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Encyclopedia > Bloodletting
Ancient Greek painting in a vase, showing a physician (iatros) bleeding a patient.

Bloodletting (or blood-letting, in modern medicine referred to as phlebotomy) was a popular medical practice from antiquity up to the late 19th century, involving the withdrawal of often considerable quantities of blood from a patient in the hopeful belief that this would cure or prevent a great many illnesses and diseases. The practice, of unproven efficacy, has been abandoned for all except a few specific conditions as modern treatments proved or believed to be effective have been introduced. It is conceivable that historically, in the absence of other treatments for hypertension, bloodletting could sometimes have had a beneficial effect in temporarily reducing blood pressure by a reduction in blood volume. Image File history File links Iatros. ... medicines, see medication and pharmacology. ... Human blood smear: a - erythrocytes; b - neutrophil; c - eosinophil; d - lymphocyte. ... The term disease refers to an abnormal condition of an organism that impairs function. ... Ancient Greek painting in a vase, showing a physician (iatros) bleeding a patient. ... This article or section does not cite its references or sources. ... A sphygmomanometer, a device used for measuring blood pressure. ...


Today the term "phlebotomy" refers to the drawing of blood for laboratory analysis or blood transfusion (see Phlebotomy (modern)). Therapeutic phlebotomy refers to the drawing of a unit of blood in specific cases like hemochromatosis, polycythemia vera, porphyria cutanea tarda etc., to reduce the amount of red blood cells. Donating blood Blood transfusion is the process of transferring blood or blood-based products from one person into the circulatory system of another. ... The phrase phlebotomy is used for different purpose today than it was in medieval times. ... Haemochromatosis, also spelled hemochromatosis, is a hereditary disease characterized by improper processing by the body of dietary iron which causes iron to accumulate in a number of body tissues, eventually causing organ dysfunction. ... Polycythemia is a condition in which there is a net increase in the total circulating erythrocyte (red blood cell) mass of the body. ... The porphyrias are inherited or acquired disorders of certain enzymes in the heme biosynthetic pathway (also called porphyrin pathway). ...

Contents

Bloodletting in the ancient world

Hans von Gersdorff, Feldbuch der Wundarznei, 1517 — Points for blood-letting

Bloodletting is one of the oldest medical practices, having been practiced among diverse ancient peoples, including the Mesopotamians, the Egyptians, the Greeks, the Mayans, and the Aztecs. In Greece, bloodletting was in use around the time of Hippocrates, who mentions bloodletting but in general relied on dietary techniques. Erastistratus, however, theorized that many diseases were caused by plethoras, or overabundances, in the blood, and advised that these plethoras be treated, initially, by exercise, sweating, reduced food intake, and vomiting. Herophilus advocated bloodletting. Archagathus, one of the first Greek physicians to practice in Rome, practiced bloodletting extensively and gained a most sanguinary reputation. Feldbuch der Wundarznei, 1517 The two-dimensional work of art depicted in this image is in the public domain in the United States and in those countries with a copyright term of life of the author plus 100 years. ... Mesopotamia refers to the region now occupied by modern Iraq, eastern Syria, southeastern Turkey, and Southwest Iran. ... This article is about the pre-Columbian Maya civilization. ... The word Aztec is usually used as a historical term, although some contemporary Nahuatl speakers would consider themselves Aztecs. ... Hippocrates of Cos II or Hippokrates of Kos (ca. ... This article or section does not cite any references or sources. ... The term Exercise can refer to: Physical exercise such as running or strength training Exercise (options), the financial term for enacting and terminating a contract Category: ... SWEAT is an OLN/TSN show hosted by Julie Zwillich that aired in 2003-2004. ... Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ... Herophilos, sometimes Latinized Herophilus (335-280 BC), was a Greek physician. ... Caecilius, of Calacte in Sicily, Greek rhetorician, flourished at Rome during the reign of Augustus. ... Motto Senatus Populusque Romanus Roman provinces on the eve of the assassination of Julius Caesar, c. ...


