getting better. Let's just keep doing it. And there's a
lot of skepticism about the practice even at at that time,
and this never really took off. There is so much
of medical history. In a way, it's almost it's amazing
that medicine exists at all, because I don't know what

(36:28):
the year was, where on the whole medicine became more
helpful than harmful. It's like shockingly recent. If you go
not even all that far back into the past, it
seems like the majority of medical interventions were just like
painful and terrible and did nothing to help and maybe
it would kill you. Yeah, once again, I come back

(36:49):
to that that that excellent Soderberg television series The Nick,
which takes place in New York City and nine, and
it's just portraying just the cutting edge of medicine at
the time, and even you know then you see like
just the catastrophic ways they get it wrong at times, uh,
you know, be at things like blood transfusions or drug
interactions or the use of X rays. Now, in terms

(37:12):
of other potential blood substitutes, things you can put into
the body in place of at least some of the
blood UH sailing solutions seemed to promising UH solution for
a bit there as doctors found that you could give
a frog a complete transfusion of sailine and it would survive,
though only for a short while. UM. However, that this
is the stuff was eventually developed as a plasma volume expander.

(37:35):
Now Sarkar does not go into detail about the beer
and the urine UM tidbits, but they certainly don't highlight
them as successes, so UM I assume they were not
huge medical successes. Now the eighteen hundreds, hemoglobin and animal
plasma seemed promising, but there were technical hurdles to isolating
enough hemoglobin and animal blood um often contain toxins that

(37:59):
were challenging to remove at the time. In eighteen eighty three,
the creation of Ringer's solution. This is named for Sydney Ringer,
who lived eighteen thirty five through nineteen ten. Uh this
changed things a bit. Uh. So this is a solution
of sodium, potassium and calcium salts that was found to
restore healthy blood pressure after blood volume loss, and it's

(38:19):
still used today as a blood volume expander. But it
does not actually work as a blood substitute. Again, we
have to think of all the things that that blood does,
and this particular solution it doesn't, for instance, do anything
that red blood cells do, such as carrying oxygen, because again,
the human body is not just a big blood balloon.
You know, It's not just about warm volume. It's about

(38:41):
the vital function of the blood. So you can boost
the volume, but you still need something in the veins
doing the things that blood does. Now, as we discussed
in our previous episode on blood types UH, the Austrian
UH immunologists and pathologist Carl Landsteiner, who of eighteen sixty
eight through ninety three, discovered the primary A, B O
blood groups around the years nineteen hundred or nineteen o one.

(39:05):
At the time, doctors knew that many blood transfusions caused
adverse reactions in their recipient, mainly agglutination, which is where
the red blood cells clumped together. Blood transfusion technology advanced
a great deal from from that point on, and um
an interest in blood substitutes was renewed, especially during the
World Wars of the twentieth century. I think I said
this in the last blood episode, but I can't see

(39:27):
the name of Carl Landsteiner without thinking of him as
Carl land Strider. Alright, so fast forward to nineteen sixty six.
This is when um per floro chemicals or PFC was
explored as a potential blood substitute. Doctors found that a
rat's blood could be completely removed and replaced with the stuff,
but only for a few hours at a time. Uh.

(39:49):
This stuff then had to be replaced with actual blood,
but a full recovery was possible. So obviously you can
see the possibilities there, you know, something something that's not
blood we could at is get in there for a
little bit to stabilize the patient until actual blood can
be made available. Star Car writes that while there was
renewed interest during the AIDS epidemic and during Vietnam, for

(40:10):
the most part, advances in blood banking itself has you know,
has resulted in less research for the idea of a
true blood substitute, because ultimately, nothing takes the place of
human blood quite like human blood. But if we're going
to have synthetic blood, star Car points out that there
are a few key uh points that must be met. Okay,

(40:33):
like what so, first of all, it has to be
safe and compatible with the human body. Ideally, it should
also be universal for all blood types. You know, that's
not an absolute requirement, but certainly, if you're talking about
something that is just on a hand, say in a
field hospital situation, to hold the patient over until an
actual blood bank can come into play. Uh, it would

(40:55):
be nice if it just took care of all humans
and you didn't have to to deal with type. On
top of that, it needs to be able to transport
oxygen throughout the body, and it needs to offer more
robust shelf stability, such as lasting a year rather than
a mere month as with donor blood. As such, there
are basically two major areas of research under way. First

(41:16):
of all, per floral carbons. These are inexpensive. They're devoid
of biological materials that could spread infection. However, they're not
water soluble and they carry much less oxygen compared to
hemoglobin based products. Second, you have hemoglobin based products, so
these are oxygen containing. They're involved in oxygen transport with
our own red blood cells. So it's a great place

(41:37):
to start. Now. The downside to this direction is that
raw hemoglobin would break down into toxic compounds, and there
are solutions stability issues as well. Quote The challenge and
creating a hemoglobin based artificial blood is to modify the
hemoglobin molecule. So these problems are resolved, so you could
depend on either isolated hemoglobin or synthetically produced hemoglobin. If

