Pathology (pathos = disease, and ology = study of) is the study of disease, and being dead is the worst disease - O.K., maybe being undead is worse. Between life and death is where the vampires live, so maybe this is a good place to start.
One prerequisite for being a vampire is that you have a taste for blood, but if that was the only rule, then almost everyone would be a vampire. Hematophagy (hemo = blood, and phagy = eat) is as common as bad Dracula impressions. Almost every culture consumes blood.
Many people eat cooked blood. The Poles eat blood soup (czernina), and the Brits love their blood pudding as much as the Chinese gobble their fried blood tofu. The next time you go to a French restaurant for the coq au vin, remember that the sauce is made with rooster blood!
There are also those cultures that drink blood. The inuit peoples drink fresh seal blood, and the Maasi in Africa rely on a mixture of cow’s milk and cow’s blood as a staple of their diet. And why not, blood is a decent source of nutrition.
Blood has a lot of protein and is a good source of lipids. Of course it is iron rich, and is a source of fluid and salt if you happen to be caught in the desert. If a vampire happens to pick out an uncontrolled diabetic, a drink of blood could also be a good source of carbohydrates.
These are Finnish blood pancakes. You have to wonder about
a recipe whose first ingredient is 40 ml of blood. But
the lingonberry jam on top is a nice touch; you would
hardly remember that you are eating blood.
As members of the Chiroptera order (chira = hand, and ptera = wing), vampire bats are members of a grand biologic exception. Bats are the only mammals that truly fly. True flying requires lift, being able to sustain a rise in altitude by mechanical means. Closest to this is soaring, which is the use of upwelling air currents to gain altitude. But gliding is the most common type of aerial motion in reptiles, amphibians, mammals. Gliding is really controlled falling; it means moving at less than a 45˚ angle to the ground.
Bats are so finely evolved for flying that they have lost most of their ability to walk, but vampire bats are an exception even in the world of bats. They often approach their victims by walking or running up to them from behind. Vampire bats were quite the biologic discovery.
The vampire bat wasn’t named as such until 1774, but vampire legends (4000 BCE) and the word vampire (circa 1734) had been around much longer. Therefore, the bat was named after the undead, blood-drinking person, not the other way around.
Three species of bat, ranging from Mexico to Chile, subsist exclusively on blood. Each has evolved tricks to help them secure the blood they need. Their noses house special thermoreceptors to help them find areas of flesh where blood vessels lay close to the surface. The way their brain perceives and interprets this information (see this post) is very similar to the way pit viper snakes sense live prey (see this post).
The common vampire bat will shave away the hair away with its teeth and then plunges its incisors in about 7-8 mm to bring blood, as its incisors are conical and are designed for cutting. Vampire bats are an exception in that they are the only bat species that do not have enamel on their incisors.
Enamel is very strong in compression and wear, but is brittle and rounds off the points of the teeth. Vampire bats need very sharp incisors, so they have forgone the enamel. Broken enamel would blunt their teeth, a lethal problem for a bloodsucker (although they don't suck).
A has shown that bat saliva may have potential in human medicine. The common vampire bat is the source of a new clot-dissolving compound called desmoteplase; it activates an enzyme called plasminogen, which breaks down early clot formation.
Desmoteplase is structurally similar to a currently used clot buster called tPA (tissue plasminogen activator), but has some differences that make it more selective for fibrin. Importantly, it doesn’t cause nearly as much neuronal apoptosis or breakdown of the blood-brain barrier as does tPA. Desmoteplase is in phase III clinical trials for use in ischemic stroke patients (a brain blood vessel is blocked by clot). I wonder if human vampires have such useful .
In certain diseases, removing excess blood is beneficial. We talked earlier about excess iron in , for which bloodletting is an appropriate treatment, but there are others. Polycythemia vera is a genetic disease in which too many red blood cells are produced, leading to high blood volume and pressure, excess bleeding and clotting. To bring the volume closer to normal, a pint of blood may be removed once a week.
Finally, in chronic hepatitis C infection there is damage to the liver, a major storehouse of iron. This releases iron into the blood, and causes a secondary hemochromatosis. Small amounts of blood can be removed to help lessen the iron overload. Maybe old-timey medicine didn’t have everything wrong.
These same old cultures had myths about the undead that would feed on human flesh, but our current vampire myths date from early 1700’s Southern Europe. There are diseases that could be mistaken for some or all of the aspects of vampirism, but are they the chicken or the egg? In many cases, myths and folklore have some basis in fact, but in these cases hindsight is hardly ever 20/20.
Tuberculosis and rabies have a few aspects that are similar to the common tales of vampires. TB leaves its victims emaciated; they end up pale with swollen eyes that make them sensitive to light. They might cough up blood, and the first victim often gave the disease to other members of the house, so it have might appeared that the first was draining the others.
Similarly, people with rabies may exhibit a bloody froth from the mouth because lesions on the throat make it very painful to swallow. They may also be driven to bite people due to the encephalitis (encephalo = brain, and itis = inflammation) that the rabies virus causes. Other behaviors associated with rabies are sleeplessness (night time activity) and fear of looking at one’s own reflection.
Another disease that mimics some vampire characteristics is xeroderma pigmentosum (XP). XP leads to an extreme sensitivity of the skin to the radiation of the sun. XP was first described in the scientific literature in 1874, just a couple of years before the first tales of sun sensitivity in vampires. There are several different types of XP, but all are autosomal recessive genetic diseases. Most involve mutation and inactivation of nuclear excision repair enzymes.
Sunlight contains UV radiation that causes DNA mutation. Excision repair enzymes usually fix the DNA damage. Without them, afflicted individuals manifest hundreds of skin cancers, and acquire others that are lethal (malignant melanoma). The patients’ eyes are very sensitive to light; they sunburn almost instantly, and must be kept out of sunlight. The children from the 2001 film, “The Others” had XP (while they were alive).
Congenital Erythropoietic Porphyria (CEP) is by far the disease most often associated with vampirism. Exceedingly rare, this autosomal recessive genetic disease has only been diagnosed in about 200 people, but there are many variants of porphyria that carry some or most of the same symptomology as CEP.
symptoms of the porphyrias do make you think of vampires: sun sensitivity with extreme burning, white skin, bloodshot eyes, sensitive eyes, anemia (low number and therefore a need for red blood cells), reddish tears, reddish urine, red pigment in the enamel of the teeth (erythrodontia).
teeth really bring to mind feeding on flesh or blood, and porphyrias also bring increased body and facial hair (hirsutism), so they may contribute to the werewolf legend as well. This is interesting because Medieval Europeans would burn the corpses of people who were thought to be werewolves, so as to prevent them from returning as vampires - better safe than sorry!
For more information or classroom activities, see:
Vampire bats –
Xeroderma pigmentosum –
Congenital Erythropoietic Porphyria –
Medcalf RL (2012). Desmoteplase: discovery, insights and opportunities for ischaemic stroke. Br J Pharmacol. DOI: 10.1111/j.1476-5381.2011.01514.x
Amy T. Gilbert, Brett W. Petersen, Sergio Recuenco, Michael Niezgoda, Jorge Gómez, V. Alberto Laguna-Torres and Charles Rupprecht (2012). Evidence of Rabies Virus Exposure among Humans in the Peruvian Amazon Am J Trop Med Hyg DOI: 10.4269/ajtmh.2012.11-0689