Headaches? "You must bleed." An infection? "You must bleed." Poisoned? "You must bleed." Medicine has had moments in the past that stand out for their lack of brilliance, and one of them was the widespread use of bloodletting as a treatment for a wide range of conditions. Fortunately, modern medicine has almost completely eradicated traditional bloodletting, but there are still some diseases that need it… in a very controlled way, of course.
One of the most impressive aspects of bloodletting is its prevalence. Available information suggests that this practice dates back to Ancient Egypt (some historians indicate that the Egyptians confused the hipposudoric acid from hippos with blood, and interpreted that they bled to "obtain relief"), but it found its "Golden Age" with Hippocrates and his "optimization" of the Theory of Humors. Its basis speaks of four fluids: Phlegm, yellow bile, black bile, and blood. When these fluids lost their balance, diseases were just around the corner…
Bloodletting in the 21st Century: How and Why?
… and as this video from SciShow teaches us, the old masters of medicine believed that bloodletting could help restore that balance. The instruments used by doctors to start the process seem designed by John Kramer (!), among which the "Scarificator" stands out, but natural resources such as leeches were also adapted. Over the centuries, all kinds of guides and references were written that recommended specific areas of the body and amounts of blood to extract, depending on the disease.
One of the most historically relevant cases was that of George Washington, who received a particularly intense bloodletting after developing a throat infection. In a period of ten hours, Washington lost 3.75 liters of blood, and died shortly after.
So, why did bloodletting manage to maintain its popularity if its effectiveness was null? Some attribute it to a combination of placebo effect (that is, "it is preferable to give any treatment than to give none") and wide availability for all social classes, but the British Columbia Medical Journal states that the work of Doctor Pierre Louis with pneumonia patients in the 19th century was essential to "remove" bloodletting.
Still, bloodletting did not completely disappear. Its modern version is therapeutic phlebotomy, and it is applied in conditions such as polycythemia vera (excess of red blood cells) and hemochromatosis (excessive and harmful accumulation of iron in the body). Phlebotomy is the primary treatment for iron depletion (approximately 500 milliliters per week), followed by the use of chelating agents.
Sources: SciShow, British Columbia Medical Journal