(42:02):
it's isolated, the product is actually made from human blood,
typically blood for transfusions that has already expired. Animal blood
is another option apparently, but in this case the hemoglobin
would need to be modified before use. Hemoglobin synthesis, however,
is a process that involves the use of a strain
of E. Coli bacteria that has the ability to produce

(42:24):
human hemoglobin. There's a process involving bacterial destruction, fermentation and
isolation in a centrifuge, then final processing via the addition
of water and electrolytes, So farming it from bacteria. I
like that. Yeah yeah. Now, as as for limitations, again,
as of this paper's writing, most of the hemoglobin based

(42:44):
products were lasting no more than twenty to thirty hours
in the body holds. Blood transfusions last thirty four days
for comparison. Also, this sort of blood substitute wouldn't bring
clotting or disease fighting to the table, so that leaves
its potential again more as a short term solution, something
to get in the body. Uh, while you're waiting to
access the fruits of blood bank. And of course this

(43:08):
is not even getting into some of the issues concerning
biosecurity and privatization of synthetic biology as it concerns ethical dimensions, etcetera.
Oh wait, so you could have like, uh, somebody's got
a patent on the blood that's in your arteries right now,
and yeah, well that's the well, that's the kind of
thing that's often brought up in these discussions. I mean, however,

(43:29):
obviously the way I do, I do think it is
important to you know, distress that it would be great
if there was if we were to develop a pure,
you know, blood substitute that, even if it only worked
for a short time, could be kept on hand. You know,
that's something that that was universal, something with with a
decent shelf life. Uh, you know, even if it wasn't

(43:49):
a permanent solution, if it wasn't quite as good as
human blood, if it could just serve as a as
as a patch, you know, until a proper blood transfusion
can take place, that would be instantly helpful. Totally. Should
we take a break and then come back to talk
a little more, Yes, thank alright, we're back. So I

(44:10):
was looking around for for more recent work. I was
looking at a two thousand seventeen study by Waging at
all published in Biomacromolecules, and they point out that hemoglobin
on its own, like we discussed this toxic, but that
a chemically modified version forms um methemoglobin which doesn't bind oxygen. Uh.
This decreases the oxygen in the blood and the generation

(44:33):
of methemoglobin produces cell damaging hydrogen peroxide. So the researchers
in this case looked into packaging hemoglobin in a quote
unquote benign envelope in this case um polydopamine or PA,
which was already understudy for biomedical applications. Their findings showed
promise with the package delivering oxygen while preventing the formation

(44:57):
of meth methemoglobin and hydrogen perox side, and it's resulted
in minimal cell damage. I mean, you can see pretty
easily why you wouldn't really want too much hydrogen peroxides
in your blood right now on the zeno transfusion front. Uh,
this is interesting. I came across a case report in
Clinical Case Reports by Rubinstein at all which discusses the

(45:18):
case of a fifty seven year old Jehovah's witness with
a form of pure red cell um aplasia or prc A. Now,
this is a type of anemia that impacts the patient's
ability to produce red, but not white blood cells. So
blood transfusions are an important form of treatment. But the
individual in question turned down these transfusions for religious reasons.

(45:41):
And I believe the stems with the Jehovah's witness faith
as an interpretation of abstaining from blood in the Bible.
I think this is from Leviticus. Yeah, there are multiple
passages cited by the Jehovah's witnesses. I think the most
common one is this one in Leviticus chapter seventeen, where
it says, Uh, for the life of the flesh is
in the blood, and I have given it to you

(46:02):
upon the altar to make atonement for your souls. For
it is the blood that makes the atonement for the soul. Uh.
And he says, therefore, to the children of Israel, you
shall not eat blood. And this and some other passages
are sort of interpreted in a in a way to say, well,
to be safe in following this, you probably shouldn't receive
blood transfusions either. But I was actually this is this

(46:23):
is interesting there's a whole Wikipedia page on the Jehovah's
Witnesses and blood transfusions that has this gigantic list of
what types of procedures are allowed and what are not
allowed according to Church doctrine. Because there are there's not
just one type of blood transfusion. They are all kinds
of blood related products that you can have put into

(46:46):
your body, and so there are some that they accept
and some they don't. In this case, however, it seems
like it was it was pretty much a don't on
the idea of more human blood being put into the
patient for this treatment. But in this case the physicians
used a quote bovine hemoglobin based oxygen carrier quote. The

(47:07):
patient received more than twenty units of HBOC two oh
one and was showing early signs of red blood cell
count recovery. Although the patient did not survive, administration of
the HBOC two oh one did sustain her long enough
to allow for administration of immunosuppressive therapy, which ultimately improved erythropoesis. Thus,

