Dark Banquet - Bill Schutt [46]
Bloodletting was also used to reduce the pain of angina pectoris (literally, “strangled chest”). Angina results from an insufficient supply of blood to the heart musculature (usually because of a blockage or constriction of the coronary arteries). Like the pain from a pulsing aneurysm, angina pectoris is a symptom rather than a disease. It’s part of the body’s warning system—telling it in no uncertain terms that something is seriously wrong. Today, vasodilators like nitrates are used to treat angina. They work primarily by increasing blood flow to the farthest reaches of the body (peripheral blood flow), which reduces blood pressure. Studies on the action of these drugs performed in 1970 indicated that therapeutic phlebotomy also lowered pressure within the resting heart.
Similarly, congestive heart disease is commonly characterized by an increase in blood volume, and the diseased heart has a tough time pumping this blood to the body. In modern times, drugs like diuretics are used to decrease blood volume (basically, more urine results in less plasma). But up until the 1960s, a viable means to achieve the same result was to perform periodic bleeding of the patient. Thankfully, as in the current treatment of aneurysms and angina pectoris, drugs have replaced bloodletting and there are few patients (or physicians for that matter) who would complain.
But before we get too carried away with the wonders of drug therapy it should be mentioned that there are several conditions that still call for bloodletting.
Porphyria (from the Greek word for “purple”) is a disease of the blood that results from the faulty production of hemoglobin, which leads to the accumulation of red and purple pigments called porphyrins. For several reasons, it was referred to as vampire disease. This is because in one form (porphyria cutanea tardia), porphyrins concentrate in the skin. When exposed to sunlight, these abnormal pigments cause damage to surrounding tissues, leading to symptoms like severe skin rashes and blistering. These light-activated toxins and the disfiguring damage they cause may have been a source for tales of vampyres and their destruction by sunlight. Additionally, in some forms of porphyria, severe anemia can result in a pale, spectral appearance, and as the gums recede (from lack of oxygen and nutrients), the teeth become more exposed, causing the canines to take on a fanglike appearance.
In the acute form of porphyria, exposure to certain substances (e.g., alcohol) can trigger severe neurological disturbances—a fact that now appears to explain the “madness” of England’s King George III (the king mentioned in the Declaration of Independence). Starting in 1762, the British monarch began to have bouts of serious health problems. These often began with flulike symptoms, but they soon segued into depression and strange behavior—racing with a horse, pretending to play a violin, and claims that he could raise the dead. In another instance, George III was reported to have talked continuously for twenty-six hours, his speech garbled and repetitive.
The king’s medical treatment was remarkably similar to that afforded (or inflicted upon) his American contemporary, George Washington. He was bled, blistered, purged from both ends, and cupped.*68 Leeches were also used to draw off presumed excesses of blood. Sometimes the king went years without an attack, but invariably they returned, and in 1811, George III’s doctors certified him to be permanently disabled.
For many years, researchers were puzzled by the sudden onset of bizarre behavior and strange outbursts that began to affect the king, especially after he’d reached his fifties. In the 1960s, two authors used information from the king’s medical records (including the observation that the monarch’s urine was the color of port wine) to conclude that George III had suffered from porphyria.
Recently, additional evidence concerning the king’s affliction has come to light. The examination of several strands of King George’s hair revealed arsenic levels that were three