Therapeutic bleeding, referred to in medical terms as venesection and in popular terms as “bloodletting,” is the practice of bleeding – removing blood from a patient – for the purpose of healing or preventing disease. It was a frequent and widespread practice until the end of the 19th century, based on ancient concepts, and was largely ineffective and harmful.
Despite this, it was one of the most frequent medical practices carried out for over 2000 years. There are illustrations in a certain ancient tomb (c. 1500 BC) that prove the use of leeches for bloodletting. The method had a wide geographical distribution, being used by Mesopotamians, Egyptians, Greeks, Mayans, Aztecs or in the Ayurvedic medicine of the Indians. Ancient Islamic authors recommend the practice, and the Jewish Talmud even suggests specific days of the week or month for bloodletting.
Therapeutic bleeding, originating from the time of the Greek physician Galen, has become increasingly popular. Galen was a proponent of Hippocrates' ideas that illnesses are the result of an imbalance of four humours (liquids): blood – linked to the liver (describing the sanguine temperament), black bile – linked to the spleen (representing the choleric), yellow bile – linked to the gallbladder (embodying the melancholic), and phlegm (mucus) – linked to the lungs (symbolising the phlegmatic). This theory was synthesised by the ancient Greeks around 400 BC, hence the theory of the four temperaments.
Health (eucrasia) represents the balance of humours, and illness (dyscrasia) represents their imbalance.
Galen made precise recommendations for the amount of blood to be removed, depending on the patient's age, symptoms, or even the weather. Barber-surgeons of Europe, in the Middle Ages and Renaissance, practised therapeutic bleeding for an unimaginable array of illnesses. President George Washington himself underwent such “therapy” for a laryngeal infection, which appears to have hastened his death.
The method of bloodletting persisted into the 20th century, even being recommended by doctors (the Canadian William Osler, for example, in the 1923 edition of his textbook on the practice of medicine).
In conventional medicine, the therapeutic phlebotomy method is used very rarely, only as an adjunct in severe polycythemias associated with hyperviscosity syndrome or in genetic diseases associated with iron overload. It was often used in hypertensive crisis to lower blood pressure.
Despite its proven negative effect, paradoxically, it is still used in various forms of alternative medicine. Most commonly, lancets (fine knives resembling later scalpels), scarifiers (spring-loaded devices with multiple blades used to make incisions in the skin), or leeches – worms from the annelid phylum – were used.
Of all these, the ones listed last are worthy of our attention, as they are currently used in many parts of the world where the method (hirudotherapy) is not prohibited by law. They are placed on various areas of the body and suck blood, piercing through the 250 tiny teeth in their oral cavity for between 5 and 30 minutes, or even an hour, until they are full and fall off, introducing saliva in their place, which appears to keep the area sterile and thin the blood, intensifying cellular metabolism.
Even though it is still used, as I was saying, by various naturopaths or even doctors, it is nevertheless considered a misleading practice based on ancient and medieval superstitions and not at all on scientific evidence.
- article written by Dr Ionel Julea for reperemedicale.ro