(47:29):
administration of alternative hemoglobin based oxygen carriers in the setting
of red cell at plasia associated with thy momus warrants
further investigation. And that's interesting. So this is a product
that is derived from the hemoglobin, the the oxygen carrying
protein that would be found in the red blood cells
originally of cows or some of their bovine And uh, yeah,

(47:52):
And I think this is in line with a lot
of the stuff I was seeing about Jehovah's witnesses beliefs
that um often that they will receive certain types of products,
but the objection more often is to whole blood. Now,
leaving medical research and uh and religious beliefs, maybe we
should come back to our vampire introduction, because I think
you were hypothesizing that, uh, vampires might might find themselves

(48:17):
rather picky over what types of synthetic blood are are
tasty or or go well with their I don't know,
what would it be the digestive system, what system receives
the blood vampire? Well, I guess that's the tricky thing
about vampires, right, is that there, of course creatures of
fantasy and interpretations of their their blood drinking. It's going
to range from the biological, the biologically grounded, to the

(48:40):
utterly magical. So what like, what is the nature of
the blood that the vampire is drinking. Are they drinking
like the magical life force of a being, you know,
the splendid eye core of the Sons of Adam? Or
is it like actual blood? Are they an actual sangovore
much like a vampire bat. And obviously, depending on what
your answer is going to be, you know, entirely different,

(49:01):
and certainly you could have You can imagine a situation
where you have a synthetic blood that is certainly helpful
treating individuals who who who need it, but he is
going to be kind of useless or at least not
all that desired by blood drinking supernatural beings. But I thought,
you know, what's what's the one thing we can definitely do.

(49:22):
We can definitely look to the vampire bats. We can
look at blood drinking in the natural world and see
if there's anything out there that at all relates to
this question. So I was looking at Wanted Blood for
vampire Bats by Lynn Laws, writing for the Iowa State
University College of Agricultural and Life Sciences. So, vampire bats,

(49:43):
we've discussed in the show before, typically feed on fresh
cow blood and only rarely bite humans. Typically for captive
vampire bats, and like a laboratory or a zoo environment
or some sort of enclosure. Cow blood does the trick um,
but zoo conditions, especially, an anticoagulant is added to the

(50:04):
blood to keep it fresh enough for feeding via little
peachree dishes that are placed out in the enclosure. Oh
I see, So like if you don't add an anticoagulant,
you could have the same problem you get where you
leave the soup out and it forms the skin. Yeah.
One imagines, yeah, that you need to keep you want
the blood. Obviously, vampire bats are not going to go
around in their natural environment drinking blood out of little puddles. Uh,

(50:27):
you know, so you need to keep it fresh. You
need something to fresh it up. An anticoagulant seems to
do the trick. There apparently have also been experiments with
freezing the blood, and there's hope that we could eventually
create a dried powder that could be reconstituted at zoos
for the bats. So you add water to it and
you got blood. You know, sort of like a kool

(50:48):
aid powder, but for blood drinkers. Oh yeah, um, this
brings me back. I think there's a part in Giermo
del Toro's Blade to where like Russian vampires are like
snorting lines of of like crystallized blood or something or something.
You know, it's supposed to be crystallized blood. Um. So,

(51:10):
I don't know, maybe they ran across the same sort
of research when they were putting together to that film.
That's funny. Would it be different snorted than it would
be just drank um? Well, I don't know. I mean,
it doesn't really, it doesn't make a lot of sense
that the psychological difference. Yeah, I don't know. You get
the idea. It's like a vampires, they just like blood.

(51:30):
They'll take it anyway they can get it. They'll drink it,
they'll snort it up their nose, they'll freak a bath
in it. Yeah, repaste the blood, smoke the blood. Um. Uh.
You know, well whatever serves as a useful metaphor for
you know, for us to use in creating a vampire,
like the vampire, as addict the vampire, as as you know,
a moral themed et cetera. Now, going back to what

(51:52):
we're discussing though, in the possibilities for for synthetic blood,
if you end up with a blood substitute it is
actually made from human blood, you know, that's that's depending
on the hemoglobin. Uh. That would be an interesting scenario, right,
because you could potentially have fake blood for the vampires

(52:12):
to keep the vampires at bay that is actually made
from human blood, but maybe is like you know, it
is the the result of of blood bank blood that
has not been fully utilized. So the vampires might not
be really all that happy about it. But maybe you know,
you wouldn't behave be having to just bleed yourself dry
for the vampires. You would. You would have like a

(52:33):
secondary product that makes them mostly happy. Yeah, they'd be
helping us deal with medical waste. Yeah, so that would
that seems kind of like a very very much a
reduced stature for something like Count Dracula. You know, it's like,
I know you want to be the lord of the
night and you know, drink our blood and have a
serve you. But what if you just gobbled up our
medical waste? Are you on board? Yes? All right on that.

(53:00):
We're gonna go ahead and close it out here. We're
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(53:21):
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(53:42):
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