Dracula and the Victorian Understanding of Disease

As you can see, this paper was written by Jessica Sutton for a college class. With her permission it was posted on my major website (which I recently discontinued). Her paper is just too good, and the ideas and approach too unique to allow it to vanish. Thus, I am re-upping it onto my SweetGoth's Vampires blog.

Jessica Sutton

Leslie Ormandy

Writing 123 (Clackamas Community College)

17 March 2010

Dracula and the Victorian Understanding of Disease

            Bram Stoker’s Dracula presents an interesting perspective on illness and death in the Victorian period. This can be viewed as creativity on Stoker’s part, or as a form of religious or social commentary on his changing era. Certainly much has been written to attest to these ideas. However, it is also useful to view Stoker’s work in light of the Victorian understanding of disease. The 1800s were a time of tremendous change in the fields of medicine and microbiology. London was ravaged by repeated outbreaks of cholera, Louis Pasteur developed a vaccine for rabies, and the germ theory of disease set the foundation for our modern understanding of infection. Through all of this, there was ongoing debate about how disease spread, and three major schools of thought informed this debate. Dracula shows evidence of all three arguments, and provides an interesting perspective on how medical research affected the mindset of Victorian England. In addition, Dracula reflects the fearful worldview of the late 1800s with respect to infectious disease, and the hope that people continually place in the science of medicine.

            Stoker depicts vampirism as an infectious disease. It is transmitted to infected humans following either a vampire’s bite or consumption of a vampire’s blood. Signs of the process begin to manifest during the infected person’s lifetime, including elongation of the canine teeth and physical signs of a curse. When Dr. Van Helsing attempts to touch the sacred wafer to Mina Harker’s forehead, it, “burned into the flesh as though it had been a piece of white-hot metal” (313). This demonstrates the curse that is associated with vampirism, since following death, the infected person does not truly die, but instead remains eternally undead.

            Although vampirism is a fictional affliction, it is also a literary vehicle that conveys much about the shifting understanding of illness in the late Victorian era. In the mid-1800s, there were two major schools of thought on how people became infected with disease: contagionism and miasmatism. Contagionism argued that some diseases spread directly from one human being to another, and there was a great deal of discussion about which diseases were contagious and why. According to Harvard University Library’s open collection on contagion and epidemics, “Historically, both the plague and syphilis were believed to be contagious … Before the late 19th century, many diseases that we now know to be contagious (such as cholera and tuberculosis) were considered non-contagious by educated physicians.” Miasmatism (sometimes called anticontagionism), in contrast, “postulated that most illness resulted from the inhalation of the effluvia of rotting animal and vegetable matter” (Corbett 195). This theory was a major argument behind the development of sanitary sewer systems, because it argued that disease was contracted from any environment where such rot could occur, including sewage, swamps, stagnant places, dusts, and fogs. Proponents of this theory argued heavily for sanitary practices in medicine because they believed that the environment needed to be kept clean in order to prevent inhalation of unhealthy air.

            Dracula makes literary reference to the worldviews behind both of these theories. The reader can see evidence of contagionist thought in the fact that vampirism is directly transmitted from an infected individual to a non-infected individual via a bite. The characters understand this, as Mina Harker’s burned forehead provides physical proof of her infection.

            The influence of miasmatic thought shows up more obliquely. When Van Helsing is describing a vampire’s capabilities, he says, “He can come in mist which he create” (253). This image conveys the miasmatic view that mists were unhealthy and threatening to life. Van Helsing goes on to describe a vampire’s limitations, including, “It is said, too, that he can only pass running water at the slack or flood of the tide” (253).  The miasma was associated with stagnation, so it is logical within the story’s context to see why running water is a healthy barrier and the vampire, as an embodiment of disease, is unable to cross it.

