Isegoria

When I recently revisited Dracula, I noticed that Van Helsing treats Lucy Westenra with a blood transfusion, as Dr. Seward explains:

Van Helsing and I were shown up to Lucy’s room. If I was shocked when I saw her yesterday, I was horrified when I saw her to-day. She was ghastly, chalkily pale; the red seemed to have gone even from her lips and gums, and the bones of her face stood out prominently; her breathing was painful to see or hear. Van Helsing’s face grew set as marble, and his eyebrows converged till they almost touched over his nose. Lucy lay motionless, and did not seem to have strength to speak, so for a while we were all silent. Then Van Helsing beckoned to me, and we went gently out of the room. The instant we had closed the door he stepped quickly along the passage to the next door, which was open. Then he pulled me quickly in with him and closed the door. “My God!” he said; “this is dreadful. There is no time to be lost. She will die for sheer want of blood to keep the heart’s action as it should be. There must be transfusion of blood at once. Is it you or me?”

“I am younger and stronger, Professor. It must be me.”

“Then get ready at once. I will bring up my bag. I am prepared.”

I went downstairs with him, and as we were going there was a knock at the hall-door. When we reached the hall the maid had just opened the door, and Arthur was stepping quickly in. He rushed up to me, saying in an eager whisper:—

“Jack, I was so anxious. I read between the lines of your letter, and have been in an agony. The dad was better, so I ran down here to see for myself. Is not that gentleman Dr. Van Helsing? I am so thankful to you, sir, for coming.” When first the Professor’s eye had lit upon him he had been angry at his interruption at such a time; but now, as he took in his stalwart proportions and recognised the strong young manhood which seemed to emanate from him, his eyes gleamed. Without a pause he said to him gravely as he held out his hand:—

“Sir, you have come in time. You are the lover of our dear miss. She is bad, very, very bad. Nay, my child, do not go like that.” For he suddenly grew pale and sat down in a chair almost fainting. “You are to help her. You can do more than any that live, and your courage is your best help.”

“What can I do?” asked Arthur hoarsely. “Tell me, and I shall do it. My life is hers, and I would give the last drop of blood in my body for her.” The Professor has a strongly humorous side, and I could from old knowledge detect a trace of its origin in his answer:—

“My young sir, I do not ask so much as that—not the last!”

“What shall I do?” There was fire in his eyes, and his open nostril quivered with intent. Van Helsing slapped him on the shoulder. “Come!” he said. “You are a man, and it is a man we want. You are better than me, better than my friend John.” Arthur looked bewildered, and the Professor went on by explaining in a kindly way:—

“Young miss is bad, very bad. She wants blood, and blood she must have or die. My friend John and I have consulted; and we are about to perform what we call transfusion of blood—to transfer from full veins of one to the empty veins which pine for him. John was to give his blood, as he is the more young and strong than me”—here Arthur took my hand and wrung it hard in silence—“but, now you are here, you are more good than us, old or young, who toil much in the world of thought. Our nerves are not so calm and our blood not so bright than yours!” Arthur turned to him and said:—

“If you only knew how gladly I would die for her you would understand——”

He stopped, with a sort of choke in his voice.

“Good boy!” said Van Helsing. “In the not-so-far-off you will be happy that you have done all for her you love. Come now and be silent. You shall kiss her once before it is done, but then you must go; and you must leave at my sign. Say no word to Madame; you know how it is with her! There must be no shock; any knowledge of this would be one. Come!”

We all went up to Lucy’s room. Arthur by direction remained outside. Lucy turned her head and looked at us, but said nothing. She was not asleep, but she was simply too weak to make the effort. Her eyes spoke to us; that was all. Van Helsing took some things from his bag and laid them on a little table out of sight. Then he mixed a narcotic, and coming over to the bed, said cheerily:—

“Now, little miss, here is your medicine. Drink it off, like a good child. See, I lift you so that to swallow is easy. Yes.” She had made the effort with success.

