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"Bloodletting (or blood-letting) is the withdrawal of blood from a patient to cure or prevent illness and disease. Bloodletting was based on an ancient system o

"Bloodletting (or blood-letting) is the withdrawal of blood from a patient to cure or prevent illness and disease. Bloodletting was based on an ancient system of medicine in which blood and other bodily fluids were regarded as "humors" that had to remain in proper balance to maintain health." - Wikipedia I am pretty sure leeches are still used, they are highly effective for the reasons you describe, but bloodletting is a dangerous practice of trying to get rid of blood from the body to cure someone.

rz2k 11y ago
I'm pretty sure jcot is aware of the problemmatic theoretical foundations for historic bloodletting, and the attending reputation that persists. However the interesting part is that it could have therapeudic uses, but physicians are understandably adverse to performing a procedure considered typical of medieval quackery. Here's an excerpt from the BMJ: >Bloodletting was done by the barbers in England at the request of patients and must, therefore, have had some beneficial effect even if it was just a placebo effect. It is very possible, however, that there were very real benefits in selected patients especially those in left ventricular or congestive cardiac failure. In withdrawing blood the venular outflow pressure from capillaries and cardiac filling pressures would have been immediately reduced. The pressure gradient between capillary and interstitial fluid may have been decreased or even reversed if it was elevated(6,7). A reversal of the pressure gradient in oedematous patients would have promoted the mobilisation of oedema fluid and excretion in urine provided renal function was normal. Bloodletting would also have improved capillary blood flow, which can be severely disturbed in septic patients, by decreasing viscosity and improving the rheological chacteristics. >Repeated epsiodes of bloodletting will cause anaemia which is an independent risk factor for adverse outcome in patients with heart failure (8). As heart failure may cause anaemia by compromising the synthesis in the Krebs cycle of substrate needed for haemoglobin synthesis and blood formation in the bone marrow this risk might be a consequence of the heart failure rather than the cause. In adequately nourished and oxygenated bone marrow haemoglobin pools should be replenished by resynthesis unless the bloodletting was repeated too often. >In the short term bloodletting achieves what the venodilators glyceryl trinitrate and isosorbide mononitrate achieve, a reduction in venular outflow pressure in capillary beds. In patients with heart failure venodilators improve exercise performance and reduce mortality (9). Whilst ACE inhibitors, angiotensin II receptor agonists and beta blockers may also decrease mortality in patients in heart failure, partly or wholly by similar mechanisms, inotropes and beta agonists may increase mortality from heart failure. These medications have not been established to improve disability-adjusted or un-adjusted longevity. >Bloodletting might have been much more effective than venodilators and as effective as diuretics for in increasing th tone of the precapillary sphincters and establishing a pressure gradient between interstitium and capillary the excretion of oedema fluid would have been promoted. If in inducing a gastric intramucosal acidosis bloodletting were also to induce preconditioning by, for example, activating anf K(atp) channel, bloodletting might even have had extended benefits not seen with medical therapy. [1] I wouldn't agree that patients' requests meant that it must have been beneficial, since people willingly do all sorts of crazy things to their bodies based on the most tenuous new age theories. It also doesn't make sense that regular bloodletting would be beneficial to an already healthy subject, since we'd presumably have evolved with a mechanism to dispose of excess "bad humors". However, as an alternate mechanism for achieving results that treat a condition like congestive heart failure, it seems a lot like drilling a hole in your head to treat a head injury — ridiculous sounding, but effective in certain cases. [1] http://www.bmj.com/rapid-response/2011/10/29/treating-heart-failure-and-sepsis-bloodletting-and-leeches http://www.bmj.com/rapid-response/2011/10/29/treating-heart-...
- jessriedel 11y ago
  That article gives no hard evidence that bloodletting is actually beneficial for the treatment of anything, correct? Observing that some tiny subset of the many things treated with bloodletting can be helped by something that shares some things in common with bloodletting -- but with no evidence that even then the benefits are wouldn't still be swamped by the large negative effects of bloodletting -- is not impressive. Nor is pointing out that some current medications haven't been shown to be beneficial in some situations.
  - deleted 11y ago
    [deleted]
MrTonyD 11y ago
Just because Wikipedia says something doesn't make it true. Bloodletting was also practiced as part of Acupuncture in China - without any "humor" theory. Interestingly, when you talk to people who have actually practiced it (I was hanging out with Traditional Chinese Medical practitioners), you hear lots of stories about how effective it often is - even though it is frowned upon since it lacks any modern theory to explain why it often works. (I did recently read about how blood has been found to "group" based on characteristics. And Traditional Chinese Medicine uses various techniques to choose the location of bloodletting. There are lots of things to be discovered - or rediscovered.)
- splawn 11y ago
  Idk about bloodletting, but Acupuncture and most if not all of TCM in general is frowned upon not because it lacks modern theory on why it works. These things are frowned upon because evidence suggests its all placebo effect and not medicine.
  - MrTonyD 11y ago
    I guess you haven't read any of the studies of Acupuncture. The World Health Organization endorses Acupuncture, and there are decades of studies showing how Acupuncture is effective for particular problems. Some insurance companies even cover it. Similarly, it was just a few decades ago that it was illegal to practice Chiropractic, and many Chiropractors were imprisoned for practicing medicine without a license - but people slowly realized that it helps for some things. The same thing is true for Acupuncture.
    - splawn 11y ago
      I did say it had a placebo effect and yes placebos are "effective for particular problems". Other than that the science isn't as solid as you seem to think it is.. the same is true of chiropractic "medicine", homeopathy and vision quest duck rubbing. Here is a good overview: http://onlinelibrary.wiley.com/enhanced/doi/10.1111/j.1365-2796.2005.01584.x http://onlinelibrary.wiley.com/enhanced/doi/10.1111/j.1365-2...

