The practice of bloodletting goes back 3,000 years. In fact, this ancient medical practice was so revered for centuries that it’s only since the 19th century that the practice fell into disfavor. Bloodletting involves withdrawing blood from a patient to cure an illness or disease, often using leeches. Though modern medical science largely discredits the practice, some practitioners still use it occasionally to treat conditions like polycythemia and hemochromatosis, and leeches still play a role in some plastic and reconstructive surgery procedures.

It All Began with the Hippopotamus

The practice of bloodletting goes back to ancient Egypt. An important ancient medical text written around 1550 B.C.E., the Ebers Papyrus, recorded the ancient Egyptian practice of bloodletting through scarification. According to historians, the practitioners witnessed hippopotami scratching themselves, apparently to relieve distress. However, the creature was not bleeding -- the observers confused the creature’s red sweat with blood.

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Hippocrates and the Humors

The practice of bloodletting was well-established in Greece by the time of Hippocrates in 370 B.C. Hippocrates believed human existence was dependent on four basic humors: blood, phlegm, yellow bile, and black bile. These humors related to the organs of the body, as well as to mood. When a person became ill, Hippocrates and others theorized that the humors were out of balance. Consequently, treatments for illnesses involved removing the humor that appeared to cause the imbalance. Bloodletting became a standard treatment that spread with Hippocrates’s influence in the medical field.

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Galen of Pergamum

Galen of Pergamum, a Greek physician practicing during the ancient Roman era, further promoted the idea of bloodletting. He believed the most dominant of all the humors was blood. He also discovered that arteries carried blood, in addition to veins. Previously, the ancients theorized that arteries carried air. Galen’s subsequent writings on blood circulation and bloodletting helped cement the practice for many centuries.

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The Cosmic Connection

The practice of bloodletting continued into the Middle Ages, when its use expanded and was regulated in many areas. Some medical practitioners among Jews, Christians, and Muslims believed that there were favorable days for bloodletting, those well-aligned with various planets or zodiacs. As cultures throughout Europe exchanged medical views and practices, bloodletting gained even more popularity.

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Reasons for Bloodletting

As bloodletting became increasingly popular, practitioners expanded its uses. At its height, bloodletting treated asthma, cancer, gout, convulsions, indigestion, smallpox, tuberculosis, insanity, jaundice, and plague, among others. Bloodletting was even used as a treatment for heavy menstruation and nosebleeds. In 1623, a French physician wrote that bloodletting could cure heartbreak.

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Venesection was one method of bloodletting. During this procedure, the physician or surgeon used a lancet and fleam to open a vein, often the medial cubital vein near the elbow. (Fleams were more likely for veterinary use, though reports of human use do exist.) Doctors also opened other veins during the procedures. In some cases, physicians employed cupping after bloodletting, which extracted air from the incision site.

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Many people associate the practice of bloodletting with leeches. Medical leeches used during the practice could ingest ten times their weight in blood. Often, practitioners would place the leeches near the organs they believed were infected. During the early nineteenth century, Paris alone employed as many as six-million leeches for use in medical treatments.

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Did It Ever Work?

Modern medicine has largely abandoned bloodletting. However, it follows that the practice must have some basis in truth for it to continue for so many centuries. Researchers note bloodletting could reduce high blood pressure, which could be the reason for improvements in certain conditions. In cases of infection, the practice may also have been beneficial as reduced blood volume meant fewer pathogens in the blood.

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Falling out of Favor

By the late 19th century, bloodletting began to fall out of favor. One of the earliest dissenters was William Harvey in 1628, followed by Pierre Charles Alexandre Louis, who wrote a treatise about the ineffective nature of bloodletting for pneumonia. New medical developments led to the disuse of the bloodletting practice until it fell out of favor entirely. By the early 20th century, most people in the medical community agreed it was generally ineffective.

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Bloodletting in Alternative Medicine

Bloodletting is rare in modern medicine today, and many in the medical community consider it an unsafe practice when used for all but a few conditions. However, many alternative medicine practitioners do support bloodletting. In traditional Chinese, Ayurvedic, and Unani medicine, practitioners still employ bloodletting in the treatment of various ailments.

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