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» LymeNet Flash » Questions and Discussion » Medical Questions » A long-discredited cure may hold a promising secret

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Author Topic: A long-discredited cure may hold a promising secret
CaliforniaLyme
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Bloodletting
A long-discredited cure may hold a promising secret
By Carolyn Y. Johnson, Globe Correspondent | October 5, 2004

For 2,500 years, doctors unleashed a single, gory cure-all on nearly every ailment known to mankind -- a good bleeding. Confronted with a fever, rattly cough, intermittent seizures, heart disease, or even mental illness, doctors bled their patients, sometimes until they passed out.
The common practice of bloodletting weakened and probably killed some patients -- including George Washington, who was bled of 2 to 3 quarts of blood after getting sick and died shortly thereafter. Undaunted, barber-surgeons and doctors continued bloodletting to the cusp of the 20th century, when it was finally consigned to the trash bin of discredited medicine.

Now, however, a discovery published last month in the journal Science suggests that bloodletting actually might have helped some patients -- and offers a tantalizing reason why. Microbiologists at the University of Chicago found that when infectious Staphylococcus aureus bacteria were deprived of the iron in red blood cells, they did not spread and cause disease in the body.

''In the earliest 20th century, some of the most respected physicians advocated using bloodletting and had honed it down to use at the beginning of a sudden onset with a harsh fever, which is very much the hallmark of a bacterial infection," said Dr. Tracey Rouault, an expert on iron metabolism who looked at the Chicago study and saw a connection to the painful ancient practice. ''Right at that point, you may be doing some good."

No one today is advocating a return to the lancet. But if Rouault is right, bloodletting may be joining the list of cures from the past, including maggots and leeches, proving to be of interest to modern doctors.

''If something rather invasive has a hold on therapy for 2,500 years," Rouault said, ''there must be some incident when somebody benefited from it."

The scientists behind the bacterial study didn't set out to find a justification for bloodletting. They were trying to solve a mystery about bacteria: The cells need iron to grow and thrive, but doctors have never known which sources of iron in the body were the first choice. So a research team at the University of Chicago put bacteria on a low-iron diet and then set them loose in a dish, with the two most common forms of iron found in the body.

Researchers found the bacteria overwhelmingly preferred heme iron, which is stored within red blood cells, especially at the beginning of the infection. ''They blow open the red blood cells, which leads to the release of heme," said Eric Skaar, a microbiologist at Chicago who coauthored the study.

He and his colleagues found that when the bacteria were altered so they could no longer capture the iron stored in the red blood cells, they were unable to cause disease in mice.

Rouault said that when she first saw the study results, she was excited. The head of the section on human iron metabolism at the National Institutes of Health, she had been musing on the rationale for bloodletting, ''because it's just so curious." The new study suggested an answer: Maybe it caused iron starvation in bacteria. She wrote a commentary drawing the connection, which appeared in the same issue of Science.

Other science historians, however, caution that Rouault's idea does not mean bloodletting was an effective therapy. The only cases in which it would have worked were bacterial infections -- a fraction of the total number of diseases treated with the technique over the centuries, at a time when doctors had no way to tell a bacterial infection from a tension headache.

Hippocrates, ''the father of medicine," first advocated bloodletting in ancient Greece as a method of bringing an unbalanced, diseased person back to equilibrium. Those ideas evolved into a theory about the body's four humors, which had to be kept in balance -- too much blood and a person would be overexcited; too much phlegm, sluggish; and so on. From there, bloodletting never got much more scientific. It was used indiscriminately on viral infections, psychosis, and even heart failure -- although, as Rouault noted, it was sometimes singled out for use at the beginning of a harsh fever, which often indicates a bacterial infection.

Medical historians say that it is impossible to divine the real reason bleeding seemed to ''work," and that to use a modern explanation would be a gross oversimplification. The perceived power of physicians wielding such an invasive procedure likely had a potent placebo effect, said Dr. David Jones, who teaches in the science, technology, and society program at the Massachusetts Institute of Technology.

A scientific rationale for bloodletting would put the practice in the growing company of outdated therapies that have shown some medical value -- and in some cases are enjoying a full-bore revival, though not always for their original purposes.

Maggots, which evoke images reeking of death and decay, may seem definitively unmedical, but can actually save limbs. The tiny white fly larvae were used to clean wounds in wartime hospitals in the 1930s until replaced by modern surgical techniques and antibiotics -- but are now gradually returning at wound clinics across the country, despite the ''yuck" factor. The US Food and Drug Administration approved maggots as a medical device to clean out wounds this January. The larvae are applied to an open wound, secured there with mesh, and left to eat the dead tissue and kill bacteria -- which they can do with a precision beyond that of a skilled surgeon, according to some studies.

