Is Chinese bloodletting the same as conventional bloodletting?

I get enquiries, from time to time, about whether Chinese medicinal bleeding can be used to remove significant volumes of blood, in a similar way to conventional bloodletting. Whaaaat? I hear you say. Yes, conventional medicine does still include bloodletting. It’s known as therapeutic phlebotomy.

Phlebotomy is when you have a blood sample taken to run some tests on the blood. Therapeutic phlebotomy is when you have a larger quantity of blood taken, simply to get rid of some blood. This can be needed to help with unusual conditions such as polycythemia vera or hemochromatosis. These involve having excessive amounts of iron, or of red blood cells. The blood taken in these procedures is usually not retained, like when you donate blood, but disposed of.

The short answer is no. Chinese medicinal bleeding is not suitable for releasing blood on that scale. And here’s a longer answer …

The quantity of blood

Therapeutic phlebotomy usually extracts 250-500ml of blood. This is comparable to blood donation, which takes 470ml of blood in Australia, or around 8% of your total blood volume.

Chinese medicinal bleeding is done in several ways, but the way that would produce the most blood is by direct bleeding from a superficial vein. We do not take, or extract, the blood. We briefly pierce the vein and let the body release as much as it wants to release.

Often the initial blood is very dark, it can be almost black, showing that the blood is oxidised and has not been circulating in a healthy way. Then it runs a healthier red colour. And then the bleeding stops. The body releases the old stagnant blood that has been stuck in that vein, and then it clots the puncture to stop the bleeding.

I have read that it is possible for the body to release 200ml this way. But in my experience even 50ml is an uncommonly large quantity for the body to release. This is much less than the amounts taken for therapeutic phlebotomy or blood donation.

Releasing large amounts of blood is never the goal. Releasing even a couple of drops of dark stagnant blood result in a very successful procedure.

The diagnosis

Chinese medicinal bleeding is done according to Chinese medical principles. First there must be a Chinese medical diagnosis, based on signs and symptoms, that indicates that bleeding may help. Often this would be ‘Blood Stagnation’.

Without a relevant Chinese medical diagnosis, it would not be ethical to perform bleeding.

Available veins

One possible symptom of Blood Stagnation is superficial veins visible on the surface of the body. These are known as thread or spider veins, and are usually purple, red or blackish, not the blue colour of healthy veins. If you don’t have any of these, it is not possible to do Chinese medicinal bleeding from a vein.

There are other forms of Chinese medicinal bleeding, such as wet cupping, but these tend to produce even less blood than bleeding from a vein.

We never directly bleed varicose veins, which are bulging out from the surface.

Scope of practice & insurance

For all these reasons, we are not registered and insured to provide Chinese medicinal bleeding for purposes which are not related to a relevant Chinese medical diagnosis.

Patient satisfaction

People’s reasons for requesting Chinese medicinal bleeding for the purpose of releasing quite a lot of blood vary. Basically, I have to say, that Chinese medicinal bleeding techniques are unlikely to achieve the desired results.

How much blood will be released is not a matter of negotiation or guarantees. It is not the case that we can promise to release a certain quantity.

If extracting relatively large quantities of blood is your goal, it seems unlikely that you would be satisfied with the results of Chinese medicinal bleeding.

References

Image by allinonemovie from Pixabay

Acupuncture, electroacupuncture, and blood-letting for gouty arthritis

As anyone who’s ever suffered it knows, gout is a horrible business. It’s a metabolic condition which can lead to a build up of uric acid in your system, forming crystals in your joints, and flaring up with nasty pain, swelling and redness in your joints.

As the scientific research into traditional Chinese medicine is becoming more advanced, it has been interesting to see studies done on not just standard acupuncture, but also electroacupuncture and traditional Chinese medicinal bleeding (blood-letting).

Acupuncture for gout

In 2018 a systematic review (a study of all the available studies) concluded that:

Ten RCTs [Randomised Controlled Trials] involving 852 gouty arthritis patients were systematically reviewed. Among them six studies of 512 patients reported a significant decrease in uric acid in the treatment group compared with a control group, while two studies of 120 patients reported no significant decrease in uric acid in the treatment group compared with the control group. The remaining four studies of 380 patients reported a significant decrease in visual analogue scale score in the treatment group … The results of the studies included here suggest that acupuncture is efficacious as complementary therapy for gouty arthritis patients.”

Electroacupuncture for gout

Electroacupuncture is a technique which uses a small machine with wires and clips, to apply a small electric current across some of the acupuncture needles. Generally this gives an odd, tapping, kind of feeling, rather than being painful. In 2024, a research team did a systematic review and meta analysis (where the data from multiple studies is pooled and re-examined) and found that:

“This systematic review examined 15 randomized controlled trials that investigated the use of electroacupuncture as a treatment for AGA [Acute Gouty Arthritis] … The current meta-analysis suggests that electroacupuncture and conventional treatments have comparable efficacy and safety in targeting painful symptoms in patients with AGA … Our study showed that when electroacupuncture and medication were used together, there was a more significant decrease in serum uric acid than alone.”

