The Nature Cure

by Andreas Michalsen

  Effort or no effort—on a daily basis, I was confronted with patients who desperately inquired about ways that would make it possible for them to take fewer pills. So, we initiated a study on bloodletting: Sixty-four patients with high blood pressure who were also overweight were divided into two groups. One group received two venesections, four weeks apart, where 13.5 ounces of blood were removed each time (the body contains five to six liters of blood—around 200 ounces). The other group had to wait for this therapy. The results were impressive. Six weeks after the study had begun, the blood pressure in the group treated with bloodletting was already significantly lower than if they had taken certain medications.33 How was this possible?

  To find out, I contacted the hematologist Leo Zacharski, who had conducted a large-scale study on bloodletting in patients with peripheral arterial disease and severe claudication a few years ago.34 More than 1,200 arteriosclerotic high-risk patients participated in it—some received repeated venesections, others received no additional therapy at all. Zacharski wanted to demonstrate that bloodletting not only improved blood flow, but that it also prolonged the life of these high-risk patients. This, however, only manifested in those participants who were under sixty-five years of age. Still, I was not disappointed with these findings, because even the physicians of antiquity had noted that bloodletting should be considered primarily for younger people.

  Leo Zacharski assumed that the antihypertensive effect of bloodletting was not only caused by the reduction of the amount of fluid in the veins, but was also connected to reducing ferritin, a protein that stores iron, in the blood. Studies conducted in Scandinavia have shown that heightened levels of ferritin increase the risk of heart attacks and strokes.35 We were subsequently also able to show that the antihypertensive effect was connected to lowering the ferritin level.36

  TOO MUCH IRON IN YOUR BLOOD IS HARMFUL

  Many people who eat an extremely high percentage of meat show severely heightened ferritin levels. But there is also a gene, the hemochromatosis gene, that plays a vital role in people with highly elevated levels of ferritin.37 This gene is not rare among people of European descent.38 In its most pronounced expression, this gene leads to severe organic diseases due to the accumulation of iron it causes.

  By now it has been proven that elevated iron levels cause increased tension in blood vessels and their inner layers (endothelium) and lead to the increased oxidation of blood fats. When paired with hemochromatosis, a genetic disease, this excess iron can also damage the organs.39 A team of researchers headed by the endocrinologist Donald A. McClain at Wake Forest School of Medicine was able to show in experiments that an excess of iron reduces adiponectin, a hormone that protects our bodies from diabetes.40 At the same time, excess iron increases our cells’ resistance to insulin, which causes even greater exhaustion of the pancreas. Bloodletting augments the level of this hormone and thus improves sugar regulation. It makes sense, then, that women who have yet to enter menopause are less prone to diabetes and vascular diseases such as heart attacks. After menopause, their risk levels even out at about the same levels as men.

  Removing excess iron from the body can possibly protect from cancer. In a long-term analysis of his study five years later, Leo Zacharski found a decidedly lower number of cancer cases in the group that had undergone bloodletting regularly. The astonishing results, published in the Journal of the National Cancer Institute, were accompanied by the comment: “The results almost seemed too good to be true.”41

  Back to our own study. After it had been published, I received many letters in which patients reported, among other things, that their blood pressure had always been normal as long as they had gone to blood drives regularly. Hypertension had only developed once their age no longer permitted them to continue donating blood. I still remember one of my own patients who had implored me to perform bloodletting on him since he hadn’t been allowed to donate blood in two years. Once he stopped donating blood, his blood pressure started to rise. He had what the physicians in antiquity described as “glut”: red cheeks, prone to sweating and overheating. We agreed on a venesection just to see whether it would help and, indeed, his blood pressure lowered considerably.

  These results encouraged me. What would it be like, I asked myself, to use blood donation as a form of bloodletting? As early as 1992, this question had been posited by a Finnish research team headed by J. T. Salonen.42 Why shouldn’t you do good and benefit from it at the same time? Wouldn’t this be a classic win-win situation?

  I contacted Abdulgabar Salama, professor for Transfusion Medicine at the Charité Hospital. Salama had researched the history of Arabic medicine and knew bloodletting from the work of Ibn Sīnā, the legendary eleventh-century Persian physician, also known as Avicenna. Shortly thereafter, we had the chance to work with roughly three hundred patients from the Charité transfusion center. They were advised to come and donate blood according to the legal recommendation, at a maximum of once every three months for women or once every two months for men. Over the course of one year, we closely monitored their blood pressure and other risk factors for cardiovascular diseases. Initially, approximately half of the patients presented with hypertension, so we were interested in how regular blood donation would influence its progression. The result: The higher the blood pressure, the more significantly it was lowered.43

  We now saw the effectiveness of bloodletting in hypertension therapy. Since there is a shortage of donated blood in blood banks around the globe, it seems to be a good thing to share the potential health benefits of donating blood with donors and potential candidates.

