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PubMedDate not supplied

[The action of the sodium salt of galbanic acid in experimental erythrocyte hyperaggregation].

During in vitro experiments a sodium salt of galbanic acid was shown to prevent the development of erythrocyte hyperaggregation induced by ATP, thrombin, histamine, adrenaline and acetylcholine. In the intact organisms of dogs at preventive intravenous administration of the compound before bloodletting it prevented the development of experimental erythrocyte hyperaggregation and at administration against the background of bloodletting relieved it.

Animals↗
PubMed2006

[Joseph Dietl (1804-1878). Reformer of medicine and his contributions to urology].

Two centuries have now passed since the birth of Joseph Dietl, whose uncommon ability, industry, inexhaustible energy, dogged perseverance, and courage contributed to the development of medical science in Europe. He also contributed to reform of the educational system, and to bringing order to the badly neglected city of Cracow. He belonged to the so-called New Vienna School of Medicine. Dietl, chief physician at the Wieden Hospital in Vienna since 1941, had voiced his disbelief in the existing therapy in such strong terms that it was recorded in the history of medicine as the program of therapeutic nihilism. Dietl demonstrated experimentally in Vienna and Cracow that bloodletting in pneumonia is not indicated, since it does not promote recovery and is indeed harmful, raising mortality rates three times compared to those patients who had received dietary treatment only. He eliminated bloodletting in pneumonia therapy. Dietl was the first to investigate and classify Galician and Silesian therapeutic springs as well as work out detailed prescriptions for spa treatments. He understood that treatment in a health resort could not be limited to balneotherapy, and he indicated that climatotherapy and physiotherapy should also play a role. Dietl described the crisis attributable to a kink in the renal vessels or ureter when the kidney dropped. It was also Dietl who gave a description of the floating kidney problem and of kidney partial incarceration, a condition still known as Dietl's crisis. He recommended conservative therapy for these cases.

Clinical Medicine↗
PubMed2003

Aspirin-responsive painful red, blue, black toe, or finger syndrome in polycythemia vera associated with thrombocythemia.

Five patients with red, purple blue, or black toes or fingers due to thrombocythemia associated with polycythemia vera (polycythemia and thrombocythemia vera) in four and essential thrombocythemia (thrombocythemia vera) in one are described. The microvascular erythromelalgic syndrome of thrombocythemia was overlooked and progressed to cold blue swollen and painful fingers or black toes in three patients with polycythemia and thrombocythemia vera due to arteriographically documented occlusions of digital or large peripheral arteries with no evidence of preexistent atherosclerotic vascular disease. Concomitant erythromelalgia of the hand palm could be confirmed by the histopathological findings of arteriolar thrombotic lesions in the reticular dermis in two patients with polycythemia and thrombocythemia vera. The increased hematocrit in the presented patients with polycythemia and thrombocythemia vera contributed to the progression of the microvascular syndrome of thrombocythemia to major occlusive ischemic events of the extremities. Standard therapy with oral anticoagulants and reduction of the hematocrit to normal by bloodletting did not affect the platelet-mediated microvascular erythromelalgic, ischemic symptoms in the patients with polycythemia vera because thrombocythemia vera persisted. Complete relief of pain and restoration of the ischemic acral circulation disturbances in patients with thrombocythemia vera or thrombocythemia associated with polycythemia vera in maintained remission by bloodletting could be obtained by long-term treatment with low-dose aspirin.

Aged↗
PubMed2006

Postmortem sole incisions - a new sign of heroin overdose?

