IRA FLATOW: This is Science Friday. I’m Ira Flatow. Halloween is right around the corner. And when you think of the spooky holiday, what comes to mind? Ghosts, goblins, and of course, blood. Even though blood runs through all of our veins, it somehow has gained a mysterious, sometimes magical reputation.

Writers have been fascinated by this substance. It revived Odysseus’ mother, and it gives vampires their immortality. And doctors have been trying to harness blood by banking it, having leeches suck it from our veins, even searching for synthetic substitutes.

My next guest is here to tell us all about that. Rose George is a journalist based out of Leeds, England. Her new book is Nine Pints, A Journey Through the Money, Medicine, and Mysteries of Blood. Welcome to Science Friday.

ROSE GEORGE: Thank you.

IRA FLATOW: I guess, being from the UK, a pint is the right measurement you would be using for blood.

ROSE GEORGE: I believe that’s something we share with you, though. So it’s the one thing we have in common, along with miles.

IRA FLATOW: [LAUGHS] There are all these different connotations about blood. The Romans drank it. Homer used it in The Odyssey to allow the dead to speak. Why are there so many almost mystical ideas about blood?

ROSE GEORGE: I think because for such a long time, it wasn’t really understood. And the only thing that was understood was that when you saw it, it was probably a very bad thing. Because it was usually followed by injury and death. So obviously, it was a really powerful substance.

But it wasn’t really understood very well until like the last 100, 150 years. So it was given this power. Because if it could kill you so easily when you lost it, then obviously, if you drank it, or if you were home Homer’s mother, you drank a bit of sheep’s blood, because the sheep happened to be handy in hell. Then it could probably revive you. So I think that’s how we got the idea of blood as this life giving substance. Of course, medically, it is a life giving substance.

IRA FLATOW: Mhm. I want to ask our listeners to join in. 844-724-8255 is our number. You can also tweet us, @SciFri. You know, right from the beginning of the book, I had an affinity for it because you mentioned Hemo the Magnificent, which I remember seeing.

ROSE GEORGE: No way. You’re the first person who’s ever heard of it.

IRA FLATOW: I remember that in the ’50s. And I remember seeing it. I remember a part where they were squeezing, spurting blood out of a pipe, like would be in an artery. And it has stuck with me ever since. And I’m so happy that you mentioned that because it really put it on the radar screen for me.

ROSE GEORGE: Yeah. I mean, I just can’t even remember how I came across that bit. I was a much, much happier person once I had. It’s slightly eccentric, shall we call it, as a film, but it’s just wonderful. And it’s got poetry. It’s got medicine. It’s got science. It’s got everything. And it’s got– yeah. It’s very hard to describe, though. I mean, once you’ve seen vascular sphincters being compared to railroad switchman. It’s quite an indescribable film. But really worth looking up.

IRA FLATOW: It’s like the early days of television. Quite indescribable and pretty good in some of the things that it did. All right. Let’s talk about the taboos about blood. You visited India, where there’s a man trying to break this taboo. Tell us about that.

ROSE GEORGE: This is a guy called– whose short name is Maruga. He’s got a long Tamil name. He’s from South India. And a lot of Indians will know him better as Pad Man, because there’s been a Bollywood film about him. But his story is extraordinary.

He was a very poorly educated young man. And his wife came home one day hiding something behind her back. And he thought she was teasing, and they had a bit of a tussle. And she eventually showed him that she was carrying her bloody menstrual rag.

A lot of Indian women use cloth. They can’t afford sanitary pads, commercial sanitary pads. So Shanthi, like millions of other Indian women and across the developing world, was using cloth. There’s nothing wrong with that if you can clean it and wash it hygienically. But because of taboos, that often doesn’t happen.

Anyway, Maruga asked Shanthi why she couldn’t afford commercial sanitary pads, because he’d seen them in the market. And she said, well, it’s either a sanitary pad or milk, and we need milk. And from that, Maruga, because he’s a bit of an extraordinary fellow, spent 12 years coming up with a low-cost sanitary pad machine that can be manually operated. So it can be operated by illiterate women. And there are now 4,000 of them all over the world.

But the way he got to understanding, he had to do reverse engineering to understand what was in commercial sanitary pads, because he thought it was just cotton. So he decided that the best way to do that, obviously, was to rig up his own uterus in the form of a goat’s bladder filled with goat’s blood. Sorry. It was a football that he filled with goat’s blood, and he attached it to his clothing and had a little pump and went around all day and every so often pumped it. And so tries to simulate the experience of a menstruating woman. And he learned a lot. I think a lot of men would if they did that.