The popularity of bloodletting in Greece was reinforced by the ideas of Galen, after he discovered the veins and arteries were filled with blood, not air as was commonly believed at the time. There were two key concepts in his system of bloodletting. The first was that blood was created and then used up, it did not circulate and so it could 'stagnate' in the extremities. The second was that humoral balance was the basis of illness or health, the four humours being blood, phlegm, black bile, and yellow bile, relating to the four Greek classical elements of air, water, earth and fire. Galen believed that blood was the dominant humour and the one in most need of control. In order to balance the humours, a physician would either remove 'excess' blood (plethora) from the patient or give them an emetic to induce vomiting, or a diuretic to induce urination. Galen (Greek: Γαληνός, Galinos; Latin: Claudius Galenus; AD 129 –c. ... In the circulatory system, a vein is a blood vessel that carries blood toward the heart. ... Section of an artery For other uses, see Artery (disambiguation). ... Layers of Atmosphere - not to scale (NOAA)[2] Earths atmosphere is a layer of gases surrounding the planet Earth and retained by the Earths gravity. ... The circulatory system or cardiovascular system is the organ system which circulates blood around the body of most animals. ... The four humours were four fluids that were thought to permeate the body and influence its health. ... Chinese Wood (木) | Fire (火) Earth (土) | Metal (金) | Water (水) Hinduism and Buddhism Vayu / Pavan — Air / Wind Agni / Tejas — Fire Akasha — Aether Prithvi / Bhumi — Earth Ap / Jala — Water Many ancient philosophies used a set of archetypal classical elements to explain patterns in nature. ... The Doctor by Samuel Luke Fildes This article is about the term physician, one type of doctor; for other uses of the word doctor see Doctor. ... Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ... A diuretic (colloquially called a water pill) is any drug or herb that elevates the rate of bodily urine excretion (diuresis). ...


Galen created a complex system of how much blood should be removed based on the patient's age, constitution, the season, the weather and the place. Symptoms of plethora were believed to include fever, apoplexy, and headache. The blood to be let was of a specific nature determined by the disease: either arterial or venous, and distant or close to the area of the body affected. He linked different blood vessels with different organs, according to their supposed drainage. For example, the vein in the right hand would be let for liver problems and the vein in the left hand for problems with the spleen. The more severe the disease, the more blood would be let. Fevers required copious amounts of bloodletting. An analogue medical thermometer showing the temperature of 38. ... Apoplexy is an old-fashioned medical term, generally used interchangeably with cerebrovascular accident (CVA or stroke) but having other meanings as well. ... A headache is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... In the circulatory system, venous blood is blood returning to the heart. ... f you all The blood vessels are part of the circulatory system and function to transport blood throughout the body. ... In biology, an organ (Latin: organum, instrument, tool) is a group of tissues that perform a specific function or group of functions. ... The liver is an organ present in vertebrates and some other animals. ... The spleen is an organ of the lower abdomen, where it functions in the destruction of old red blood cells and holding a reservoir of blood. ...


The Talmud recommended a specific day of the week and days of the month for bloodletting, and similar rules, though less codified, can be found among Christian writings advising which saints' days were favourable for bloodletting. Islamic authors too advised bloodletting, particularly for fevers. The practice was probably passed to them by the Greeks; when Islamic theories became known in the Latin-speaking countries of Europe, bloodletting became more widespread. Together with cautery it was central to Arabic surgery; the key texts Kitab al-Qanum and especially Al-Tasrif li-man 'ajaza 'an al-ta'lif both recommended it. It was also known in Ayurvedic medicine, described in the Susruta Samhita. The first page of the Vilna Edition of the Babylonian Talmud, Tractate Berachot, folio 2a The Talmud (Hebrew: תלמוד) is a record of rabbinic discussions pertaining to Jewish law, ethics, customs and history. ... Christianity is a monotheistic[1] religion centered on the life and teachings of Jesus of Nazareth as presented in the New Testament. ... The calendar of saints is a traditional Christian method of organising a liturgical year on the level of days by associating each day with a saint, and referring to the day as the saints day of that saint. ... Islam (Arabic:  ) is a monotheistic religion based upon the teachings of Muhammad, a 7th century Arab religious and political figure. ... Latin is an ancient Indo-European language originally spoken in Latium, the region immediately surrounding Rome. ... This article is 150 kilobytes or more in size. ... Hot cauters were applied to tissues or arteries to stop them from bleeding. ... Languages Arabic other languages (Arab minorities) Religions Predominantly Islam Some adherents of Druze, Judaism, Samaritan, Christianity Related ethnic groups Jews, Canaanites, other Semitic-speaking groups An Arab (Arabic: ); is a member of a Semitic group of people whose cultural, linguistic, and in certain cases, ancestral origins trace back to the... Shirodhara, one of the techniques of Ayurveda Ayurveda (Devanagari: ) or Ayurvedic medicine is a practice in use primarily in the Indian subcontinent, which advocates argue assists with health and healing. ...


