Heroic medicine, also referred to as heroic depletion theory, was a therapeutic method advocating for rigorous treatment of bloodletting, purging, 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), [2] 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. [3]
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. [4] 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. [5] 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.[ citation needed ] 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. [4]
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. [6] [7] [8] [9] [10]
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. [11]
Heroic medicine does not have a definitive start date, as its treatments themselves were not new to the field of medicine. Bloodletting, purging, and sweating are cemented firmly in medical tradition back to the advent of humoral theory in the time of Hippocrates and Galen. [12] 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. [5]
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. [5] Likewise, dramatic evacuations, both by pharmacological emetics and laxatives, 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. [4]
Heroic medicine became less favoured with the advent of medical science. Even during its heyday, heroic medicine faced criticism from physicians and alternative medicine healers like the Homeopaths, who pushed for more natural cures. [13] In the modern day, there are few proponents of heroic medicine.
Hippocrates of Kos, also known as Hippocrates II, was a Greek physician and philosopher of the classical period who is considered one of the most outstanding figures in the history of medicine. He is traditionally referred to as the "Father of Medicine" in recognition of his lasting contributions to the field, such as the use of prognosis and clinical observation, the systematic categorization of diseases, and the formulation of humoral theory. The Hippocratic school of medicine revolutionized ancient Greek medicine, establishing it as a discipline distinct from other fields with which it had traditionally been associated, thus establishing medicine as a profession.
Medicine is the science and practice of caring for patients, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others.
Bloodletting 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 fluids were regarded as "humours" that had to remain in proper balance to maintain health. It is the most common medical practice performed by surgeons from antiquity until the late 19th century, a span of over 2,000 years. In Europe, the practice continued to be relatively common until the end of the 19th century. The practice has now been abandoned by modern-style medicine for all except a few very specific medical conditions. In the beginning of the 19th century, studies had begun to show the harmful effects of bloodletting.
Allopathic medicine, or allopathy, is an archaic and derogatory label originally used by 19th-century homeopaths to describe heroic medicine, the precursor of modern evidence-based medicine. There are regional variations in usage of the term. In the United States, the term is sometimes used to contrast with osteopathic medicine, especially in the field of medical education. In India, the term is used to distinguish conventional modern medicine from Siddha medicine, Ayurveda, homeopathy, Unani and other alternative and traditional medicine traditions, especially when comparing treatments and drugs.
Humorism, the humoral theory, or humoralism, was a system of medicine detailing a supposed makeup and workings of the human body, adopted by Ancient Greek and Roman physicians and philosophers.
In the Middle Ages, the medicine of Western Europe was composed of a mixture of existing ideas from antiquity. In the Early Middle Ages, following the fall of the Western Roman Empire, standard medical knowledge was based chiefly upon surviving Greek and Roman texts, preserved in monasteries and elsewhere. Medieval medicine is widely misunderstood, thought of as a uniform attitude composed of placing hopes in the church and God to heal all sicknesses, while sickness itself exists as a product of destiny, sin, and astral influences as physical causes. On the other hand, medieval medicine, especially in the second half of the medieval period, became a formal body of theoretical knowledge and was institutionalized in the universities. Medieval medicine attributed illnesses, and disease, not to sinful behavior, but to natural causes, and sin was connected to illness only in a more general sense of the view that disease manifested in humanity as a result of its fallen state from God. Medieval medicine also recognized that illnesses spread from person to person, that certain lifestyles may cause ill health, and some people have a greater predisposition towards bad health than others.
The Hippocratic Corpus, or Hippocratic Collection, is a collection of around 60 early Ancient Greek medical works strongly associated with the physician Hippocrates and his teachings. The Hippocratic Corpus covers many diverse aspects of medicine, from Hippocrates' medical theories to what he devised to be ethical means of medical practice, to addressing various illnesses. Even though it is considered a singular corpus that represents Hippocratic medicine, they vary in content, age, style, methods, and views practiced; therefore, authorship is largely unknown. Hippocrates began Western society's development of medicine, through a delicate blending of the art of healing and scientific observations. What Hippocrates was sharing from within his collection of works was not only how to identify symptoms of disease and proper diagnostic practices, but more essentially, he was alluding to his personable form of art, "The art of true living and the art of fine medicine combined." The Hippocratic Corpus became the foundation upon which Western medical practice was built.
