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I took logic courses from a professor who happened to be an expert on history and philosophy of medicine. He had the interesting tidbit that nearly every cultur

I took logic courses from a professor who happened to be an expert on history and philosophy of medicine. He had the interesting tidbit that nearly every culture has had bloodletting in medicinal usage, even though it doesn't help health-- the reason is that the drop in blood pressure makes the patient feel a bit better initially, even though it harms them overall. That's what I remember from it anyways, that was over a decade ago.

scarby2 6y ago
It's amazing the amount of historical medicine that was either completely ineffective or actually harmful and hastened the demise of the patient.
- wahern 6y ago
  In 2018 a story about Anthony Mancinelli, the oldest living barber, made the rounds. https://www.nytimes.com/2018/10/07/nyregion/worlds-oldest-barber-anthony-mancinelli.html https://www.nytimes.com/2018/10/07/nyregion/worlds-oldest-ba... When he first began barbering he had to learn how to apply leeches and (AFAICT) cupping. (Mancinelli died last year: https://www.nytimes.com/2019/09/26/nyregion/anthony-mancinelli-dead.html https://www.nytimes.com/2019/09/26/nyregion/anthony-mancinel...) The use of leeches seems very fringe today, but here in California Kaiser Permanente insurance covers cupping. In my neighborhood there's a local acupuncturist that does Hijama, aka "wet cupping"[1], which is literally bloodletting. Though advertised as an Islamic technique such bloodletting was (is?) widely practiced the world over and his clientele seem to be similarly diverse. (Many Chinese and Russians in my neighborhood, among others.) As far as I understand, insurers are slowly embracing acupuncture, cupping, etc as a cheaper alternative to patients using valuable physician time. Also, AFAICT there's a subset of chiropractors that basically apply modern physical therapy techniques (providing a reverse placebo effect?), and so medical doctors seem to be increasingly comfortable referring patients to chiropractors. Though, the distinctions among different types of chiropractors aren't distinguished in the medical literature so the quack chiropractors (i.e. the ones who diagnose everything as a spinal disorder, do regular x-ray imaging, and charge hundreds of dollars for tapping a couple of vertebrae) seem to be benefiting from the improved legitimacy. [1] As opposed to regular cupping, which uses suction to break capillaries, bruising the skin.
- renewiltord 6y ago
  I believe we lacked the epistemological and statistical techniques to do good medicine until really late. In fact, computer science may precede modern medicine. It's a close thing, in either case.
- InfiniteRand 6y ago
  I think part of the reason these techniques persisted for so long is to some degree the harmful effects can be mitigated by an expert carefully adjusting things to the patient’s needs. Of course the careful ad hoc adjustments and countermeasures were rarely written down and depended heavily on the expert’s honed intuitions. And people with less talent and knowledge inevitably tried to follow the incomplete instructions. This meant you had just enough cases of real success to justify the existence of doctors even though the value of an average medical expert historically was questionable (with the probable exception of nursing care which usually did less active harm). That’s just my theory anyway
gridlockd 6y ago
This is a dubious explanation, considering that high blood pressure by itself is largely symptom-free. Consider that if bloodletting had benefits, we would be unlikely to find out about it in our system.

scarby2 6y ago

It's amazing the amount of historical medicine that was either completely ineffective or actually harmful and hastened the demise of the patient.

wahern 6y ago
In 2018 a story about Anthony Mancinelli, the oldest living barber, made the rounds. https://www.nytimes.com/2018/10/07/nyregion/worlds-oldest-barber-anthony-mancinelli.html https://www.nytimes.com/2018/10/07/nyregion/worlds-oldest-ba... When he first began barbering he had to learn how to apply leeches and (AFAICT) cupping. (Mancinelli died last year: https://www.nytimes.com/2019/09/26/nyregion/anthony-mancinelli-dead.html https://www.nytimes.com/2019/09/26/nyregion/anthony-mancinel...) The use of leeches seems very fringe today, but here in California Kaiser Permanente insurance covers cupping. In my neighborhood there's a local acupuncturist that does Hijama, aka "wet cupping"[1], which is literally bloodletting. Though advertised as an Islamic technique such bloodletting was (is?) widely practiced the world over and his clientele seem to be similarly diverse. (Many Chinese and Russians in my neighborhood, among others.) As far as I understand, insurers are slowly embracing acupuncture, cupping, etc as a cheaper alternative to patients using valuable physician time. Also, AFAICT there's a subset of chiropractors that basically apply modern physical therapy techniques (providing a reverse placebo effect?), and so medical doctors seem to be increasingly comfortable referring patients to chiropractors. Though, the distinctions among different types of chiropractors aren't distinguished in the medical literature so the quack chiropractors (i.e. the ones who diagnose everything as a spinal disorder, do regular x-ray imaging, and charge hundreds of dollars for tapping a couple of vertebrae) seem to be benefiting from the improved legitimacy. [1] As opposed to regular cupping, which uses suction to break capillaries, bruising the skin.
renewiltord 6y ago
I believe we lacked the epistemological and statistical techniques to do good medicine until really late. In fact, computer science may precede modern medicine. It's a close thing, in either case.
InfiniteRand 6y ago
I think part of the reason these techniques persisted for so long is to some degree the harmful effects can be mitigated by an expert carefully adjusting things to the patient’s needs. Of course the careful ad hoc adjustments and countermeasures were rarely written down and depended heavily on the expert’s honed intuitions. And people with less talent and knowledge inevitably tried to follow the incomplete instructions. This meant you had just enough cases of real success to justify the existence of doctors even though the value of an average medical expert historically was questionable (with the probable exception of nursing care which usually did less active harm). That’s just my theory anyway

gridlockd 6y ago

This is a dubious explanation, considering that high blood pressure by itself is largely symptom-free. Consider that if bloodletting had benefits, we would be unlikely to find out about it in our system.