Bloodletting Works

May 2002
by Steven Novella, MD

Science is rediscovering this ancient healing art.  Warning: The following is a work of complete fiction intended as satire.

Jane suffers from an uncommon blood disorder called polycythemia – which means that she has too many red blood cells in her blood. As a result her blood is too thick and does not flow well through her small blood vessels and capillaries, putting her at risk for things like strokes and heart attacks. In this modern age of miracle high-tech medicine you may be surprised to learn that Jane is treating her illness with an ancient technique thousands of years old – bloodletting.

In the recent craze to search for alternatives to effective scientific medicine, the public’s attention has been drawn again and again to ancient healing practices. Most often this search has focused on the ancient beliefs of other cultures, because they seem more exotic and less ridiculous. In so doing, however, we have neglected the superstitious and pre-scientific ideas of our own culture. Well, not any more.

The ancient practice of blood-letting is gaining attention and respectability. Blood-letting is based upon the two thousand year old concept of the four humors. Before anything was actually known about how the human body works, and the causes of disease, Greek philosophers developed the concept of the four bodily humors: blood, phlegm, green bile, and black bile. Health, they reasoned, resulted from each of the four humors being in perfect balance. Illness resulted when one or more of the humors were out of balance. This simple approach reduced the vast complexity of diagnosis and treatment down to just a few manageable variables.

“The beauty of the humoral theory,” says Dr. G. Lable, a holistic practitioner in Beverly Hills, “is in its elegant simplicity. As a practitioner, I do not have to spend a lot of time learning about hundreds of different diseases, complex treatments and diagnostic tests. There are only four humors, and if they are out of balance they exist either in excess or insufficient amounts. Treatment options are reduced to either purging the excess humor, or its opposite for humors that are too low.”

Dr. Lable has found a throng of patients eager to receive his treatments. He claims to have cured everything from headaches, fatigue, insomnia, and muscle aches to even cancer. He also has a treatment program for weight loss and smoking cessation. “Losing weight is just a matter of being less sanguine,” he states with a comforting smile.

Of course, this latest trend in the advance of natural medicine has its skeptics. “Dr. Lable has provided no evidence that his treatments are safe and effective,” states Dr. Novella rather phlegmatically, an outspoken critic of unproven remedies. “The humoral theory was abandoned hundreds of years ago for a reason – it didn’t work. Once scientific methods were developed and incorporated into western medicine, superstitious medical practices were abandoned. Resurrecting them now would be a huge step backwards into the dark ages.”

But Dr. Lable counters that his treatments are completely natural, and therefore do not need evidence that they are safe and work. “I prefer to rely upon uncontrolled anecdotal evidence,” he says. “It saves me the trouble of doing any actual research, and I already know the outcome – my patients love it. Besides, blood-letting has already been proven to work. It is the accepted treatment for polycythemia – they just call it by another name, phlebotomy, because is sounds more modern. But the skeptics can’t argue with the fact that blood letting works.”

Promoters like Dr. Lable point out that modern medicine often just treats the symptoms of disease, but humoral practitioners treat the true underlying cause of illness. “If someone has an infection, sure antibiotics can kill the bacteria and make the infection go away, but that doesn’t treat the reason why the infection was there in the first place – an excess of black bile weakens the immune system and attracts bacteria, who are comfortable in the melancholy environment. And what about illnesses that modern medicine can’t cure – if they can’t cure a patient then they shouldn’t criticize blood letting as an alternative. At least I offer hope.”

Despite almost wholesale rejection by the scientific community, the acceptance of blood letting by Dr. Lable and others like him is sure to prompt attention from a media enamored with the bizarre and sensation, and this will in turn drive consumer demand. So let the naysayers gripe all they want, blood letting seems here to stay.