The resulting molecule has a prolonged therapeutic effect even after a single-dose administration and a lower risk of adverse effects associated with fluctuations of drug levels in blood.


The resulting molecule has a prolonged therapeutic effect even after a single-dose administration and a lower risk of adverse effects associated with fluctuations of drug levels in the blood.

Do these sentences mean the same, or does the second imply that some particular blood is being mentioned?

I wrote "in the blood", but another translator said he would write "in blood". The ngram is as follows:

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Would "in the blood" be understood as "in the blood of the patient who took the drug" and thus be for 99% of intents and purposes equal in meaning with option 1?

  • 5
    No particular person's blood or no particular blood is being referred to with the. With the article it is analogous to "this drug affects the heart". Both versions, with and without the article, are correct. – Tᴚoɯɐuo Mar 17 '17 at 17:33
  • 2
    When you're talking about the effects on a person or individuals, "the" indicates that. Leaving out "the" would typically be used for more abstract discussion, where you're talking more about the science than the individuals. Including "the" is appropriate in your example. – fixer1234 Mar 17 '17 at 20:02

I didn't want to offer an answer that just went by my subjective opinion given your specific question and purpose, so I looked around the Internet for any references or style guides for medicine or medical transcription.

The most relevant one I was able to find was this document about Using Articles in Medical Writing from the English Language Unit of the Health Sciences Centre in Kuwait. That document has the following recommendations when it comes to describing blood: Usage of 'blood' with the definite article

I think your usage would be the third case shown above - you'd need to have previously set the context that "blood" refers to the blood of a patient who has ingested a drug, and since that context has been set, you can thereafter refer to it as "the blood" to make it clear you're referring to this specific blood sample (and not anyone's blood in general).

Using "in blood" is more general in that it refers to a typical sample of blood and not a specific sample of blood. However since you're referring to a specific subject's blood sample, it would seem more appropriate to use "in the blood" (after having set the context, as explained above).

I trust this offers the clarity you're looking for.

As a general note to all, I found that the English Language Unit mentioned earlier provides useful English resources specific to medicine on grammar, vocabulary, etc.

  • 1
    Very good answer. Additional observations: If drug levels in blood were being differentiated from drug levels measured in other bodily fluids or tissues, you could leave out "the" (essentially sample a in the table). You could also argue that usage here is as described in b (blood as an organ), for which "the" still applies. – fixer1234 Mar 20 '17 at 19:46
  • @Phylyp: If you write the blood you also have to use the definite article everywhere else (drug levels, adverse effects, fluctuations), wouldn't you? Clearly those are all countable since they are plural. Please see my answer. – Hector von Mar 20 '17 at 20:54

This drug thins the blood.

The blood is understood to mean the liquid that flows through the circulatory system of animals as a feature or component of their physiology. The usage is analogous to

This drug affects the heart.

We're referring there to the organ that all animals have.

Unless the context explicitly refers to a specific individual and blood drawn from that individual, the definite article does not refer to a particular individual's blood, or to some blood in particular, but to blood in general, as the life-sustaining feature of animal physiology, comparable to an organ as element of physiology.

If we leave the definite article off, we're referring to the substance per se in general.

This drug thins blood.


It doesn't make much difference after all. After reading this sentence you will notice that the the brain doesn’t recognize the second the. (That's a well known joke). But still:

  1. "In blood" is an has an adverbial objective, like "in vitro" or "at home". I suggest to compare this to to go home.

  2. In @Phylyp's source, "The blood" is the subject in the nominative case, but in the question, blood is in the accusative case, so they are not directly comparable. Some languages even know the locative case.

Those two points seem to contradict each other I'm not really sure though, e.g.: the adverbial phrase "near the wall" would sound odd without article. The case might be indecisive, as English becoming an analytic language looses grammatical inflections. However, if you write the blood you also have to use the definite article everywhere else (drug levels, adverse effects, fluctuations)

Alone to decrease the word count I would not use any article there. I can only suggest to follow the advise of the editor, not only for grammatical reasons.

  • This answer is a bit abstract and I'm struggling to understand what it means. Any chance you could expand it with examples to illustrate the points and meanings? Thanks. (btw, not my downvote, so I don't know if it reflects disagreement or similar confusion.) – fixer1234 Mar 20 '17 at 21:17
  • "in vitro" is the perfect example. I struggle with the grammatical terms and especially the use of articles, though. – Hector von Mar 20 '17 at 21:58
  • I'm with fixer1234. I get the part about the adverbial objective, but don't quite grasp the rest of it. (PS - I too didn't downvote you, I wish they'd left a comment at least stating their reason). – Phylyp Mar 22 '17 at 8:08
  • I suppose the downvotes are because of contrarz evidence from the ngram in the question (or in question? :D). – Hector von Mar 22 '17 at 11:09
  • What is confusing? If it's the blood, it should be the drug levels, simply by analogy. Why wouldn't the drug level could be considered a phenomenon like the rising tides of the ocean? However, rising tides of sea water (uncountable) makes sense again. – Hector von Mar 22 '17 at 11:17

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