The possible effects of iron loss from bloodletting on mortality from pneumonia in the nineteenth century

OBJECTIVE

To estimate iron losses and disease severity following 19th century bloodletting in patients with pneumonia.

STUDY DESIGN AND SETTING

Benefits of bloodletting in pneumonia patients were contested during the 19th century. Although large blood volumes during infection were removed there was no systematic data collection assessing efficacy and knowledge of iron composition of blood was rudimentary. This observational analysis of historical data quantifies iron losses in pneumonia cases in relation to disease severity.

RESULTS

Based on one detailed case series average blood volume removed for survivors was 830 mL (range 114-2272 mL), and mean recovery times were shorter in patients bled within 2 days of illness (P < 0.001). Average iron removed was 446 mg with phlebotomy done ≤2 days of illness presentation and 347 mg after >2 days of illness (P = 0.012). Across several European hospitals average case fatality in pneumonia patients receiving phlebotomy was higher than in those treated without phlebotomy (19.9% vs. 12.8%, OR 1.55, 95% CI 1.38-1.74, P < 0.001).

CONCLUSION

Variable efficacy for bloodletting could at least in part be explained by altered iron status.

Efficacy and safety of bloodletting for herpes zoster: A protocol for systematic review and meta-analysis

BACKGROUND

The study aims to evaluate the effectiveness and safety of bloodletting therapy for herpes zoster.

METHODS

The following electronic databases will be searched from PubMed (1966 to March 2020), the Cochrane Central Register of Controlled Trials (update to March 2020), EMBASE (1980 to March 2020), China National Knowledge Infrastructure (1979 to March 2020), Wan Fang Data (1980 to March 2020), Chinese Scientific Journal Database (1989 to March 2020), Chinese Biomedical Database (1978 to March 2020) and traditional Chinese medicine Literature Analysis and Retrieval Database (1949 to March 2020). All randomized controlled trials without any limitation of blinding or publication language about this topic will be included, exclude cohort studies and case reports. Two independent researchers will operate article retrieval, duplication removing, screening, quality evaluation, and data analyses by Review Manager (V.5.3.5). Meta-analyses, subgroup analysis, and/or descriptive analysis will be performed based on the included data conditions.

RESULTS

High-quality synthesis and/or descriptive analysis of current evidence will be provided from cure rate, converting to clinical diagnosis rate, and side effects of bloodletting.

CONCLUSION

This study will provide the evidence of whether bloodletting is an effective and safe intervention for herpes zoster.

PROSPERO REGISTRATION NUMBER

CRD42020171976.

Bloodletting at EX-HN6 as an adjunctive therapy to eye drops for stye: A meta-analysis

BACKGROUND

This study evaluated the effectiveness and safety of bloodletting (BL) at ear-apex (EX-HN6) as an adjunctive therapy to eye drops for stye.

METHODS

This study systematically searched electronic databases from inception to March 1, 2020 in PUBMED, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Full-text Database, and WanFang Database. All potential randomized controlled trials (RCTs) investigating the effectiveness and safety of BL at EX-HN6 as an adjunctive therapy to eye drops for stye were included in this study. Study quality of all included studies was assessed by Cochrane Risk of Bias Assessment Tool. RevMan 5.3 software was used for statistical analysis and meta-analysis performance.

RESULTS

A total of 11 RCTs, involving 1718 subjects, were included in this study. Results showed that BL at EX-HN6 as an adjunctive therapy to eye drops was superior to the eye drops alone in enhancing total effectiveness rate (risk ratio [RR] 1.21, 95% confidence intervals [CIs] [1.11, 1.32], I = 79%), and total cure rate (RR 1.28, 95% CIs [1.14, 1.43], I = 69%). After removing two studies, results of subgroup analysis still showed significant improvements in total effectiveness rate (RR 1.13, 95% CIs [1.08, 1.18], I = 0%), and total cure rate (RR 1.16, 95% CIs [1.08, 1.24], I = 0%). No data of adverse reactions was reported in primary trials, thus, this study did not analyze adverse reactions of BL at EX-HN6 as an adjunctive therapy to eye drops for stye.

CONCLUSION

BL at EX-HN6 as an adjunctive therapy to eye drops may benefit stye. However, high-quality RCTs addressing on this issue is still needed to warrant the findings of this study.

