Pediatrician Children First Pediatrics Rockville, Maryland, United States
Background: Current asthma management consists of a combination of drugs with different mechanisms of action. Ancient asthma care, by contrast, focused on loosening the humours using remedies such as drinking animal blood, eating rabbit fat and fox lungs, inhaling or consuming certain herbs and plants, bloodletting (including wet cupping), diet (eating raisins, dried figs, vegetables, barley, capers, bread, cake), steaming, baths, wet compresses, and moderate helpings of wine with dinner. Bloodletting was believed to purge the body of noxious humours that caused human disease and thereby reduce inflammation. Here we address the use of bloodletting in asthma management over the centuries and in diverse cultures. Objective: Explore the history of bloodletting as asthma treatment. Design/Methods: Selected books, scholarly articles, and online resources on bloodletting and asthma in both children and adults were examined. Results: Asthma was described and treated by the ancient Greeks, Egyptians, and Chinese. The etiology of asthma evolved from being thought of as an imbalance of the humours by Celsus and Hippocrates to a disease of inflammation in the 1800s. Bloodletting was first described by the ancient Egyptians >3500 years ago and its use in a variety of ailments spread globally. Numerous factors were to be considered before prescribing this treatment (Table). Celsus and Hippocrates practiced the art of bloodletting to treat asthma. Galen also stressed the importance of bloodletting in the treatment of various ailments, but in moderation. Bloodletting was widely practiced in the medieval era and was championed by Maimonides. Lectures by Dr. Henry Clutterbuck were published in the Lancet in the 1830s on the use of bloodletting in children and adults to treat asthma and other disease of the respiratory system (2-3 bleedings of 10-12 ounces were sufficient to subdue the inflammation for adults). Wet cupping (WC), a form of low-volume bloodletting, was introduced in ancient times and continues to be widely used in the Far East and countries in the MENAP region. Cupping therapy as adjunctive therapy for asthma in children is advertised and offered in the United States. Studies on efficacy of bloodletting/WC are limited, usually favorable, generally of poor quality, and mostly in the non-English language medical literature.
Conclusion(s): Bloodletting in the treatment of asthma is an ancient practice utilized in many regions over the centuries. Evidence for its usefulness is anecdotal and well-controlled studies are needed given the scope and extent of its use.