And also because he lived in South India, where it’s hot, he was wearing white, which is pretty much every woman’s nightmare, no matter what sanitary pad advertising has told us over the years. So there were stains and leaks, and he spent a lot time checking behind himself, like women do a lot. And he eventually understood what was in sanitary pads and has revolutionized sanitary pads in India. Quite an amazing fellow.

IRA FLATOW: That is amazing. More men should try that to figure out the trials and tribulations of what women go through.

ROSE GEORGE: Plus multitasking with football.

IRA FLATOW: [LAUGHS] There’s so many great little moments in your book and little statistics that just jump out. Let me go through a few of them. You have a stat that every three seconds, someone receives a blood transfusion. Wow. You know, the joke behind that is they ought to find that guy and stop him.

ROSE GEORGE: In the States, it’s actually every two seconds.

IRA FLATOW: Is that right?

ROSE GEORGE: Yeah. And I was given the breakdown of those figures, and it all makes sense.

IRA FLATOW: How did this idea of banking blood first come about?

ROSE GEORGE: Well, we haven’t been– the system that we’re all used to, which is the mass donation and supply and transfusion of blood, it’s really not very old at all. It’s about 120 years old. And in the beginning, in the US and the UK, they started in pretty similar fashion, that people were selling their blood. They had this product that they could sell, and so they did.

And there was even a union of blood sellers in New York. And there were people who– men, usually– who traveled around the country, selling their blood. So they were their own blood market. But eventually, in the 1930s, a doctor in Chicago, called Bernard Santos, tried to organize things a bit better. And he was convinced that the best thing to do was to treat blood as a commodity, really. So he thought that what went in must come out. And if you used blood, you should supply blood.

So he set up a blood bank. And eventually that transformed– in the 1970s in the US, the notion of paying for blood died out. And it’s now all donated. It’s not actually illegal to sell your blood in the US, but it’s just frowned upon and not done.

IRA FLATOW: You know, when I was in college, I knew lots of college students who were selling their blood for money. Just to have some spending cash.

ROSE GEORGE: Well, you can still do that. But what you’re doing is selling blood plasma. So you’re selling the yellow stuff, the 55% of liquid in your blood. And yeah, you can do that. The US has got very, very generous regulations about how often you can do that.

You can do it twice a week if you want to. Other countries only let plasma donors do it every couple of weeks. But yes, you can earn $30, $50 a pop selling your plasma in the US. So yeah, it’s a good income stream for a lot of people.

IRA FLATOW: Now, you write that the US is seen as the OPEC of plasma. [CHUCKLES] Like it is a cartel of plasma.

ROSE GEORGE: Well, that wasn’t my phrase. That came from somebody in the plasma industry. But it’s certainly a global giant in the selling of plasma. It supplies 70% of plasma and plasma products. So what happens to plasma, it can either be used for transfusions, or it can be refined and fractionated and become medicinal products.

So what the US does is it exports a lot of plasma, which is turned into plasma products around the world. Because it takes so much plasma to get a single product, other countries just don’t have enough of it. Because we’re not paying people to donate it twice a week, probably.

IRA FLATOW: Now, we know that blood comes in many different types, but I never realized how many types of blood. A couple of dozen types?

ROSE GEORGE: I think the International Society for Blood Transfusion currently lists 37 blood types. So we all know about the main four, which is A, B, O, and AB. And then of course we all know positive and negative. So that’s another four.

So most people think there are probably eight, but there are lots more rarer and rarer blood types. I mean, there are probably far more than 37, but those are the ones that have been established. And they have pretty cool names. I like the one that’s called OK. And then there’s one named after Karl Landsteiner, who was the Austrian biologist who discovered that blood was different and that that’s why if you gave blood to someone, and they fared very badly and possibly died, it was probably because you shouldn’t mix certain types of blood who reacts.

IRA FLATOW: I have a who’s on first joke on my head with the blood type OK going, but. [LAUGHS] But that brings up a point I was always interested in. When did we first discover that you needed to have the right type of blood for the right person? How did we discover that there were types that needed to be matched?

ROSE GEORGE: Well, it was a slow process. So when people first started experimenting with removing blood from one creature and putting it in another creature, it was in the 16th and 17th century. And it generally tended to be two different types of creatures. So because of that point, again, blood was thought to have this spiritual, mysterious quality.

