[ENGLISH] Drinking blood to restore health (like potions in Zelda… or like Dracula?)
![[ENGLISH] Drinking blood to restore health (like potions in Zelda… or like Dracula?)](/content/images/size/w2000/2023/02/potions-banner-image-1.png)
What is a potion?
Anyone who plays videos games must have already seen objects such as in Figure 1.
You surely even drank it to restore health, cure poison or sometimes be poisoned. According to the Cambridge Dictionary, a potion is “a drink containing […] medicine or poison, or having magic effect” [1]. It is also referred to “a mixture of liquids (such as liquor or medicine) [2].
A potion is then a drink, made from a mixture of ingredients, which can heal or cause illness. For me, it sounds like modern medicines! Paracelsus once said “All things are poison and nothing is without poison; only the dose makes a thing not a poison”. So that is not a surprise we can assume potions are the ancestors of nowadays medicines.
What is the common effect of potions?
When a character drinks a potion, it usually increases his “health” or his “life” (Figure 2).
![](https://www.manhsterz.com/content/images/2023/02/Picture2.png)
It is never explicitly said that one character’s health of life represents his blood quantity. According to Diablo Wiki: “When Life reaches 0, the player character (or monster) dies” [3]. Doesn’t it remind you of the blood? Don’t you agree that “When Blood reaches 0 mL, the human dies”. Well, this is not the only criterion making you die, because you can also die while your Blood full. However, your body will start to dysfunction way long before you lose all your blood!
What is blood?
By the way, do you know how much blood you have? Blood refers to the “total amount of fluid circulating within the arteries, capillaries, veins, venules and chambers of the heart at any time” [4].
The word “blood” have an interesting etymology and firstly appeared in the literature at late 14th century, as “the fluid of life” [5].
You might already know, but blood contains many stuffs inside: red blood cells (known as erythrocytes), white blood cells (WBC, also called leukocytes), platelets, and plasma. Roughly, red blood cells occupy 40% of the blood volume while plasma occupies 60%. Blood volume depends on many parameters but you approximately have around 5 liters of this red liquid circulating in your body. During pregnancy, women’s blood volume increases by about 50%.
Fun facts
Blood donation usually takes about 0,4 to 0,5 L of blood (400-500 mL) which is about 8-10% of your total blood volume [6]. It is the same as one pint of your favorite beer! Don’t worry, your body makes 2 million new red blood cells every second, which takes only few weeks to replenish your blood!
Also, the average lifespan of a red blood cells in the circulating system is 120 days.
Red blood cells (RBC) are shaped like a doughnut, carved in the middle but without the hole of the doughnut (Figure 3).
![](https://www.manhsterz.com/content/images/2023/02/image-3.png)
Two or three RBC can fit into one human hair length. Indeed, one RBC is about 7 micrometers of diameter. RBC conveys oxygen to tissues via hemoglobin that diffuses through RBC membrane. This particular shape increases the area of oxygen exchange [7], [8].
Therefore, is it possible to drink blood and restore our “health” (blood quantity) in the same way Link does in Zelda? If we look for “drinking blood” on the internet, it yields very interesting information!
Drinking blood to restore our health (like in Zelda... or like Dracula?)
Iron overload
If you have ever bit your tongue or mouth, you might have tasted your own blood and realized the metallic flavor of it. Indeed, hemoglobin within RBC is made of iron [9]. Iron is thus essential for human health and a lack of it can cause a anemias (decreased hemoglobin) [10].
Educational facts
Young ladies losing lot of blood during periods can experience anemia. We usually advise them to eat more iron-rich food (red meat) or we also prescribe oral iron. Elderly people with anemias must alert us on the possibility of colorectal cancer, causing very small bleeding over time resulting in iron loss and anemia: it is therefore of utmost importance to explore the digestive tract in these patients!
On average, there is about 50 mg/100mL of blood in normal individuals [11]. When you eat normally, the daily intake is of 10-20 mg of iron, which the body only absorbs 1-2 mg (Figure 4 [9]).
![](https://www.manhsterz.com/content/images/2023/02/Image-4.jpg)
75% of this iron are used for hemoglobin creation. You then lose 1-2 mg from what it is called “epithelial desquamation” (meaning lost of surface cells from the body) coming from the skin, gastrointestinal tract or the genitourinary tract. Thus, there is no other iron excretion mechanism, other than various bleeding.
The message here is that the human body cannot hold a huge intake of iron, because it cannot excrete it (unless massive bleeding!).
Replacing a pint of beer by blood (500 mL) will bring about 250 mg or iron which is 10 to 15 times higher than average daily intake. The intestinal tract absorb about 5-35% of the iron [9], resulting in about 12,5-87,5 mg or iron absorbed.