Traditional Chinese medicinal bleeding (blood-letting) for gout

A 2022 systematic review and meta analysis is not presented in the most accessible language, but it concluded that:

“BLT [Blood-Letting Therapy] is effective in alleviating pain and decreasing CRP level [serum C-reactive protein] in AGA [Acute Gouty Arthritis] patients with a lower risk of evoking adverse reactions.”

CRP is a blood test that is indicative of your body’s level of inflammation.

More research ongoing

All three studies (like other studies into many different kinds of medical intervention) also noted limitations in the evidence base to date, and encouraged further research into these topics.

I was surprised to find all three of these systematic reviews on this topic, it’s fabulous to see the evidence base moving forwards! I look forward to hearing what comes next.

Try Chinese Medicine for your gout symptoms

I offer all three of these treatments, in a fully tailored approach driven by your individual needs and preferences. To see if they may be able to help in your case, just get in touch.

References

Lee WB, Woo SH, Min BI, Cho SH. Acupuncture for gouty arthritis: a concise report of a systematic and meta-analysis approach. Rheumatology (Oxford). 2013 Jul;52(7):1225-32. doi: 10.1093/rheumatology/ket013. Epub 2013 Feb 18. PMID: 23424263.

Ni Z, Xiao Q, Xia Z, Kuang K, Yin B, Peng D. Electroacupuncture for acute gouty arthritis: a systematic review and meta-analysis of randomized controlled trials. Front Immunol. 2024 Jan 4;14:1295154. doi: 10.3389/fimmu.2023.1295154. PMID: 38239361; PMCID: PMC10794621.

Li SH, Hu WS, Wu QF, Sun JG. The efficacy of bloodletting therapy in patients with acute gouty arthritis: A systematic review and meta-analysis. Complement Ther Clin Pract. 2022 Feb;46:101503. doi: 10.1016/j.ctcp.2021.101503. Epub 2021 Nov 11. PMID: 34814062.

Image by cnick from Pixabay

Medicinal bleeding for psoriasis

Bloodletting might not be the first thing you’d think of as a modern treatment for psoriasis, but research suggests that it may be able to help.

Psoriasis often involves chronic pain, and is not a nice condition to have. Genetics play a big role, and it’s now recognised as an immune disorder. Triggers for a new flareup can be as minor as small cuts or scrapes, infections or cold weather. New biological therapies have proved to be a powerful help for many people suffering with psoriasis, but sadly not everyone’s psoriasis has responded well.

Medicinal bleeding

Bloodletting, or medicinal bleeding is part of traditional Chinese medicine, like acupuncture, cupping and moxibustion. Less research has been done for this therapy than for some of those other techniques, so it’s not that often that i come across relevant research that reaches the level that I can share it with you. So I was interested to come across a study looking at the effectiveness of medicinal bleeding for psoriasis.

Wet cupping

Traditional Chinese medicinal bleeding can be performed in various ways, but this study looked at wet cupping. This is where we make small incisions in the skin and then use a cup to create a vaccum and draw out a small amount of blood. When I do wet cupping, I use automatic lancets like people with diabetes use, which generally gives a sensation more of pressure than of any pain. I use fully disposable cups for this, for hygeine and infection control.

In traditional Chinese medical theory, this helps to release some toxicity along with the blood, and makes space for fresh blood to move into the tissues, promoting your body’s flow of Qi and blood. This explanation does not have scientific evidence to support it so far, but what research has been able to look at is the results of treatment. Does bloodletting help psoriasis?

Research results

In 2023 a team did a systematic review and metanalysis of the studies of medicinal bleeding for psoriasis, which means they took a close look at all of the available studies on this topic. They whittled them down to 10 studies with 833 patients. They looked at Psoriasis Area and Severity Index (PASI), adverse effects, and the Dermatology Life Quality Index (DLQI), and found:

“Bloodletting cupping combined with conventional treatment can achieve the ideal treatment for psoriasis. However, the combined treatment in psoriasis needs to be further evaluated in high-quality RCTs with large sample sizes to enable future studies in clinical use.”

“We found no significant difference in adverse reactions.”

2023 systematic review and metanalysis of the studies of medicinal bleeding for psoriasis

As is common in medical research, they also noted limitations in the research performed so far, and encouraged further studies with large samples to improve the confidence of this result.

Get in touch

So if you continue to suffer with psoriasis, and would like to try medicinal bleeding to see if it may help, just get in touch.

Reference

Ma, X., Li, D., Zhao, M., He, J., Yang, F., & Kong, J. (2023). Bloodletting cupping combined with conventional measures therapy for psoriasis: A systematic review and meta-analysis of randomized controlled trials. Frontiers in Medicine, 10. https://www.frontiersin.org/articles/10.3389/fmed.2023.1132928

Image from the British Acupuncture Council.