Heroic medicine, also referred to as heroic depletion theory, was a therapeutic method advocating for rigorous treatment of
bloodletting
Bloodletting (or blood-letting) is the withdrawal of blood from a patient to prevent or cure illness and disease. Bloodletting, whether by a physician or by leeches, was based on an ancient system of medicine in which blood and other bodily flu ...
,
purging
A purge is the forcible removal of undesirable people from political activity, etc.
Purge or The Purge may also refer to:
* Purge (occupied Japan), the forcible removal of undesirable Japanese from public service during occupation of Japan
* G ...
, and sweating to shock the body back to health after an illness caused by a
humoral imbalance. Rising to the front of orthodox medical practice in the "Age of Heroic Medicine" (1780–1850),
it fell out of favor in the mid-19th century as gentler treatments were shown to be more effective and the idea of
palliative treatment began to develop.
History
Pockets of medical methodology that can be classified as "heroic" appear in the early 17th century with Parisian physician
Guy Patin and French anatomist
Jean Riolan the Younger. Patin, nicknamed "Le Grand Saigneur" (the Grand Bloodletter), was infamous for his rigorous procedure plans, which included intensive courses of bloodletting and application of
senna. Because heroic medicine used popular techniques, it is difficult to absolutely classify a healer's therapeutic epistemology as heroic. Intensive bloodletting treatments can be identified throughout American history, with
William Douglass in Massachusetts advocating for a heroic treatment plan in the early 18th century.
While there were practitioners here and there who were particularly eager to perform aggressive treatment, heroic medicine did not become a concentrated school of thought until later in the 18th century.
Many associate
Benjamin Rush with an abrupt acceptance of heroic techniques into the realm of mainstream medicine, especially in America. Founding father, creator of
University of Pennsylvania’s medical school, and known as the "American Hippocrates," Rush was well respected and revered in the medical field. The
Philadelphia Yellow Fever outbreak in 1793 is looked upon as a major event in the merging of heroic medicine into the course of best practices in the medical profession.
Much of the city was left incapacitated by the rampant epidemic. As healers fled the city, Rush bravely remained to treat people, and ultimately himself, with drastic regimens of intensive bloodlettings and purgatives. He taught many students who then carried the tradition to other parts of the United States. Varied in its influence, heroic medicine was particularly concentrated around Pennsylvania and spread into other locations. The term "heroic medicine" was coined later in the mid-19th century to describe extreme treatment.
Heroic medicine was used to treat
George Washington on his deathbed in 1799. He was bled repeatedly and given
Mercury(I) chloride (calomel) and several blisters of
cantharidin to induce sweating. Washington died shortly after receiving this rigorous heroic treatment.
Heroic medicine was very much in the hands of the professional, as the invasive interventions involved were beyond the capabilities of rustic practitioners. Symptoms were not regarded as the body's attempt to fight the disease, but were considered a complication that would exacerbate the patient's condition and do further harm. Practitioners believed that a fever should be suppressed and any drugs used should be powerful and given in large dosages. Under this onslaught, domestic medicine dwindled in importance; even treatments that had been found effective in the past were relegated to the realms of old-fashioned folk medicine.
Practices
Heroic medicine does not have a definitive start date, as its treatments themselves were not new to the field of medicine.
Bloodletting
Bloodletting (or blood-letting) is the withdrawal of blood from a patient to prevent or cure illness and disease. Bloodletting, whether by a physician or by leeches, was based on an ancient system of medicine in which blood and other bodily flu ...
,
purging
A purge is the forcible removal of undesirable people from political activity, etc.
Purge or The Purge may also refer to:
* Purge (occupied Japan), the forcible removal of undesirable Japanese from public service during occupation of Japan
* G ...
, and
sweating
Perspiration, also known as sweating, is the production of fluids secreted by the sweat glands in the skin of mammals.
Two types of sweat glands can be found in humans: eccrine glands and apocrine glands. The eccrine sweat glands are distri ...
are cemented firmly in medical tradition back to the advent of humoral theory in the time of
Hippocrates
Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history o ...
and
Galen
Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be on ...
. With hopes of rebalancing the body's delicate homeostasis of four humors – black bile, yellow bile, phlegm, and blood – the careful manipulation of bodily discharge, like bleeding and evacuation, was believed to nudge the body back to its healthy, natural state. The physician's role was always to monitor the path of the body's humoral levels back to normal.
Heroic medicine takes this methodology to the extreme, draining significant volumes of blood and ordering intensive regimens of evacuation. It was not uncommon for physicians to strive to drain up to 80 percent of a patient's blood volume.
Likewise, dramatic evacuations, both by pharmacological
emetics and
laxative
Laxatives, purgatives, or aperients are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation.
Laxatives vary as to how they work and the side effects they may have. Certain stimulant, lub ...
s, induced the forceful removal of bodily fluid. Commonly used emetics include
senna and
tartar emetic. General intestinal cleansing was instigated by massive doses of
calomel, to the point of acute mercury poisoning. Sweating was also induced using blisters of
cantharidin and
diaphoretic
Perspiration, also known as sweating, is the production of fluids secreted by the sweat glands in the skin of mammals.
Two types of sweat glands can be found in humans: eccrine glands and apocrine glands. The eccrine sweat glands are distri ...
.
Fall of heroic medicine
Heroic medicine became less favoured with the rise of safer
placebos such as
hydrotherapy and
homeopathy
Homeopathy or homoeopathy is a pseudoscientific system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths, believe that a substance that causes symptoms of a di ...
. Even during its heyday, heroic medicine faced criticism from physicians and alternative medicine healers, who pushed for more natural cures.
While it is easy to discuss and question the ethical implications of such a severe course of treatment, it is important to remember that in that time period physicians were operating under their best understanding of the body and its physiology. There were dissenting voices at the time, but heroic medicine remained an important, legitimate part of the medical tradition in that era.
See also
*
Heroic measure
In medicine, heroic treatment or course of therapy is one which possesses a high risk of causing further damage to a patient's health, but is undertaken as a last resort with the understanding that any lesser treatment will surely result in failu ...
References
{{DEFAULTSORT:Heroic medicine
History of medicine