Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Bloodletting

Episode Date: July 5, 2013

Welcome to Sawbones, where Dr. Sydnee McElroy and her husband Justin McElroy take you on a whimsical tour of the dumb ways in which we've tried to fix people. This week: We put a leech on you and Justin loses a finger. Music: "Medicines" by The Taxpayers (http://thetaxpayers.net)

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, Tommy is about to books. One, two, one, two, three, four. We came across a pharmacy with a toy and that's lost it out. We were shot through the broken glass and had ourselves a look around.

The medicines, the medicines, the escalators, my cop, for the mouth Wow, everybody and welcome to solvones a marital tour of Misguided medicine. My name is Justin McAroy. And I'm Sydney. I'll also Mac. Sydney I want to say happy and welcome Well, thank you Justin when you're listening to this not when you're listening or recording it Well, we record live obviously. I, obviously this is live to you directly. You can tell because we hired an intern to sit in the room and go beep every time we accidentally use profanity. It's probably overpaid.

That's his only job. Are you bored back there, Jerry? No, he's fine. No, he's good. He's good. Happy anniversary, sweetie. Well, thank you. Happy anniversary to you.

I'm glad you brought that up, because of course it is tomorrow, our seven year anniversary. So I got you a present. Oh gosh, that's too sweet. I want to share it with you here, live on here. I'm gonna give each other anything you said.

I know, but, you know, I've been thinking seven years we've been married now, and I mean, let's be honest, honey. It's a magic story honest honey. It's magic No, oh, but it's it's starting to show on you a little bit, right? You know, I mean like you look seven years older. I think I think that's fair to say Oh interesting, okay, don't you think you do? Huh? Good to know. Would you say that I do? No, not at all. I would never say that in a million bajillion years.

That would be a good thing to say. No, I think it would actually be considering that you are my wife, and I love you very much. I think it would be inadvisable for me to say that. No, it would be good for you to say exactly what you said. Correct, okay, I did good. But I bet you've been wondering, it's probably not just a line.

You've probably just wondered how I've kept my youthful glow for so long. Nice, and which crown? No, it's a secret much older. Tell me. Well, here it is. Let me give it to you. Open this box.

OK. Let me just ask. Gosh. It's leeches. That's right. This is a box of leeches. That's right. This is a box of leeches. You're welcome. I don't, what am I going to do with a box of leeches? How does that have any bearing on what we're talking about?

Well, much is what I imagine is the basis for, you know, that hit film death becomes her. Right, classic classic. You may see it on the AI, best movies to watch list. Exactly. What you didn't know is that the original script for that movie was just a bunch of women applying leeches to themselves, but everybody thought that would be kind of gross. No, yeah, short movie.

Because leeches, which obviously suck your blood. Yeah, right. There are many people who believe that using leeches periodically to remove some blood and, well, really just blood. Yeah, right. There are many people who believe that using leeches periodically to, you know, remove some blood and, well, really just blood, and whatever's in the blood, might improve your, your youthfulness, your vigor, make you look more beautiful and young. Leeches. Yes, leeches. Leeches therapy. I think actually even a, well known eryter maybe tried this. about playing it. Because she still looks Lydia fresh. She is, she is youthful.

She is youthful. She is youthful. She's like the dick clerk of, but alive obviously. So I thought that would be a good, well one, a good present for you and two, I thought that would be a good thing for us to talk about. So leeches are, this is an old thing, right? This is not like a new invention

that you and the other bees in the, in your leech circle. In my leech circle. Yeah, we sit around, we do hot yoga and then we, we leech each other. That sounded terrible. No, leeches are probably the oldest bloodletting. I shouldn't say leeches, obviously leeches are a way of bloodletting, but bloodletting, the concept of getting rid of blood in order to improve your health in some way, is one of the oldest medical practices for probably 2,000 years. And it continued until the 1900s, and I'm even going to you in on some ways that it still used today. So let's go back to the beginning though. I find the leech.