Bloodletting therapy for treating patients with chronic urticaria: A systematic review and meta-analysis protocol

BACKGROUND

Chronic urticaria is a common disease affecting patients' quality of life, and leading to substantial burden to both patients and society. Many trials have shown that bloodletting therapy is effective in treating chronic urticaria. There are currently no systematic reviews of bloodletting therapy for chronic urticaria. This protocol aims to present the methods used to assess the effectiveness and safety of bloodletting therapy for patients with chronic urticaria.

METHODS

The following databases will be searched from their inception: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Database (VIP database), and Wan-Fang Database. Clinical randomised controlled trials related to bloodletting therapy for treating chronic urticaria will be included, regardless of publication status and languages. Study selection, data collection, and quality assessment will be independently conducted by 2 researchers. For data synthesis, we will select either the fixed-effects or random-effects model according to heterogeneity assessment. Disease activity control will be assessed as the primary outcomes. Response rate, recurrence rate and adverse events will be evaluated as secondary outcomes. If it is appropriate for meta-analysis, RevMan V.5.3 statistical software will be used. Otherwise, a systematic narrative synthesis will be conducted. The results will be presented as risk ratio (RR) with 95% confidence intervals (CIs) for dichotomous data and weight mean difference (WMD) or standard mean difference (SMD) 95% CIs for continuous data.

DISSEMINATION AND ETHICS

The protocol of this systematic review will be disseminated in a peer-reviewed journal and presented at relevant conferences. It is not necessary for a formal ethical approval because the data are not individualised.

TRIAL REGISTRATION NUMBER

PROSPERO CRD42018111143.

[Coiling method combined with bloodletting from the corpus cavernosum for penile incarceration with a metal ring: A case report and literature review]

OBJECTIVE

To explore the treatment of penile incarceration with a metal ring.

METHODS

Based on our experience in the successful management of a case of penile incarceration with a metal ring by coiling and bloodletting from the corpus cavernosum, we reviewed the relevant literature and analyzed the indications, advantages and disadvantages of different methods for the treatment of penile incarceration with a circular foreign body.

RESULTS

The clamping and cutting methods were non-invasive, fast, effective, and with few complications, which could be applied to the treatment of penile strangulation at all levels. However, clamping was not desirable enough for a hard metal ring and the cutting method took a longer time and might increase the risk of unnecessary damage to the penile skin, urethra and cavernous body. Prepuce edema decompression and the thin tube-coiling method, with the advantages of minimal invasiveness, simple operation and no need of special tools, were suitable for penile strangulation injury under level 3, but might cause penile skin injury and potential postoperative erectile dysfunction. Surgical resection, as an invasive procedure, could be applied to severe penile strangulation at level 4 or 5.

CONCLUSIONS

The principle for the treatment of penile incarceration with a circular foreign body is to remove the foreign object as soon as possible and not to add secondary damage.

[Treatment by bloodletting in the past and present]

INTRODUCTION

Therapeutic bloodletting has been practiced at least 3000 years as one of the most frequent methods of treatment in general, whose value was not questioned until the 19th century, when it was gradually abandoned in Western medicine, while it is still practiced in Arabic and traditional Chinese medicine.

CONTENT

In modern medicine bloodletting is practiced for very few indications. Its concept was modeled on the process of menstrual bleeding, for which it was believed to"purge women of bad humours. "Thus, bloodletting was based more on the belief that it helps in the reestablishment of proper balance of body "humours" than on the opinion that it serves to remove excessive amount of blood as well as to remove toxic "pneumas" that accumulate in human body. It was indicated for almost all known diseases, even in the presence of severe anemia. Bloodletting was carried out by scarification with cupping, by phlebotomies (venesections), rarely by arteriotomies, using specific instruments called lancets, as well as leeches. In different periods of history bloodletting was practiced by priests, doctors, barbers, and even by amateurs. In most cases, between one half of liter and two liters of blood used to be removed. Bloodletting was harmful to vast majority of patients and in some of them it is believed that it was either fatal or that it strongly contributed to such outcome. In the 20th century in the "Western"medicine bloodletting was still practiced in the treatment of hypertension and in severe cardiac insufficiency and pulmonary edema, but these indications were later abandoned.

CONCLUSION

Bloodletting is still indicated for a few indications such as polycythemia, haemochromatosis, and porphyria cutanea tarda, while leeches are still used in plastic surgery, replantation and other reconstructive surgery, and very rarely for other specific indications.