The history of alternative medicine covers the history of a group of diverse medical practices that were collectively promoted as "alternative medicine" beginning in the 1970s, to the collection of individual histories of members of that group, or to the history of western medical practices that were labeled "irregular practices" by the western medical establishment. It includes the histories of complementary medicine and of integrative medicine. "Alternative medicine" is a loosely defined and very diverse set of products, practices, and theories that are perceived by its users to have the healing effects of medicine, but do not originate from evidence gathered using the scientific method, are not part of biomedicine, or are contradicted by scientific evidence or established science. "Biomedicine" is that part of medical science that applies principles of anatomy, physics, chemistry, biology, physiology, and other natural sciences to clinical practice, using scientific methods to establish the effectiveness of that practice.
The treatise On Ancient Medicine is perhaps the most intriguing and compelling work of the Hippocratic Corpus. The Corpus itself is a collection of about sixty writings covering all areas of medical thought and practice. Traditionally associated with Hippocrates, the father of Western medicine, philological evidence now suggests that it was written over a period of several centuries and stylistically seems to indicate that it was the product of many authors dating from about 450–400 B.C.
Mercury(I) chloride is the chemical compound with the formula Hg2Cl2. Also known as the mineral calomel (a rare mineral) or mercurous chloride, this dense white or yellowish-white, odorless solid is the principal example of a mercury(I) compound. It is a component of reference electrodes in electrochemistry.
Calomel is a mercury chloride mineral with formula Hg2Cl2 (see mercury(I) chloride). It was used as a medicine from the 16th to early 20th century, despite frequently causing mercury poisoning in patients.
In the history of medicine, "Islamic medicine" Also known as "Arabian medicine" is the science of medicine developed in the Middle East, and usually written in Arabic, the lingua franca of Islamic civilization.
Herodicus was a 5th century BC Greek physician, dietician, sophist, and gymnastic master (παιδοτρίβης). He was born in the city of Selymbria, a colony of the city-state Megara, and practiced medicine in various Greek cities including Selymbria, Megara, Athens, and Cnidos. Herodicus believed that exercise and a good diet are key foundations of health, and emphasized the use of both to treat various ailments. He may have also been one of the tutors of Hippocrates. He also recommended massage using beneficial herbs and oils. His theories are considered the foundation of sports medicine.
Ancient Greek medicine was a compilation of theories and practices that were constantly expanding through new ideologies and trials. The Greek term for medicine was iatrikē. Many components were considered in ancient Greek medicine, intertwining the spiritual with the physical. Specifically, the ancient Greeks believed health was affected by the humors, geographic location, social class, diet, trauma, beliefs, and mindset. Early on the ancient Greeks believed that illnesses were "divine punishments" and that healing was a "gift from the Gods". As trials continued wherein theories were tested against symptoms and results, the pure spiritual beliefs regarding "punishments" and "gifts" were replaced with a foundation based in the physical, i.e., cause and effect.
Therapeutic nihilism is a contention that it is impossible to cure people or societies of their ills through treatment.
Vis medicatrix naturae is the Latin rendering of the Greek Νόσων φύσεις ἰητροί, a phrase attributed to Hippocrates. While the phrase is not actually attested in his corpus, it nevertheless sums up one of the guiding principles of Hippocratic medicine, which is that organisms left alone can often heal themselves.
De Medicina is a 1st-century medical treatise by Aulus Cornelius Celsus, a Roman encyclopedist and possibly a practicing physician. It is the only surviving section of a much larger encyclopedia; only small parts still survive from sections on agriculture, military science, oratory, jurisprudence and philosophy. De Medicina draws upon knowledge from ancient Greek works, and is considered the best surviving treatise on Alexandrian medicine. It is also the first complete textbook on medicine to be printed, and has an "encyclopedic arrangement that follows the tripartite division of medicine at the time as established by Hippocrates and Asclepiades – diet, pharmacology, and surgery." This work also covers the topics of disease and therapy. Sections detail the removal of missile weapons, stopping bleeding, preventing inflammation, diagnosis of internal maladies, removal of kidney stones, the amputation of limbs and so forth.
On the Nature of Man is a work in the Hippocratic Corpus. On the Nature of Man is attributed to Polybus, the son in law and disciple of Hippocrates, through a testimony from Aristotle's History of Animals. However, as with the many other works of the Hippocratic Corpus, the authorship is regarded as dubious in origin.
Domestic medicine or domestic health care is the behavioral, nutritional and health care practices, hygiene included, performed in the household and transmitted from one generation to the other.
Modern understanding of disease is very different from the way it was understood in ancient Greece and Rome. The way modern physicians approach healing of the sick differs greatly from the methods used by early general healers or elite physicians like Hippocrates or Galen. In modern medicine, the understanding of disease stems from the "germ theory of disease", a concept that emerged in the second half of the 19th century, such that a disease is the result of an invasion of a micro-organism into a living host. Therefore, when a person becomes ill, modern treatments "target" the specific pathogen or bacterium in order to "beat" or "kill" the disease.