Origins of the PRP Plasmolifting Method (Part 1)

Throughout human history, men have been interested in treatments with blood and its components. Many attributed magical properties to blood, considering it the elixir of youth, a font of strength, or a symbol of eternal life. For example, the ancient Roman surgeon and philosopher Galen believed that blood contained a "life spirit," captured out of the air by the act of breathing and transported to the various organs and tissues of the body. The Flemish alchemist Van Helmont went further by claiming that blood is a substance obtained from the "dust of the macrocosm," i.e., the quintessence of all that exists, so that elements of all that existed were contained in blood. In this book, however, we shall turn our attention away from mythology and mystical concepts, nor will we dwell on the rituals borne out of such popular beliefs. Instead, we shall direct our gaze towards solid facts grounded in authoritative sources. In this chapter, we hope to follow this method to outline a decisive picture of the historical development of auto-hemotherapy, the true predecessor and the prototype of autologous blood plasma therapy.

Our historical account naturally begins with the question: when did blood begin to be used for medicinal purposes? The answer may never be known. There are reports that even the Inca successfully practiced human blood transfusion. According to other sources, one could trace the first treatment with blood back to 47 A.D. However, other sources place the origin at least four centuries earlier, claiming that Hippocrates himself was an adept of such methods. That is, following these sources, he not only performed and described venesection (a.k.a. bloodletting) procedures but also found blood to be effective in the treatment of skin ulcers.

The picture becomes clearer in more recent history. In Europe, interest in blood transfusion became widespread only after the English physiologist William Harvey published Estudo anatômico do movimento do coração e do sangue nos animais [Anatomical study of the movement of the heart and blood in animals] in 1628. In that treatise, Harvey first formulated his theory of blood circulation and provided supporting empirical evidence. In the same year, the Italian doctor Giovanni Colle, inspired by Harvey's explanations, performed the first blood transfusion in animals. Less than three decades later, in 1667, the personal physician of King Louis XIV, Jean-Baptiste Denys, transfused animals' blood into three patients. The first two received small amounts of sheep's blood, apparently being able to withstand any allergic reaction due to the small amount of blood transfused. The third patient, having received calf's blood, died, leading to Denys's arrest. Despite Denys's subsequent acquittal and the fact that the fatality was due to arsenic poisoning rather than the transfusion, the procedure was banned in France and subsequently in England and Italy. Over a century passed until interest was revived in 1796 due to the efforts of Erasmus Darwin, the grandfather of Charles Darwin. Erasmus Darwin ardently insisted on the effectiveness of blood transfusion for the treatment of various diseases. Furthermore, the fact that there were few methods available to treat heavy bleeding and acute anemia induced physicians to turn to blood transfusion as a possible resource. In 1819, the London obstetrician James Blundell, realizing that blood from animals of different species were incompatible, successfully carried out the first documented human-to-human blood transfusion. The replacement of animal blood with human blood did not lead to a reduction in the alarmingly high mortality rate. Therefore, a proposal was put forward to use a physiological saline solution instead of blood. The resulting procedures offered no noticeable side effects and did not lead to the dangerous coagulation which occurred with the earlier practice. Nonetheless, interest in, as well as further research into, the therapeutic potential of blood continued unabated.

The consequences of blood transfusion remained unpredictable until the beginning of the 20th century, when the Vienna bacteriologist Karl Landsteiner, and later his colleagues Adriano Sturli and Alfred Von Decastello, discovered the four blood groups in 1902. This revelation finally provided the answer to the puzzle, and thereby issued in a revolution in surgical techniques. Surgery soon rid itself of the high risk of massive and fatal bleeding.

However, hindsight may be misleading, and it remains uncertain whether this discovery was responsible for the conviction of researchers at that time that a patient's own blood could turn out to be not only the safest but also the most effective therapeutic agent for that patient. Be that as it may, a half-century later, the German surgeon Max Schede advanced a method, now called Schede's clot, for treating bone necrosis with autologous blood. Some sources place the beginnings of auto-hemotherapy back to 1898 when the American doctors Carl E. Elfström and Axel V. Grafström used patients' own blood in order to treat croupous pneumonia.

We digress for a moment to note that tracing the origins of the term "auto-hemotherapy" can be somewhat confusing. In the late nineteenth and early twentieth centuries, the term "auto-hemotherapy" as such did not exist. Until the term came into its own, all procedures to inject the patient with either autologous blood or in fact any other biological fluids were subsumed under the terms "serum therapy" or "auto-serotherapy." At that time, two main types of therapy were known involving the extraction of the pathogen from the body and its reinjection into tissues to trigger an appropriate reaction. These were auto-serotherapy and autogenic vaccines, both widely described in the literature as effective methods of treating a number of common pathological conditions.

The origins of traditional serum therapy followed the publication of works of Kitasato Shibasaburo and Emil von Behring in the 1890s. This therapy proved successful, although some reviewers proposed that any beneficial effect associated with it was in reality due to autogenous vaccine therapy. The traditional "serotherapy" of Kitasato and Von Behring involved the intravenous administration of the "immunized" serum and the presumptive transfer of passive immunity to the patient. The subsequent auto-hemotherapy procedure consisted of simple reinjections of the patient's own blood, either intramuscular or subcutaneous, partially repeated it. The popularity of reinjections of autologous blood serum increased significantly since the publication of the works of Bodo Spiethoff in 1913.

To confuse the history further, the terms "serotherapy" and "serum therapy" meant both intravascular and extravascular (i.e., intramuscular and subcutaneous) injections; eventually, it was only the extravascular methodology that became known as "auto-hemotherapy."

The question as to the difference between autogenous vaccine therapy and auto-serotherapy naturally arises. Autogenous vaccine therapy is based on the discovery of Louis Pasteur who found that injecting "attenuated" microbes could protect animals from future exposure to virulent ones, and on the experiences of Almroth Wright as he subsequently used this discovery to create autogenous anti-typhoid vaccine. As S. Hale Shakman mentioned in his book, autogenous vaccines allow better dosage control than does auto-hemotherapy. The downside was that the creation of a vaccine required much more time and resources, "along with the risk of inadvertently excluding or altering the disease-causing agent. If such an agent is in one's blood, auto-hemotherapy ensures its inclusion." Auto-hemotherapy in any case ensures the introduction of this microorganism into the tissue – provided that it is present in the blood. Wright has repeatedly criticized auto-serotherapy, arguing that it was only a variation on bacterial vaccines, and thus inheriting the vaccine's success. Wright's criticisms aside, one can conclude that auto-hemotherapy clearly cannot be classified as "passive immunization" since the blood is received from the patients themselves rather than other donors with appropriate immunity. Furthermore, the results of Edward Rosenow's bacteriological research indicate that the effects of auto-hemotherapy may be attributed, at least partially, to the presence of the corresponding antigen in the blood; that is, auto-hemotherapy can act as a therapeutic vaccine. It is assumed that auto-serotherapy, autopyotherapy (that is, reinjection of autogenic serum and pus, resp.), and similar therapies act on the same principle.