There is a condition where the body is overloaded with iron: hemochromatosis. This disease is most of the time a genetic disease, due to a mutation in HFE gene [12]. The only way to currently treat hemochromatosis is to regularly perform bloodletting (same as blood donation) to deplete blood from iron-overload.
Drinking blood can cause iron overload, cause hemochromatosis which is a disease. By definition, it cannot “restore our health”.
Blood-type mismatch
Everyone knows the A, B, O blood type. There are plenty of other RBC subtypes, such as rhesus positive or negative, Kell antigen, Duffy etc. These names actually refers to small entities (antigens) located at the RBC surface [13]. Essentially, blood-type mismatch happens when your body does not have the antigens and thus, has never been exposed to it. Let’s say you are blood type O (standing for “zero”, nor A nor B, so basically there is no A nor B on the RBC surface). Your body never encountered antigens A or B. So, if you exposed your body to a RBC with antigen A on the surface, it will detect it as an invader, and activate the immune system to destroy it.
Fun fact
People who are of blood type O and rhesus negative, can thus donate their blood to anyone else: we can call them “universal donor”. Such true heroes!
People who are of blood type AB and rhesus positive, can only donate their blood to other AB rhesus positive people. This can be the basis of some other Game of Throne’s series, right?
If we drink blood, our gastrointestinal tract will likely destroy the RBC and slowly digest all the protein. But let’s imagine you have a wound that makes you bleed (a gastric ulcer), your bloodstream will be exposed to the non-native antigen, and your will likely experience blood-type mismatch reaction (which is alike a severe allergic reaction). Whereas drinking your favorite beer won’t make any different whether you have an ulcer or not!
Drinking blood definitely cannot restore our “health” …
Infectious diseases
We all agree that blood donations are made in sterile conditions within hospital or recognized institution, most of the time (at least for me, I don’t know about you!). Blood must then be processed through many different machines, separating RBC from platelets, from WBC, resulting in plasma and serum which are different.
Educational fact
- Plasma: take blood, in a sampling tube with anticoagulant compounds, centrifuge it so all cells are on the bottom of the tube. Remove all cells, and then you have plasma, containing coagulations factors of the blood.
- Serum: take blood in a sampling tube without anticoagulant compounds, let it rest for 30 at room temperature so cells will be trapped within coagulations materials. Centrifuge it so the coagulated material is located at the bottom. The top liquid is the serum.
Sterile and storage conditions must be strict to prevent infectious agents to grow. But imagine in Diablo game? I don’t see any fridge… And I don’t think storing blood donation with salt works neither. Wait, since when people took out blood for analysis?
A little research on the internet shows that blood sampling (called as bloodletting) by phlebotomy (-phlebos for veins and -tomy for cutting) was widely practice since Hippocrates in 500 BC, and even in the ancient Egypt [14]!
Just a glimpse at the center for diseases control and prevention and you will see the huge variety of diseases that blood can carry [15]: bacterial infection (staphylococcus, Escherichia coli, Brucellosis etc.), parasitic infections (chagas disease, malaria, leishmaniasis etc.), viral diseases (HIV, hepatitis A, B, C, E, Zika virus etc.), prion disease (Creutzfeldt-Jakob Disease).
Well, I’ll have a beer please. It does probably not restore my “health”, but seems definitely safer than drinking “rosy BLOOD mary” cocktail!
Then, how video games character can restore their health (assuming it’s to replenish their loss of blood volume during fights) by drinking “potions”?
Good question! According to the initial definition of potions, it either involved a mixture of different ingredients, or it can involve magic. Magic is defined as “the use of special powers to make things happens that would usually be impossible, such as in stories for children” according to the Cambridge Dictionary.
It was impossible to fly before the invention of aircrafts. It was impossible to land on the moon before the invention of space rockets. It was impossible to survive from the plague in the 17th century, before the discovery of antibiotics. Is that magic? Interesting…
In the video game realm, every game taking place in different parallel universes (multiverse theory), so far I have never seen any “blood transfusion to restore health”. Heroes always restore their health by drinking potions, or with magic!
Minimal criterions for a successful oxygen-transporter alternative from the RBC
- That means they discovered a way to add more oxygen transporter in the bloodstream through the intestinal tract.
- It might not be RBC indeed! It has to be something absorb such as nutrients we eat.
- Also, it has to be unprocessed when going through the liver (absorbed nutrients flow through the hepatic portal vein, then through the left subclavian vein to the main bloodstream circulation)
- Once in the main bloodstream, this oxygen-transporter compound has to be able to fix oxygen and to deliver it with the same efficiency as RBC when needed.