Wet-cupping removes oxidants and decreases oxidative stress

OBJECTIVES

Wet-cupping therapy is one of the oldest known medical techniques. Although it is widely used in various conditions such as acute\chronic inflammation, infectious diseases, and immune system disorders, its mechanism of action is not fully known. In this study, we investigated the oxidative status as the first step to elucidate possible mechanisms of action of wet cupping.

MATERIAL AND METHODS

Wet cupping therapy is implemented to 31 healthy volunteers. Venous blood samples and Wet cupping blood samples were taken concurrently. Serum nitricoxide, malondialdehyde levels and activity of superoxide dismutase and myeloperoxidase were measured spectrophotometrically.

RESULTS

Wet cupping blood had higher activity of myeloperoxidase, lower activity of superoxide dismutase, higher levels of malondialdehyde and nitricoxide compared to the venous blood.

CONCLUSION

Wet cupping removes oxidants and decreases oxidative stress.

[Research of bleeding volume and method in blood-letting acupuncture therapy based on data mining]

Through computer-based technology and data mining method, with treatment in cases of bloodletting acupuncture therapy in collected literature as sample data, the association rule in data mining was applied. According to self-built database platform, the data was input, arranged and summarized, and eventually required data was acquired to perform the data mining of bleeding volume and method in blood-letting acupuncture therapy, which summarized its application rules and clinical values to provide better guide for clinical practice. There were 9 kinds of blood-letting tools in the literature, in which the frequency of three-edge needle was the highest, accounting for 84.4% (1239/1468). The bleeding volume was classified into six levels, in which less volume (less than 0.1 mL) had the highest frequency (401 times). According to the results of the data mining, blood-letting acupuncture therapy was widely applied in clinical practice of acupuncture, in which use of three-edge needle and less volume (less than 0.1 mL) of blood were the most common, however, there was no central tendency in general.

[Analysis of the medicinal leech effects on the state of arterial functions of aged probationers, using hardwarily software system "Angioscan-01"]

The state of elderly patients arterial wall after the putting of one medicinal leech was estimated by use hardwarily software system "Angioscan-01". There was compared the effect of one medicinal leech on indicators of vasomotor function of endothelium of small resistance arteries and of middle arteries of muscular type. Stickiness index and augmentation index were determined in order to evaluate the medicinal leech effect on the rigidity state of arterial wall. It is shown that the putting of one leech stimulates the improving of endothelium vasomotor function and of normalization arterial wall stickiness. It is supposed the participation in this process the secretion of the medicinal leech salivary cells, which, as has been shown recently, is able to activate e-NOS and n-NOS in human endothelium culture (HUVEC) and increase NO level. Elevation of share stress during occlusion test is also stimulated NO production in vascular endothelium.

[Exploration on the application characteristics of bloodletting therapy for the diseases relevant with soft tissue infection by data mining technology]

OBJECTIVE

Using the data mining technology to analyze the application law of bloodletting therapy for the diseases relevant with soft tissue infection and explore the effect specificity of bloodletting therapy.

METHODS

The variety of diseases treated with bloodletting therapy was taken as the sample data by collecting the reports from the periodical literatures. The network database of bloodletting literature was set up. The association rule of data mining technology was adopted to extract the information on the diseases relevant with soft tissue infection in the periodical literatures. The frequency item of the superiority disease category was calculated. And the deep mining was done in terms of the needle device, point selection and the bleeding amount separately. The application law of bloodletting therapy was summarized in the treatment of the diseases relevant with soft tissue infection.

RESULTS

Fourteen kinds of relevant diseases of soft tissue infection treated with bloodletting therapy were included in the contemporary periodical literatures, of which, the reported case number and the reporting frequency were the highest for hordeolum and breast abscess. The three-edged needle was used the most frequently in the manipulation. The acupoints selected were the local Ashi points, combined with the symptomatic acupoints. The bleeding amount was not normalized by the ideas of different physicians.

CONCLUSION

The bloodletting therapy achieves the better curative effect on some diseases relevant with soft tissue infection and this therapy deserves to be further promoted in clinical practice.

[Discussions on history of the bloodletting therapy overseas]

To introduce the origin, development and theoretical source of the bloodletting therapy overseas. The bloodletting therapy, which was based on Hippocrates's four fluid theories, had the therapeutical effect and therefor spread abroad. Many people not only thought this therapy was benefit, but also let out blood regularly. During the medieval Europ, the bloodletting therapy reached its top, which was caused by the part-time job of barber. It was questioned when spreading in the America. After that, as the development of the other medical method, the disadvantage was exposed. With several clinical mistherapies, it faded away from the stage of history. The recent research shows that the normative bloodletting therapy could treat some diseases.

