Bloodletting - Not Just for Vampires!

Before Hippocrates and up until the middle of the 19th century, physicians believed that certain humors, or fluids in the body needed to be in balance for the body to function properly. According to this belief, an imbalance in these humors could cause illness or death.

In an attempt to control these humors, physicians turned to bloodletting believing that the release of blood would set the body’s humors back into balance, thus curing the person. For years, physicians accepted the practice of bloodletting with only minor dissention. By the early 19th century, the debate was not over whether to bleed, but how best to bleed the patient. This technique reached its height of practice in Paris between 1825 and 1835.

Over time, the process of bloodletting evolved into several different methods:

• General phlebotomy by lancet
  • The physician selected a promising site - usually the back of the hand, arm, ankle, or tongue, although any part of the body was used. He then tied a tourniquet above and toward the heart to engorge the vein. Using a lancet (such as the one pictured above), he sliced approximately a fifth of an inch for the cut. An assistant would hold the bowl to catch the flowing blood.
• Dry or wet cupping
  • In dry cupping, blood was not removed from the body. The idea was to bring a concentration of blood to the surface from deep within the body. By placing a heated cup made of stone, metal, or glass on the skin, it created a vacuum as it cooled, thus drawing the blood to the surface.
  • In wet cupping, after a sponge with warm water dilated the capillaries, a scarificer would cut the skin, and then cupping would extract the blood.
• Leeches
  • Leeches operated in a manner similar to wet cupping. Using a large suction cup on one end of its body, a leech attaches itself to the skin. The other end of the leech contains three sharp teeth that make the puncture and a smaller suction cup to suck the blood. Leeches were especially useful for confined spaces such as the larynx, trachea, or around the eyes.

By 1840, bloodletting began to fall into disrepute when Pierre Louis claimed that bloodletting did not benefit pneumonia cases. He skillfully demonstrated the validity of his argument with statistics on pneumonia patients that were bled versus those that were not. Today, bloodletting is still practiced to resolve the overproduction of red blood cells. However, the idea that bloodletting "set the humors right" ceased to exist when physicians reached a better understanding of what bloodletting did, and how the body worked.