It astonished me how long the drug took to act. This, in fact, marked the extent of her weakness. The time seemed endless until sleep began to flicker in her eyelids. At last, however, the narcotic began to manifest its potency; and she fell into a deep sleep. When the Professor was satisfied he called Arthur into the room, and bade him strip off his coat. Then he added: “You may take that one little kiss whiles I bring over the table. Friend John, help to me!” So neither of us looked whilst he bent over her.

Van Helsing turning to me, said:

“He is so young and strong and of blood so pure that we need not defibrinate it.”

Then with swiftness, but with absolute method, Van Helsing performed the operation. As the transfusion went on something like life seemed to come back to poor Lucy’s cheeks, and through Arthur’s growing pallor the joy of his face seemed absolutely to shine. After a bit I began to grow anxious, for the loss of blood was telling on Arthur, strong man as he was. It gave me an idea of what a terrible strain Lucy’s system must have undergone that what weakened Arthur only partially restored her. But the Professor’s face was set, and he stood watch in hand and with his eyes fixed now on the patient and now on Arthur. I could hear my own heart beat. Presently he said in a soft voice: “Do not stir an instant. It is enough. You attend him; I will look to her.” When all was over I could see how much Arthur was weakened. I dressed the wound and took his arm to bring him away, when Van Helsing spoke without turning round—the man seems to have eyes in the back of his head:—

“The brave lover, I think, deserve another kiss, which he shall have presently.” And as he had now finished his operation, he adjusted the pillow to the patient’s head. As he did so the narrow black velvet band which she seems always to wear round her throat, buckled with an old diamond buckle which her lover had given her, was dragged a little up, and showed a red mark on her throat. Arthur did not notice it, but I could hear the deep hiss of indrawn breath which is one of Van Helsing’s ways of betraying emotion. He said nothing at the moment, but turned to me, saying: “Now take down our brave young lover, give him of the port wine, and let him lie down a while. He must then go home and rest, sleep much and eat much, that he may be recruited of what he has so given to his love. He must not stay here. Hold! a moment. I may take it, sir, that you are anxious of result. Then bring it with you that in all ways the operation is successful. You have saved her life this time, and you can go home and rest easy in mind that all that can be is. I shall tell her all when she is well; she shall love you none the less for what you have done. Good-bye.”

When Arthur had gone I went back to the room. Lucy was sleeping gently, but her breathing was stronger; I could see the counterpane move as her breast heaved. By the bedside sat Van Helsing, looking at her intently. The velvet band again covered the red mark. I asked the Professor in a whisper:—

“What do you make of that mark on her throat?”

“What do you make of it?”

“I have not examined it yet,” I answered, and then and there proceeded to loose the band. Just over the external jugular vein there were two punctures, not large, but not wholesome-looking. There was no sign of disease, but the edges were white and worn-looking, as if by some trituration. It at once occurred to me that this wound, or whatever it was, might be the means of that manifest loss of blood; but I abandoned the idea as soon as formed, for such a thing could not be. The whole bed would have been drenched to a scarlet with the blood which the girl must have lost to leave such a pallor as she had before the transfusion.

“Well?” said Van Helsing.

“Well,” said I, “I can make nothing of it.” The Professor stood up. “I must go back to Amsterdam to-night,” he said. “There are books and things there which I want. You must remain here all the night, and you must not let your sight pass from her.”

“Shall I have a nurse?” I asked.

“We are the best nurses, you and I. You keep watch all night; see that she is well fed, and that nothing disturbs her. You must not sleep all the night. Later on we can sleep, you and I. I shall be back as soon as possible. And then we may begin.”

“May begin?” I said. “What on earth do you mean?”

“We shall see!” he answered, as he hurried out. He came back a moment later and put his head inside the door and said with warning finger held up:—

“Remember, she is your charge. If you leave her, and harm befall, you shall not sleep easy hereafter!”