[Comparative study of bloodletting therapy between traditional Chinese medicine and Tibetan medicine]

The comparative study of bloodletting therapy between traditional Chinese medicine and Tibetan medicine in view of history development, theoretic basis, bloodletting location, bloodletting tool, operation method, bloodletting amount, indications, contraindications and the others are conducted in this paper. It is pointed out that the bloodletting therapy could be better carried forward and developed through the interaction and integration of bloodletting therapy between traditional Chinese medicine and Tibetan medicine in term of the theoretic, practical and development patterns under the guidance of these two different medical theoretical systems.

[Reinforcing and reducing method of bloodletting therapy]

Through review and analysis on description of bloodletting therapy in ancient medical classics, it is found that bloodletting therapy can be classified as two categories of reinforcing and reducing. And the classification is related with many factors such as the quantity of blood, apparatus selected, depth of acupuncture, points selected and physical conditions, etc. Bloodletting therapy is not confined only in excessive syndromes, it is also applied to the treatment of complicated syndrome of excess and deficiency as well as deficiency syndrome with excessive manifestations and deficiency syndrome.

A randomized controlled trial of a multifaceted integrated complementary-alternative therapy for chronic herpes zoster-related pain

INTRODUCTION

Our objective was to determine whether a three-week complementary and alternative medicine (CAM) approach integrating several therapies from Traditional Chinese Medicine (TCM) along with neural therapy (injection of 1% procaine as local anesthesia) reduces the level of unresolved pain associated with herpes zoster.

METHODS

The design was a randomized controlled clinical trial in a community-based primary care clinic in Toronto, Ontario. We studied individuals 18 years of age and older with a confirmed diagnosis of herpes zoster of at least 30 days duration and with at least moderate postherpetic neuralgia pain (≥4) on a 10-point Likert scale. The CAM therapies used were acupuncture, neural therapy (1% procaine injection as a local anesthetic), cupping and bleeding, and TCM herbs. An immediate treatment group (n=32) received the CAM intervention once daily, five days per week, for three weeks. A wait-list (delayed treatment) group (n=27) was used as a control and received the same treatment starting three weeks after randomization. This three-week time period, when one group was receiving active CAM treatment and the other was not, was used as basis of comparison for treatment effects between groups. Pain, quality of life, and depression were measured at baseline, and three, six, and nine weeks post-randomization. Patients were followed for up to two years.

RESULTS

Participants had a mean age of 69.8 years (SD=11.1) and had had herpes zoster-related pain for a median of 4.8 months (range: 1 month to 15 years). The immediate treatment and control groups had similar pain levels at baseline (treatment = 7.5; control = 7.8; p=0.5; scores based on the 10-point Likert pain scale). At three weeks post-randomization (i.e., after the immediate treatment group completed treatment) pain scores differed significantly (treatment = 2.3; control = 7.2; p<0.001). The observed reduction in pain in the immediate treatment group was maintained at nine weeks and at long-term follow-up (one to two years later). The delayed treatment (control) group also had significant reductions in pain after their integrated CAM treatment was completed.

CONCLUSION

The described CAM protocol was associated with significantly reduced sub-acute and chronic post-herpes zoster neuralgia pain within three weeks of initiating treatment. Improvements persisted for up to two years.

[Blood letting by cupping--a "medical" vignette]

This is a report on a "clinic" in northern Israel, in which a considerable number of people are treated by bloodletting. The authors witnessed the procedures of cupping various areas of the body and puncturing them by needles. The person in charge, who does not have any medical education or Licensing, and a client were interviewed. This report aims to bring to the attention of the medical community a procedure that spreads within the framework of so-called alternative medicine.

[Discussion on collateral puncture therapy in Japan]

The history of collateral puncture therapy in Japan was traced, the current status and characteristics of collateral puncture therapy in Japan were introduced in this paper. Originated in China, the collateral puncture therapy in Japan combined Japanese knowledge of acupuncture with the theory and practice of bloodletting of Portugal Medicine and Netherlands Medicine. The discussion on the theory and technique of the collateral puncture therapy by Kudo Kunsei became the standard of the collateral puncture therapy in Japan in modern times. Based on this discussion, Tetuo Asami proposed a new theory of the collateral puncture therapy which improved the collateral puncture therapy in Japan. Currently, as a part of Japanese health care system, the collateral puncture therapy with Japanese characteristics is gradually accepted by the medical profession in Japan.