Postmortem sole incisions have been observed in a number of heroin overdose fatalities. Acqueintance of those victims confessed to producing those incisions as a life saving procedure in a futile attempt to help the comatose overdose victim. They thought that bleeding the unconscious victim would remove the overdose, in manner similar to bloodletting or phlebotomy which is still popular in the Gulf region. The presence of such wounds has become a first indication or rather "sign" of heroin poisoning. In such cases, laboratory investigation confirmed the pathologist's preliminary suspicion. In Dubai, postmortem sole incisions are important sign of death from heroin overdose even in the absence of other classical signs. This sign becomes more credible when accompanied by other signs and/or circumstantial evidence suggestive of heroin use. It is suggested that this should be called "bloodletting sign" of death from heroin overdose. The sign should not be confused with the self-inflicted cuts seen on the arms and forearms of drug misusers which are caused for other reasons.

Adolescent↗
PubMed1998

The effect of acupuncture on the incidence of postextubation laryngospasm in children.

Laryngospasm occurring after tracheal extubation in children is potentially dangerous. This study uses acupuncture with bloodletting at the Shao Shang (L 11) or Shang Yang (Li 1) acupoints to investigate whether this technique can prevent or treat laryngospasm. Seventy-six patients were randomly divided into two groups. Patients in the acupuncture group (n = 38) were treated with bilateral Shao Shang acupunctures at the end of the operation. Patients in the control group (n = 38) were not. The incidence of laryngospasm in the acupuncture group (5.3%) was less than that in the control group (23.7%) (p < 0.05). If laryngospasm developed, patients were immediately treated with acupuncture at either the Shao Shang or Shang Yang acupoints. As judged by an increase in peripheral oxygen saturation, the laryngospasm was relieved within 1 min of acupuncture in all patients. It is concluded that acupuncture with bloodletting at the Shao Shang acupoint may prevent and treat laryngospasm occurring after tracheal extubation in children.

Acupuncture Points↗
PubMed1999

[Flu-like infection and liver disease after a stay in the tropics].

HISTORY AND ADMISSION FINDINGS: A 38-year-old patient, an experienced traveller to the tropics, fell ill with a flu-like infection, a fever of up to 38.6 degrees C and nausea on returning from an 8-week trip to southern Africa (Namibia, Zambia and Zimbabwe). Physical examination was unremarkable, except for slight physical debility. His father had died of liver cirrhosis of unknown aetiology, aged 68 years. INVESTIGATIONS: Laboratory tests revealed eosinophilia (12% on a count of 7,800 WBC/microliter, increased transaminase activities [SGPT 142 U/l, SGOT 50 U/l, gamma GT 32 U/l], slightly increased serum ferritin [1057 ng/dl], but normal serum iron and transferrin levels). Untreated stool contained Schistosoma mansoni eggs. Tests for a haemochromatosis gene and its type showed a homozygotic C282Y variant. Liver biopsy demonstrated chronic portal hepatitis with parenchymal transformation and marked haemosiderin deposits in liver epithelium. DIAGNOSIS, TREATMENT AND COURSE: The schistosomiasis was treated with praziquantel, 40 mg/kg by mouth on one day, divided in three doses, without complication. The haemochromatosis was treated symptomatically, at first by weekly bloodletting 500 ml while monitoring serum ferritin concentration. Life-long bloodletting at longish intervals is anticipated. CONCLUSIONS: The incidence of some infectious diseases has greatly risen as a result of an increase in tourism to distant lands. In particular, the diagnosis of frequent parasitic diseases should become part of the expertise in internal medicine. The combination of several diseases should be considered in the differential diagnosis.

Adult↗
PubMed2004

Pathophysiology and treatment of platelet-mediated microvascular disturbances, major thrombosis and bleeding complications in essential thrombocythaemia and polycythaemia vera.