Bloodletting in the 2nd millennium

Ioannis Sculteti, Armamentium Chirugiae, 1693 — Diagrammed transfusion of sheep's blood
Ioannis Sculteti, Armamentium Chirugiae, 1693 — Diagrammed transfusion of sheep's blood

Even after the humoral system fell into disuse, the practice was continued by surgeons and barber-surgeons. Though the bloodletting was often recommended by physicians, it was carried out by barbers. This division of labour led to the distinction between physicians and surgeons. The barbershop's red-and-white-striped pole, still in use today, is derived from this practice: the red represents the blood being drawn, the white represents the tourniquet used, and the pole itself represents the stick squeezed in the patient's hand to dilate the veins. Bloodletting was used to 'treat' a wide range of diseases, becoming a standard treatment for almost every ailment, and was practiced prophylactically as well as therapeutically. Patient is bled and receives a sheeps blood transfusion. ... Patient is bled and receives a sheeps blood transfusion. ... Species See text. ... A cardiothoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. ... The barber surgeon was one of the most common medical practitioners of medieval times - generally charged with looking after soldiers during or after a battle. ... The Doctor by Samuel Luke Fildes This article is about the term physician, one type of doctor; for other uses of the word doctor see Doctor. ... Division of labour is the specialisation of cooperative labour in specific, circumscribed tasks and roles, intended to increase efficiency of output. ... For other uses of the word, see the Barber disambiguation page. ... Two tourniquets of different fabrication, these are used for venipuncture A tourniquet is a tightly tied band applied around a body part (an arm or a leg) sometimes used in an attempt to stop severe traumatic bleeding, but also during venipuncture, and other medical procedures. ... Look up stick, sticks in Wiktionary, the free dictionary. ... Dilation in physiological context may mean: pupil dilation (mydriasis) dilation of blood vessels (vasodilation) cervical dilation (or dilation of the cervix) in childbirth Dilation and curettage (surgical dilation) In mathematics: Dilation This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same... Prophylaxis refers to any medical or public health procedure whose purpose is to prevent, rather than treat or cure, disease. ...

Scarificator
Scarificator
Scarificator mechanism
Scarificator mechanism
Scarificator, showing depth adjustment bar
Scarificator, showing depth adjustment bar
Diagram of scarificator, showing depth adjustment

The practice continued throughout the Middle Ages but began to be questioned in the 16th century, particularly in northern Europe and the Netherlands. In France, the court and university physicians advocated frequent phlebotomy. In England, the efficacy of bloodletting was hotly debated, declining throughout the 18th century, and briefly revived for treating tropical fevers in the 19th century. Image File history File links Size of this preview: 692 × 600 pixelsFull resolution (1095 × 949 pixel, file size: 401 KB, MIME type: image/jpeg) I, the creator of this work, hereby grant the permission to copy, distribute and/or modify this document under the terms of the GNU Free Documentation... Image File history File links Size of this preview: 692 × 600 pixelsFull resolution (1095 × 949 pixel, file size: 401 KB, MIME type: image/jpeg) I, the creator of this work, hereby grant the permission to copy, distribute and/or modify this document under the terms of the GNU Free Documentation... Image File history File links Size of this preview: 565 × 600 pixelsFull resolution (761 × 808 pixel, file size: 202 KB, MIME type: image/jpeg) I, the creator of this work, hereby grant the permission to copy, distribute and/or modify this document under the terms of the GNU Free Documentation... Image File history File links Size of this preview: 565 × 600 pixelsFull resolution (761 × 808 pixel, file size: 202 KB, MIME type: image/jpeg) I, the creator of this work, hereby grant the permission to copy, distribute and/or modify this document under the terms of the GNU Free Documentation... Image File history File links Size of this preview: 755 × 599 pixelsFull resolution (1043 × 828 pixel, file size: 274 KB, MIME type: image/jpeg) I, the creator of this work, hereby grant the permission to copy, distribute and/or modify this document under the terms of the GNU Free Documentation... Image File history File links Size of this preview: 755 × 599 pixelsFull resolution (1043 × 828 pixel, file size: 274 KB, MIME type: image/jpeg) I, the creator of this work, hereby grant the permission to copy, distribute and/or modify this document under the terms of the GNU Free Documentation... Image File history File links No higher resolution available. ... Image File history File links No higher resolution available. ... The Middle Ages formed the middle period in a traditional schematic division of European history into three ages: the classical civilization of Antiquity, the Middle Ages, and modern times, beginning with the Renaissance. ... Motto (French) God and my right Anthem God Save the King (Queen) England() – on the European continent() – in the United Kingdom() Capital (and largest city) London (de facto) Official languages English (de facto) Government Constitutional monarchy  -  Queen Queen Elizabeth II  -  Prime Minister Tony Blair MP Unification  -  by Athelstan 967  Area...


