In fashion, it seems that everything old becomes new again. But that is not always the case in medicine, a field that is continually striving to discover and use the most modern technologies and advanced techniques to improve people’s health.
However, there are some age-old medical practices that are still in use today. These older medical approaches may seem medieval or sound like “barbaric” treatments in the 21st century, but research has shown that they are actually effective, and have a legitimate medical use.
Medical procedures and remedies need to be understood in their historical context because the rationale for their use long ago is often very different from the reasons for using them today, said Dr. Scott Podolsky, an internist at Massachusetts General Hospital and the director of the Center for the History of Medicine at Countway Library at Harvard Medical School in Boston.
Here are five examples of “barbaric” medical treatments that have modern-day relevance, along with a look at why doctors may turn to these older approaches, and their potential risks.
A 4th century Chinese doctor first had the idea of giving a suspension that contained the dried stool from a healthy person by mouth as a treatment to someone with severe diarrhea or food poisoning. According to numerous accounts, this remedy may have been an ancient attempt at what is now called “fecal microbiota transplantation.”
By the 16th century, another Chinese doctor used “yellow soup,” a broth containing the dried or fermented stool of a healthy person as a treatment for severe diarrhea, vomiting, fever and constipation, several sources claim.
Today, stool transplantation, also called fecal microbiota transplantation, or FMT, is not done by spooning down “yellow soup.” It does involve the transfer of stool from healthy donors to sick people, but the stool may be given by an enema or inserted through a tube into a person’s stomach or small intestine, a process that introduces a healthy mix of bacteria to restore a better microbial balance in the gut. [The Poop on Pooping: 5 Misconceptions Explained]
“Poop transplants” may be used to treat people with recurrent Clostridium difficile (C.diff) infections, a bacterial infection that can be life-threatening. The symptoms of people who receive FMT get better within days, although their gut bacteria may undergo a dramatic change for at least three months after the procedure, according to a study presented in May at Digestive Disease Week, a gastrointestinal system research meeting, in San Diego.
In the Stone Age, scalpels with blades made from rock called obsidian, or volcanic glass, were used to bore a hole into the skull. These medical instruments had an extremely sharp cutting edge, and these days an obsidian scalpel is still used in a few situations. But obsidian tools are expensive compared with stainless-steel scalpels, and few manufacturers make them.
Obsidian blades are said to be at least 100 times sharper than stainless-steel surgical scalpels and there’s some evidence that cuts made with them may heal more rapidly with less scarring. But an obsidian blade is also very thin and fragile, and surgeons cannot apply the same amount of force to this cutting tool as a steel scalpel or it may break and shatter its pieces into the wound.
Obsidian blades are not FDA-approved for use in the U.S., although a small number of surgeons in other countries use them, often for very delicate procedures in cosmetically sensitive areas.
Although not considered ancient because it was first developed in the late 1930s and introduced in the U.S. about one year later, electroconvulsive therapy (ECT) may have gained a modern-day reputation as a barbaric treatment when it was famously depicted in the movie “One Flew Over the Cuckoo’s Nest” and administered unwillingly to Jack Nicholson’s character.
Once known as electroshock therapy or simply called “shock treatment,” ECT involves passing electrical currents through the brain, either by implanting electrodes in the brain or placing electrodes on the scalp, according to the National Institute of Mental Health.
Electroconvulsive therapy may have developed a negative reputation from its past use when the therapy might have been used inhumanely, with high doses of electricity, without anesthesia, and over many more treatment sessions than it is given today.
There’s definitely a stigma attached to electroconvulsive therapy, and many people may be frightened of it even in its uses today, Podolsky said. But in modern medicine, ECT is used for people with a condition called treatment-resistant depression, which is severe depression that has not improved with medication or other treatments.
Today, ECT is done under general anesthesia, and is typically given three times a week for three to four weeks. The treatment affects brain chemicals and nerve cells, and can produce changes in mood, sleep and appetite, according to information about ECT from the University of Michigan Health System Department of Psychiatry.
The most common side effects of ECT are memory loss, confusion, headaches and nausea.
Trepanation is the oldest known surgical procedure, and dates back to the Stone Age. It involves making a hole in a person’s skull.
Trepanning might have been done in ancient civilizations to rid a person of evil spirits believed to cause illness, or to treat conditions such as severe headaches, epilepsy, convulsions, head injuries and infections.
A version of trepanation is performed by neurosurgeons for very different reasons today, Podolsky said. These days, surgeons use the technique and different tools for drilling a small hole in the skull (but not into the brain itself) when there’s internal bleeding due to trauma, such as from a car accident. Trepanning may also be used for a subdural hematoma, which is bleeding between the cover of the brain and the brain itself, which can commonly occur after an older adult suffers a minor head injury, or when a stroke has occurred, Podolsky said.
The modern-day use of trepanning helps to help relieve intracranial pressure, which prevents too much pressure from building up inside the skull, Podolsky said. Side effects of the procedure include a possible injury to the brain, as well as general risks from surgery, such as bleeding and infection, he said.
Leeches are primitive worms (Hirudo medicinalis) that are equipped with suckers on their front and back ends that let them feed on blood, and teeth that can make a quick, clean cut, Sherman said.
These qualities make leaches useful for “bloodletting,” a medical practice that removes blood from the body and dates back to ancient times.
In the 21st century, the FDA has cleared the use of medical leeches for a condition called venous congestion, in which blood pools in a particular area of the body and the veins can’t pump it back to the heart, Sherman said. Venous congestion may occur following surgeries to reattach a limb, such as a finger or an ear, for example, or other major surgical reconstructions, such as a breast, he explained.
Leeches can extract a significant volume of blood from a surgical site in a short amount of time, about 45 minutes, which allows more oxygen to reach the site, Sherman said.
In addition, the saliva from leeches contain substances with anticoagulant properties, meaning they can prevent the blood from clotting, he added.
One major risk of leech therapy is anemia, or the loss of too much iron, Sherman said. It’s also possible to get an infection at the site where the leeches bite the person’s skin, he explained.