Today, the term “progress” holds a place of honor among society, conjuring thoughts of innovation and enlightenment. Nowhere is progress more impactful to humanity than in the field of medicine. Medical science and its advancements have propelled humans so far ahead that its rudimentary foundations are easily dismissed as fodder from bygone eras.

The truth, however, paints a different picture. Some of the seemingly barbarous medical practices from centuries past retain their validity, informing our approaches to modern healthcare in surprising — and sometimes skin-crawling — ways. Despite their gruesome nature, certain ancient medical practices have earned their place in the annals of modern medicine.

Before the days of penicillin, anesthesia, and “germaphobia,” the medical profession employed an arsenal of leeches, maggots, screws, saws, nasal hooks, and other frightening tools to heal afflicted patients. Which of these ancient medical practices are still in use today, and how have they evolved? The answers are only for the brave!

Ancient Medical Practices Still Used Today

1. Leech Therapy

Ancient Application

Also known as “bloodletting,” this ancient medical practice dates to 800 B.C. and was popularized by the ancient Greeks. The Greeks believed that an imbalance of the blood humors caused many common diseases and that removing some measure of blood would restore balance and cure illnesses.

Leech therapy, a prevalent method for bloodletting, utilized leeches as a means for controlling the elimination of blood from the human body. It has existed for thousands of years but regained popularity during the Renaissance as classical culture and ideas reemerged.

Modern Application: Hirudotherapy

While bloodletting is rarely used in today’s medical practices, leech therapy is still a surprisingly valid method of treatment in microsurgery for procedures such as skin grafts and reconstructive surgery. Sometimes surgical procedures that involve a high risk of soft tissue loss due to deadening will require leech therapy to maintain and help reconnect healthy tissues.

Medical leeching restores circulation and prevents tissue death. Leech saliva acts as an anticoagulant, allowing blood to flow through the severed tissue to the new connective tissues introduced during the procedure. Blood clotting near the wound or incision results in dead flesh that cannot attach to the supplied living tissue. When doctors must remove too much dead tissue, the surgery becomes more difficult or even impossible. Leeching keeps tissues healthy during long and difficult surgeries where tissue deadening is a concern.

2. Maggot Therapy

Ancient Application

This form of medicine is simultaneously fascinating and stomach-turning. The earliest recorded use of maggot therapy exists in the Old Testament, and its usefulness has continued throughout history. Like their ancient counterparts, Army medics during the American Civil War discovered maggots were an effective tool for cleaning wounds. The fly larvae were introduced to a wound and allowed to feed on dead flesh, dissolving the unwanted tissue along with any infectious bacteria.

Modern Application: Larval Debridement Therapy

Modern medicine employs maggot therapy much like the ancients. Medical maggots arrive at hospitals in tea bag-sized packages, allowing doctors to apply as many as necessary to the open wound.

Interestingly, maggots secrete an enzyme that only digests dead tissue, leaving healthy tissues untouched. This enzyme allows physicians to administer the treatment with little fear of excessive tissue damage. Today, maggot therapy is primarily used on wounds with large surface areas that are too substantial for continuous manual cleaning.

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3. Transsphenoidal Surgery

Ancient Application

Ancient Egyptians used a crude version of transsphenoidal surgery to prepare bodies for mummification. Their mummification process required the removal all of organs from the corpse. They soon learned that the quickest way to access the brain was through the nose, and it became their predominant method for removing that organ from the body.

Modern Application

Even though today’s culture has left mummification far behind, the concept of transsphenoidal surgery is still medically relevant. Modern surgeons use the nose as an access point to remove tumors from the brain, and it has become the most common procedure for removing tumors from the pituitary gland. It’s classified as a minimally invasive surgery because only small incisions are made through the sphenoid sinus to create access for the tools and a microscope for visual guidance.

4. Cesarean Section

Ancient Application

The early Romans performed this ancient medical practice to bolster birth rates and increase the general population. The cesarean section was only used to save the life of the child when the mother was dead or dying. Physicians during this time believed women couldn’t survive the procedure and employed it as a last attempt to save newborns. The surgical method remained rudimentary and rough because the mother wasn’t expected to live anyway. Doctors focused solely on saving the infant before the mother’s passing.

Modern Application

The dawning of the Renaissance brought new understanding to human anatomy. Detailed illustrations of the human composition offered a depth of insight previously unknown in the medical field. The new information provided doctors with the foundation necessary to increase their knowledge of biology.

Medical professionals realized that both women and their babies could survive a cesarean section. Initial attempts to achieve this goal weren’t often successful, but the 1800s ushered in a time of greater access to cadavers. The cadavers allowed individual doctors to personally dissect the human body and hone their surgical skills. Today, the widely-used procedure has evolved into a highly successful medical practice, accounting for nearly one-third of all births (about 1.3 million each year) as of 2017. Thanks to medical advancements, modern cesarean sections have a very low mortality rate for mothers.

Medieval Medical Practices Still Used Today

5. Trepanation

Ancient Application

One of the medieval medical practices that is perhaps the most shocking to modern culture is trepanation. The procedure involves drilling a hole into the skull of a living human. Scientists believed the most common medical reason for trepanation was to relieve pain from skull trauma or a neurological disease. They’ve also uncovered evidence that the technique was sometimes ritualistic and used in certain cultures to release evil spirits from the body.

Modern Application: Burr Hole

Today, doctors employ a form of trepanation, commonly referred to as a burr hole, to relieve pressure on the brain caused by fluid build-up (intracranial pressure) that’s often due to head trauma.

Physicians make an incision in the scalp and then use a surgical drill to create the burr hole. They make another incision in the dura, or tough film covering the brain, which allows them to drain the unwanted fluid. Afterward, doctors surgically close the dura, cover the burr hole with a small metal plate, and then stitch the scalp. The patient remains largely unaffected by the procedure and must simply care for the surgical site to promote healing and prevent infection.

6. Tracheostomy/Tracheotomy

Ancient Application

Although the medieval medical practice has existed in some form since ancient Egyptian times (pharyngotomy, laryngotomy or bronchotomy), the first successful case wasn’t documented until 1546. The procedure (tracheotomy) creates a hole (tracheostomy) in the trachea to allow a direct flow of air. It’s performed when there’s an obstruction of the airway with little time to address the blockage before suffocation.

Ancients rarely used the medical practice for fear of slicing through the carotid artery that runs through the neck. However, legend states that, around 1000 B.C., Alexander the Great saved a soldier from suffocation by using his sword to make an incision in his trachea. Early in the middle ages, tracheotomies were performed only in the strictest of emergencies and often with little success.

Modern Application

As the understanding of human anatomy progressed, so did the technique. Medical professionals began using a vertical incision, rather than a horizontal one, to decrease the odds of cutting the carotid. Additional surgical enhancements and proper post-surgical care gave rise to the modern medical practice, which currently has a very low mortality rate and has saved countless lives.

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