            Later, there is direct reference to the miasma when Dr. Seward, Van Helsing and the others visit Dracula’s home near the asylum. “… There was an earthy smell, as of some dry miasma, which came through the fouler air … composed of all the ills of mortality and with the pungent, acrid smell of blood” (265). These are Jonathan Harker’s words, and they reflect his earlier experience with the vampire in Transylvania, when he visits the Count’s room and smells, “… a deathly, sickly odour,” (50). Throughout the text, there is reference to this sense of decay suspended in the air in the presence of the vampire. It is clear that Stoker uses miasmatic imagery to convey the horror of illness. This not only creates a dark, sinister literary atmosphere, but it also reinforces the concept of vampirism as disease.

            As disease research progressed through the late 1800s, the germ theory began to take precedence over both contagionism and miasmatism. Germ theory argues that disease is spread by microorganisms, or “germs,” which can be transmitted from one organism to another, or obtained from the environment. This theory still holds true today, and it is the central principle behind the microbiology of infectious disease. Proof of the theory occurred in 1876, when a researcher named Robert Koch was able to prove that the bacterium Bacillus anthracis was the cause of anthrax. In his experiment,

He observed B. anthracis cells in the blood and spleen of dead sheep. He then inoculated mice with the infected sheep blood and was able to recover B. anthracis from the blood of the mice. In addition, he grew bacteria in pure culture and showed that they caused anthrax when injected into healthy mice. (Nester 451)

Koch’s work revolutionized disease research because it proved that specific microscopic organisms were the source of specific diseases. This theory of germs supported the ancient contagionist notion that illness could be spread from one individual to another, and explained that microorganisms were the source of that contagion. It also supported some of the miasmatic view, because it raised questions about where these microorganisms exist within the natural environment. It also upheld the miasmatic perspective that cleanliness is important in preventing disease transmission, since cleanliness can eliminate some harmful microorganisms.

            Since Dracula was published in 1897, it is likely that Bram Stoker had some exposure to the germ theory and the concurrent changes in medical science. In fact, it is important to note that several of his family members were part of the medical world. According to Martin Willis’ research in his article, “The Invisible Giant, Dracula, and Disease,”

… Stoker's uncle, William Stoker, was an eminent Irish physician closely involved in the organization of the Dublin Fever Hospital, one of the most influential organizations for infectious disease in Victorian Ireland … his brother George was also a practicing physician. George lived with Stoker and his family in the late 1870s and was appointed the official physician to the Lyceum Theatre where Stoker was Theatre Manager … Another of Stoker's brothers, Thornley, practiced medicine in Ireland … when Stoker was keenly at work on Dracula … While there is no direct evidence to prove that disease was ever a topic of discussion between Stoker and his family it is nevertheless significant that medicine and infection were a common and consistent part of Stoker's life. (14)

In light of this understanding of Bram Stoker’s background, it is reasonable to say that aspects of Dracula may allude to the new understanding of germs. For example, when the characters sterilize Dracula’s boxes of earth, they are isolating the source of the “disease” of vampirism and preventing its transmission. As Van Helsing says, “Thus when we find the habitation of this man-that-was, we can confine him to his coffin and destroy him, if we obey what we know” (254). It is this notion of obeying what is known, and sterilizing a dangerous object, that brings to mind images of medicine and the treatment of illness. Once the characters have come to understand their enemy, they are able to isolate him and eliminate the threat.

            There were many real-world threats in Bram Stoker’s era. Once of the most noteworthy was the bacterium known as cholera. Christopher Hamlin, in his research for Cholera: the Biography, argues that, “… cholera stands out as the signal disease of the nineteenth century” (4). Hamlin provides an example of fatality records in India and Pakistan from 1877-1954, saying, “There were 22 million deaths, with decadal cholera mortality rising as high as 1.5/1000 by 1887-96” (3). The disease spread world-wide through contaminated water systems and human-to-human contact, and the results were often devastating.

