Bloodletting, Lobotomies, and the secret skin grafting treatments! What?!
Today we are breaking down 5 truly bizarre and bloodcurdling past medical procedures that were shockingly used to treat patients. Were they truly a medical necessity or an ineffective misery-inducing procedure, I’ll let you be the judge. Plus are they still used in medicine today?
5. Bloodletting
Nowadays in modern medicine losing a ton of blood is a bad thing. Whether it's due to a major trauma like a car accident, gunshot wound, or worksite injury, in the Emergency Department where I work, if a patient comes in and is bleeding out, the goal is to stabilize the person and stop the bleeding as soon as humanly possible. But what if I told you that this was not always the case? Quite the opposite. In fact, doctors encouraged blood flow. Yes, for thousands of years, Bloodletting or removing the blood from a person with the goal of treating a medical condition was one of the most common procedures performed by doctors. Ancient Egyptians all the way through the Greeks, Romans, and even into the early 1940s if you’d believe it, bloodletting was believed to be a suitable cure for just about any ailment you could imagine.
So what was the purpose of this medically induced bloodshed? And how would they do it? Well depending on whether it was generalized or local, doctors might have gone about it a few different ways. First, they may cut a vein or artery, or even employ leeches, or use a scarification cupping type of procedure to draw the blood out of the body. On a very basic level, the belief was if a person was ill, there was an imbalance in the body. And the thought was: to release blood over several days, this would restore the balance to the body. But was it effective? I’m sure this may come as no surprise to you but there were a lot of risks with bloodletting. It puts people at risk for infections, organ failure, and even death. The most common cause of death is blood loss. In fact, they say that America’s first president George Washington may have even died of bloodletting gone wrong. Evidently, historians say Washington had a throat infection and upon his request, his doctor performed bloodletting 4 different times over an 8-hour period. You know, trying to restore balance to his body. But as it turns out he ended up losing about 40% percent of his blood and died.
So although this antiquated practice may sound like a gruesome form of torture do you think we still use this process today in medicine? I'll give you a few seconds to take a guess.
Yes, believe it or not, there are versions of this bloodletting process that we still use today. Now it's no longer used to treat every ailment under the sun, but in a very limited way, it can be quite useful. If a patient has Hemochromatosis, for instance, is a disorder where the body can build up too much iron in the skin, heart, liver, pancreas, and more. And this buildup of iron in the body over time can cause serious damage to the tissue and organs. So to treat hemochromatosis, doctors will in fact remove blood from your body on a regular basis. But nowadays it is more like donating blood than yesteryear’s bleeding out process.
4. Lobotomy
Our next barbaric and infamous medical procedure may be the most feared of all time. Originally known as the leukotomy, the Lobotomy was a surgical procedure in which the nerve pathways in a lobe or lobes of the brain were severed from those in other areas. You see, the belief was that mental illness was caused by faulty connections between the frontal lobes and another part of the brain -- the thalamus. So the idea was that severing those connections and regrowing them could treat symptoms and agitations of the mental illness.
Sounds maybe kind of, sort of reasonable when you just hear the definition and thought process behind it right? But what if I told you that this radical therapy was performed with an ice pick? Yes, and patients were not always anesthetized and often left in a vegetative state. Brutal for sure.
First performed in Portugal by a neurologist, the procedure was later adapted and popularized in the US in 1936 by Dr. Walter Freeman. He performed tens of thousands of lobotomy procedures and yes used an actual ice pick-like tool to hammer into the corner of an eye socket and jiggle into the prefrontal portion of the brain. This 10-minute procedure was believed to help patients with schizophrenia, manic depression, bipolar disorder, and many other mental illnesses.
So I know what you're thinking: did the lobotomy ever work? According to records, there were about 40-50,000 lobotomies performed in the US, and about a third of the lobotomies were considered successful. For instance, one patient named Ann Krubsack said that after enduring schizophrenia for 8 years she had a lobotomy in 1961 and it worked for her. To what degree though I’m not sure. However, in the majority of other patients, things did not generally go so well. Some were paralyzed during the procedures, some were left devoid of personality, and some died throughout the process. And in 1967 Freeman was banned from performing this procedure after his patient suffered a fatal brain hemorrhage.
So what do you think? Do we still use this procedure to treat mental illness today?
No, not exactly. Although the lobotomy procedure was used well into the 1960s in the US and even the 1980s in other parts of the world. Today shock therapy and another psychosurgery (the surgical removal or altering of specific regions of the brain) occasionally are used to treat patients whose symptoms have resisted all other treatments
3. Trepanation
Trepanation aka drilling or scraping a hole in the skull is one of the most brutal sounding and surprisingly oldest forms of surgery that we know of. I'm sorry Doctor Wagner, what in the what? It's true, I’m no historian but evidently, humans have been performing this procedure since neolithic times. For instance, at a burial site in France dating back to 6500 BCE, tons of prehistoric skulls have been found to have trepanation holes in them.