It was thought that if you transfused someone with blood, you would get the quality, the characteristics, of the creature. So sheep’s blood was very popular, because they were thought to be mild and nice. Cows were popular too, because they were thought to be gentle. Dogs. Dog blood was experimented with a lot.

With various results. Some people, some experiments died. And these were transfused into humans. But the first real experimentation with human blood going into another human was an obstetrician called James Glendale in the 19th century. And he had about a 50% success rate.

And there were other people who tried throughout the 19th century. But because it wasn’t understood that there were these blood types and that obviously, you could have a hemolytic reaction. You could die. So it was not really until Karl Landsteiner in the 1901, more or less, discovered blood types. But even he didn’t really think his discovery was massively important. He kind of ignored it for about 10 years.

IRA FLATOW: Talking with Rose George, a journalist based in Leeds, England. Her new book is Nine Pints, A Journey Through the Money, Medicine, and Mysteries of Blood on Science Friday from WNYC Studios. There have been attempts to create synthetic blood. I’ve been following it for years. But why is it so hard to do that?

ROSE GEORGE: Because blood is so amazing and because we cannot replicate it. Even though so much money and so much effort and so many great minds have been trying, as you say, for decades to try to do it, we still haven’t done it, and we still cannot reproduce something that does everything that blood does in the body. It’s very, very busy.

It’s transporting oxygen. It’s removing carbon dioxide. It’s keeping us warm. It’s transporting nutrients. And we just haven’t come up with a synthetic alternative yet. There has been really good progress. And there have been synthetic red blood cells which have been used and transfused, in fact. But the trouble is that at the moment, they would be so expensive that they’re just not a meaningful alternative except perhaps in rare cases. So for now, even despite all the effort, there is nothing better than the stuff that comes out of someone’s arm.

IRA FLATOW: Tell us about hemoglobin. How that works in the blood cells.

ROSE GEORGE: I am not– I do not have a medical background, so I don’t want to get anything wrong. But I can tell you that when I give blood, my hemoglobin takes about three weeks to recover. And I am a runner, and I run up hills. So I can tell you, what I know about hemoglobin is it makes running up hills extremely difficult for about three weeks.

So it’s transporting– it’s just helping your muscles out. It’s your fuel. And if you give a pint of blood, which I encourage anyone who can should do, you will notice the difference for a couple of days or up to a few weeks.

IRA FLATOW: So those people who give two pints a week, they must be quite lethargic.

ROSE GEORGE: Well, they’re giving plasma. Plasma is different. So plasma is not cellular. And you can replenish– your body replenishes your plasma within 24 to 48 hours. So you’re not going to notice that for very long. But your red blood cells take longer to recover.

IRA FLATOW: You visited a leeching center. In modern day, leeching is a big industry? They’re still doing it very, very– I mean, it’s thriving, according to your book.

ROSE GEORGE: It is. And I’m so pleased you asked me about leeches. I’m very fond of them. Although I don’t really like picking them up. So leeching came back into use. It was widely done throughout the 19th century, to the point where the native medicinal leech in Europe was pushed to extinction.

And they were widely abused, really. And there was a French doctor who was one of Napoleon’s doctors who was known as the Leecher. And he used it almost as preventive medicine. So he would prescribe 60 leeches even before he’d seen his patient.

But then they fell out of fashion once we understood things like germ theory and disease. And because they were used for bloodletting, and bloodletting was thought to balance the humors in the body. Once the humoral theory went out the window, so did leeches.

But then about 50 years ago, some Slovenian doctors used them again and found that they were still the best thing available if you have blood that’s congested, because leeches have a really astonishing anti-coagulant in their saliva. So when they bite, they give you this anti-coagulant, and it can keep blood flowing for up to 10 hours.

So if you, for example, you’ve had something amputated or torn off, and it’s somewhere where there are lots of tiny blood vessels, they are extremely difficult to stitch together again, to knit together, really, and to get the blood flowing. So if it doesn’t, what you need is a leech. And so they’re still widely used by plastic surgeons and micro surgeons.

IRA FLATOW: Wow. Thank you, Rose George. Fascinating. It’s a great book. Rose George is a journalist in Leeds. Her new book is Nine Pints, A Journey Through the Money, Medicine, and Mysteries of Blood. And you can read an excerpt from that book on our website at sciencefriday.com/plasma. You really will enjoy it.

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