A look at some possible origins of the myth
In light of today’s holiday, I thought it would be a good time to explore the history of one of the most popular creatures generally associated with Halloween – vampires! Vampires are mythical creatures very prevalent in popular culture – but where did this myth begin? What if there are medical conditions associated with superstitions surrounding these fictional and folkloric creatures?
First, let’s take a look at the history of vampires. The folklore history of vampirism is long and convoluted; nearly all cultures have some record of a vampire myth, and the accounts vary so widely that it is difficult to group them into any one common category. The vampires of folklore have merged and morphed over the years, so that the vampires we are left with in popular culture are somewhat different than the “original” vampires of folklore.
Traditionally, vampires were thought to be undead humans. Usually, vampires had been humans who had recently died and were somehow cursed, or had been bitten by another vampire. The defining characteristic of a vampire was his/her need for human blood as sustenance. They were often portrayed as nocturnal, usually wrapped in some sort of black cloak, and some were portrayed as being able to transform into bats. Because of their intake of human blood, they often had a ruddy, purplish appearance and appeared bloated.
A more modern interpretation of the vampire is similar to what is imagined of Bram Stoker’s Dracula or as seen in Stephanie Meyer’s Twilight: pale skin, red eyes, tall, and gaunt. This vampire looks quite different from traditional folklore, but retains the characteristics, in general (undead and drinking blood).
Perhaps you are asking what any of this has to do with medicine. Read on…
The origin of the vampire myth has been long debated, but one idea (that has now been largely discredited) is that sufferers of poryphyria were mistaken as vampires. Poryphyria is a genetic disease that can take many forms, but in general is related to a deficiency of an enzyme necessary for the production of heme, which is vital for carrying oxygen. This idea, put forth by David Dolphin in 1985, proposed that the symptoms of one type of poryphyria – reddish and blistering skin – could fit the “ruddy, bloated” description of vampires. He also suggested that sufferers of poryphyria may have attempted to drink human blood to replenish their own supply of heme. Dolphin’s idea was based on a very poor understanding of the disease and has been discredited for now-obvious reasons – namely, that drinking blood would in no way solve the heme problem, and that those with poryphyria would certainly not “crave” human blood.
The more modern vampire, with his pale skin and red eyes, may actually be an allusion to albinism. Individuals with albinism lack melanin, and thus have very little or no pigment in their skin, hair, and eyes. Therefore the typical appearance of an albino individual is pale skin, blonde hair, and blue or sometimes red eyes (due to the apparent vasculature beneath the surface of the eye). This fits the physical description of the modern fictional vampire. (Interestingly, individuals with albinism often have vision problems, which would contrast the typical vampire’s “night vision.”)
Additionally, this is connected to a common literary cliché, the “evil albino.” This stereotype refers to the fact that villains and evil characters in literature are often given (purposely or not) albino characteristics to distinguish them from good characters. (Some notable examples are H.G Wells’ The Invisible Man and Marvel’s Tombstone from the Spiderman comics.) This “evil albino” stereotype aligns with vampire mythology, since vampires are nearly always antagonists, or at the very least, outcasts because of their desire for human blood.
The beliefs about both of these medical conditions – poryphyria and albinism – and their contribution to superstitions about vampires have something very important in common: they are dehumanizing to individuals with these diseases. This realization, coupled with a better understanding of biochemistry and human metabolism, certainly contributed to discrediting Dolphin’s ideas about poryphyria. Poryphoria has many different etiologies, but none of them involve a need or desire drink human blood. This myth makes light of the disease and individuals with it, who often have very difficult prognoses.
The stereotypes surrounding albinism are much more far-reaching than simply vampires, as discussed with the “evil albino” stereotype. Many individuals with albinism have spoken out about confronting these stereotypes and the difficulties that accompany common misconceptions about albinism.
In short, vampires are not real, and the legends surrounding them are unlikely to be directly connected to any medical conditions. Any connection needs to be addressed as a dehumanizing way of viewing both poryphyria and albinism and the individuals with those conditions. Humans are not synonymous with the diseases they have. It is critical for healthcare professionals to be leaders in treating every individual as a valuable, and that begins with viewing each patient as a person. This can be difficult, especially with conditions affecting outward appearance, but at those times it is all the more critical, and ultimately will lead to better medical care.
Sources: Bunson’s Vampire Encyclopedia, David Dolphin’s “Werewolves and Vampires,” WebMD, The National Organization for Albinism and Hypopigmentation, and Inborn Metabolic Diseases.
Special thanks to Dr. Joseph Lechner of Mount Vernon Nazarene University.
Brent Schnipke, MD is a physician and writer based in Dayton, OH. He graduated medical school in 2018 and completed his psychiatry residency at Wright State University Boonshoft School of Medicine. He currently practices in Dayton, OH. His professional interests include medical humanities, mental health, and medical education.