At right are three photos and a diagram of a 19th century bloodletting device called a scarificator. It has a spring loaded mechanism with gears that snaps the blades out through slits in the front cover and back in, in a circular motion. The case is cast brass and the mechanism and blades steel. One knife bar gear has slipped teeth, turning the blades in a different direction than those on the other bars. The last photo and the diagram show the depth adjustment bar at the back and sides.


A number of different methods were employed. The most common was phlebotomy or venesection (often called "breathing a vein"), in which blood was drawn from one or more of the larger external veins, such as those in the forearm or neck. In arteriotomy an artery was punctured, although generally only in the temples. In scarification (not to be confused with scarification, a method of body modification) the "superficial" vessels were attacked, often using a syringe, a spring-loaded lancet, or a glass cup that contained heated air, producing a vacuum within. A scarficator is a bloodletting tool used primarily in 19th century medicine. Leeches could also be used. The withdrawal of so much blood as to induce syncope (fainting) was considered beneficial, and many sessions would only end when the patient began to swoon. Scarification is a permanent body modification that uses scar tissue produced by the body to form designs, pictures, or words in the skin. ... Lancet may refer to: A lancet is a medical instrument, similar to a scalpel but with a double-edged blade. ... Look up Vacuum in Wiktionary, the free dictionary. ... Orders Arhynchobdellida or Rhynchobdellida There is some dispute as to whether Hirudinea should be a class itself, or a subclass of the Clitellata. ... This article or section does not cite its references or sources. ...


William Harvey disproved the basis of the practice in 1628, and the introduction of scientific medicine, la méthode numérique, allowed Pierre Charles Alexandre Louis to demonstrate that phlebotomy was entirely ineffective in the treatment of pneumonia and various fevers in the 1830s. Nevertheless, in 1840 a lecturer at the Royal College of Physicians would still state that "blood-letting is a remedy which, when judiciously employed, it is hardly possible to estimate too highly" and Louis was dogged by the sanguinary Broussais, who could recommend leeches fifty at a time. William Harvey William Harvey (April 1, 1578 – June 3, 1657) was an English medical doctor, who is credited with being the first to correctly describe, in exact detail, the properties of blood being pumped around the body by the heart. ... Evidence-based medicine (EBM) is an attempt to more uniformly apply the standards of evidence gained from the scientific method, to certain aspects of medical practice. ... Pierre Charles Alexandre Louis (1787-1872, was a French physician, known for introducing the use of statistics in the field of medicine. ... Pneumonia is an illness of the lungs and respiratory system in which the alveoli (microscopic air-filled sacs of the lung responsible for absorbing oxygen from the atmosphere) become inflamed and flooded with fluid. ... College building by Denys Lasdun The Royal College of Physicians of London is the oldest medical institution in England was founded in 1518 and is one of the most active of all medical professional organisations. ...


Bloodletting was especially popular in the young United States of America, where Benjamin Rush (a signatory of the Declaration of Independence) saw the state of the arteries as the key to disease, recommending levels of blood-letting that were high, even for the time. George Washington was treated in this manner following a horseback riding accident: almost 4 pounds (1.7 litres) of blood was withdrawn, contributing to his death by throat infection in 1799. Dr. Benjamin Rush, painted by Charles Wilson Peale, c. ... A copy of the 1823 William J. Stone reproduction of the Declaration of Independence The United States Declaration of Independence was an act of the Second Continental Congress, adopted on July 4, 1776, which declared that the Thirteen Colonies were independent of the Kingdom of Great Britain. ... George Washington (February 22, 1732 – December 14, 1799)[1] led Americas Continental Army to victory over Britain in the American Revolutionary War (1775–1783), and was later elected the first president of the United States under the U.S. Constitution. ... horse, see Horse (disambiguation). ... Officially the pound is the name for at least three different units of mass: The pound (avoirdupois). ... The litre or liter (U.S. spelling, see spelling differences) is a unit of volume. ... Look up Throat in Wiktionary, the free dictionary. ... An infection is the detrimental colonization of a host organism by a foreign species. ...