Put simply, cholera is a bacterium that, if untreated, can cause fatal dehydration from severe vomiting and diarrhea. According to the New York State Department of Health’s fact sheet on cholera, “The single most preventative measure is to avoid consuming uncooked foods or water in foreign countries where cholera occurs unless they are known to be safe” (1). It is now common knowledge that water should be treated or boiled prior to drinking; we know what cholera is and how it is transmitted. In the nineteenth century however, the source of cholera’s transmission was a subject of great debate. The contagionist and miasmatic worldviews greatly influenced the subject. Researchers of the day debated whether the disease spread from one individual to the next or if it came from putrid environments and a lack of sanitation.

Bram Stoker had a personal understanding of cholera’s devastation. His mother survived the epidemic of 1832 in Sligo, Ireland, and she told the story in grim detail to her sons, saying,

‘It was said to have come out of the East, rising out of the Yellow Sea, growing nearer and nearer until it was in Ireland! … men looked at each other and whispered cholera, but the whisper next day deepened to a roar, and in many houses lay one, nay two or three dead … There was no telling who would go next, and when one said “good-bye” to a friend, he said it as if forever.’ (Belford, 22)

This image of an invader from “the East” seems to be echoed in Dracula, when the vampire travels a great distance from Transylvania to England, bringing death and infection with him. The characters identify the danger they face, but for much of the novel, they don’t understand what is causing it. They stand where nineteenth century physicians stood when facing an outbreak of cholera: the signs were visible, but for a long time the cause, the enemy, was mysterious and hidden.

If vampirism’s threat mimics the story of cholera, it is also interesting to observe how it manifests the traits of another disease: rabies. The effects of rabies have been known and feared since antiquity. According to E. Lendell Cockrum in his study of the disease, “Rabies is usually transmitted to a person or another animal by the bite of an infected animal, with the saliva containing the virus” (18). Without treatment, this disease is fatal. Until 1885, only twelve years before Stoker wrote Dracula, the contraction of rabies was well known as a death sentence.

            The year 1885 is important because it was then that a French physician named Louis Pasteur developed the first successful vaccine for rabies. To test his work, Pasteur’s vaccine was,

… administered to a nine-year-old boy who had been severely bitten by a mad dog. Given the nature of the injuries, physicians who examined the boy were sure that he would die of rabies. Despite the painful series of rabies injections, the boy made a complete recovery. (Magner, 35-36)

Pasteur published a case study of this treatment, which was distributed world-wide. “The media sensation triggered by the rabies vaccine also heightened interest in the germ theory of disease and led the public to expect miraculous benefits from medical research” (36). Pasteur’s success supported the growing notion that the application of scientific thought could tackle frightening afflictions.

            The most obvious parallel between rabies and vampirism is of course the bite. Dracula transmits his disease to his victims by a bite, as would a rabid animal. In fact, some of the wild animals known to be natural reservoirs for rabies are the same animals that Van Helsing describes when he says, “He can transform himself to wolf” and, “he can be as bat …” (252). During Lucy’s slow decline from Dracula’s predation, she recounts a memory of the vampire’s animal appearance, “The window blind blew back with the wind that rushed in, and in the aperture of the broken panes there was the head of a great, gaunt grey wolf” (151). In this moment, the wolf is thwarted because she is wearing a wreath of garlic flowers.

            The effect of garlic on the vampire is similar to the effect of water to a rabid animal or person. Rabies is also known by the name “hydrophobia” because infected creatures, “react violently [to] attempts to give them fluids orally” (Cockrum, 22). It is not possible to know whether Stoker drew on this parallel deliberately, but the similarity could lead readers to associate a vampire attack with the behavior of a rabid animal –an association that intensifies the novel’s atmosphere of horror.

It is also possible to view Van Helsing’s use of garlic in a medicinal sense. Garlic has been used medically for thousands of years. According to Matthias Hermann in his text Herbs and Medicinal Flowers, “… the Romans believed [garlic] warded off evil … Boiled in milk, it has been used as an anthelminthic and expectorant” (18). An anthelminthic specifically is a medicine used to treat the body for worms. Here it is possible to see how the vampire is not only something evil that must be “warded off” but is also a particularly dangerous parasite. Dracula preys on Lucy repeatedly before her death, and it works to his benefit that she survives these attacks with the help of blood transfusions. Her survival results in a continued source of food. He is able to seek her as prey multiple times, and he is only kept at bay by garlic and the crucifix. In this setting, the vampire is a complex embodiment of illness and condemnation. The reader can understand the horror this creature presents to the living characters in the story, especially to Van Helsing, who realizes that people infected by vampirism cannot escape the curse, even in death.

