Bloodletting

Blood donation is about donating blood; it does not affect the health of the person donating.

Ancient Greek painting in a vase, showing a physician (iatros) bleeding a patient

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Points for blood-letting, Hans von Gersdorff (surgeon), Field book of wound medicine, 1517

Bloodletting is the practice of withdrawing blood from a patient to cure a disease. The practice was widely used in Antiquity and the Middle Ages. People stopped using it in the 19th century. The idea of bloodletting comes from an ancient system of medicine called Humorism: This system states, that there are different humors in the body. To remain healthy, a patient had to keep these humours in balance. Bloodletting was the most common medical practice performed by physicians from antiquity until the late 19th century, a span of almost 2,000 years.

It was found that only in very few cases, this treatment helps cure a disease. The practice has now been abandoned for all except a few very specific conditions. There was no other treatment for hypertension. Bloodletting could sometimes have had a beneficial effect in temporarily reducing blood pressure by reducing blood volume. The problem with hypertension is that it is difficult to diagonse from its symptoms. Modern methods directly measure blood pressure. In Antiquity, this effect was therefore unintentional. In most cases, the historical use of bloodletting was harmful to patients.

• The diseases where bloodletting actually helps include Polycythemia vera. In this disease, the number of red blood cells is increased, which changes the viscosity of the blood. Another disease is Polycythemia, which also leads to an increased number of red blood cells.

• Bloodletting is a historical medical practice that involves the withdrawal of blood from a person's body. It was a widely used therapeutic intervention in various cultures and time periods, dating back thousands of years. The practice was based on the belief that imbalance or "humoral theory" of bodily fluids (humors) caused illness, and by removing blood, the body could be restored to health.

Historical Background

Bloodletting has a long history and was practiced in different civilizations and cultures, including ancient Egypt, Mesopotamia, Greece, Rome, and medieval Europe. It was also prominent in traditional Chinese medicine and Islamic medicine.

Principles and Methods

• Bloodletting was based on the belief that the human body contained four primary humors: blood, phlegm, yellow bile, and black bile. According to the humoral theory, illnesses were believed to result from an imbalance or excess of these humors. By removing blood, it was thought that the body's humoral balance would be restored, promoting healing.
• Various methods of bloodletting were employed throughout history, including:
• Venesection: The most common method involved making an incision or puncture in a vein, typically in the arm or leg, and allowing blood to flow out.
• Cupping: Cupping involved placing heated cups on the skin, creating a vacuum that drew blood to the surface, after which incisions were made to allow the blood to be released.
• Leeches: Medicinal leeches were applied to the skin, and they would attach themselves and draw blood from the person. Leeches contain natural anticoagulants, which prevented blood clotting.
• Scarification: This method involved making shallow cuts or scratches on the skin's surface to let blood flow out.

Medical Rationale and Uses

• Bloodletting was believed to have several therapeutic effects, including:
• Restoring Humoral Balance: Bloodletting was thought to correct imbalances of the humors by removing excess or "corrupted" blood from the body.
• Promoting Blood Flow: It was believed that bloodletting improved blood circulation and relieved congestion, particularly in cases of inflammation or fever.
• Clearing Toxins: Bloodletting was seen as a way to eliminate toxins from the body, thereby promoting overall health.
• Bloodletting was used to treat a wide range of conditions, including fevers, infections, headaches, mental disorders, inflammation, and even certain cardiovascular diseases. However, its efficacy and scientific basis were eventually questioned as medical knowledge and understanding advanced.

Decline and Modern Perspective

• As scientific understanding of human physiology and disease progressed, bloodletting began to be viewed skeptically. The rise of evidence-based medicine and the development of effective treatments led to the decline of bloodletting in the 19th and 20th centuries. The practice was gradually replaced by more effective therapies, such as medications, surgical interventions, and targeted treatments based on scientific understanding.
• Today, bloodletting is considered an obsolete and potentially harmful practice. While certain therapeutic uses of bloodletting, such as therapeutic phlebotomy for specific medical conditions like hemochromatosis, still exist, they are based on modern medical knowledge and carefully controlled protocols.

See Also

• Humoral Theory
• Therapeutic Phlebotomy
• Traditional Chinese Medicine
• Islamic Medicine

References

• Fye, W. B. (1997). Bloodletting in early modern Europe: The history of bloodletting. Circulation, 95(11), 2591-2593. doi: 10.1161/01.CIR.95.11.2591
• Garrison, F. H. (1921). An introduction to the history of medicine. W.B. Saunders Company.
• Cushing, H. (1901). The life of Sir William Osler. Clarendon Press.
• Moore, A., & Whiteman, A. (1997). Cupping: A century of half-hearted inquiry. The Lancet, 350(9081), 1646-1647. doi: 10.1016/S0140-6736(05)65694-5

References

Bloodletting Resources
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