Essential thrombocythaemia (ET) is associated with a broad spectrum of microvascular circulation disturbances including erythromelalgia and its ischaemic complications, episodic neurological symptoms of atypical and typical transient ischaemic attacks (TIAs), transient ocular ischaemic attacks, acute coronary syndromes, and superficial 'thrombophlebitis'. The microvascular circulation disturbances are caused by spontaneous activation and aggregation of hypersensitive thrombocythaemic platelets at high shear stress in the endarterial microcirculation involving the peripheral, cerebral and coronary circulation. As this microvascular syndrome is a pathognomonic feature of essential thrombocythaemia and of thrombocythaemia associated with polycythaemia vera (PV) in complete remission with normal haematocrit, we have labelled these two variants of thrombocythaemia as thrombocythaemia vera. The arterial thrombophilia of microvascular circulation disturbances in thrombocythaemia vera already occur at platelet counts in excess of 400 x 10(9)/l. Complete relief of microvascular circulation disturbances in thrombocythaemia vera is obtained with the platelet cyclooxygenase inhibitor aspirin 50-100 mg/day, but not with dipyridamole, ticlopidine, coumarin or heparin. Haemorrhagic thrombocythaemia (HT) is a clinical syndrome of recurrent spontaneous mucocutaneous and secondary haemorrhages associated with extremely high platelet counts far in excess of 1000 x 10(9)/l. The paradoxical occurrence of microvascular circulation disturbances and mucocutaneous bleeding is usually seen at platelet counts between 1000 and 2000 x 10(9)/l. At increasing platelet counts from below 1000 to in excess of 2000 x 10(9)/l, the arterial thrombophilia of thrombocythaemia vera changes into a spontaneous bleeding tendency of HT as a consequence of platelet-mediated increased proteolysis of the large von Willebrand factor multimers leading to a type 2 acquired von Willebrand syndrome. As PV is usually associated with thrombocythaemia, the vascular complications in PV patients are microvascular circulation disturbances typical of thrombocythaemia. On top of this, major arterial and venous thrombotic events and haemorrhages are related to increased haematocrit, red cell mass and its concomitant increased blood viscosity. Correction of increased blood viscosity and haematocrit to normal values (0.40-0.44) by bloodletting alone will significantly reduce the risk of major thrombotic complications, but does not prevent the microvascular circulation disturbances because thrombocythaemia persists. The microvascular syndrome associated with thrombocythaemia in PV patients in remission after bloodletting is best controlled by low-dose aspirin (50-100 mg/day) or by reduction of platelet count to normal (< 350 x 10(9)/l).

Blood Platelets↗
PubMed2006

[Descriptions of treatment in the Hippocratic Collection with special reference to surgery, particularly for urinary stones].

PURPOSE: I analyzed mentions of treatment in the Hippocratic Collection. MATERIALS AND METHODS: I examined quantitatively mentions of treatments in the Hippocratic Collection (Roeb edition, Otsuki edition, and Kon edition) to compare preferences for therapy between the Kos and Knidos schools. RESULTS: Treatments, mentioned in 2,687 passages, were medical in 2,319 (86%), and surgical in 368 (14%). These 2,687 descriptions included 1,023 (38%) from the Kos, 1,261 (47%) from the Knidos school, and 403 (15%) from unspecified schools. Of the 2,319 descriptions of medical treatment, 560 (24%) referred to medicines and 466 (20%) to diet, followed by baths, vapor baths, exercise, running, walking, warm applications, and others. The 368 surgical descriptions involved traction and adjustment for treating fractures of bones or dislocation of joints in 166 (45%) and surgery using knife or fire in 202 (55%). Of the latter 202 mentions, 87 (43%) referred to incision with knife, 74 (37%) to cauterization and 73 (37%) to bloodletting. Diet, exercises, running, walks, traction, adjustment and bloodletting were mentioned more frequently by the Kos school than the Knidos school, while medicines, baths, vapor baths (for gynecological diseases) and incision were mentioned more frequently by the Knidos school (chi-squared test, p < 0.01). Medicines, diet, baths, warm applications, and incision over the kidney were mentioned among treatments for urinary stones, but cystolithotomy was not. Hippocates stated in "Aphorisms" that diseases that medicines do not cure can be cured by the knife. He also, stressed that any one intending to practice surgery for wounds arising in military service must serve in the army. CONCLUSIONS: A large number of medical treatments were mentioned in Hippocratic Collection, while surgical treatments also were emphasized. Hippocrates warned beginning doctors not to used unproven treatments for urinary stone in the introduction to the "Oath", but did not forbid surgical treatments.