Working With Rather Than Against Macaques During Blood Collection

Training macaques to cooperate during blood collection is a practicable and safe alternative to the traditional procedure implying forced restraint. It takes a cumulative total of about 1 hr to train an adult female or adult male rhesus macaque successfully to present a leg voluntarily and accept venipuncture in the homecage. Cooperative animals do not show the significant cortisol response and defensive reactions that typically occur in animals who are forcibly restrained during this common procedure.

[Discussion on the suitable diseases and symptoms of bleeding therapy]

In order to explore the suitable diseases and symptoms treated by bleeding therapy so as to guide the clinical practice. The retrospective study of periodical literature series is used and all clinical literatures about bleeding therapy were searched in the China Journal Full Text Database in CNKI, the VIP Chinese Scientific Journals Full Text Database (CSJD), Wanfang Database, and the Chinese Bio-medical Literature Database, and the frequen cy of the literature and the total cases treated with bleeding therapy were statistically analyzed, and the principles and methods of clinical epidemiology and evidence-based medicine were used to classify and grade the literatures, and the diseases were classified according to the international statistical classification about diseases and related healthy problems (ICD10) issued by World Health Organization. As a result, 1149 effective literatures including 98,526 cases were searched out, which were involved in 18 major systems and 261 kinds of diseases. It is indicated that the bleeding therapy has lots of suitable diseases and symptoms and it is worth to be popularized. Particularly, this therapy has obvious advantages for treatment of herpes zoster, acne, hordeolum, cervical spondylosis, and oral ulcer.

Pregnancy in a woman with uncorrected tetralogy of fallot

Tetralogy of Fallot (ToF) is the most common form of cyanotic congenital heart disease after 1 year of age, with overall incidence approaching 10% of all congenital heart disease. Natural survival (i.e. without corrective procedure) into the fourth decade is extremely rare (only about 3%), but there is a tendency of increasing number of women with cyanotic congenital heart disease living 3 to 4 decades and are becoming pregnant. Because of significant physiology adaptation and changes, pregnancy and delivery process are troublesome for mostly unhealthy women, including those with uncorrected ToF. For ToF patients, it remains an important cause of maternal morbidity (62,5%), and even mortality (10%) and has significant effects on fetal outcome. Discussed below a case of pregnancy in a 28 year old woman with uncorrected ToF, was diagnosed to have pneumonia, ToF-class III-IV of New York Heart Association, secondary polycythemia caused by hypoxia, and uncompensated metabolic acidosis on 25th week pregnancy. Through delicate medical care, patient's condition improvement can be seen. Patient decided to continue the pregnancy. Without optimal either obstetrical or medical management, prognosis of pregnancy in patient with uncorrected ToF is poor.

[Effect of the amount of portal blood stasis removal on endotoxemia and liver function after liver transplantation]

OBJECTIVE

To investigate the influence of the amount of portal blood stasis removal on endotoxemia and liver function after liver transplantation.

METHODS

Forty-seven patients who received liver transplantation from February 2006 to November 2007 were divided into 2 groups according to the amount of portal blood stasis removal during operation: group A (n = 26) 50 ml and group B (n = 21) 200 ml of portal blood stasis removal respectively. The levels of plasma endotoxin, D-lactate, tumor necrosis factor-alpha, interleukin-6, liver function and blood coagulation were examined and analyzed.

RESULTS

Under the condition of no significant difference in sex, age, primary liver diseases and Child-pugh's classification, cold ischemic time, total operation and anhepatic time, operation methods, volume of blood loss and transfusion, and all preoperative observations. Most of observations showed the restoration of the patients in group B was better than that in group A. The plasma levels of endotoxin, D-lactate, tumor necrosis factor-alpha, interleukin-6, alanine aminotransferase, aspartate aminotransferase, prothrombin time and activated partial thromboplastin time in group B were significantly lower than those in group A (P < 0.05). The level of plasma prealbumin in group B was significantly higher than that in group A (P < 0.05).

CONCLUSIONS

The removal of 200 ml portal blood stasis leads to a better results than that of 50 ml, and it can help alleviate endotoxemia and facilitate the restoration of the liver function after liver transplantation.

