Bloodletting

Long ago, doctors took blood from sick people.

They thought this helped them get well. They believed the body needed balance. They thought too much blood caused sickness.

Doctors used many tools to do this. Some used small worms called leeches. Others used tools with sharp blades. This was a common way to treat people. It was used for over 2,000 years. Today, doctors do not use this to cure sickness. They only take blood for tests now.

For over 2,000 years, doctors used a way to treat sickness called bloodletting.

This meant taking blood out of a person on purpose. Doctors believed the body had four fluids called humors. They thought these fluids must stay in balance to keep you healthy. If a person had too much blood, they might get a fever or a headache.

To fix this, doctors would remove the extra blood. They used many different tools for this job.

Some doctors used leeches, which are small worms. Others used a tool called a scarificator.

This tool had a spring and small blades. It could snap the blades out to make tiny cuts. People also used a method called phlebotomy. This is when a doctor opens a large vein, like in the arm.

In the 1800s, doctors found out this did not actually cure many diseases. Today, doctors only take blood for tests or to help specific illnesses. This new way is called phlebotomy.

Bloodletting was a medical practice used for over 2,000 years.

It involved the deliberate removal of blood from a person. Doctors used this to try to prevent or cure many diseases. The practice was based on a system of medicine involving four fluids. These fluids were called humors. They included blood, phlegm, black bile, and yellow bile.

People believed these humors had to stay in balance to keep a person healthy.

This system worked by looking for an imbalance in the humors. Doctors thought that too much blood caused a condition called plethora. This could lead to a fever, a headache, or apoplexy. To fix this, a physician would remove the extra blood. They might use a specific vein based on the illness. For example, they might use a vein in the right hand for liver problems. They might use a vein in the left hand for spleen problems.

Some doctors even believed that bleeding a person until they fainted was helpful.

Many different people studied and used bloodletting throughout history. In Ancient Egypt, people may have used scarification to bleed patients. In Greece, a physician named Hippocrates mentioned the practice in the 5th century BC. Later, the Roman physician Galen became very influential. He believed blood was the most important humor to control. During the Middle Ages, Islamic medical authors also advised bloodletting for fevers. In the 1600s, the practice became part of a group of treatments called heroic medicine.

Even George Washington was bled heavily during a throat infection in 1799.

There were several ways that doctors actually performed bloodletting. One way was phlebotomy, which means opening a large vein. Another way was arteriotomy, which involved puncturing an artery.

Some doctors used a tool called a scarificator. This was a brass case with a spring-loaded mechanism inside. When triggered, steel blades would snap out in a circular motion.

Other doctors used leeches to draw blood from the skin. In the 1830s, France alone imported 40 million leeches every year for medical use.

Today, we know that traditional bloodletting is a pseudoscience.

This means it is not based on the scientific method. In the 1830s, Pierre Charles Alexandre Louis showed it did not work for pneumonia. Modern medicine now uses the term phlebotomy for different reasons. We draw blood for laboratory analysis or for blood transfusions. We also use therapeutic phlebotomy for very specific conditions. This helps reduce the number of red blood cells in certain illnesses. It is a very different way of using blood than in the past.

Bloodletting is the deliberate withdrawal of blood from a patient to prevent or cure various illnesses.

For over 2,000 years, it served as one of the most common medical practices performed by surgeons and physicians. This long history spans from antiquity through the late 19th century in Europe. While it was once a standard treatment for almost any ailment, modern medicine has largely abandoned it. Today, the traditional practice is classified as a pseudoscience because it is not based on scientific evidence. However, modern medical procedures like phlebotomy still involve drawing blood, but for very different purposes such as laboratory analysis or blood transfusions.

The practice was rooted in an ancient medical theory regarding the four humors. These humors were bodily fluids that had to remain in a specific balance to maintain health. The four humors included blood, phlegm, black bile, and yellow bile. These fluids were thought to correspond to the four Greek classical elements: air, water, earth, and fire. Physicians believed that an imbalance, such as an overabundance of blood called plethora, caused disease. Symptoms of plethora were thought to include fever, headache, and apoplexy. To restore balance, a doctor would remove the excess blood to treat the patient.

Different methods were used to withdraw the blood depending on the goal. Phlebotomy, or venesection, involved opening one or more large external veins, like those in the neck or forearm. Arteriotomy was another method where an artery was punctured, though this was usually limited to the temples. Doctors also practiced scarification, which targeted superficial vessels. They might use a syringe, a glass cup with heated air to create a vacuum, or a specialized tool.

This tool was called a scarificator. It was a brass case containing a spring-loaded mechanism with steel blades. When triggered, the blades snapped out in a circular motion through slits in the cover.

Another common method involved using leeches to draw blood from the skin.

Medical history shows many different cultures utilized these techniques. In Ancient Egypt, evidence suggests bloodletting by scarification was an accepted practice. Some accounts suggest Egyptians may have based this on observations of hippopotamuses. In Greece, the physician Hippocrates mentioned the practice in the 5th century BC. Later, the Roman physician Galen became a major influence by advocating for physician-initiated bloodletting. Galen discovered that both veins and arteries were filled with blood. He believed blood was created and then used up rather than circulating. He also developed a complex system to decide how much blood to remove based on a patient's age, the season, and even the weather.

During the Middle Ages, bloodletting remained popular and was even guided by the stars. Bleeding charts showed specific sites on the body that aligned with the zodiac and planets. Islamic medical authors also advised bloodletting, particularly for treating fevers. By the 18th century, the practice became part of "heroic medicine," which was a collection of traumatic and destructive medical treatments. This era saw the rise of the distinction between physicians and barbers. While physicians recommended the treatment, barbers often performed the actual bleeding. This history is even reflected in the red-and-white-striped barber poles seen today. The red symbolizes blood, while the white symbolizes bandages.

The scale of bloodletting in the 19th century was immense. In the 1830s, France imported about 40 million leeches every year for medical use. England imported 6 million leeches annually from France alone during the following decade. The practice was also widespread in the United States. In 1799, George Washington was bled heavily for a throat infection. In a single ten-hour period, doctors withdrew between 124 and 126 ounces of his blood. This was roughly 3.75 liters of blood before his death. Such intense treatments were common because doctors believed it was better to provide a treatment than nothing at all.

The decline of bloodletting began with the rise of scientific medicine. In the 1830s, Pierre Charles Alexandre Louis used a method called la méthode numérique to study pneumonia patients. He demonstrated that phlebotomy was entirely ineffective for treating pneumonia and various fevers. Despite this evidence, many physicians resisted his findings because they preferred traditions validated by their own experience. Eventually, the humoral theory fell out of use. Today, we only use therapeutic phlebotomy for specific conditions like hemochromatosis or polycythemia vera. In these cases, drawing blood helps reduce the number of red blood cells in the body.