Contemporary Americans might look back to the eighteenth and nineteenth centuries and see an enormous gap in knowledge, but serious questions concerning the determination of death continue unresolved into the present. For instance, is the “soul” or “vital principle” of life located in a single organ or is it spread throughout a person’s organs, tissues and cells? Some in the medical community now are asking, “Does death occur and unique ‘personhood’ end when a small number of organs, or perhaps only one, permanently cease(s) to function, or must the entire organism go through such a process before death is defined?” A by-product of the medical profession’s failure to successfully treat tuberculosis prior to the twentieth century was the preservation of the ambiguous vampire figure, the living dead. Modern medicine’s current inability to reach consensus regarding the definition and diagnosis of death has reintroduced the ambiguity of the living dead. The artificial ventilator and the concept of brain death have conjured ancient apprehensions, as one medical ethicist wrote: “Concern about ‘bad’ deaths—those that are unnatural, accidental, or untimely, or repugnant—is a universal, age-old preoccupation. Technologically orchestrated deaths appear intuitively to many people to be unnatural. We worry that individuals who die bad deaths suffer unduly, and, even though most of us consider such thoughts irrational, even some health-care practitioners may be harrowed by the idea that this suffering will come back to haunt the living.”

Blaming the dead for death seems a logical step from the fundamental vampire concept that the dead have a life after death. A cause-and-effect relationship between the dead and death lurks beneath the surface of everyday folklore. Fear that the angry, jealous or vengeful dead will prey upon the living unless certain steps are taken to appease or disable them, probably explains why a reanimated corpse is the primary type of vampire. A common folk belief in both the United States and Great Britain, for example, is that a corpse not stiffening “is a sure sign that death will be knocking pretty soon again at the door of this house for some other member of the family.” This belief suggests an uncanny connection between living and dead family members, evoking the scene at the graves of the American vampires, where corpses that appeared to be in an unnatural state were interpreted to be at least signs, if not the actual causes, of the looming death of kin. The inclination of these vampires to infect their near relations with a lethal disease links pre-twentieth century America to a very large community. This core belief is found in Europe, India, Asia, and Africa and is as persistent as it is widespread.

In the vast stretch of history before the twentieth century, death and disease were ever-present and endured. Yet, almost everyone alive in America today was brought up believing in the inevitable conquest of disease and, by extension, death. Vaccines, antibiotics, modern hygiene and aggressive public health campaigns had all but eradicated such feared scourges as tuberculosis, pneumonia, small pox, polio and measles. We seemed to be on the way to a disease-free world. Today, however, some terrible things have shaken our complacency. Antibiotic-resistant bacteria and new infectious enemies, such as AIDS, Avian Flu and Swine Flu, have appeared and some old ones, particularly tuberculosis and pneumonia, have reemerged. Our microbial adversaries have shown us the vulnerability even of modern medicine. Humbled by our failure to conquer disease and decipher death, we should acknowledge our kinship with those who endured the fear and uncertainty that tuberculosis embodied in pre-twentieth century America.

One clear message delivered by vampirism, real as well as fictional, is that the human body is a double-edged sword, both life-giving and lethal. A human being who is fully alive and animated with a soul, or one who is dead and crumbling into dust, presents no extraordinary danger. But, within the framework of the vampire tradition, anything in between—the ambiguous corpse—is to be feared. Even people who knew nothing of death-causing germs understood that, if one lost enough blood, one died. So, if blood itself is not the life, it must contain the essence, soul, or spirit of life. This concept, termed  “vitalism,” was carried well into the nineteenth century by physicians who viewed blood as the “paramount humor.” Vampires, eager to obtain this conveyer of life, sought out its nearest source—their living relatives.

The magical power of blood is one of the two fundamental principles upon which the vampire concept rests. And if life was in the blood, its home was the heart. According to European and European-derived folklore, the heart’s blood is the brightest red, which explains why the bright red blood from a consumptive’s lung hemorrhages (freshly oxygenated) was seen as blood from the heart. Beliefs concerning the restorative powers of both blood and the heart are ancient. By eating the blood or heart of a slain person, one could acquire his life, soul, courage, power, or other such qualities. In our folklore, the heart of anything is its essence, its center, its soul. Indeed, the heart was long supposed to be not only the seat of passion—and by logical extension, love and courage—but the locus of life itself. It was thus horrifyingly unnatural to discover “fresh” blood in the heart of an exhumed corpse. People understood that blood coagulates following death, but they apparently did not know that blood can liquefy again, depending on the circumstances of death. That blood in its liquid state proclaims the presence of life goes back at least to the Greek conception of life as the ongoing  reduction of liquid inside a person.  A corpse that has decomposed is dry, indicating that death is complete and the corpse is inert. But a corpse that has not sufficiently dried—one with liquid blood still in the heart, say—would be viewed as incompletely dead. The remedy was to remove life’s liquid by burning the heart or the entire corpse, thus consummating the drying process. As long as a corpse was a fountain of life, it retained the potential to be an instrument of death.

The second fundamental principle of the vampire concept, the belief in life after death, raises some fundamental questions that transcend time and place and, therefore, speak to what it is to be human: What is death? When is a person truly dead? Can the dead interact with the living? What is the relationship between the impermanent and the eternal aspects of a human being? In the early nineteenth century, a definition of death as the point at which the heart and lungs cease to function, termed the “cardiopulmonary standard,” began to displace the long-standing belief that putrefaction (or decomposition) was the decisive sign of death. The older conception persisted into the beginning of the twentieth century, however, as a number of medical practitioners continued to voice misgivings about their ability to objectively determine death. Thus, strangely, both vampire hunters and medical practitioners in pre-twentieth-century America were in agreement that putrefaction was the key for distinguishing death from life.