Wang Hongcai China Academy of Chinese Medical Sciences
The Chinese are familiar with bloodletting therapy as it is part of acupuncture. In fact, bloodletting therapy is a part of world medicine. From a historical point of view, no matter how advanced medicine is today, the history of human medicine is basically a history of bloodletting therapy; no matter in which region medicine occurs, it has a common origin-bloodletting.
Bloodletting in Ancient Civilizations
Blood vessels are like rivers on the earth. The places where big rivers flow give birth to civilization and also originate medicine. Around 3500 BC, bloodletting therapy appeared in these places with "big" river civilizations at the same time.
In the hieroglyphic script written by ancient Egyptian doctors, there is content referring to using something like an arrow to let blood out to treat people. People in Mesopotamia believed that bloodletting could drive away demons. Indian medicine believes that human health is maintained by the balance of the three body fluids, qi, gallbladder, and phlegm. An imbalance between them will lead to blood disorders, so bloodletting is considered an effective method. In addition to using sharp tools to let blood, Indians also inherited the bloodletting method of leeches from Egypt and Shulia. After bloodletting therapy traveled from the Nile and Tigris rivers to ancient Greece and Rome, it gradually developed into a fashionable medicine.
who is the father of bloodletting
If you want to trace the ancestor of modern Western medicine, Hippocrates is undoubtedly the most famous name. In his view, disease is not a local phenomenon, but a disorder of the balance of blood, mucus, black bile, and yellow bile in the whole body. Methods such as bloodletting, purging, and diet adjustment can help the body heal naturally. This Western "father of medicine" has also become the originator of bloodletting therapy.
The popularity of bloodletting therapy in the West is also related to Galen, another great medical scientist. His achievements in anatomy, physiology, and therapeutics were unmatched before the 16th century. Galen advocated bloodletting, and in works such as "The Method of Healing", he clarified the view that bloodletting can be applied to almost any kind of disease, including bleeding and weakness. Bloodletting therapy is not only the preferred treatment for gout, arthritis, vertigo, epilepsy, depression, eye disease and other serious diseases, but also the main means of disease prevention. Galen was so enthusiastic about bloodletting that he recommended it twice a day under certain circumstances.
Phlebotomy Turns Barbers Into Surgeons
In 1163, Pope Alexander III introduced bloodletting therapy to the people, and barbershops became the main places for bloodletting therapy. The knife used by the barber and people's hot demand for bloodletting compose an interesting history of Western medicine-the development of surgery came out of the barber shop. The iconic figure was the 16th-century French barber Ambroise Paré, who was later hailed as the "father of surgeons".
Barbers have developed a complete set of bloodletting procedures and tools. The double-edged knife used in bloodletting therapy is called "Lancet". The famous British medical journal "Lancet" (Lancet) comes from the double-edged blade used in bloodletting. In the barber shop's red, blue and white striped columnar logo, red represents flowing arterial blood, blue represents flowing venous blood, and white represents bandages for hemostasis. This is a vivid advertisement for bloodletting therapy.
Doubts about bloodletting
As time went on, accidents caused by bloodletting therapy gradually made people question it.
On December 12, 1799, the 68-year-old first president of the United States, George Washington, came back from a horseback tour of the plantation. He felt a sore throat, and his condition worsened on the third day, with difficulty breathing. Washington believed in bloodletting, and so did his personal doctor. After several consecutive bloodlettings, Washington stopped breathing.
The doctor who bled Washington was a student of Benjamin Rush, the "father of medicine" in the United States. Benjamin created the American medical education system, and three-quarters of American doctors at that time were his students. Due to the thriving slave trade between Philadelphia and the West Indies, yellow fever frequently visited this port city in the 18th century. The epidemic of yellow fever in Philadelphia in 1794 and 1797 caused Benjamin, a phlebotomist, to suffer a lawsuit. At that time, hundreds of people lined up every day to wait for the massive bloodletting therapy performed by Benjamin. A British journalist named William Cobbett questioned this, followed up the incident and found that the patients treated by Benjamin had a higher mortality rate, so he published an article saying that Dr. Benjamin and his students were responsible for the human population. Reduction has made an outstanding contribution. Benjamin's authority was questioned, and he took the reporter to court. In the end, the law fined Cobbett a lot, but Benjamin was still a hero in the fight against infectious diseases.
