MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Bloodletting therapy (BLT) has been widely used for centuries until it was discovered that it is not merely useless for almost all diseases but also potentially harmful. Yet in so-called alternative medicine (SCAM) BLT is still sometimes employed, for instance, to relieve acute gouty arthritis (AGA). This systematic review aimed to evaluate the feasibility and safety of BLT in treating AGA.

Seven databases were searched from the date of establishment to July 31, 2020, irrespective of the publication source and language. BLT included fire needle, syringe, three-edged needle, and bloodletting followed by cupping. The included articles were evaluated for bias risk by using the Cochrane risk of bias assessment tool.

Twelve studies involving 894 participants were included in the final analysis. A meta-analysis suggested that BLT was highly effective in relieving pain (MD = -1.13, 95% CI [-1.60, -0.66], P < 0.00001), with marked alterations in the total effective (RR = 1.09, 95% [1.05, 1.14], P < 0.0001) and curative rates (RR = 1.37, 95%CI [1.17, 1.59], P < 0.0001). In addition, BLT could dramatically reduce serum C-reactive protein (CRP) level (MD = -3.64, 95%CI [-6.72, -0.55], P = 0.02). Both BLT and Western medicine (WM) produced comparable decreases in uric acid (MD = -18.72, 95%CI [-38.24, 0.81], P = 0.06) and erythrocyte sedimentation rate (ESR) levels (MD = -3.01, 95%CI [-6.89, 0.86], P = 0.13). Lastly, we demonstrated that BLT was safer than WM in treating AGA (RR = 0.36, 95%CI [0.13, 0.97], P = 0.04).

The authors concluded that BLT is effective in alleviating pain and decreasing CRP level in AGA patients with a lower risk of evoking adverse reactions.

This conclusion is optimistic, to say the least. There are several reasons for this statement:

  • All the primary studies came from China (and we have often discussed that such trials need to be taken with a pinch of salt).
  • All the studies had major methodological flaws.
  • There was considerable heterogeneity between the studies.
  • The treatments employed were very different from study to study.
  • Half of all studies failed to mention adverse effects and thus violate medical ethics.

6 Responses to Blood letting: yes it’s still a thing in so-called alternative medicine

  • Well, I find a nice bacon, lettuce, and tomato sandwich (BLT) will cheer up many folks with arthritis and make them feel better – and a pinch of salt is needed on the tomato. Yum!
    Take care, and keep taking the placebo.

  • Gad…you seem to love to rewrite history!

    The use of bloodletting had its origin in Chinese medicine…but they only bloodlet very small amounts. Then, it was European conventional medicine has sought to bloodlet larger amounts. The assumption that the benefits accrued by small amounts is “improved” by increasing the dose was once again proven WRONG!

    And it was Samuel Hahnemann, MD, the founder of homeopathy, who led the fight AGAINST bloodletting.

    Heck…rewriting history doesn’t change facts.

    • firstly, the post is not on the history of bloodletting and barely mentions it
      secondly, “bloodletting is thought to have originated in ancient Egypt”
      [https://www.history.com/news/a-brief-history-of-bloodletting#:~:text=Considered%20one%20of%20medicine%E2%80%99s%20oldest%20practices%2C%20bloodletting%20is,stemmed%20from%20an%20overabundance%20of%20blood%2C%20or%20plethora.]

  • This is just a ranting opinion that has no research to support any points in the “so-called” conclusion. Credentials mean nothing when the education for writing a proper critique or review of the literature is ignored, presuming they actually have any. This is merely an inappropriate way of seeking attention.

    • @Lisa
      Are you saying that Edzard Ernst lacks the education to write a critique or review of the literature? And that as a result, his judgement and conclusions are ‘just a ranting opinion’?

      Now I think I know the answer to the following question, but I ask it anyway: have you actually looked at Prof. Dr. Ernst’s background and credentials?
      And speaking of which, what are yours? If I should hazard a guess, I’d say that you are an alternative practitioner who is once again reminded of the unpleasant fact that their daily work is basically fooling sick people with useless quackery and making them pay for the privilege.

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