Famous Persons↗
PubMed2005

Leech therapy: a history.

Bloodletting is an ancient procedure that was utilized for curing the ills of man. This article traces the use of leeches for bloodletting therapy from ancient Greek times to the Chapin Harris era in the 1840s to modern day usage by plastic surgeons. The leech is described as both a parasite and a therapeutic agent. The techniques used by both medicine and dentistry are historically documented.

Europe↗
PubMedDate not supplied

A study of erythropoiesis and iron metabolism in the rabbit in vivo. I. Characterization and limits of the physiological response.

1. An experimental model system was developed in the rabbit to study the transport of iron and the erythropoietic response to chronic bloodletting. 2. This model presents certain novel features as the capacity to measure total red blood cell production and total hemoglobin production in a daily basis. 3. Daily red blood cell production and output of hemoglobin are directly proportional to the volume of blood extracted. The limits of the erythropoietic response were determined. 4. When only minimal bloodletting was performed (3-6 ml blood/kg body weight) a normocytic response was obtained; with the removal of larger volumes of blood, a switch to macrocytic anemia was observed. Cats and guinea pigs responded in a similar fashion. 5. After induction of macrocytic anemia, the diameter of erythroid precursor cells in the bone marrow of the long bones increased and their numbers increased 11.5-fold.

Anemia↗
PubMedDate not supplied

[Effect of the sodium salt of galbanic acid on thrombocyte aggregation].

During in vitro experiments galbanic acid (a derivative of 7-hydroxycoumarin) at concentrations of 50, 100, 200 micrograms/ml suppressed the development of platelet aggregation induced by ADP, thrombin, histamine, adrenaline, acetylcholine and collagen. Intravenous administration of galbanic acid before bloodletting prevented and against the background of bloodletting eliminated platelet hyperaggregation in dogs.

Animals↗
PubMed1987

[Mathematical modeling of protein loss during prolonged blood loss].

The dependence of protein losses on the initial condition and experimental conditions were studied in dogs on a model of repeated bloodletting. Various animals have an intensive increase in this value in the beginning and a gradual decrease at later stages. Four mathematical models adequately describing changes in losses depending on the number of bloodlettings and duration of arterial pressure compensation phase have been suggested.

Animals↗
PubMed1983

[Effect of naloxone in hypotension caused by acute blood loss in Papio hamadryas baboons].

Naloxone or physiological solution were injected in different doses to 11 baboons (Papio hamadryas) weighing 7-8 kg after bloodletting in a volume of 40% of the total amount of the blood. Naloxone effectively raised (in all the doses) the arterial blood pressure which dropped after bloodletting. The action of naloxone injected in small doses was more pronounced and had unique time parameters. Besides, the respiratory rate was also increased. Injection of nalorphine in a dose of 1 mg/kg produced a similar but a more demonstrable action as compared with naloxone in a dose of 1 mg/kg. A conclusion is made about the possibility of using the antagonists of opioid peptides on a clinical basis for the treatment of shock conditions. An assumption of an inconclusive role played by the subtypes of opiate receptors in the formation of shock conditions is also confirmed.

Acute Disease↗
PubMedDate not supplied

[Effect of sodium selenite and alpha-tocopherol on the microcirculation in massive blood loss in dogs].

Effect of little doses of sodium selenite combined with alpha-tocopherol on microcirculation was studied in experimental bloodletting in dogs. It was established that more rapid recovery, as compared to control, of blood flow in the visceral basin and more rapid elevation of arterial blood pressure after massive bloodletting occur following the pretreatment with sodium selenite at a dose of 30 micrograms/kg and alpha-tocopherol at a dose of 25 mg/kg. The blood flow gets recovered in small vessels (arterioles, vanules and capillaries) while in controls it recovers largely in greater vessels.