Dr. Seward watches over her for a few nights. Then, when he returns after finally getting a good night’s sleep…

As I raised the blind, and the morning sunlight flooded the room, I heard the Professor’s low hiss of inspiration, and knowing its rarity, a deadly fear shot through my heart. As I passed over he moved back, and his exclamation of horror, “Gott in Himmel!” needed no enforcement from his agonised face. He raised his hand and pointed to the bed, and his iron face was drawn and ashen white. I felt my knees begin to tremble.

There on the bed, seemingly in a swoon, lay poor Lucy, more horribly white and wan-looking than ever. Even the lips were white, and the gums seemed to have shrunken back from the teeth, as we sometimes see in a corpse after a prolonged illness. Van Helsing raised his foot to stamp in anger, but the instinct of his life and all the long years of habit stood to him, and he put it down again softly. “Quick!” he said. “Bring the brandy.” I flew to the dining-room, and returned with the decanter. He wetted the poor white lips with it, and together we rubbed palm and wrist and heart. He felt her heart, and after a few moments of agonising suspense said:—

“It is not too late. It beats, though but feebly. All our work is undone; we must begin again. There is no young Arthur here now; I have to call on you yourself this time, friend John.” As he spoke, he was dipping into his bag and producing the instruments for transfusion; I had taken off my coat and rolled up my shirt-sleeve. There was no possibility of an opiate just at present, and no need of one; and so, without a moment’s delay, we began the operation. After a time—it did not seem a short time either, for the draining away of one’s blood, no matter how willingly it be given, is a terrible feeling—Van Helsing held up a warning finger. “Do not stir,” he said, “but I fear that with growing strength she may wake; and that would make danger, oh, so much danger. But I shall precaution take. I shall give hypodermic injection of morphia.” He proceeded then, swiftly and deftly, to carry out his intent. The effect on Lucy was not bad, for the faint seemed to merge subtly into the narcotic sleep. It was with a feeling of personal pride that I could see a faint tinge of colour steal back into the pallid cheeks and lips. No man knows, till he experiences it, what it is to feel his own life-blood drawn away into the veins of the woman he loves.

The Professor watched me critically. “That will do,” he said. “Already?” I remonstrated. “You took a great deal more from Art.” To which he smiled a sad sort of smile as he replied:—

“He is her lover, her fiancé. You have work, much work, to do for her and for others; and the present will suffice.”

When we stopped the operation, he attended to Lucy, whilst I applied digital pressure to my own incision. I laid down, whilst I waited his leisure to attend to me, for I felt faint and a little sick. By-and-by he bound up my wound, and sent me downstairs to get a glass of wine for myself. As I was leaving the room, he came after me, and half whispered:—

“Mind, nothing must be said of this. If our young lover should turn up unexpected, as before, no word to him. It would at once frighten him and enjealous him, too. There must be none. So!”

When I came back he looked at me carefully, and then said:—

“You are not much the worse. Go into the room, and lie on your sofa, and rest awhile; then have much breakfast, and come here to me.”

I followed out his orders, for I knew how right and wise they were. I had done my part, and now my next duty was to keep up my strength. I felt very weak, and in the weakness lost something of the amazement at what had occurred. I fell asleep on the sofa, however, wondering over and over again how Lucy had made such a retrograde movement, and how she could have been drained of so much blood with no sign anywhere to show for it. I think I must have continued my wonder in my dreams, for, sleeping and waking, my thoughts always came back to the little punctures in her throat and the ragged, exhausted appearance of their edges—tiny though they were.

Lucy slept well into the day, and when she woke she was fairly well and strong, though not nearly so much so as the day before. When Van Helsing had seen her, he went out for a walk, leaving me in charge, with strict injunctions that I was not to leave her for a moment. I could hear his voice in the hall, asking the way to the nearest telegraph office.

