Cutting-edge science and long-pondered questions explained in plain English. Bad science gutted. Great science extolled.

Friday, November 14, 2008

Bleed a Cold, Purge a Fever

The medical community is sluggish to embrace new, even well-supported, therapies that are at odds with established medical dogma.

In addition to the outright hostility that the discoverers of H. pylori experienced, other examples of medical foot-dragging abound.

In fact, speaking of slugs, leeches come to mind.

Dr. V. Dracula, M.D.

One historical case of this provincial reluctance involves the practice of bleeding sick people to cure disease. Various methods of exsanguinations were utilized to withdraw blood from the body, from leeches to deep cuts to shallow lacerations with vacuum to draw the blood from the body.

Bloodletting was practiced in ancient times. The practice is a sordid mimicry of menstruation, as Hippocrates noted that women seemed overcome with bad humours, perhaps referring to hormonal mood swings but more likely a reference to headache, cramps, and bloating. The bleeding of menstruation relieved the symptoms.

Thus, the theory of therapeutic bleeding extended by analogy the idea that excess blood causes disease, and removing excess blood must cure disease.

Bloodletting, medical purges (induced vomiting,) rigorous enemas, and fasting with restriction of fluids were primary medical interventions for millennia.

Patients were often bled to the point where they fainted from blood loss, as that was thought to be the natural endpoint of the therapy. Before an amputation, doctors generally removed a quantity of blood equal to the volume of the limb to be amputated, lest the person be burdened with an excess of blood afterward. Then they cut off the limb.

“Absurde”

In 1835, Pierre Charles Alexandre Louis wrote a scathing polemic on bloodletting to treat disease (Récherches sur les Effets de la Saignée), which conclusively proved that far from benefiting patients, this fashionable, standard procedure harmed and sometimes killed them.

Louis studied 78 patients with pneumonia and noted that bloodletting in the first two days doubled the risk of death.
Louis was astonished by his own results and found his conclusion frightening and absurd on its face: “R´esultat effrayant, absurde en apparence.”

Doctors, however, refused to believe Louis’s methodically researched results, and therapeutic bloodletting persisted nearly a century into the early 1900’s.

Modern Day Bleeding

Surely, you think, such ineffective medical interventions are far behind us. Surely, all medicine is now evidence-based. If a doctor gives me a drug, it will work.

Nope. I’ll explore that more in my next post.

TK Kenyon
Author of RABID: A Novel, a novel of autoexperimentation, unwitting guinea pigs, and green-glowing rabies virus, and CALLOUS: A Novel, a story about free will, neuroscience, fate, the nature of memory, and the End of Days.