The Analogy Between the Tradition Chinese Acupuncture and Phlebotomy in Medieval Bohemia.

The common opinion is that in Europe acupuncture was introduced in China at the end of the XVII century. However there are some publications, which describe the similar treatment method in the Stone Age Europe. From ancient to late middle century theoretical and practical aspects of medieval medicine in Europe were very similar to the Tradition Chinese medicine. So it is possible that historical phlebotomy in Europe (bloodletting) played the same role as the acupuncture in the Chinese therapy and they had one scientific source. In this article we are comparing the modern acupuncture with some Bohemian medical tractates (Practica medicinalis by Sigismundus Albicus from 1408-1424, De sanguinis minucione by Cristannus de Prachaticz from 1430). We can see the close relationship between localizations and indications of medieval phlebotomy and modern acupuncture points. 40% of the bloodletting points have close localization with the modern acupuncture points and 57% of their indications are common or very similar. The similarity of two methods may be explained in two ways. First is a common scientific source and intensive interaction and crosscultural transmission of knowledge during medical development in China and Europe up to the beginning of the XV century. This possibility indicates also some linguistic coincidences. On the other hand, both methods could have been developed separately based on common clinical empire and objective neuro-physiological patterns of human body.

[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.

Lady Brilliana Harley (1598-1643): Her medicines and her doctors.

Lady Brilliana Harley was the redoubtable chatelaine of Brampton Bryan Castle in Herefordshire during the mid-seventeenth century. Her many letters reveal much about the medications which she dispensed to her family and about the family's medical attendants. Whenever possible the Harleys preferred to consult university-educated physicians rather than the local apothecary or surgeon. These physicians are all known from other sources but Brilliana's letters add to what is known of their provincial practices. In particular, they reveal their willingness to undertake blood-letting, often thought to be the province of the more lowly surgeon, and they emphasise the great distances travelled by these practitioners and the difficulties faced by two of them during the Civil War.

Rhazes and an Early Case With Possible Hypertensive or Reversible Encephalopathy.

In one of Rhazes' medical treatises, Tales and Stories of Patients, descriptions, medical manifestations, and treatment approaches of 34 patients were mentioned. Among those, an epileptic patient with a florid face and congested veins was cured by performing venesection on his saphenous and basilic veins. Signs and symptoms of the case might correspond to hypertensive or reversible encephalopathy.

The demise of bloodletting.

Bloodletting was a practice favoured by doctors and barber-surgeons for many centuries, and is now, perhaps surprisingly, still employed for a few specific indications. The effectiveness of bloodletting for treating diseases such as pneumonia was convincingly challenged in the mid-nineteenth century, but medical conservatism ensured the practice continued well into the twentieth century. As late as 1942, a famous medical textbook considered bloodletting appropriate treatment for pneumonia.

In a time of cholera.

INTRODUCTION: Dr. Nathaniel Alcock in his book A treatise on cholera described 22 cases of cholera that he treated in 1832. Blood-letting, either by leeches or venesection, was an essential part of the treatment. RATIONALE: The belief was that reducing the blood volume would relieve stress on the heart and lungs allowing for better function. The receipts of the Townsend Street Cholera Hospital where Dr. Alcock worked show how extensive the practice was. Outside Dublin, local Boards of Health dealt with the cholera epidemic. Various public measures such as street cleaning and removal of patients to temporary hospitals were undertaken and various cures were tried. OUTCOME: The overall mortality rate from cholera in Ireland during the epidemic was 38 %, but in some areas much higher. CONCLUSION: Even as cholera was spreading in the 1830s, a number of doctors were showing that intravenous fluids could dramatically alter the course of the disease. Unfortunately, their work was ignored and blood-letting continued to be a major component of the treatment of cholera for another 55 years.

[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.

[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.

Barberos y Sangradores en Iberoamérica / Barbers and Bleeders in Latin America

El descubrimiento del Nuevo Mundo trajo consigo una serie de profundos cambios y transformaciones en las costumbres y estilos de vida indígenas, no sólo en cuanto a la organización política, social y económica de las nuevas civilizaciones, sino también en el campo de las ciencias, como la Medicina y las distintas ramas del arte de curar, siendo un exponente claro en este sentido la llegada de barberos y sangradores procedentes de la Península Ibérica (AU)

O descobrimento do Novo Mundo trouxe consigo uma série de profundas mudanças e transformações nos costumes e estilos de vida indígenas, não somente em relação à organização política, social e econômica das novas civilizações, mas também no campo das ciências, como a Medicina e as distintas especialidades da arte da cura, destacando-se, como um expoente claro, a chegada de barbeiros e sangradores, procedentes da Península Ibérica (AU)

The discovery of the New World brought a series of profound changes and transformations in the habits and lifestyles of indigenous peoples, not only in terms of political, economic social and new civilizations, but also in the field of science, as Medicine and the different branches of the healing art, being a clear example in this sense the arrival of barbers and bleeders from the Iberian Peninsula (AU)

[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.