These are the minimal criterion.
We can imagine a protein which is alike the hemoglobin, encapsulated within an organic an time-degradable membrane which is resistant to gastric acidity and liver processing. It will slowly be digested by all the enzymes, and once in the main bloodstream, will expose the main oxygen-transporter compound. Pretty futuristic though… However this question of “synthetic blood” of “artificial blood transfusion” has already been assessed and though through by some researchers [16], [17]. Apparently, the first blood substitutes were made in early 1600. But all of these techniques were by perfusion! Not oral intake.
Magic then must have an important part in the creation of those potions… We must uncover the secret of Magic! And don’t forget to go donate your blood if you can, you can save a lot of people’s lives!
Take care and cheers!
REFERENCES
[1] “potion | translate English to French - Cambridge Dictionary.” https://dictionary.cambridge.org/dictionary/english-french/potion (accessed Feb. 18, 2023).
[2] “Potion Definition & Meaning - Merriam-Webster.” https://www.merriam-webster.com/dictionary/potion (accessed Feb. 18, 2023).
[3] “Life | Diablo Wiki | Fandom.” https://diablo.fandom.com/wiki/Life (accessed Feb. 18, 2023).
[4] “Physiology, Blood Volume - PubMed.” https://pubmed.ncbi.nlm.nih.gov/30252333/ (accessed Feb. 18, 2023).
[5] “blood | Etymology, origin and meaning of blood by etymonline.” https://www.etymonline.com/word/blood (accessed Feb. 18, 2023).
[6] “How your body replaces blood - NHS Blood Donation.” https://www.blood.co.uk/the-donation-process/after-your-donation/how-your-body-replaces-blood/ (accessed Feb. 18, 2023).
[7] L. Mesarec, W. Góźdź, A. Iglič, V. Kralj-Iglič, E. G. Virga, and S. Kralj, “Normal red blood cells’ shape stabilized by membrane’s in-plane ordering,” Sci. Reports 2019 91, vol. 9, no. 1, pp. 1–11, Dec. 2019, doi: 10.1038/s41598-019-56128-0.
[8] R. Wang and B. Fang, “A combined approach on RBC image segmentation through shape feature extraction,” Math. Probl. Eng., vol. 2012, 2012, doi: 10.1155/2012/194953.
[9] N. Abbaspour, R. Hurrell, and R. Kelishadi, “Review on iron and its importance for human health,” J. Res. Med. Sci., vol. 19, no. 2, p. 164, 2014, Accessed: Feb. 18, 2023. [Online]. Available: /pmc/articles/PMC3999603/.
[10] J. L. V. Corrons and E. Krishnevskaya, “Rare anemias in adolescents,” Acta Biomed., vol. 92, no. 1, pp. 1–11, 2021, doi: 10.23750/abm.v92i1.11345.
[11] M. Helmer and C. P. Emerson, “THE IRON CONTENT OF THE WHOLE BLOOD OF NORMAL INDIVIDUALS.”
[12] K. V. Kowdley, K. E. Brown, J. Ahn, and V. Sundaram, “ACG Clinical Guideline: Hereditary Hemochromatosis,” Am. J. Gastroenterol., vol. 114, no. 8, pp. 1202–1218, Aug. 2019, doi: 10.14309/AJG.0000000000000315.
[13] L. Dean, “Blood group antigens are surface markers on the red blood cell membrane,” 2005, Accessed: Feb. 18, 2023. [Online]. Available: https://www.ncbi.nlm.nih.gov/books/NBK2264/.
[14] L. A. Parapia, “History of bloodletting by phlebotomy,” Br. J. Haematol., vol. 143, no. 4, pp. 490–495, 2008, doi: 10.1111/j.1365-2141.2008.07361.x.
[15] “Diseases and Organisms | Blood Safety | CDC.” https://www.cdc.gov/bloodsafety/bbp/diseases-organisms.html (accessed Feb. 18, 2023).
[16] S. Sarkar, “Artificial blood,” Indian J. Crit. Care Med., vol. 12, no. 3, p. 140, Jul. 2008, doi: 10.4103/0972-5229.43685.
[17] R. Haldar, D. Gupta, S. Chitranshi, M. K. Singh, and S. Sachan, “Artificial Blood: A Futuristic Dimension of Modern Day Transfusion Sciences,” Cardiovasc. Hematol. Agents Med. Chem., vol. 17, no. 1, pp. 11–16, Jun. 2019, doi: 10.2174/1871525717666190617120045.