So why would one drill a hole into the skull of another human and it is such a common practice in ancient times? Although it could have been for injuries or other practices that we have yet to discover, some experts believe it could have been that ancient humans may have done this as a way to quote release demons from the skull. And No, I'm not making that up. Now whether these skull demons were religious in nature, or a metaphor for some other physical ailment or mental component, experts don't really know exactly. But something they do know? Shockingly some neolithic patients did actually survive this demon-dispelling procedure as there is evidence of healing on ancient skulls that have been found. Wild Right?
Alright, what do you think? Is this alarming procedure still used today in medicine?
Well, sort of …Not necessarily to dispel demons but nowadays we do in fact use a more advanced version of this technique called the Burr hole. This brain surgery is often done after mild to severe head injuries have occurred. In this procedure, a neurosurgeon will drill a small hole into the skull in order to drain excess blood from the brain. This build-up of blood from an injury can cause pressure and compress brain tissue which can lead to brain damage and even death. So shockingly yes doctors still do drill into patients' heads for the sake of saving their lives. I can’t say I've ever seen a demon come out though.
2. Rhinoplasty
But wait a minute doc, I’ve heard of this one before! Eh, maybe not in the way you think you have heard of it before. You see, rhinoplasty as we know it today is a surgery that changes the shape of one’s nose. This could be done to improve breathing, for cosmetic purposes, reconstructive purposes. You name it. But back in 16th-century Europe however, the motivating factor for this unpleasant procedure may have been the result of the syphilis epidemic.
You see syphilis or bacterial infection that is usually spread by sexual contact, showed up in Italy in the 16th century. Allegedly carried by sailors after they went out into the world um- exploring. But you see, Syphilis develops in stages with symptoms varying per stage. Things like sores on the genitals, and possible heart complications. And one of the lesser-known symptoms of syphilis: it can also destroy the soft tissue in the nose, and lead to the collapse of the cartilaginous bridge of the nose. Which can cause a gaping hole in the middle of a person’s face or a deformed saddle nose. So if the possible social stigmatization wasn't enough the huge hole in one’s face was absolutely a motivating factor for the first rhinoplasty that was to be performed.
This is why one Italian surgeon, Dr. Tag-lia-cozzi, developed a method for concealing this nasal syphilis-induced deformity. He created a new nose using tissue and skin from the patient's arm. A skin flap would be connected between the arm and face. And after about three weeks of the awkward nose arm growth process, the skin graft could finally be completed/was finally complete. The doctor would then separate the skin from the arm and finish restructuring the previously damaged nose.
So do we still use this old-timey rhinoplasty in today’s modern world? Not exactly although the foundation is there and we do use skin grafts and reconstruct noses for all sorts of reasons. This procedure wasn't always the most reliable, there are reported cases of patients’ noses turning purple and blue in cold winter months and falling off. Luckily for us today we have come a long way with reconstructive surgery and syphilis is usually treated with an easy course of antibiotics.
1. Lithotomy
Meaning “Cutting of the stone” was a jaw-dropping procedure used by everyone over time. From Ancient Greeks, Romans, and Persians, all the way up to the early 1800’s even. Put very simply it was a procedure that was used to remove bladder stones. Bladder stones are hard masses of minerals in the bladder and they can be crazy painful. They develop and build up when the minerals in urine crystalize and form stones. Sometimes this happens when a person has trouble completely emptying their bladder. Or maybe has an unhealthy diet. But it seems like a simple enough treatment. Lithotomy Just gotta remove those stones, right? WRONG!
This was in fact a miserable excruciating old medical procedure that I’m about to describe to you so put down your lunch maybe. In old-time lithotomy, a patient would lay on their back, feet apart while a blade was passed through the perineum (You know the spot between the genitals and the anus) yeah so an instrument was just casually passed through that delicate area into the patient bladder. Then there other surgical tools may have been inserted into the urethra or rectum to further assist with removing the bladder stones. Intensely painful. And did I mention it had a 50 percent mortality rate? So it's kind of like the worst game of would you rather? Suffering from bladder stones which can be unbearable or test your fate with a 50/50 shot of kicking the bucket. Either one is not good.
So I know what you are thinking. Is this crazy procedure still used today? What do you think?
Yes and no. Today if an adult gets a bladder stone, doctors will do a procedure called a transurethral cystolitholapaxy. For this, the surgeon inserts a small, rigid tube with a camera at the end into your urethra and up into your bladder. From there they may do a
Lithotripsy treatment, where they use ultrasound shock waves, breaks up the stones into smaller pieces that can be passed out by the body.