            In discussion of the fear experienced by these characters, it is possible to draw another parallel between vampirism and rabies: the social terror associated with both conditions. When questioned about his choice to develop a vaccine for rabies, Louis Pasteur, “referred to memories of the howls of a rabid wolf that had terrorized the village in the countryside where he grew up” (Magner, 35). The fear associated with an uncontrolled, possibly diseased animal would have been a well-recognized in an era when wolves still roamed much of Europe. Bram Stoker evokes the same image when he writes through Jonathan Harker’s voice near the beginning of the novel. Harker seeks to leave Dracula’s castle, but the Count prevents it by calling his wolves to the door. As Harker writes, “the howling of the wolves without grew louder and angrier; their red jaws, with champing teeth, and their blunt-clawed feet as they leaped, came in through the opening door” (52). This is not the aloof behavior of a healthy wild animal, but instead shows the violence commonly associated with rabies or “madness.” The wolves behave as though they are either mad or starved, and the only power to hold them back belongs to the vampire.

            In contrast to the Dracula’s embodiment of sickness, it is interesting to discuss the scientific approach of Stoker’s protagonists. Both Seward and Van Helsing are physicians. Their interactions in much of the novel show an ongoing conversation between the science of illness and the unknown of the supernatural. This can be seen in their care of Lucy as she slowly declines from Dracula’s repeated attacks. Van Helsing is clearly aware that something abnormal is happening, but he persists in using his medical knowledge to intervene. As Carol Senf describes in her essay on the science of Dracula,

That all of their medical attention prolongs Lucy’s life but is ultimately powerless to save her suggests to me that Stoker was aware of the limitations of science, a field that was rapidly gaining social and political power along with greater proficiency at the end of the nineteenth century. (77)

While Stoker’s characters are fighting for Lucy’s life, they clearly believe that hope lies with the science of medicine. When she dies, they come to realize that despite their best efforts, their scientific knowledge has limits.

            In particular, Van Helsing has an interesting body of medical knowledge. When Dr. Seward introduces him, he says Van Helsing, “… knows as much about obscure diseases as anyone in the world” (Stoker, 118). He later describes him as carrying, “… a bag in which were many instruments and drugs, ‘the ghastly paraphernalia of our beneficial trade,’ as he once called, in one of his lectures, the equipment of a professor of the healing crafts” (127). One of his most prominent uses of this “ghastly paraphernalia” is in the multiple blood transfusions that attempt to save Lucy Westenra’s life. Stoker’s description of these transfusions is vague, probably indicating a lack of understanding of the process involved. Seward relates that Van Helsing performed the operation, “With swiftness, but with absolute method …” (130). Beyond that, the actual task is left to the reader’s imagination.

            Although it is likely that Stoker had exposure to discussion of medical practice in his life, blood transfusions were not well understood during the time when he was writing Dracula. Blood transfusions had been attempted since the 1600s with limited success. The early attempts tried to transfuse animal blood into humans. In 1666, a French mathematician and philosopher named Jean Baptiste Denis, “… transfused lamb’s blood into 3 men with great success to cure their diseases, but the fourth patient died as the result of the transfusion” (Hajdu, 471). Other attempts were made in the following centuries, and the body of knowledge about human circulation grew. For instance, by the end of the 1700s it was determined that interspecies transfusion was not a safe practice and further studies focused on human-to-human transfusion. In general however, much of the scientific world regarded blood transfusion as a dangerous procedure that was not well understood.