This process of getting better and getting worse again goes on for ten days, as she receives fresh blood from each of our four heroes:

”Ten days! Then I guess, Jack Seward, that that poor pretty creature that we all love has had put into her veins within that time the blood of four strong men. Man alive, her whole body wouldn’t hold it.” Then, coming close to me, he spoke in a fierce half-whisper: “What took it out?”

The novel is from 1897, and blood transfusion was not a safe and effective procedure:

Working at the Royal Society in the 1660s, the physician Richard Lower began examining the effects of changes in blood volume on circulatory function and developed methods for cross-circulatory study in animals, obviating clotting by closed arteriovenous connections. The new instruments he was able to devise enabled him to perform the first reliably documented successful transfusion of blood in front of his distinguished colleagues from the Royal Society.

According to Lower’s account, “…towards the end of February 1665 [I] selected one dog of medium size, opened its jugular vein, and drew off blood, until its strength was nearly gone. Then, to make up for the great loss of this dog by the blood of a second, I introduced blood from the cervical artery of a fairly large mastiff, which had been fastened alongside the first, until this latter animal showed … it was overfilled … by the inflowing blood.” After he “sewed up the jugular veins”, the animal recovered “with no sign of discomfort or of displeasure”.

Lower had performed the first blood transfusion between animals. He was then “requested by the Honorable [Robert] Boyle … to acquaint the Royal Society with the procedure for the whole experiment”, which he did in December 1665 in the Society’s Philosophical Transactions.

The first blood transfusion from animal to human was administered by Jean-Baptiste Denys, eminent physician to King Louis XIV of France, on June 15, 1667. He transfused the blood of a sheep into a 15-year-old boy, who survived the transfusion. Denys performed another transfusion into a labourer, who also survived. Both instances were likely due to the small amount of blood that was actually transfused into these people. This allowed them to withstand the allergic reaction.

Denys’s third patient to undergo a blood transfusion was Swedish Baron Gustaf Bonde. He received two transfusions. After the second transfusion Bonde died. In the winter of 1667, Denys performed several transfusions on Antoine Mauroy with calf’s blood. On the third account Mauroy died.

Six months later in London, Lower performed the first human transfusion of animal blood in Britain, where he “superintended the introduction in [a patient's] arm at various times of some ounces of sheep’s blood at a meeting of the Royal Society, and without any inconvenience to him.” The recipient was Arthur Coga, “the subject of a harmless form of insanity.” Sheep’s blood was used because of speculation about the value of blood exchange between species; it had been suggested that blood from a gentle lamb might quiet the tempestuous spirit of an agitated person and that the shy might be made outgoing by blood from more sociable creatures. Coga received 20 shillings (equivalent to £206 in 2025) to participate in the experiment.

[…]

Finally, in 1668, the Royal Society and the French government both banned the procedure. The Vatican condemned these experiments in 1670.

[…]

In the early 19th century, British obstetrician James Blundell made efforts to treat hemorrhage by transfusion of human blood using a syringe. In 1818, after experiments with animals, he performed the first successful transfusion of human blood to treat postpartum hemorrhage at Guy’s Hospital in London. Blundell used the patient’s husband as a donor, and extracted four ounces of blood from his arm to transfuse into his wife. During the years 1825 and 1830, Blundell performed 10 transfusions, five of which were beneficial, and published his results.[96] He also invented a number of instruments for the transfusion of blood.[97] He made a substantial amount of money from this endeavour, roughly $2 million ($50 million real dollars).

In 1840, Samuel Armstrong Lane, aided by Blundell, performed the first successful whole blood transfusion to treat haemophilia at St George’s Hospital Medical School in London.

However, early transfusions were risky and many resulted in the death of the patient.

[…]

Only in 1901, when the Austrian Karl Landsteiner discovered three human blood groups (O, A, and B), did blood transfusion achieve a scientific basis and become safer.

Lucy Westenra was apparently AB positive (AB+), a universal recipient.

Posted in Media | 2 Comments »