  It’s possible there is another factor that explains the effect of bloodletting in relation to hypertension. When we donate blood, we stimulate bone marrow, which begins to produce new red blood cells immediately. A normal blood cell lives for about 120 to 160 days. It is not surprising that young blood cells are more supple and flexible than old ones. When we undergo bloodletting, the level of young blood cells rises, and the blood flow works well even in the smallest capillaries. Ultimately, this can also lead to lower blood pressure. And thus, bloodletting is a kind of inherent “fresh cell cure.”

  There is a lot to discover in the circulatory system: In one study, older mice were transfused with blood from younger mice. Afterward, their decrease in brain function slowed down and atrophying of the nerve cells was retarded.44 It’s presumed that there exists an “aging factor,” called β2 microglobulin, in older blood, which in this circumstance had been reduced. It’s possible this factor could be influenced by bloodletting, but as of yet we are unable to prove it.

  Lowering ferritin levels is not suitable for all cardiac patients, especially not for those who suffer from a weak heart. On the other hand, regular bloodletting is helpful in treating a fatty liver, which occurs with increasing frequency and can be quite dangerous. But it’s important to remember that bloodletting must not become a substitute for healthy lifestyle choices. For many hypertensive patients, a healthier diet, weight loss, more exercise, and stress reduction should be the most important courses of treatment.

  PATIENT HISTORY

  Stroke Risk

  Gaining from Blood Loss

  The patient—a dentist in her early sixties—had landed in the hospital after a stroke scare. She described feeling as though she had “small cotton balls” in her head. Doctors discovered that a large vein in her brain was blocked to a great extent. Her maximum blood pressure reading was at 230 instead of the normal 120.

  The dentist was facing stress from all sides: Her practice was facing financial pressure, her husband relegated all household tasks to her, and her youngest daughter was a competitive athlete and had to be accompanied to sporting events. It was all simply too much.

  After the stroke scare, the patient stayed in the hospital for a few days. After that, her cardiologist tried to get her blood pressure under control—unsuccessfully. For more than six months, he p
rescribed different drugs for her to try. Finally, a clinical pathologist at the Charité Hospital advised her to look at the problem in its entirety—and she came to our Department of Mind-Body Medicine.

  To lower the dentist’s high blood pressure, we performed a venesection: This facilitates the formation of young blood cells that are still supple and glide through the small veins better. Furthermore, this reduces ferritin, which contributes to the hardening of the vascular walls and causes them to become rigid. In two sessions that were six weeks apart, we removed 16.9 ounces of blood altogether. This lowered her blood pressure significantly.

  The mind-body team taught the dentist to change her habits. None of us can rid ourselves of stress entirely—but we can make ourselves aware of it and find new ways of dealing with it. It sounds simple, but the dentist had to retrain herself to say no. She reduced her workload by half and employed additional staff. She practiced qigong. Beyond that, the dentist also found the courage to set boundaries between herself and her family. Her husband used to utter remarks like, “Unfortunately, my coat is still at the dry cleaners, because my wife is never here on Thursdays.” But by now, her whole family has understood that she needs to put herself first in order to stay healthy. She makes time for herself, pays visits to old friends, and regularly undergoes bloodletting and music therapy.

  Now, when she gets stressed out, she resorts to a “quickie”—a short breathing meditation where she inhales, counts backward from ten, and exhales when she has reached one. And if the day was especially stressful, she takes a bath with lavender oil. She can measure how this lowers her blood pressure by ten points straight away. At the moment, it is around 140 / 80 on average. Almost perfect.

  THE ANCIENTS WERE RIGHT AFTER ALL

  When I look at studies on the “big three” traditional healing methods—leeches, cupping, and bloodletting—it becomes clear that hundreds of years ago, physicians were already using highly effective methods. It is worthwhile to carefully analyze and examine these traditional methods. The world of science, however, lacks the curiosity to do so—in large part due to a lack of sponsors. The past is often dismissed as old-fashioned or outdated. Leo Zacharski told me that he had very consciously put the reduction of ferritin in the foreground of his publications: “If you write about bloodletting, you’re out,” he warned me. “Nobody wants to hear that.” I thought he was exaggerating, but I found out that he was right. When I submitted my study on bloodletting to journals, I received one rejection after the other. They told me in no uncertain terms that the scientific data was impressive, but that they didn’t believe that there could be a place for such an “antiquated” therapy in modern medicine. After I revised the language of the study to focus on “ferritin reduction” it was soon accepted for publication.45

  The public, on the other hand, responded in an entirely different fashion. When we were looking for subjects for our first study on bloodletting, I found myself buried in inquiries. Ultimately, this method has found wide acceptance and has established itself as a useful and promising therapeutic possibility. But I always recommend getting a physician’s consultation and examining your personal results.

  CHAPTER THREE

  The Healing Power of Water

  Hydrotherapy

  Hydrotherapy—the application of water through various methods, temperatures, and pressures to create a healing effect—has been a part of my life since I was a child. The town near where I grew up, Bad Wörishofen, was where Sebastian Kneipp (1821–1897) made hydrotherapy famous. Kneipp was a Bavarian priest and is considered one of the forefathers of naturopathic medicine. In the second half of the nineteenth century, as industrialization boomed and cities began to rapidly expand, many people struggled with physical overexertion and claustrophobia. Kniepp, known fondly in Germany as the “water priest,” showed people how to regain their inner balance and restore their health. His trust in the self-healing powers—today we would call them physical and mental resources—of his patients is in fact what inspired my own grandfather to become a physician.