I put it on me. Who am I? Where am I? When am I? Well, you could be anywhere. Literally anywhere in time or in the world. The Mesopotamians practice bloodletting, the Egyptians, the Greeks, the Aztecs, the Mayans, everybody. Everybody all over the world, ancient civilizations,

practiced bloodletting. The idea, when you start looking at it, who wrote about it and talked about why they did it, if you look back to like fifth century Greece, did it. If you look back to like 5th century Greece, hypocrite has probably started this idea. Basically, the idea is that people would have plethora. A plethora. A plethora. Which we thought meant they had too much blood. Oh, okay. So it's a fake thing, not a fake thing. Okay. So we thought people had too much blood. I won't learn it then. I won't commit it to memory if it's fake. Do you commit any of this to memory? No, ma fake thing. So we thought people had too much blood. I won't learn it then. I won't commit it to memory if it's fake. Do you commit any of this to memory? No, ma'am.

OK. Who are you again? Exactly. So people had too much blood. And they would have all kinds of symptoms because of it. And really, we thought people had too much blood, so they'd get what we would now call a fever, or they'd have a headache, or they would have a stroke.

We don't know. Any of these things, we thought, well, it's probably just too much blood. And it's not like a completely crazy thing, right? You can see where someone might come to that conclusion because, for example, they, when you have an inflammation somewhere, that's the blood rushing to that area. So, it would make sense that they might think, oh, well, they have too much blood because they would see some of much of a mass in one place. That's a very good point and I'm really impressed. You know what inflammation is. Woo!

Yeah, I just gave you credit for that. I'm doing my arch heli dance. If you want to see it at home, you can't see it. Man, it's good. It is good. So no, you're right. Absolutely right. It does make sense that somebody would be, say they have a fever and they look

flushed and sweaty and their heads hurt anything. They got a bunch of extra blood up there. It made sense too if you consider that when you go back one of the predominant medical theories, if you can even call a medical theory, just random guesses as to how our bodies work, or the whole four-humors theory. Okay, I know a little bit about these, the Four Humors. What are the recap from?

Well, why don't you tell me what you think the Four Humors are? Well, the Four Humors are Mel Brooks, Jerry Sramfeld, and Sid Cesar, and Carl Reiner. Okay, that was good. I like how timely that joke was. Yeah, I have some awesome make sure I count current. It was. You're really you're really aiming at like the 18 to 24 year old demographic with that one. I'm riding the middle of the demo. I think that's true. Okay, no, those aren't the four humors. Fair enough. So they were blood, black bile, yellow bile, and flim.

Now, black bile and yellow bile, there's real. There's real things. I mean, there's bile, there's blood, there's flim. All those things are real, but not in the sense that they thought, not in the way they thought they were real. So how might we try to balance those out if they get a little awry a little... So they're all responsible for different bodily functions and in all honesty I don't

know all of the things that we thought these different things did. I mean I know what blood actually does but you don't know what are that. But the idea was that you had to keep them in balance and if something was, if you had too much of something or too little of something else, the way to get your stuff back in order was to get rid of something. So you either threw up, so we gave you an ametic, you know, epicach or something herbal like that, or we gave you a diuretic, we did know of certain plants that you could create decoctions out of, basically boil them down and drink something,

it would make you pee a lot, or make you have massive diarrhea, that too. Like earth shattering diarrhea. Earth shattering diarrhea, like the greatest diarrhea you've ever had. I got down through the ages. Your ancestors are still talking about this diarrhea. Or if you had too much blood,

you bleed yourself. You're right of it. You can put a leach on it. You can put a leach on it, absolutely. You could also exercise a lot. I don't think I said that. That gets a sweat out. That gets a sweat out.

Stink it. You could sweat out. I don't know. I think you probably sweat out black or yellow bio, maybe I don't know. That seems okay. I don't think you sweat. I don't know what they thought you sweat out,

but they thought you could sweat out something Yeah, I mean it is pretty it's pretty gross How do they not know? I mean can you just look at somebody's been exercising? No, they haven't sweated on any black bile or yellow bile or any bile really? I don't know that they knew exactly what black or yellow bile was I imagine that fluids came out of people's body and they went well that that's yellow That's bio and they went, well, that's yellow. That's bio. And I mean, and people would get really angry and so they'd be like, well, it's bio.