[The study on the establishment of acupuncture].

In ancient china, four famous literatures, Huang Di Nei Jing, Nan Jing, Ben Cao, Shang Han Lun appeared, which made the foundation of oriental medicine. Huang Di Nei Jing, the book of acupuncture, is the most essential literature among these four litertures. So the question asking the identity of oriental medicine can be turned into the question about the identity of acupuncture. The investigation into origin will not be the only way to study of identity but one of the most attractive means. So we can answer with the study of origin to the question about identity. Acupuncture is comprised of theories like jing mai, qi xue and technical factors like moxibustion, bian which is like present operating knife. To trace the origin of acupuncture, we must investigate not only technical factors but also theories. But it will be impossible to trace every theories underlying the acupuncture in this small thesis. This is the reason that I restricted my attention to the principle of preventive medicine, regimen. Before the excavation of Mawangdui, the belief that acupuncture started long ago before Han period had been generally accepted. But there was not any proof proving the presence of acupuncture in the excavated literatures representing the Han period medicine. This fact announced that we must draw the time of establishment of acupuncture back after the Mawangdui literature buried in B.C. 168. But we can find the proof of the presence of acupuncture just before B.C. 168 in Shiji written by Si Mi Qian. Through these facts and inferences that we got until now, we can reach a conclusion that acupuncture would have appeared around 190-176 when Chun Yu Yi was practicing as a doctor. As you know, in the Mawangdui literature, what was associated with jing mai was moxibustion. But at the same time, moxibustion was being used just as the experience medicine technique without theory. So the moxibustion would has been about to be associated with jing mai theory in Mawangdui period. The word zhen jiu, the acupuncture and moxibustion, means there was a way to reconcile two techniques. It was by assuming bu and handing xie over to acupuncture that moxa can coexist with acupuncture. bian is used for infection treatment more than bloodletting tool in ancient china. but there is a bridge between acupuncture with bian. Acupuncture inherited its appearance from bian. It is generally believed that blood-letting is commonly developed in the classic east and west medicine. But the blood-letting could be harmonious with the old chinese belief that vitality must be retained in the body? No. The blood-letting is not generally practiced in ancient china. We can scarcely find the evidence of blood-letting in the ancient literature now in hand except Huang Di Nei Jing. Blood-Letting widened its territory in ancient chinese medicine with the help of the medical version of wuweierwubuwei principle which means 'not do anything, then everything does'. But soon lost its territory. Even in the Huang Di Nei Jing, We can find its disappearance. What is the reason? For its disharmony with chinese life idea, 'not lose essence'. Acupuncture replaced the blood-letting. It was the response of the ancient chinese healers to the regimen spirit and harmonious with chinese life view. Regimen spirit, the medical version of 'wuweierwubuwei' does not pursue cure after being ill but defense before disease. Acupuncture, meeting the demands of time, appeared in pre-han period as the association with jingmai theory which may be developed in regimen field, inheritence of moxa's esperience, and the shape of bian.

