Semin Thromb Hemost
DOI: 10.1055/s-0041-1732469
Letter to the Editor

Why “the Love of Blood” in Hemophilia?

Jecko Thachil
1  Department of Haematology, Manchester University Hospitals, Manchester, United Kingdom
Margarita Triantafillou
1  Department of Haematology, Manchester University Hospitals, Manchester, United Kingdom
Sotirios Bristogiannis
1  Department of Haematology, Manchester University Hospitals, Manchester, United Kingdom
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It is widely assumed that the word hemophilia is derived from the two Greek words, “hema” meaning “blood” and “philia” meaning “the love of.” However, hemophilia treaters and persons with hemophilia might have often wondered how “love of blood” could stand for the increased tendency to bleed in this hereditary condition. What made the Greeks choose hemophilia when naming this bleeding disorder? Or did they name it at all?

Although symptoms associated with hemophilia have been known for centuries, most experts refer to the 19th century as the period when it was described as a separate disease entity.[1] [2] [3] In the first decade of the 1800s, the American physician, John Conrad Otto published his observations of two families, the Smith family from Plymouth neighborhood and the Benjamin Benney family from Maryland, who presented with bleeding symptoms.[4] He noticed the females in these families transmitted the hemorrhagic disease while the males were affected and he called these males “bleeders.” As might happen with any new disease, several names were proposed to describe it. In the older French books of the time, hemophilia was called as diathese hemorrhagique (hemorrhagic diathesis), hemorrhagie constitutionnelle (constitutional hemorrhage), and purpura constitutionnelle (constitutional purpura).[5] The patients themselves were called hommes saignants (bleeding males) similar to the “bleeders” terminology of Otto. The German choice of words for hemophilia were Bluterkrankheit (bleeder illness) commonly, and Blutsucht and Blutungssucht (blood addiction) less commonly, Bluter being the German translation of bleeder.[5] What is noticeable so far is the absence of descriptions of hemophilia in the 19th century Greek literature. Indeed, Greek dictionaries explain hemophilia as a Greek work constructed outside of Greece.[6]

Historical accounts credit a German physician, Friedrich Hopff, working in the first half of the 19th century as the inventor of the word “hemophilia.”[1] [2] [3] There was a sudden surge in interest in the study of bleeding disorders during this period, possibly because bleeding symptoms were noted in several members of the Royal family. The most celebrated physician of the time, Johann Lukas Schoenlein (his name is remembered in the bleeding disorder, Henoch Schoenlein purpura) was keen on a developing a classification system for pathological conditions according to their characteristics and symptoms.[7] He created the three classes—morphae, hematoses, and neuroses—which were subdivided into families, and further into groups similar to the classification schemes known in botany and zoology.[7] It is certainly possible that some of the patients included in the class of hematoses would have had hemophilia, although Schoenlein had a high disinterest in publishing his findings. He is said to have called the disease “hemorrhaphilia” (love of bleeding) in his Vorlesungen (lectures).[5] The word “hemophilia” was the apparent invention of Schoenlein's student, Friedrich Hopff, who used it in the title of his dissertation, “Über die Hämophilie oder die erbliche Anlage zu tödtlichen Blutungen” (“about hemophilia or the hereditary predisposition to fatal bleeding”).[5] Why may he have chosen this particular word? Did he have the hereditariness of the bleeding disorder in mind?

While using the Greek terminology, the exact spelling of “philia” makes a significant difference to the meaning. If spelt with a Greek iota as ϕιλία where the accent is on the penultimate syllable, it would mean affinity toward blood as “filia,” the ancient Greek word for friendship. However, if spelt with a Greek ypsilon as ϕυλή (fyli) where the accent is on the final syllable, this means race or tribe. Since the title of Hopff's dissertation included hereditary, it is possible that he was intending ϕυλή to indicate the “inheritedness” of hemophilia. Wickham Legg's treatise on haemophilia[5] gives a pointer to this possibility: “The etymology of the word seems to be plain αἷμα and ϕιλία. M. de Fleury, however, prefers to derive the name from ϕυλή, a race, or tribe, with reference, I suppose, to its hereditary character.”

We sought the assistance of a Greek linguist (acknowledged) for a possible explanation for Hopff's choice of the word “hemophilia.” He suggested an alternate meaning of the word “haima” to be “blood flow” rather than just blood. Thus, hemophilia would have possibly meant for Hopff, the “love of blood flow.” Did he choose “hemophilia” rather than “hemorrhophilia” as the title of his thesis because he wanted to distinguish himself from his eminent professor? Did he want to be more specific about the hereditary nature of the disorder? Do we wrongly assume that it stands for the love of blood instead of the love of blood flow?

In summary, due to a quirk of language, the word “hemophilia” has come to commonly mean “love of blood” when it may have instead denoted a hereditary tendency to bleeding or “the love of blood flow” at the baptismal font.


24. August 2021 (online)

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