Because they're really angry. So bio makes you angry. I think bio was supposed to make you like, er, so let's focus. Let's drill down on on bloodletting specifically as balancing the four humors. So, okay. So the idea was, you know, we know all these other ways to get rid of bile, the various bile and flim. So, how can we get rid of blood? Okay, I know one stabs.

Stabs? That's a great one. Stabs are great. That's a great way. That's a great way. But, they wanted to be, I mean, it's like, if you're going to make up a medical theory, you may. This only works for vampires that was I like that yeah topical humor yeah uh i'd say topical humor because he just wants to do blood so there you go it's topical for us it's topical for two people in this room jerry doesn't watch tripline if you're gonna make up a medical theory like the four humors and then you're gonna like bleed people you may as well make up a whole way to bleed people. Why not?

So like Galen developed this entire system. Galen. He's like an ancient physician guy. There's some, you got some stuff in your body that's named for him, trust me. Okay, I'll take your word for it. Wait, Galen's process? Is that thing?

I don't know what you're talking about. I void, I void. No, that's a Zyphoid process. Galen's process. Galen's process. Galen's sign. Is there a Galen's? Galen's...

You don't know any... Yes, Galen's hoedown. Where is my Galen's hoedown in my body? You're not old enough to know yet. Okay, maybe when I'm in my 40s. Galen developed a whole system of what vein or artery to bleed depending on what your symptoms are and how much you should get rid of and all this.

And he was actually the first one to discover that we have blood in our arteries. They used to think that we had blood in our veins and our arteries were just full of air. We were probably better off before we figured that out. Yeah. Because then he started cutting open arteries. Oh man. I'll get one. And you could do this for anything. That was the idea was, you know, you used blood-letting to treat basically anything that was wrong with anybody ever. So acne, how about we bleed you? You had a stroke?

Yeah, I did. Maybe a seizure. Sure. Maybe you've got the plague. Maybe you've got tetanus. Maybe you've got tuberculosis. Whatever. We'll bleed you.

For all of that. For all of that. Bloodletting was a cure. Well, thought to be a cure for everything. In fact, it was thought to be a cure for bleeding. That sounds countermeasure. I know. That was a thought. Hey, is your wife menstruating too much?

I got an idea. This is actually an interesting lesson from past medicine. I'm starting to pick up on a common theme. We're seeing some of these emerge as we talk more about medical history. If you want to know if something is made up and I think this is probably applicable today, something you could like keep in mind in your day-to-day life now. If something is a cure all, and I mean literally like, oh, you got asthma? No problem. Bloodletting. Leposy, bloodletting, scurvy, bloodletting. Like, this is a recurring thing. Mercury was like, oh, you're too sad?

Mercury. Yeah, angry, mercury. Have you got cyphyl? Yes, cyphyl, cyphyl, cyphyl, it's a mercury on it. That like, I think that you should be suspect of any treatment that someone's like, anything is good for anything, because then it's like, probably not good for anything, actually, probably good for anything because it's like probably not good for anything actually probably good for nothing

Probably good for making me so sad that I almost lose the Civil War only applicable to a room Lincoln bestil That's absolutely true because it really once it once it took hold and it was it was great because It was something that you could explain to people based on the whole four-humor theory. And so it sounded really, I mean, that's a very simplistic theory. You gotta balance this stuff. We need to get rid of one of them. Sure. Very simple. You can explain it to the layman, you know?

I would see, I would have insisted. I would have been a real pioneer. I would have insisted that you just add more of the other three until I become some sort of superman, some sort of like so many humors that I just waddle around like the Michelin man, my skin swashing with humor. Swashing with humor.

Do you wanna be the first one to get extra flim? Come on, just give him a flim and jack. You. Put it right in my goiter. The thing was that it was also easy to do. I mean, so it's easy to explain and it's easy to do. You know, how are you going to, so how are you going to do this? Just cut them open.

Yeah, just cut them open. I mean, you could do something easy, the phlebotomy or venice section, just cutting open a vein using a flame, which is just a, you know, like a knife, a scalpel thing they use at the time. You could do arterotomy, which is like puncturing an artery, and they usually actually use your temporal arteries. Those are on your temples as you may imagine.

