November 16, 2012

Medicine in the Nineteenth Century: Bloodsuckers (and I don't mean vampires) Part 4

Some of the nastiest bloodsuckers of all were fellow human beings, not creepy critters.  Or should I say "bloodletters" for bloodletting was a mainstay of medical treatment for multiple ailments up until
the late nineteenth century. Indeed, in some parts of rural America, bloodletting persisted until well into the 1920's (Sir William Osler included the treatment in his 1923 edition of "The Principles and Practices of Medicine").

Bloodletting was the longest running tradition in medicine.  It was believed that the four "humors", blood, phlegm, yellow bile and black bile, must be kept in balance to maintain health.  Balance was restored by purging, starving, vomiting or bloodletting. The practice of opening a vein or artery to restore balance dates back to the Egyptians and Greeks.  It was used for over 2500 years for everything from insanity to hemorrhage (yes, hemorrhage was treated by taking more blood - yikes! what were they thinking?)

A vein (or in some cases, an artery) usually in the arm, leg or neck was cut diagonally or lengthwise with a small knife called a lancet and the blood collected in a bowl. There were elaborate directions for determining how much and how often bloodletting should occur.  With the advent of the scientific method, bloodletting was determined to be ineffective, even harmful, and it fell out of favor.

However, lest you think bloodletting is no longer practiced in modern medicine, think again.  In certain rare diseases such as hemachromatosis, polycythemia vera and prophyria cutanea tarda, withdrawal of a unit or two of blood has proven to be a very effective treatment.

For additional reading and references, see the Extras section.

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