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Blockchain has come a long way: a system that was initially proposed specifically for cryptocurrencies is now being adapted and adopted as a general-purpose transactional system. As blockchain evolves into another data management system, the natural question is how it compares against distributed database systems. Existing works on this comparison focus on high-level properties, such as security and throughput. They stop short of showing how the underlying design choices contribute to the overall differences. Our work fills this important gap and provides a principled framework for analyzing the emerging trend of blockchain-database fusion. We perform a twin study of blockchains and distributed database systems as two types of transactional systems. We propose a taxonomy that illustrates the dichotomy across four dimensions, namely replication, concurrency, storage, and sharding. Within each dimension, we discuss how the design choices are driven by two goals: security for blockchains, and performance for distributed databases. To expose the impact of different design choices on the overall performance, we conduct an in-depth performance analysis of two blockchains, namely Quorum and Hyperledger Fabric, and two distributed databases, namely TiDB, and etcd. Lastly, we propose a framework for back-of-the-envelope performance forecast of blockchain-database hybrids.