  Because my father and grandfather practiced medicine in accordance with Kneipp’s teachings, Kneipp’s hydrotherapeutics were part of my daily life. My father took morning baths in the small swimming pool in our garden—even in the icy winter. Life with cold baths and Scotch hose treatments seemed normal to me.

  This time was also the golden age of sanitarium treatments in Germany. Across the country, from my hometown of Bad Waldsee to big cities like Essen, there were health resorts and parks with public pools for water treading. Hydrotherapy was practiced and taught from generation to generation. But by the time I was training to become a doctor, things were changing. Hospitals removed bathtubs that had been used for hydrotherapy, and rooms for Kneipp’s Scotch hose treatments gathered dust until they were remodeled to house endoscopies, lung examinations, and other functional diagnostic tests.

  WATER: ONE OF THE OLDEST CURES IN THE WORLD

  Water is one of the oldest cures in the world. We know that baths were an integral part of day-to-day life in ancient Rome. At the bathhouses, you would begin by entering the caldarium, a room holding hot-water baths. You had to wear wooden shoes to enter the room, since the heated floor reached temperatures of up to 122 degrees. There, you could plunge into tubs filled with hot water. Then, after passing through an intermediate area, you would enter the frigidarium, a cold-water pool in which you would cool off. In the Roman Caracalla baths there are 1,600 marble seats, where people could sit and let themselves be doused with cold water. Sweat baths that didn’t use water—similar to modern saunas—and treatment rooms for masseuses and physicians could also be found in the large public baths of antiquity.1

  Sweat and tub baths have existed in Northern Europe since the Middle Ages—knights and soldiers had brought these traditions home from their crusades.2 But infectious diseases such as the plague, combined with the Catholic Church’s disapproval, caused the baths to slowly be shut down one after the other.3 In the Baroque age, the healing power of water was rediscovered by two Silesian physicians, Siegmund Hahn and his son Johann Siegmund Hahn.4 In 1783, Johann Siegmund Hahn wrote the book Unterricht von Krafft und Würckung Des Frischen Wassers In die Leiber der Menschen, besonders der Krancken Bey dessen Innerlichen und äusserlichen Gebrauch (Teachings on the Power and Effect of Fresh Water on the Bodies of Humans, Especially the Sick, in Its Internal and External Usage), which would later inspire Sebastian Kneipp.

  Water is the best medium for transporting heat and cold. Hot stimuli through water relax muscles, stimulate circulation, and raise body temperature. These processes have positive effects on the body—defense cells are activated, and hormones and other messengers are released. Cold stimuli through water, on the other hand, have a pain-relieving and anti-inflammatory effect. As blood vessels contract and the body works to keep its internal temperature up, there is a distinct stimulus-reaction that influences the entire metabolism. For this reason, water treatments where the body is exposed to heat and cold in turns are most effective.

  REDISCOVERING KNEIPP’S HYDROTHERAPEUTICS

  Sebastian Kneipp’s methods had completely gone out of fashion in the 1980s and 1990s. Many efforts were undertaken to change its image: Portraits of Kneipp were designed in the trendy style of Andy Warhol, and people looked to rebrand it under terms such as “Kneippness,” but all to no avail. Kneipp was “out,” and he remained so, at least for younger generations. When I used to show images of water treading in my lectures and ask whether anyone knew this therapy, very few students raised their hand.

  As costs for water and staff kept rising and insurance companies offered little reimbursement, hospitals and doctors lost money with every Kneipp method they performed, which is why even the last remaining Scotch hose treatment rooms and baths disappeared—except in medical rehabilitation facilities and naturopathic clinics. During my time as a medical resident at the Moabit Hospital, every patient received at least
one, ideally two, hydrotherapeutic treatments every day. The same is true at the Immanuel Hospital in Berlin today. We use chest and body compresses; arm, thigh, and knee dousing; foot and full-body baths, as well as various moist wraps, sometimes in combination with medicinal herbs.

  In clinical practice, Kneipp’s methods have an exceptional effect as supplementary therapies. My very first clinical study dealt with hydrotherapy. Patients with a weak heart (cardiac insufficiency) were instructed to perform Kneipp hydrotherapy twice a day at home, with precise directions on how to perform Scotch hose treatments up to their knees and thighs, and how to apply compresses. The treatments were carried out over the course of six weeks. Half of the patients, chosen at random, were instructed to start this therapy immediately. The other group of patients was advised to perform this therapy from week seven to week twelve. This way, we created two comparable periods of time in each group. We asked patients to report on their quality of life, and we monitored their blood pressure and pulse during exercise on stationary bicycles. During the phase in which hydrotherapy was practiced in the respective groups, patients reported improved quality of life and less discomfort. Patients also had lower increases in heart rate (pulse) while exercising, which is an important indication of successful treatment in cases of cardiac insufficiency.5 Even though this was a small study, it presented some evidence for the effectiveness of Kneipp treatments.