Those are bad ones right there. Those are breeders? Yeah, well, I mean arteries in general are breeders. You don't laugh at me. I mean, come on, it's my immersion. Yeah, those are bad ones, they're on your head. Try not to poke the arteries on your head. You gotta keep that hip lead in place.

They had a tool called a scarificator. You could do scarification. Well, what is that? It's like this little spring loaded box with a bunch of sharp blades in it. And you just like hold them on your arm and you could like make like parallel cuts on your arm and leg. Okay, now I've seen this. You have to put your hand in it to get the key out because it's the only thing that can unlock you,

but then, but holding the key out, you fire up a chainsaw that kills your friend. I saw saw, I know how these things go. That's exactly what it was. That was the impetus for saw, the saw movies. That's how saw the saw movies were invented. Thank you. Now we have shared with you the origin story

of the saw movies. The problem we have is too much blood and also flam. To your right, you'll see more flam. Your friend is a little low on flam. Top him off. That's my jigsaw impression. That was it. I think that was a good jigsaw impression. Thank you so much.

Jerry's terrified. Look at him over there. He's just clivering. So, so that's that was the those were the main ways that you did bloodletting. That was the main thing to do. And it was pretty popular until about 1163 when the church actually, because, you know, the, when I'm talking about the church, I'm really talking about the Catholic church at the time, was obviously full of religious people. But they were also learned men and they read a lot and they

Realized that bleeding people was probably not working very well. There was no evidence that it was helping most of the time If it helped by the way if it helped to do anything the only thing we have in theory thought it may have helped with was hypertension Because if you have less blood you have less blood pressure now. That's not a treatment for hypertension I would not advise that but there you go So the church turned against it in 1860 1163 You have less blood pressure. Now that's not a treatment for hypertension, I would not advise that, but there you go. So the church turned against it in 1860, 1163. Now the only time the church will plead to dry is when the collection played his past around me.

Good one. What is up on the edge of the bridge? Oh, no. George Carlin, pushing down the rope. So at that point, of course, who's gonna pick up that, you know, that torch, who's gonna keep carrying it? Well, barbers. Oh sure, right. They already had sharp things lying around the your one. History's rebels. Barbers. The bad boys. The bad boys of medicine. Barbers, surgeons.

So they started bleeding patients. So they would, and they actually barbers did all kinds of stuff. They would, they do, you know, bleeding, they would do tooth extractions, they would do amputations. Presumably they'd cut your hair off for you as shame. So a physician would see you and write you a prescription for bleeding and then you'd go to a barber and they'd cut you up. Could they write a prescription for a haircut too? Also a wire in there, you need tens of seeds of a trim.

Also a wire in there, that mullet is not working. I know the Walrus mustache is very popular right now, but it is not working for you. It is 1520, what are you doing? And they continue to do that as late as it, 1923, Sir William Osler published the principles and practices of medicine. And he was still talking about bloodletting at 1923 Sir William Osler published the Principles and Practices of Medicine. And he was still talking about bloodletting.

1923. Dude, get to that. It's over. What you're probably wondering is where did the leachis come in. Yeah, right. I'm ready. Right. So everybody's getting blood all the time.

And most of the time they're just cutting people open. But then in the 1800s, they got the idea that, you know, let's take a more natural approach to this. Homeopathic approach. Homeopathic approach. And that's where Herudith therapy, which comes from the Herudo medicinalis, which is the Latin name for leeches. Herudith therapy became popular where you just, you know, we already have these creatures that, you know, suck your blood. And they actually release like a natural anticoagulant. Okay. So to make your blood not clot as they're sucking it, called herudin. And so it

was, it seemed like a really good idea. We'll just put leeches on people. Apply until syncopy, which means passing out. That was the general idea. Just put them on there until you pass out and then take them off. Perfect. Perfect. No danger there. That seems all perfectly safe. It does not seem like a great idea. And do you know that in France, it was really popular.

They imported in the 1830s 40 million leeches a year. Where are they all coming from? For medical use of year. What are they all coming for medical use? Where are they all coming from? I don't know. I guess. I guess. Yeah. Leech bogs. That bog from standby me? That was all of them came from there. That's the only place you can find them naturally occurring.

