Isovolemic hemodilution as a functional therapy of decompensated arteriosclerotic stenoses of the femoral, cerebral and ophthalmic artery.

As a microcirculationist and a rheologist I appreciate this opportunity to address this distinguished audience and attempt an explanation why we seemingly turn back the clocks of medical history. Isovolemic hemodilution is in fact a modern day version of the old practice of phlebotomy that dates back to the eons of mankind — and which is also presently practiced by the Papua witch doctors in Neuguinea. It is well-known that the Greek’s supplied the traditional practice of phlebotomy with a rationalization, namely the first materialistic pathological theory of humours. “Humoral pathology” related disease to an abnormal mixture or composition of the blood and phlebotomy was performed in order to remove noxious material or materia peccans. The Greek doctors and all their subsequent colleages until the beginning of this century must have some success — this we can judge from the effects of therapies in which arteriosclerotic lesions are treated by defibrinogenation (with Ancrod or Arvin) or Raynaud’s syndrome by plasmaphoreses. These therapies resume the idea it is useful to reduce the pathological concentration of physiological blood components because these are causally related to the disease symptoms due to their abundance in the blood.