Later, another British doctor named Alexander Hamilton took a more scientific approach to bloodletting. 366 sick soldiers were equally divided into 3 groups. One group of patients received bloodletting therapy, and the other 2 groups received other methods of treatment. The conditions of the 3 groups were basically the same. The results were: 2 and 4 patients died in the two groups without bloodletting, while 35 patients died in the group receiving bloodletting.
In the early 19th century, French physicians declared that bloodletting was completely ineffective in treating pneumonia and febrile diseases. In addition, Pierre Louis (Pierre Louis) also published his clinical observation of nearly 2,000 patients in 7 years, and found that bloodletting therapy significantly increased the mortality rate of patients. At this point, people began to shake their faith in bloodletting, but bloodletting was still popular in the 19th century and reached its peak. In 1833 alone, France imported 41.5 million leeches for bloodletting.
It was not until the appearance of a group of medical microbiologists such as Robert Koch that this therapy, which has been popular for thousands of years, finally faded out of the mainstream medical stage in Europe and America. Because, people have found a better way of antibacterial and anti-inflammatory. However, bloodletting did not die.
Does bloodletting really work?
In fact, as early as 1628, Harvey strongly questioned bloodletting. The tenacious vitality of bloodletting therapy mainly comes from its practical value. Although it has faded out of Western mainstream medicine, it is still active in the arena of complementary medicine, playing a role in certain diseases or certain needs.
Research on bloodletting therapy has confirmed that it can eliminate organ inflammation to a certain extent, lower body temperature, reduce the burden on the heart, and stimulate immunity. Those who completely deny bloodletting therapy are too extreme, and those who simply attribute the effect of bloodletting therapy to "emergency response" are also a bit superficial.
Alan Gurdon, a long-distance runner, suffered from fatigue and knee pain before preparing to participate in the "Cross-Sahara Desert Marathon". After a doctor's diagnosis, he was diagnosed as "hemochromatosis (Hemochromatosis)". The disease is caused by high levels of iron in the blood. Excess iron accumulates in the body, causing damage to joints and organs, and severe cases may cause death from heart failure. The easiest way to treat this disease is to periodically phlebotomy. Gordon is under the treatment of this method, the body has reached a new balance. In April 2006, he finished the "Desert Marathon".
There may be a "genetic" reason why Europeans have been superstitious about bloodletting for so long. About 1/8 Europeans carry the HFE gene (hereditary hemochromatosis candidate gene), and the proportion of pure Western Europeans is even as high as 25%. According to some statistics, there is one hemoglobin in about every 200 Europeans Mentally ill people. Further research also showed that the onset of hemochromatosis was later in women, and their monthly menstruation explained why their condition often didn't show up until after menopause.
The reason why people are unwilling to completely give up bloodletting is that, in addition to bloodletting can indeed resist some bacterial infections to a certain extent, and is helpful to improve blood viscosity and the speed of blood passing through capillaries, it is also helpful for some people with high blood pressure, surgery, etc. Post-heat etc. also play a role. However, for traditional Chinese medicine, changing the bloodletting by cutting the veins with a knife into pricking the collaterals with three-edged needles is a choice that seeks advantages and avoids disadvantages.
bloodletting and pricking
Influenced by different cultures, the development of medicine has gone in different ways. Western medicine Pope Galen believed that: blood is produced by the human body and is often "excessive"; bloodletting is suitable for any patient, including bleeding and weak patients. His views deeply influenced the style of Western bloodletting, calling the bloodletting by cutting along the veins "venous breathing". Chinese doctors believe that blood is very precious and cannot be released in large quantities or casually. Therefore, strictly speaking, bloodletting in acupuncture should be called "pricking". "Huangdi Neijing" says: "Those who pierce the collaterals, pierce the blood vessels of the small collaterals", "Wan Chen removes them, and the blood will come out", it can be seen that this is not exactly the same as Galen's point of view. Acupuncture is not only different from Western bloodletting in terms of blood loss, but also is carried out under the guidance of a complete set of meridian and acupoint theory and syndrome differentiation and treatment theory, with strict contraindications and indications.
Professor Sydnty Burwell, dean of Harvard Medical School, said to his students: "In 10 years, half of what you learn now will be proven wrong, and what's worse, we have no way of knowing which half is wrong. "The once mainstream medicine has faded out today. After many centuries, will people treat today's medicine the same way they treat bloodletting therapy.