Leeches were once an important method of bloodletting, but now serve a completely different purpose. Bred in sterile conditions by special leech farms, they are applied to surgically reattached fingers or ears, where they help to stimulate circulation. The most important component of a leech bite is the saliva, which prevents blood clotting, and synthetic forms of leech spittle are being used as anticoagulant drugs. Marie Bonazinga, president of Leeches U.S.A., said that her company sells in excess of 10,000 farm-raised leeches each year to major trauma centers across the country.

What may seem strangest about some of the old cures -- the fact that doctors had little understanding of how they truly affected the body -- is true of much modern medicine as well. ''There are a lot of things we think of as therapy, but have no scientific rationale," said Dr. Robert Aronowitz, who teaches history and sociology of medicine at the University of Pennsylvania.

Even with a scientific rationale, no researcher is going to start bleeding patients to see whether it actually works. But the iron-starvation research may yet yield a new therapy.

Skaar's work suggests that doctors could one day kill bacteria by disrupting their ability to gather iron from red blood cells -- in essence, starving them by locking the food away rather than by throwing it out, as bloodletters may have unwittingly been doing for centuries.

As for bloodletting, the question of whether it really worked will probably never be resolved, and no one anticipates a randomized clinical trial to set the record straight.

''Bloodletting," Jones said, ''would probably hurt the patient before it hurt the bacteria."


Carolyn Y. Johnson can be reached at [email protected]

2006 Globe Newspaper Company.

--------------------
There is no wealth but life.
-John Ruskin

All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer

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luvs2ride
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My LLMD draws blood constantly for tons of tests and I have jokingly accused her of curing me by bloodletting but calling it blood testing.

--------------------
When the Power of Love overcomes the Love of Power, there will be Peace.

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AZURE WISH
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interesting - ty [Smile]

--------------------
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Virginia of Yore
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Back in June, 2000, I was sent an email on the following interesting bit on Bb and iron:

"ATHENS, Ga. New research from scientists at the University of Georgia,
just published in the journal Science, demonstrates that Borrelia burgdorferi,
the
bacterium that causes Lyme disease in humans, is the first pathogenic
bacterium identified that does not need or use iron..."

Sorry, but they didn't cite the journal date, etc., but might be interesting to look it up online if someone has time & energy.

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Truthfinder
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[Big Grin] Interesting!

I just brought up an old thread that I posted about a year ago on bloodletting.... thought it might be of interest....

I still think it may have some role to play in fighting Lyme and/or co-infections. I think we can make new blood way faster than the bugs can replicate.....

--------------------
Tracy
.... Prayers for the Lyme Community - every day at 6 p.m. Pacific Time and 9 p.m. Eastern Time just take a few moments to say a prayer wherever you are.

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TerryK
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I have a low red blood cell mass which takes my blood volume down to 60% of a normal blood volume - makes it 40% below normal.

I asked my doctor if this could be babs bursting the red blood cells and he said it could be. My mother and sister have the same problem and Dr. Streeten (a specialist in NMH) & Dr. Bell measured red blood cell mass in a number of CFIDS patients (small study) and the majority had the low red blood cell mass.

I suspect that a number of lyme patients have the low red blood cell mass. I don't think I'd do well with bloodletting. I think the whole vascular system might collapse if it gets too low.

Terry

[ 12. November 2007, 02:02 AM: Message edited by: TerryK ]

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HaplyCarlessdave
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quote:
Originally posted by luvs2ride:
My LLMD draws blood constantly for tons of tests and I have jokingly accused her of curing me by bloodletting but calling it blood testing.

\\--Ain't THAT the truth!
..Maybe that was the key...
But no, I don't think so, in the case of Lyme- you need all the red blood cells you can get, since the red blood cells are the ones under attack!
DaveS

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klutzo
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Interesting article.

I know two men who have diseases for which blood letting is still used today. One has polycytemia vera, and the other has hemochromatosis. The second guy has to get bloodletting done once a month.

Klutzo

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canbravelyme
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Thanks, Sarah. I often feel a bit better for a day or so after my blood is taken. I wondered about this. Peryaps there is something beneficial in addition to the decreased iron, that we are not yet specifically aware of.

Best wishes [Smile]

--------------------
For medical advice related to Lyme disease, please see an ILADS physician.

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Gabrielle
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Somebody in the German Lyme forum is having regular blood lettings. She got better with abx treatment but her heart symptoms didn't go away and she often had to go to the emergency room because of that.

Then she found a special clinic where they found that her blood volume is too high and the blood too thick and therefore, the heart had a very hard time pumping it. There was already a little damage done to her heart which was never found in the normal hospitals.

Since she is doing the blood lettings she feels great and considers herself cured but will have to continue with the blood lettings.

