From the Vault: I Want a New Blood

need a new blood. Oh, the animal blood it's not working. Yeah, I tried it. It made me crash my car, made 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, 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 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 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 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, 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 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 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 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 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 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 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 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, 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 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 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. 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. 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 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 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,

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, 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. 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 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. 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 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 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 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, 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 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 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, 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

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, 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 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 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, 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 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 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

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, 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 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 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 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. 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 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. 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, 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, 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,

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 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 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. 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, 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 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 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 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 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 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. 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 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 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 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 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 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 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 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.

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, 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 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 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, 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 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 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 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.

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 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, 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. 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 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, 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 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 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 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 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. 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, 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 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 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 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

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 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 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 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 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 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

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. 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 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 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 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.

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 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 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 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. 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 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. 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 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, 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 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 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 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 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 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 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 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, 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 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

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

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 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 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. 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 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 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 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 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, 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, 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 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 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, 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. 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, 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 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, 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 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, 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.

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 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 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

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.

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