Bloodletting

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Physician in the Middle Ages letting blood from a patient
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Last Update

This entry is out of date, and will not be updated, June 2017

Introduction

See also Avicenna | Barber surgeons | Édouard Beaupré | Mütter Museum in Philadelphia | Medical oddities | Trephination

"...bloodletting began around 3000 years ago with the Egyptians, then continued with the Greeks and Romans, the Arabs and Asians, then spread through Europe during the Middle Ages and the Renaissance. It reached its peak in Europe in the 19th century but subsequently declined and today in Western medicine is used only for a few select conditions. With a history spanning at least 3000 years, bloodletting has only recently—in the late 19th century—been discredited as a treatment for most ailments..."

Bloodletting is the ancient practice of opening a vein to release some blood since its "excess" was thought to be the cause of illness and disease. It is important to understand why bloodletting was a popular form of treatment from Hippocrates through Galen and consistently over the next 1700 years to the 19th century. Back to Hippocrates' time, human health was said to be based on a balance of the four humors: blood, phlegm, black bile and yellow bile. Each was linked to a specific organ — brain, lung, spleen and gall bladder — and to personality types such as sanguine, phlegmatic, melancholic and choleric. Therefore, being ill meant that the four humors were out of balance; removing an excess was therefore indicated. Accordingly, health practitioners used one of the following to restore health: bloodletting, purging, catharsis, diuresis and so on.

By the 1st century, bloodletting was widely-used and, later, once Galen had declared blood to be the most dominant humor, venesection became popular. Throughout human history, bloodletting has been practiced by various groups such as the Mesopotamians, Egyptians, Greeks, Mayans and Aztecs. In fact, bloodletting was practiced throughout Europe and the Americas well into the 19th century. In 1799, George Washington fell ill with an infection, and subsequently was bled by an employee and later by three doctors. He died later that day, and bloodletting likely hastened his death. Today, most people know bloodletting is ineffective in treating diseases. The irony is that its practitioners believed in bloodletting even though it signicantly weakened patients.

Bloodletting (or phlebotomy) is used in 21st century medicine for the treatment of hemochromatosis, polycythemia vera and porphyria cutanea tarda. The use of leeches in medicine is a form of bloodletting.

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