Gabrielle

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canbravelyme
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Gabrielle,

Thank you. This is fascinating stuff.

My blood pressure is low, and when I do a Google search, this would indicated that I don't need the blood volume to be any lower.

_However_, it may be that I'd gotten used to _even lower_ blood pressure before, when I was even more sick, and I suspect what it is, is it's taking my body some time to adjust. Still 100/60, but that's better than before...

Best wishes,

--------------------
For medical advice related to Lyme disease, please see an ILADS physician.

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ByronSBell 2007
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Life is in the blood.
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Eight Legs Bad
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Hi all

Please don't try "bloodletting" on yourselves- it could be extremely dangerous.

Re Virginia's point- the published studies that found that Lyme does not need to steal our iron to function, found that it uses manganese instead.

Yet another thing that makes Bb an exceptional bug.

Manganese is an essential trace element in our bodies which incidentally, plays a very important role in keeping our mitochondria healthy. The mitochondria are the "energy powerhouses" of our cells.

Elena

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Justice will be ours.

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lpkayak
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actually a friend who thought his mom had lyme said after she had a surgery w/ complications so she needed lots of blood...her lyme symptoms seem gone. he wonders if she lost so much lyme infected blood and then got enough good blood that the ketes were eliminated.

sounds incredibel...but who knows?

--------------------
Lyme? Its complicated. Educate yourself.

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caat
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maybe she got some other kind of bacteria or organism that ate the lyme. Who knows?
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Marnie
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Years ago, Tincup also remarked that she felt better after the lab had taken lots of vials of blood for testing.

Fe or "simply" too much FLUID in circulation? Na problem?

There is a disease called hematochromatosis in which some people store too much iron. They have to have a unit of blood removed every so often.

Bb has a gene for transferrin which transports Fe.

I would be logical the body would go into a "store iron" mode since many OTHER pathogens DO use iron to replicate. Hence, the spleen may become enlarged.

I also distinctly remember Tincup said to look closely at RDW...Red Blood Cell Distribution Width on your general blood cell count report...re: how far apart the cells are...as a POSSIBLE...clue to babesia.

As a last resort only, some hospitals will allow a total blood transfusion for very serious babesia. Extremely costly. That info. is buried in old files of mine...somewhere.

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treepatrol
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The cells need iron to grow and thrive, but doctors have never known which sources of iron in the body were the first choice.


I read it a couple of times in journals that Bb dosent need iron or even really require it at all hmm

But almost all other bacteria seem to need it?

--------------------
Do unto others as you would have them do unto you.
Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.

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CaliforniaLyme
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This would affect people like that with Babesiosis I believe-

--------------------
There is no wealth but life.
-John Ruskin

All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer

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treepatrol
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Yep and other bacteria that use it.

--------------------
Do unto others as you would have them do unto you.
Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.

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JimBoB
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quote:
Originally posted by ByronSBell 2007:
Life is in the blood.

##

YOU are correct, Byron. And it is NOT OUR place to fool with it.

Seems like some would either Cure you or Kill you! Course it seems life is not all that important to some of them.

Jim [Cool]

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HaplyCarlessdave
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quote:
Originally posted by luvs2ride:
My LLMD draws blood constantly for tons of tests and I have jokingly accused her of curing me by bloodletting but calling it blood testing.

--yes I'll agree to that! Maybe there is something to it... (actually, I think that with lyme, you need to keep all the healthy red cells you can; thus too much "bloodletting" should usually be avoided!)
DaveS

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beachcomber
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Traditional Chinese Medicine uses a combination of cupping with bleeding (not called bloodletting). The glass cups will raise portions of the skin. Some of the round welts may turn deep purple. The practioner will lance the purple areas to remove the stagnant blood and encourage circulation.

I have tried the cupping and will eventually venture into the bleeding. If I remember, I will post on how/if it makes me feel better.

Bc

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map1131
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I was excited for a minute when I seen this thread started by California Lyme. I thought she was back with us.

Her posts were informative. This posting was from '07. You can do a search on her lymenet member # and bring up some very good reading, if interested.

Pam

--------------------
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MY3BOYS
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interesting info, but hope know one gets desperate enough to try this!! dangerous stuff

i have seen magots used for wounds though, gross

but very effective!! best tx for very necrotic

and infected skin (like burns, etc). REALLY

freaks out the pt..can u imagine ur doc saying,

ok..and tomm we will put maggots on ur leg..lol

they are grown sterile so dont try this at home

kids!!

--------------------
i am not a Dr. any info is only for education, suggestion or to think/research. please do not mis-intuprest as diagnostic or prescriptive, only trying to help. **

dx in 08:lyme, rmsf, bart, babs, and m.pneumonia.

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