rz2k 11y ago

I'm pretty sure jcot is aware of the problemmatic theoretical foundations for historic bloodletting, and the attending reputation that persists. However the interesting part is that it could have therapeudic uses, but physicians are understandably adverse to performing a procedure considered typical of medieval quackery. Here's an excerpt from the BMJ: >Bloodletting was done by the barbers in England at the request of patients and must, therefore, have had some beneficial effect even if it was just a placebo effect. It is very possible, however, that there were very real benefits in selected patients especially those in left ventricular or congestive cardiac failure. In withdrawing blood the venular outflow pressure from capillaries and cardiac filling pressures would have been immediately reduced. The pressure gradient between capillary and interstitial fluid may have been decreased or even reversed if it was elevated(6,7). A reversal of the pressure gradient in oedematous patients would have promoted the mobilisation of oedema fluid and excretion in urine provided renal function was normal. Bloodletting would also have improved capillary blood flow, which can be severely disturbed in septic patients, by decreasing viscosity and improving the rheological chacteristics. >Repeated epsiodes of bloodletting will cause anaemia which is an independent risk factor for adverse outcome in patients with heart failure (8). As heart failure may cause anaemia by compromising the synthesis in the Krebs cycle of substrate needed for haemoglobin synthesis and blood formation in the bone marrow this risk might be a consequence of the heart failure rather than the cause. In adequately nourished and oxygenated bone marrow haemoglobin pools should be replenished by resynthesis unless the bloodletting was repeated too often. >In the short term bloodletting achieves what the venodilators glyceryl trinitrate and isosorbide mononitrate achieve, a reduction in venular outflow pressure in capillary beds. In patients with heart failure venodilators improve exercise performance and reduce mortality (9). Whilst ACE inhibitors, angiotensin II receptor agonists and beta blockers may also decrease mortality in patients in heart failure, partly or wholly by similar mechanisms, inotropes and beta agonists may increase mortality from heart failure. These medications have not been established to improve disability-adjusted or un-adjusted longevity. >Bloodletting might have been much more effective than venodilators and as effective as diuretics for in increasing th tone of the precapillary sphincters and establishing a pressure gradient between interstitium and capillary the excretion of oedema fluid would have been promoted. If in inducing a gastric intramucosal acidosis bloodletting were also to induce preconditioning by, for example, activating anf K(atp) channel, bloodletting might even have had extended benefits not seen with medical therapy. [1] I wouldn't agree that patients' requests meant that it must have been beneficial, since people willingly do all sorts of crazy things to their bodies based on the most tenuous new age theories. It also doesn't make sense that regular bloodletting would be beneficial to an already healthy subject, since we'd presumably have evolved with a mechanism to dispose of excess "bad humors". However, as an alternate mechanism for achieving results that treat a condition like congestive heart failure, it seems a lot like drilling a hole in your head to treat a head injury — ridiculous sounding, but effective in certain cases. [1] http://www.bmj.com/rapid-response/2011/10/29/treating-heart-failure-and-sepsis-bloodletting-and-leeches http://www.bmj.com/rapid-response/2011/10/29/treating-heart-...

jessriedel 11y ago
That article gives no hard evidence that bloodletting is actually beneficial for the treatment of anything, correct? Observing that some tiny subset of the many things treated with bloodletting can be helped by something that shares some things in common with bloodletting -- but with no evidence that even then the benefits are wouldn't still be swamped by the large negative effects of bloodletting -- is not impressive. Nor is pointing out that some current medications haven't been shown to be beneficial in some situations.
- deleted 11y ago
  [deleted]

MrTonyD 11y ago

Just because Wikipedia says something doesn't make it true. Bloodletting was also practiced as part of Acupuncture in China - without any "humor" theory. Interestingly, when you talk to people who have actually practiced it (I was hanging out with Traditional Chinese Medical practitioners), you hear lots of stories about how effective it often is - even though it is frowned upon since it lacks any modern theory to explain why it often works. (I did recently read about how blood has been found to "group" based on characteristics. And Traditional Chinese Medicine uses various techniques to choose the location of bloodletting. There are lots of things to be discovered - or rediscovered.)

splawn 11y ago
Idk about bloodletting, but Acupuncture and most if not all of TCM in general is frowned upon not because it lacks modern theory on why it works. These things are frowned upon because evidence suggests its all placebo effect and not medicine.
- MrTonyD 11y ago
  I guess you haven't read any of the studies of Acupuncture. The World Health Organization endorses Acupuncture, and there are decades of studies showing how Acupuncture is effective for particular problems. Some insurance companies even cover it. Similarly, it was just a few decades ago that it was illegal to practice Chiropractic, and many Chiropractors were imprisoned for practicing medicine without a license - but people slowly realized that it helps for some things. The same thing is true for Acupuncture.
  - splawn 11y ago
    I did say it had a placebo effect and yes placebos are "effective for particular problems". Other than that the science isn't as solid as you seem to think it is.. the same is true of chiropractic "medicine", homeopathy and vision quest duck rubbing. Here is a good overview: http://onlinelibrary.wiley.com/enhanced/doi/10.1111/j.1365-2796.2005.01584.x http://onlinelibrary.wiley.com/enhanced/doi/10.1111/j.1365-2...