Animals↗
PubMed2006

Testing the Paleolithic-human-warfare hypothesis of blood-injection phobia in the Baltimore ECA Follow-up Study--towards a more etiologically-based conceptualization for DSM-V.

OBJECTIVE: The research agenda for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) has emphasized the need for a more etiologically-based classification system, especially for stress-induced and fear-circuitry disorders. Testable hypotheses based on threats to survival during particular segments of the human era of evolutionary adaptedness (EEA) may be useful in developing a brain-evolution-based classification for the wide spectrum of disorders ranging from disorders which are mostly overconsolidationally such as PTSD, to fear-circuitry disorders which are mostly innate such as specific phobias. The recently presented Paleolithic-human-warfare hypothesis posits that blood-injection phobia can be traced to a "survival (fitness) enhancing" trait, which evolved in some females of reproductive-age during the millennia of intergroup warfare in the Paleolithic EEA. The study presented here tests the key a priori prediction of this hypothesis-that current blood-injection phobia will have higher prevalence in reproductive-age women than in post-menopausal women. METHOD: The Diagnostic Interview Schedule (version III-R), which included a section on blood and injection phobia, was administered to 1920 subjects in the Baltimore ECA Follow-up Study. RESULTS: Data on BII phobia was available on 1724 subjects (1078 women and 646 males). The prevalence of current blood-injection phobia was 3.3% in women aged 27-49 and 1.1% in women over age 50 (OR 3.05, 95% CI 1.20-7.73). [The corresponding figures for males were 0.8% and 0.7% (OR 1.19, 95% CI 0.20-7.14)]. CONCLUSIONS: This epidemiological study provides one source of support for the Paleolithic-human-warfare (Paleolithic-threat) hypothesis regarding the evolutionary (distal) etiology of bloodletting-related phobia, and may contribute to a more brain-evolution-based re-conceptualization and classification of this fear circuitry-related trait for the DSM-V. In addition, the finding reported here may also stimulate new research directions on more proximal mechanisms which can lead to the development of evidence-based psychopharmacological preventive interventions for this common and sometimes disabling fear-circuitry disorder.

Adult↗
PubMed1994

[True and artificial leeches and their use in otology. Images from the history of otorhinolaryngology, presented with instruments from the Ingolstadt German Medical History Museum collection].

Based on the concepts of humoral pathology in former centuries bloodletting was used as remedy to great extent, systematically by puncturing a vein or locally by scarification and cupping glasses. In the 18th and 19th century leeches were introduced and applied in huge numbers to cure all conceivable affections including diseases of the ear. J. M. G. Itard in Paris in 1821 for treating various types of hearing disorders recommended to place leeches at the anus or in the nose to imitate bleeding of haemorrhoids or nose-bleeds, which were considered natural resources of the body to cope with disorders of the humours. H. Schwartze in Halle in 1885 still followed this suggestion. W. R. Wilde in Dublin in 1842 and A. F. von Tröltsch in Würzburg 1867 advocated local blood-letting by leeches around the external ear. The surgeon Ch. L. St. Heurteloup in Paris 1840 invented an artificial leech, which was soon widely used in otology and ophthalmology. After the first World War the application of leeches became obsolete. The humoral pathology had found new approaches: immunology including stimulation of the inherent bodily means of defence, and rheology, particularly haemodilution. The historical development and the technique of applying live and artificial leeches in otology are described in detail.

Animals↗
PubMedDate not supplied

The power to terrify: eclampsia in 19th-century American practice.

Throughout the 19th century, eclampsia was among the most dreaded complications of pregnancy. Conflicts arose over proposed etiologies and therapeutic modalities. Bloodletting and other harsh therapies reflected the prevailing humoral, neurovascular, and toxicologic theories. The role of untrained and professional nurses in the lying-in room of an eclamptic woman emerges from the literature of the time. An appreciation of the history of eclampsia provides context for the modern obstetric nurse.

Anesthesia, Obstetrical↗