Diagnosing Dracula’s Renfield: Sanguine

Dr Seward described his strange patient Renfield as ‘sanguine’ – but what did he mean?

Lavater Sanguine
Lavater: Sanguine Physiognomy Wellcome Collection

‘Sanguine’ was the name of the ancient medical ‘humour’ supposedly related to an excess of blood. The associated temperament was active and cheerful, while the appearance or ‘physiognomy’ was as above.

Now Renfield was not always cheerful, although he could be, but he was certainly keen on consuming blood to maintain his liveliness.

Looking through the old Journals of Mental Science, it seems that when the doctors were describing one of their own brethren as ‘sanguine’ it meant ‘calmly optimistic’. When the term is used about a patient, it is usually someone with ‘General Paralysis of the Insane (GPI), presumably because of ‘grandiose delusions’.

Diagnosing Dracula’s Renfield: Lunacy

Hogarth’s Rakewell ends up in Bethlem

‘Lunacy’ was a term the medico-psychologists of the late nineteenth century were trying to change, as their studies seemed not to indicate an effect of the moon. The public, however, were not receptive. Dr Seward of ‘Dracula’ thought that somehow his pet patient Renfield was affected, although in a different way.

Three nights has the same thing happened, violent all day then quiet from moonrise to sunrise.

Seward did not realise at first that a vampire was involved…

Tom Rakewell, of Hogarth’s painting series ‘The Rake’s Progress’, had had too much nightlife (judging from his sinisterly syphilitic acquaintances) and his ensuing lunacy was thus probably General Paralysis of the Insane (GPI).


Childish Psychiatry Horror, 5. Pauline

Pauline Picture1

Another terrible tale from Dr Hoffmann’s ‘Struwwelpeter’. And again Pauline (aka Harriet) disobeys, lights a match, and manages to set fire to herself.

Then how the pussy-cats did mew
What else, poor pussies, could they do?
They screamed for help, ’twas all in vain,
So then, they said, “We’ll scream again.
Make haste, make haste! me-ow! me-o!
She’ll burn to death,- we told her so.”

So she was burnt with all her clothes,
And arms and hands, and eyes and nose;
Till she had nothing more to lose
Except her little scarlet shoes;
And nothing else but these was found
Among her ashes on the ground.

fire4 D4D

A fiery blaze does not occur in the Dracula novel, apart from the Vampires’ eyes – but in the films it can be a wonderful effect as the horror director Roger Corman knew.

Childish Psychiatry Horror, 4. Conrad.


Conrad Suck-a-Thumb

Dear Readers, this maternal approach is certainly going to give Conrad a COMPLEX, and these days would be strongly advised against. Indeed the whole of ‘Struwwelpeter’ should be approached with extreme caution.

Needless to say the very word ‘not’ has the opposite of the desired effect, and the thumb goes in as soon as Mamma has turned her back. I fear this time I cannot spare you the consequences…

The door flew open, in he ran,
The great, long, red-legged scissorman.
Oh! children, see! the tailor’s come
And caught our little Suck-a-Thumb.

Snip! Snap! Snip! the scissors go;
And Conrad cries out – Oh! Oh! Oh!
Snip! Snap! Snip! They go so fast;
That both his thumbs are off at last.
Mamma comes home; there Conrad stands,
And looks quite sad, and shows his hands;-
“Ah!” said Mamma “I knew he’d come
To naughty little Suck-a-Thumb.

Childish Psychiatry Horror, 3. Philip

Fid Phil pic

We all know this little horror, who these days might be prescribed medication for his Attention Deficit/Hyperactivity Disorder. He does not, of course obey his kindly Pappa’s instructions and continues:

See the naughty, restless child,
Growing still more rude and wild ,
Till his chair falls over quite.
Philip screams with all his might,
Catches at the cloth, but then
That makes matters worse again.

For the final and literal denouement, see https://germanstories.vcu.edu/struwwel/philippe.html

Childish Psychiatry Horror, 1. Frederick

Cruel Frederick pic

The author of this horrid warning rhyme was Heinrich Hoffmann, a German psychiatrist, in his book ‘Struwwelpeter’, published in 1845, and written to entertain his little son.

This sort of animal cruelty has been attributed to the lunatic Renfield in ‘Dracula’, but I think he had different motives. On the other hand, the real life ‘Jack the Ripper’ may have had such a childhood background according to Dr George Savage  writing on  ‘Homicidal Insanity’ for The Fortnightly Review in 1881.

I have known such children kick cats and dogs to death, or set light to them, or pour boiling water over them, the fiendish pleasure being increased if the young of the animals were thus reduced to starvation. The morally undeveloped child has been pointed out to me by several devout friends as a proof of the existence of the devil.

Savage and other ‘medico-psychologists’ of his time regarded this as a type of ‘moral insanity’, which is perhaps more apt than the modern ‘conduct disorder’ or, in adulthood, ‘severe antisocial personality disorder’ or ‘psychopathy’.


‘Dracula for Doctors’ out for Halloween

D4D pic png2

At last, the moment we have all been waiting for – the publication of my book ‘Dracula for Doctors’, cleverly timed by Cambridge University Press for 31st October, Halloween. Many thanks to all my patient friends, colleagues and family members.

And more secrets will no doubt be unearthed by delving further into libraries of old books, especially those of the Royal College of Psychiatrists, the Wellcome and the London Library, where Bram Stoker did some of his own research.