The effect of wet cupping on serum lipid concentrations of clinically healthy young men: a randomized controlled trial

OBJECTIVE

The aim of this study was to determine if a reduction in serum lipoproteins, especially LDL cholesterol, is a preventive approach against atherosclerosis. Phlebotomy has been a recommended method to reduce serum lipoprotein levels. The present study was conducted to investigate the effects of wet cupping on serum lipoprotein concentrations.

SUBJECTS AND METHODS

In this randomized controlled trial, 47 men (18 to 25 years old), without chronic disease or a history of hyperlipidemia and antihyperlipidemic drug consumption were randomly assigned into control (N = 24) and treated (N = 23) groups. Men in the treated group were subjected to wet cupping, whereas men in the control group remained untreated. The serum concentrations of lipids, collected from brachial veins, were determined at the time of wet cupping and then once a week for 3 weeks. Data were analyzed using a repeated measure ANOVA.

RESULTS

A substantial decrease in LDL cholesterol (p < 0.0001) and in the LDL/HDL ratio (p < 0.0001) was found in the treated group compared to the control. There were no significant changes in serum triglyceride between groups (p > 0.05). Although there were no statistically significant variations in total cholesterol and HDL cholesterol (p > 0.05), a 7% decrease in total cholesterol and 3% increase in HDL cholesterol may be clinically important.

CONCLUSIONS

Wet cupping may be an effective method of reducing LDL cholesterol in men and consequently may have a preventive effect against atherosclerosis.

[Observation on the therapeutic effect of a red-hot needle therapy combined with blood-letting puncture and cupping for treatment of neurodermatitis]

OBJECTIVE

To search for an effective therapy for neurodermatitis.

METHODS

Ninety-six cases were divided into 2 groups by random number table. The treatment group (n = 54) were treated by hot-red needle therapy combined with blood-letting puncturing and cupping at skin-injured area, and the control group (n = 42) were treated with external smearing of halometasone cream.

RESULTS

The cured rate and the total effective rate were 51.9% and 96.3% in the treatment group, and 28.6% and 81.0% in the control group, respectively, with a significant difference between the two groups in the therapeutic effect (P < 0.05).

CONCLUSION

Red-hot needle therapy combined with blood-letting puncture and cupping has a definite therapeutic effect on neurodermatitis, without toxic and adverse effects.

Bleeding Babies in Badakhshan

The bleeding of infants via the skin (pile) and the roof of the mouth (qüm) is practiced in Badakhshan, the easternmost province of Tajikistan. Like folk practices elsewhere, pilé and qüm exist at the interstices of modern society and reflect a complex religious, historical, and social response to poverty, marginality, and the global processes associated with the collapse of the Soviet Union. In this article, I attempt to move beyond an ethnomedical analysis by examining these bloodletting practices in the context of their contemporary meaning, as a moral response to suffering and to the social changes that have taken place in the post-Soviet period.

Thirty-two cases of acne treated with blood-letting puncture, cupping and Chinese-drug facemask

To observe the therapeutic effect on acne treated with blood-letting puncture, cupping and Chinese-drug facemask. Thirty-two patients with acne were treated with above-mentioned therapeutic method. Cure, improvement and ineffectiveness were respectively found in 24, 7 and 1 case, with a curative rate of 75.0% and a total effective rate of 96.8%. The combination of blood-letting puncture, cupping and external application of Chinese-drug facemask is effective in treating acne.

Effect of blood-letting puncture at twelve well-points of hand on consciousness and heart rate in patients with apoplexy

OBJECTIVE

To observe the effect of blood-letting puncture at Twelve Well-Points of Hand on consciousness and heart rate in patients with early apoplexy.

METHOD

Under observation were patients with disturbance of consciousness within 3 days after the apoplectic seizure. The patients were divided into a large injury team, a moderate injury team and a mild injury team. Each team was again randomly divided into a puncture group and a control group, with routine treatment in both groups but blood-letting puncture only in the puncture group. Quantitative changes in consciousness, blood pressure and heart rate of the patients were observed.

RESULT

Blood-letting puncture at Twelve Well-Points of Hand can improve the consciousness and raise the systolic pressure in patients of the mild injury team, and accelerate the heart rate in all the patients in the puncture group.

CONCLUSION

Blood-letting puncture at Twelve Well-Points of Hand can improve the consciousness of patients with brain injury in small area.

Did some 18th and 19th century treatments for mental disorders act on the brain?