I don't think that was a bog. I think it was a pond, honey. Something of what is the difference? You don't look at being the item of the different student bog in a pond, is it? I am a medical doctor, I don't know. Not a common doctor. Do you know that the modern word leech is derived from a Latin word for physician?

Yeah, well. One of an old Latin word. Hey, hey, but that's how in twined leeches and medical practice became after that point, which I think is really interesting that it became the name for a doctor is a is elite you know the name for a leech is derived from the name for a physician. Are there famous people that got this? There were a couple famous people who had who who were blood. One that you

may have heard of father of our country George Washington. Okay all right that's what I was thinking of and I didn't want to embarrass myself by suggesting it but yeah he was blood, right? Yeah, and that may actually have contributed to his death. So he had a retrofaring gel abscess to an abscess like in the back, back of his throat, like behind his throat kind of area. All of a they put a leash back there?

No, but they thought, you know, we didn't have antibiotics, let's just stick leeches on him. Sure. So they did, and then he died. But we don't know that it was because of leeches, but that can't have helped. It don't be too sad.

He would be dead by now anyway. You would have never gotten them to meet him. That's fair. If that's the worry about a home, that they robbed you of your chance, it don't worry about he would be many years dead. That's an excellent point. That's what I think about a lot of times

if I get sad that a famous person got killed a long time ago, what I really think about it is they would be dead anyway. So why try to alter, why don't cry over spelled dead people? Like, you couldn't have met them. They would be dead, no way. Stop trying to build that tardis and get over it. Just get out, let it, let it, let it live. I should too.

Marie Antoinette was also blood. I couldn't matter. Well, she didn't die though. Oh, okay. Well, I mean, she did die. I mean, she's still alive. She's not alive now, as far as't know. Well, she didn't die, though. Oh, OK. Well, I mean, she did die. So she's still alive. She's not alive now, as far as I know.

She didn't die, but she was blood. It was actually not uncommon to bleed women prior to childbirth, or if they have any problems immediately afterwards to bleed them, which is a really terrible idea. But she became very ill right after she gave birth. She was hurting, which makes sense, like we should. So they bled her and then she passed out and woke up and felt better. Oh, good.

So. And there we go. Another case, another evidence that we can use in the case for four leeches from leeches. You know, I think that's my favorite idea is that we use leeches and we use bleeding therapy for people who are bleeding. I think that's the most fascinating to me. I mean, because it really flies in the face

of the original theory, which is that we need to get, you have plethora, we need to get rid of blood, we're getting rid of blood. This is great. If they were gonna amputate your leg, if they're gonna cut off your leg, ahead of time, they would remove as much blood as they thought was in the leg.

Oh my God. So they get what you're doing. What you think, the first time you cut somebody's leg off and it blood, you'd go, well, I guess they're so blood in there, that's probably not a good idea. Yeah, I guess I didn't make any sense. I guess it goes through your whole body maybe, or something.

I don't know, I'm not a scientist. You are a scientist. Just because it's in the 1800s doesn't mean you're not like the best they have right then we knew about veins We knew that we mean it's not there was error in them. We knew something was up. We need something Something about veins and stuff I man that makes the I mean to be fair if you do bleed someone with leeches They will stop bleeding out of other holes just for our process of liberation.

I mean, eventually the boy being will stop in their defense. All bleeding stops eventually. That's a good that we've learned that rule early in medical school. All bleeding stops eventually. Now, are there are these, this isn't still on on day, of course. Bleeding? Any of them. Bloodletting?

Yes. Oh, no, yeah, absolutely actually the most horrifying process I think if you consider like cutting somebody's vein and little scarficator and then leeches leeches are still being used today. So you're kidding me? No, like not in like developing nations and places where sciences and as far sort of Nope, in the usva. You're kidding. Appearance and places where science isn't as far sort of nope in the us a your kid. Yeah, it's a it's a it's a considered I don't want to say cutting edge because that implies that it's a new idea and it's an old idea, but it has had a

Renaissance as it were so Here's the here's the way we use it now Let's say that well, let me cut your finger off. Okay. Can I cut your finger off? Sure, one second. Ah! Okay. Cut off. Now, let's say that I knew how to reattach it.