            Relatively safe blood transfusions did not occur until the twentieth century. In 1900, an Austrian pathology assistant named Karl Landsteiner, “… discovered iso-agglutinins in the human blood and identified 3 specific blood groups. The fourth group was added 2 years later” (Hajdu, 473). This was the beginning of blood typing, a process which is now recognized as vital to the safe transfusion of blood. Bram Stoker would not have had access to this knowledge when he wrote Dracula in the 1890s. Van Helsing’s knowledge of blood transfusion, and the fact that he carries suitable equipment for the procedure in his doctor’s bag, would have appeared as cutting-edge science to the original readers of Dracula. In truth however, he could not have understood the procedure well enough to perform it safely, and the odds of four different men all having blood types compatible with Lucy’s would be very slim.

            Stoker’s use of blood transfusion in the novel is clearly a literary tool and not a scientific one. He shows that even though the vampire can take blood from the body, there is still hope in medicine and human knowledge. The problem for Lucy is that the vampire is a persistent threat and her doctors do not realize that blood transfusions will not be enough. It takes her death for them to truly acknowledge the threat posed by the vampire and take steps to destroy him. Before that point, they spend a great deal of time responding to each of Lucy’s crises as they occur, instead of trying to prevent each episode in the first place.

            During this period in the novel, Dr. Van Helsing spends a great deal of time in research. Dr. Seward writes about this in his journal, and the reader is left with the impression that Seward does not understand what Van Helsing is researching, but he respects the man’s vast knowledge and trusts that he works with Lucy’s best interests in mind. Stoker also leaves the reader with an impression that Van Helsing knows what his enemy is from an early point. Following Lucy’s first blood transfusion, her velvet necklace gets moved, revealing the vampire’s bite marks. Van Helsing sees this, and Seward describes his reaction, saying, “I could hear the deep hiss of indrawn breath which is one of Van Helsing’s ways of betraying emotion” (130). Van Helsing later asks Seward what he thinks of the bite marks, and Seward is unable to account for them, although in his journal he admits, “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” (131). Van Helsing then leaves for Amsterdam to follow up on his theories.

            It is worth wondering why Van Helsing keeps silent about his suspicions regarding Lucy’s ailment. Why does he wait until after her death to tell the others she was the victim of a vampire? There is the impression that he knows the truth seems too suspicious or too unreasonable for his companions to accept. When he finally begins to explain vampires to Dr. Seward, he says, “Ah, it is the fault of our science that it wants to explain all; and if it explain not, then it says there is nothing to explain” (200). There is a tension here, between scientific knowledge and the elements in life that remain inexplicable. This tension existed in Bram Stoker’s time as much as it does today. Van Helsing does not voice his suspicions because he knows that no one will believe him. He waits until they have visible proof of the vampire in Lucy before revealing his knowledge, and in doing this, he stands in a place familiar to researchers of Bram Stoker’s day. Many had suspicions about germs, about cholera, about rabies, and about numerous other threats to human health, but it took a great deal of debate and social persuasion to teach people about the reality of disease and what must be done to prevent it. In these cases, medical research was not trying to explain the inexplicable, but simply to help people see the reality of their environment.

Medical science in the Victorian Era clearly informed the writing of Dracula in many ways. The story presents the vampire as an enemy who is frightening because he is a threat to health and life; he is capable of infecting human beings and condemning them to an undead eternity. The vampire is the embodiment of illness, and illness was as frightening in Bram Stoker’s lifetime as it is today, if not more so. Stoker sets up his story using imagery of contagion and miasma to reinforce the horror of the vampire. Later, he uses images of sterilization and human understanding, shadows of the germ theory, to ultimately destroy Dracula and remove the threat of infection. In addition, while the story’s protagonists are fighting the threat of vampirism, the reader can see reflections of the medical reality of Stoker’s era. Vampirism manifests like an infectious disease, and it echoes the real-life stories of cholera and rabies and other diseases prevalent in the 1900s. It spreads through the community leaving fear in the minds of those who understand what infection really means. However, since the protagonists are victorious in the end, the story ultimately leaves the reader with hope, a hope echoed by medical science, that human understanding can intervene in the space between infection and death.

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