Once thought to be the miracle cure for whatever was ailing you, the practice of bloodletting or Phlebotomy has been around for over 3,000 years or so.
Who Did It?
Evidence goes back as far as the ancient Egyptians, the ancient Greeks and the Roman Empire. The practice of bloodletting was performed by just about every culture up until the late 1800’s.
Background
The practice of bloodletting can trace its roots to a mixture of medicine, magic and religion. Before such things as diseases were discovered, the belief amongst the masses was that a person who was afflicted with an ailment was not actually sick but was instead possessed by demons. Bloodletting was believed to free the demons and thus, cure what was ailing you.
In ancient cultures, the priest and the physician were often regarded as one and the same. Bloodletting was the accepted practice for cleansing the body and bringing the four humours back into balance. The tools that were in the procedure used were indicative of the times. Items such as sharp sticks, thorns, bones, and animal teeth were all used in ancient man's search for a cure.
The Four Humours
It was during the times of Aristotle and Hippocrates that the concept of the four humours was born. In short, the body consisted of four fluids. They were defined as blood, phlegm, yellow bile and black bile. In order for one to be healthy, the four fluids had to remain in balance. Bloodletting was one way to do that. The concept of the four humours also led to what can best be described as a “diagnosis” of sorts and contributed to the demise in the belief of evil spirits and demonic possession as the cause of illness.
Haircut Anybody?
By the time the year 1163 rolled around, the church had taken a dim view on the practice of bloodletting. They even went so far as to ban them from performing the practice. Who then would cure you of your ills? Well, back in those days, your friendly neighborhood barber did much more than cut your hair. (For a fine depiction of what a barber in the olden days did, I highly recommend Barber Surgeon by fellow noder BlueDragon.) In short, the familiar sign of the barber, the barbers pole and its colors of red and white had a dual meaning. The red on the sign signifies blood and the white signifies bandages.
It’s In The Stars
As if things weren’t complicated enough, astrology also played an important part in bloodletting. A table was drawn up that related every part of the body to signs of the zodiac and the practice of bloodletting was performed at specific times for specific body parts.
A Word of Advice from the Father of Surgery
Here’s what Ambroise Paré, the most respected surgeon in his day, had to say about the practice of bloodletting .
"But blood is let by opening a vein for five respects: the first to lessen the abundance of blood, as in plethoric bodies, and those troubled with plentitude. The second is for diversion, or revulsion, as when a vein of the right arm is opened to stay the bleeding of the left nostril. The third is to allure or draw down, as when the vein is opened in the ankle to draw down the menstrual flow in women. The fourth is for alteration or introduction of another quality, as when in sharp fevers we open a vein to breathe out that blood which is heated in vessels, and cooling the residue which remains behind. The fifth is to prevent imminent disease, as in the spring and autumn we draw blood by opening a vein in such as are subject to spitting of blood, quinsy, pleurisy, falling sickness, apoplexy, madness, gout, or in such as are wounded, for to prevent the inflammation which is to be feared. Before bloodletting, if there be any excrement in the guts, they shall be evacuated by a gentle clyster, or suppository, lest the mesenteric veins should thence draw unto them any impurity."
Tools of the Trade
Some had really bland names such as the lancet but others were really cool. Two that come to mind are the fleam and the scarificator. I envision the following:
Doctor: :Nurse, pass me the fleam and the scarificator and we will commence to cupping.”
You're Gonna Do What?
Somehow I just can’t imagine my doctor saying something to the effect of “First we’re gonna need a shitload of leeches.”
Again, to quote Ambroise Paré
In those parts of the body whereto cupping-glasses and horns cannot be applied, to those leeches may for the most part be put, as to the fundament to open the coat of the hemorrhoid veins, to the mouth of the womb, the gums, lips, nose, fingers. After the leech being filled with blood shall fall off, if the disease require a large evacuation of blood, and the part affected may endure it, cupping-glasses, or horns, or other leeches shall be substituted. If the leeches be handled with the bare hand, they are angered, and become so stomachfull as that they will not bite; wherefore you shall hold them in a white and clean linen cloth, and apply them to the skin being first lightly scarified, or besmeared with the blood of some other creature, for thus they will take hold of the flesh, together with the skin more greedily and fully. To cause them to fall off, you shall put some powder of Aloes, salt or ashes upon their heads. If any desire to know how much blood they have drawn, let him sprinkle them with salt made into powder, as soon as they are come off, for thus they will vomit up what blood soever they have sucked. If you desire they should suck more blood than they are able to contain, cut off their tails as they suck, for thus they will make no end of sucking, for that it runs out as they suck it. The leeches by sucking draw the blood not only from the affected part whereto they are applied, but also from the adjacent and distant parts. Also sometimes the part bleeds a good while after the leeches be fallen away, which happens not by scarification after the application of cupping-glasses or horns. If you cannot stop the bleeding after the falling away of the leeches, then press the half of a bean upon the wound, until it stick of itself, for thus it will stay; also a burnt rag may be fitly applyed with a little bolster and fit ligature.
Estimates are that in its heyday, the practice and popularity of bloodletting led to the import of over 40 million leeches to France in a single year. That, my friends, is a lot of blood.
Actually, the use of leeches has regained a measure of popularity in recent years. The same cannot be said for the practice of bloodletting.