A Historical Overview Of Bloodletting: From Ancient Times To The 19th Century.pdf

Bloodletting, or venesection (drawing blood from a vein), has been practiced since ancient times as a medical procedure to remove excess fluids and impurities causing illness. Its origins date back to at least 1550 BC in the Egyptian Ebers papyrus and the Susruta Samhita, an ancient Indian surgical text.

Ancient Practices:
- The Greek physician Hippocrates (460–370 BC) believed in four humours (blood, phlegm, black bile, yellow bile), and bloodletting was used to balance them.
- Galen of Pergamon (130–210 AD) and Aulus Cornelius Celsus (c. 25 BC – c. 50 AD) further advocated for bloodletting as a treatment.
- By the Middle Ages, calendars with astrological and astronomical signs were used to determine optimal bleeding sites and times.

Local Bloodletting Methods:
- Leeches (Hirudo medicinalis) and wet cupping were common methods for local bloodletting, drawing blood from capillaries.

Venesection with Fleams:
- A fleam or phlebotome, an instrument used for venesection (venous bleeding), is one of the oldest bloodletting tools known.
- Roman fleams have been found dating back to early Roman times, suggesting their use in both humans and animals.
- The first recorded mention of a fleam appears in an Anglo-Saxon manuscript from around AD 1000.
- Fleams were widely used during the 18th and 19th centuries when bloodletting was popular.

Modern Developments:
- Ambroise Paré (c. 1510 – 1590) featured fleams with both slitting and blunt ends in his works. He also introduced the thumb lancet, which remained in use until the 19th century.
- Veterinary fleams with multiple blades were used for animals, requiring less force than human fleams due to varying skin thickness.
- Today, therapeutic phlebotomy is still practiced for specific conditions like Haemochromatosis, Polycythemia Vera, and Porphyria.