Review of 18th and 19th century psychiatric therapies raises the possibility that several may have altered the activity of vasopressin or Na-K-ATPase. Bleeding, whirling, nausea created by medicines, and vagus nerve stimulation by application of electricity through the skin all perturb the hypothalamic hormone, arginine vasopressin, while helleborus and digitalis inhibit the sodium pump enzyme, Na-K-ATPase. These approaches were used with reported benefit many years ago, acting on the brain in ways ongoing research suggests may play a role in affective disorders. Study of long-abandoned treatments may clarify their mechanisms of action and the characteristics of responsive patients.

The leech and the physician: biology, etymology, and medical practice with Hirudinea medicinalis

The history of the word "leech" and the practice of leeching reveal interconnected social histories. We give the linguistic and medical histories of the word, and explore its biology and clinical history. Our historical account extends from the earliest known record of leeching to current research. Despite historical variation in its reputation as a therapeutic technique, leeching remains useful today in a number of applications. Further investigation may well disclose even more uses for the leech, particularly for its enzymes with anesthetic, anticoagulant, and antimetastatic properties.

[The leech therapy of infectious myocarditis]

The novelty of the work consists in application of hirudotherapy (leeches) to treat infectious myocarditis, which therapy has been embarked on for the first time in the treatment of this medical condition. Coagulation methods used by the author are modern, the methodical approach is adequate. The role of hirudotherapy versus heparin therapy is shown.

Leech therapy for complicated varicose veins

Several methods of limb bandaging have been described to reduce the oedema and enhance ulcer healing in complicated varicose veins, with varying success rates. Leech therapy has never before been tried for the same. We evaluated the effectiveness of medicinal leech therapy in producing venous decongestion, reversal of oedema, hyperpigmentation and healing of varicose ulcer(s). Whether the leech selectively sucks venous blood was also investigated. Hirudo medicinalis (medicinal leech) was applied to the area surrounding the varicose ulcer(s) in 20 patients with varicose veins with complications and the patients monitored for ulcer healing, and decrease in hyperpigmentation, oedema and limb girth. The partial pressure of O2 (pO2) of 7 patients' arterial and venous blood was compared to that sucked by the leech. After leech therapy all the ulcers showed healing, while 95 per cent of patients showed a decrease in oedema and limb girth. Seventy five per cent patients demonstrated a decrease in hyperpigmentation. The mean pO2 of blood sucked by the leech was 40.05 +/- 7.24 mmHg, which was similar to the mean pO2 of the patients' venous blood (34.33 +/- 8.4 mmHg). Thus it appears from this study that the medicinal leech sucks venous blood and aids ulcer healing, and can probably therefore be used as an effective adjunct in the management of complicated varicose veins. This however requires further evaluation by controlled trials.

Observation on therapeutic effects of blood-letting puncture with cupping in acute trigeminal neuralgia

In the present paper, 45 cases of acute trigeminal neuralgia were treated and observed by comparative method. Results showed no significant difference in transient analgesic effect (P > 0.05) but a significant difference in therapeutic effect (P < 0.01) between the treatment and control groups. This indicates that blood-letting puncture with cupping is an effective therapy for the disease.

Making sense of the technique of venepuncture

Venepuncture is a skill being undertaken by an increasing number of nurses. This paper describes the steps to be taken together with some of the measures employed to avoid problems.

Suprahepatic vein oxygen tension in alcoholics with severe and mild liver damage

We measured suprahepatic vein and arterial partial oxygen pressure in 35 alcoholics with severe (N = 7) or mild (N = 28) histological liver damage and without evidence of clinical liver failure. The suprahepatic vein was punctured with a fine needle, using a percutaneous approach. Suprahepatic vein partial oxygen pressure was lower and arterial-suprahepatic gradient higher in alcoholics with severe liver damage compared to those with mild damage (35.1 +/- 1.7 vs 44.1 +/- 2.1 and 58.9 +/- 3.7 vs 45.9 +/- 2.4 mm Hg, respectively; P < 0.001). Suprahepatic puncture was well tolerated and devoid of complications. It is concluded that alcoholics with severe liver damage have lower oxygen tensions in the suprahepatic vein, a phenomenon that supports the hypoxic theory of alcoholic liver disease.

Use of a phlebotomy service in a paediatric unit

This article evaluates the literature and research concerning venepuncture and the use of a phlebotomy service in an acute paediatric setting. It also highlights concerns expressed by nursing and medical staff about the introduction of such a service.