One reason for the continued popularity of bloodletting (and purging) was that, while anatomical knowledge, surgical and diagnostic skills increased tremendously in Europe from the 17th century, the key to curing disease remained elusive and the underlying belief was that it was better to give any treatment than nothing at all. The psychological benefit of bloodletting to the patient (a placebo effect) may sometimes have outweighed the physiological problems it caused. Bloodletting slowly lost favour during the 19th century, but a number of other ineffective or harmful treatments were available as placebos—mesmerism, various processes involving the new technology of electricity, many potions, tonics, and elixirs. Anatomical drawing of the human muscles from the Encyclopédie. ... It has been suggested that this article or section be merged into Placebo. ... Hypnosis, as defined by the American Psychological Association Division of Psychological Hypnosis, is a procedure during which a health professional or researcher suggests that a client, patient, or experimental participant experience changes in sensations, perceptions, thoughts, or behavior. ... Lightning strikes during a night-time thunderstorm. ...


In the absence of other treatments bloodletting actually is beneficial in some circumstance, including the fluid overload of heart failure, and possibly simply to reduce blood pressure. In other cases, such as those involving agitation, the reduction in blood pressure might appear beneficial due to the sedative effect. In 1844 Joseph Pancoast listed the advantages of bloodletting in "A Treatise on Operative Surgery". Not all of these reasons are outrageous nowadays:

The opening of the superficial vessels for the purpose of extracting blood constitutes one of the most common operations of the practitioner. The principal results, which we effect by it, are 1st. The diminution of the mass of the blood, by which the overloaded capillary or larger vessels of some affected part may be relieved; 2. The modification of the force and frequency of the heart's action; 3. A change in the composition of the blood, rendering it less stimulating; the proportion of serum becoming increased after bleeding, in consequence of its being reproduced with greater facility than the other elements of the blood; 4. The production of syncope, for the purpose of effecting a sudden general relaxation of the system; and, 5. The derivation, or drawing as it is alleged, of the force of the circulation from some of the internal organs, towards the open outlet of the superficial vessel. These indications may be fulfilled by opening either a vein or an artery.

This article or section does not adequately cite its references or sources. ... f you all The blood vessels are part of the circulatory system and function to transport blood throughout the body. ... Blood plasma is the liquid component of blood, in which the blood cells are suspended. ... The term Faint redirects here. ... In biology, an organ is a group of tissues which perform some function. ...

Phlebotomy

Today it is well-established that bloodletting is not effective for most diseases, or at best less effective than modern treatments. Bloodletting still has its place in the treatment of a few diseases, including hemochromatosis and polycythemia; it is practiced by specifically trained practitioners in hospitals, using modern techniques. Haemochromatosis, also spelled hemochromatosis, is a hereditary disease characterized by improper processing by the body of dietary iron which causes iron to accumulate in a number of body tissues, eventually causing organ dysfunction. ... Polycythemia is a condition in which there is a net increase in the total number of red blood cells in the body. ... A physician visiting the sick in a hospital. ...


In most cases, phlebotomy now refers to the removal of small quantities of blood for the purpose of performing blood tests. For more details on this subject, see Phlebotomy (modern). Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ... The phrase phlebotomy is used for different purpose today than it was in medieval times. ...


See also

Blood donation is a process by which a blood donor voluntarily has blood drawn for storage in a blood bank or for subsequent use in a blood transfusion. ... Hijama (Arabic حجامة lit. ... Cupping is an activity that started a short time ago, but is rapidly growing in popularity. ... Alternative medicine describes practices used in place of conventional medical treatments. ... “Give blood” redirects here. ... Hematology is the branch of medicine that is concerned with blood and its disorders. ... This article does not adequately cite its references or sources. ... 18th century French illustration of trepanation Trepanation (also known trepanning, trephination, trephining or burr hole) is a form of surgery in which a hole is drilled or scraped into the skull, thus exposing the dura mater in order to treat health problems related to intracranial diseases, though in the modern... The four humours were four fluids that were thought to permeate the body and influence its health. ...

External links


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Bloodletting - Information from Reference.com (1774 words)
Bloodletting (or blood-letting, in modern medicine referred to as phlebotomy) was a popular medical practice from antiquity up to the late 19th century, involving the withdrawal of often considerable quantities of blood from a patient in the hopeful belief that this would cure or prevent a great many illnesses and diseases.
In England, the efficacy of bloodletting was hotly debated, declining throughout the 18th century, and briefly revived for treating tropical fevers in the 19th century.
Bloodletting was especially popular in the young United States of America, where Benjamin Rush (a signatory of the Declaration of Independence) saw the state of the arteries as the key to disease, recommending levels of blood-letting that were high, even for the time.
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