The Study on the Establishment of Acupuncture / 의사학

In ancient china, four famous literatures, Huang Di Nei Jing, Nan Jing, Ben Cao, Shang Han Lun appeared, which made the foundation of oriental medicine. Huang Di Nei Jing, the book of acupuncture, is the most essential literature among these four litertures. So the question asking the identity of oriental medicine can be turned into the question about the identity of acupuncture. The investigation into origin will not be the only way to study of identity but one of the most attractive means. So we can answer with the study of origin to the question about identity. Acupuncture is comprised of theories like jing mai, qi xue and technical factors like moxibustion, bian which is like present operating knife. To trace the origin of acupuncture, we must investigate not only technical factors but also theories. But it will be impossible to trace every theories underlying the acupuncture in this small thesis. This is the reason that I restricted my attention to the principle of preventive medicine, regimen. Before the excavation of Mawangdui, the belief that acupuncture started long ago before Han period had been generally accepted. But there was not any proof proving the presence of acupuncture in the excavated literatures representing the Han period medicine. This fact announced that we must draw the time of establishment of acupuncture back after the Mawangdui literature buried in B.C. 168. But we can find the proof of the presence of acupuncture just before B.C. 168 in Shiji written by Si Mi Qian. Through these facts and inferences that we got until now, we can reach a conclusion that acupuncture would have appeared around 190-176 when Chun Yu Yi was practicing as a doctor. As you know, in the Mawangdui literature, what was associated with jing mai was moxibustion. But at the same time, moxibustion was being used just as the experience medicine technique without theory. So the moxibustion would has been about to be associated with jing mai theory in Mawangdui period. The word zhen jiu, the acupuncture and moxibustion, means there was a way to reconcile two techniques. It was by assuming bu and handing xie over to acupuncture that moxa can coexist with acupuncture. bian is used for infection treatment more than bloodletting tool in ancient china. but there is a bridge between acupuncture with bian. Acupuncture inherited its appearance from bian. It is generally believed that blood-letting is commonly developed in the classic east and west medicine. But the blood-letting could be harmonious with the old chinese belief that vitality must be retained in the body? No. The blood-letting is not generally practiced in ancient china. We can scarcely find the evidence of blood-letting in the ancient literature now in hand except Huang Di Nei Jing. Blood-Letting widened its territory in ancient chinese medicine with the help of the medical version of wuweierwubuwei principle which means 'not do anything, then everything does'. But soon lost its territory. Even in the Huang Di Nei Jing, We can find its disappearance. What is the reason? For its disharmony with chinese life idea, 'not lose essence'. Acupuncture replaced the blood-letting. It was the response of the ancient chinese healers to the regimen spirit and harmonious with chinese life view. Regimen spirit, the medical version of 'wuweierwubuwei' does not pursue cure after being ill but defense before disease. Acupuncture, meeting the demands of time, appeared in pre-han period as the association with jingmai theory which may be developed in regimen field, inheritence of moxa's esperience, and the shape of bian.

[Origin of three symbols in medicine and surgery]. / El origen de tres símbolos utilizadosen medicina y cirugía.

BACKGROUND: Humans use many ways to communicate with fellow humans. Symbols have been one of these ways. Shamans probably used these in the beginning and adopted other distinctive symbols as they were introduced. DISCUSSION: The origin, the reason and use of three symbols in medicine and surgery are discussed. Some symbols currently remain the same and others have been modified or have disappeared. The oldest of these three symbols is the staff of Aesculapius, related to the Greek god of medicine and health. Since the 19th century, in some countries the symbol of the medical profession has become the caduceus, but the staff is the natural symbol. The second symbol is the barber pole that was created at the beginning of the Middle Ages. This was the means to locate the office and shop of a barber/surgeon in towns, cities and battlefields. On the other hand, the surgeon made use of the emblem of the union, trade or fraternity to which he belonged, accompanied by the bowl for bloodletting. The third symbol is the wearing of long and short robes that distinguished graduate surgeons from a medical school and the so-called barber/surgeons. CONCLUSIONS: Symbols facilitate the manner in which to identify the origin or trade of many working people. Some symbols currently remain and others have either been modified or are obsolete, losing their relationship with surgery and medicine.

From bloodletting to apheresis in Japan.

The ancient therapy of bloodletting that was universal in the West traveled to Japan 500 years ago on the trading vessels that carried physicians and barber-surgeons to care for the body and Christian missionaries to care for the soul. Then bloodletting was replaced by blood transfusion in the 19th century, only to return less than 50 years ago as apheresis. An understanding of those transitions can be gained from the story of the introduction of Western medicine to Japan and the events that have led to the practice of apheresis there today.

Medicinal use of leeches in the texts of ancient Greek, Roman and early Byzantine writers.

Blood-letting was a common therapeutic method in antiquity; many means were used to draw blood, including the application of leeches. In this paper, ancient Greek, Roman and Byzantine authors up to the 7th century AD were studied, a research that provided us with references that may be divided into two groups: those related to the medicinal use of leeches, and those related to cases in which leeches were swallowed and had to be removed. In the first group, detailed descriptions of the method of usage and of the diseases requiring leeching were found. In the second group, brief reference is made to the problems caused by swallowing leeches, and to the methods used to expel them from the human organism. The earliest references to the medicinal use of leeches may be found in the writings of Theocritus (3rd century BC), Nicander (2nd century BC) and Horace (1st century BC, while the phenomenon of swallowing a leech is first mentioned in one of the Epidaurian 'iamata' dating to the 4th century BC.

'For the benefit of the people': the Dutch translation of the Fasciculus medicinae, Antwerp 1512.

The article deals with the Dutch translation of the Fasciculus medicinae based on the Latin edition, Venice 1495, with the famous woodcuts created in 1494 for the Italian translation of the original Latin edition of 1491. The woodcuts are compared with the Venetian model. New features in the Antwerp edition include the Skeleton and the Zodiac Man, bot originally based on German models. The text also deals with other woodcuts in the Low Countries based on these Venetian illustrations. The Appendices provide a short title catalog of all the editions and translations based on the Venetian edition and a stemma.