Wonderful. We should have gone through this before. I don't know how to reattach it. But if I did, if I were a surgeon who specialized in reattaching limbs, and specifically microsrgery like fingers, then I would be really good at connecting all the arteries because they're bigger. They're easier to see, you know, where the arteries are. So I'd be really good at sewing all the tissues together and connecting all those little muscles and tendons and arteries back together, right? The veins are so

tiny that you can't reconnect them. You can't sew them all, you can't just like, you know, piece them all back together and sew them back up. So what happens is, you know, arteries carry blood away from the heart to the body. And veins carry blood back to the heart, right? You remember that? Yes, sir.

So the arteries are taking the blood from your heart to the finger that's been reattached. But then all the little veins are broken So that can't carry the blood back away from it. So it gets congested Plethora if you will. Yeah gets plethora So it's all congested and you've got all this blood that can't return and get swollen and it's painful And it can start damaging the structures and make um tissue healing impossible So we need to get rid of some of that blood.

So leeches. So we put a leech on it. Now, is that, isn't that a short-term fix? I mean, when you continue to have these issues with the blood getting back to your body? No, because eventually the veins will reattach the heal. You'll develop what we call collateral circulation, so other new blood vessels will grow.

Huh. So eventually you will get, you know, normal function in that finger, but in the meantime to save that appendage, we can put a leech and not all hospitals do this, not all facilities offer this. Like at the hospital where I work, I think if I tried to bring a leech into an operating room, people would freak out. But there are hospitals where they do this commonly, and it with really good results.

So if people want to read more about bloodletting, if they want to learn more, there are any resources online that they can go check out. Do you mean real bloodletting or fake? Either way. So if you want to learn about real bloodletting, you can just, I mean, look up heru to therapy, leach therapy, bloodletting. I would type that into your search engine of choice and read about it.

And I put in a dog pile or ask Jeaves about it. Ask Jeaves about it. I think that's what everybody uses now, right? Ask Jeaves. If you want to know nothing about actual bloodletting, but you do want to laugh, I would recommend bloodletting.org. What's bloodletting.org? Well, bloodletting.org.

It really has to do with choosing your own destiny and the limits of your imagination. What are you talking about? Well, it's basically an RPG fantasy world where vampires, slayers, werewolves, witches, antangels interact, roleplay fight, and engage in war with each other. Okay. I just read that off of the website. Off of bloodletting.

Off of bloodletting.org. I think it's some kind of game Nothing leech related right there is nothing leech related There is nothing scientific. Well, I don't want to say that there might be science here I don't see it when I look at the screen But it's possible someone in here is a science. I do see in the news and update section that there's a zombie threat. Okay, good And there's some worm reviews What I don't know

We don't understand any of this, but we are playing it every hour on the hour. So if you want to come Joy doesn't bloodletting dot work. We're not really playing it is not bloodletting really But we did stumble upon it during Sydney's research and wanted to... I see they stole a picture of a cane from Legacy of Cain. They're using the logo there. Maybe have a case against them. Oh, now we've just exposed them. These poor guys.

Why do we do that? I don't know. We put them on blasts like this. I want to thank you so much, you at home, for listening to our program, Saul Bones, a myrtle tour of Miscite and Medicine. We've launched this show just recently, and your response has been so fantastic. If you can, please go to iTunes Search for our program. Give us a subscription and a review if you have the time.

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Come on, do it. Who mentioned my other podcast. Right. So go to MaximumFunderal and check out those podcasts. Go to the forums, you can talk about our program and so much more. You can all mention how I did not talk about hemacrimatosis, which is a real disease

that we use bloodlighting for today. So now I've said it, doctors, are you medical students doing, you're gonna yell at me for it? Back off. I've said it, I know about that. It's just not as interesting because we don't use leeches. So there, whatever.

Whatever, and make sure you join us again next Friday for sawbots. As always, I'm Justin McRoy. I'm Cindy McRoy. Don't put a police. I'm not a big cross. You can't see me. I'm not a big cross. You can't see me. I'm not a big cross. You can't see me.

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