Phlebotomy: The Ancient Art of Bloodletting
By Graham Ford
By Graham Ford
The practice of bloodletting seemed logical when the foundation of all medical treatment was based on the four body humors: blood, phlegm, yellow bile, and black bile. Health was thought to be restored by purging, starving, vomiting or bloodletting.
The art of bloodletting was flourishing well before Hippocrates in the fifth century B.C. By the middle ages, both surgeons and barbers were specializing in this bloody practice. Barbers advertised with a red (for blood) and white (for tourniquet) striped pole. The pole itself represented the stick squeezed by the patient to dilate the veins.
The art of bloodletting was flourishing well before Hippocrates in the fifth century B.C. By the middle ages, both surgeons and barbers were specializing in this bloody practice. Barbers advertised with a red (for blood) and white (for tourniquet) striped pole. The pole itself represented the stick squeezed by the patient to dilate the veins. From
The Project Gutenberg EBook of Bloodletting Instruments in the NationalMuseum of History and Technology, by Audrey Davis and Toby Appel
.
To distinguish his profession from that of a surgeon, the barber-surgeon placed a striped pole or a signboard outside his door, from which was suspended a basin for receiving the blood
To distinguish his profession from that of a surgeon, the barber-surgeon placed a striped pole or a signboard outside his door, from which was suspended a basin for receiving the blood
.
Cervantes used this type of bowl as the “Helmet of Mambrino” in Don Quixote Special bowls to catch the blood from a vein were beginning to come into fashion in the fourteenth century. They were shaped from clay or thin brass and later were made of pewter or handsomely decorated pottery. Some pewter bowls were graduated from 2 to 20 ounces by a series of lines incised around the inside to indicate the number of ounces of fluid when filled to that level. Ceramic bleeding bowls, which often doubled as shaving bowls, usually had a semicircular indentation on one side to facilitate slipping the bowl under the chin. Bowls to be used only for bleeding usually had a handle on one side. Italian families had a tradition of passing special glass bleeding vessels from generation to generation.
Bloodletting came to the U. S. on the Mayflower. The practice reached unbelievable heights in the 18th and early 19th centuries. The first U.S. president, George Washington, died from a throat infection in 1799 after being drained of nine pints of blood within 24 hours. The draining of 16-30 ounces (one to four pints) of blood was typical. Blood was often caught in a shallow bowl. When the patient became faint, the "treatment" was stopped. Bleeding was often encouraged over large areas of the body by multiple incisions. By the end of the 19th century (1875-1900), phlebotomy was declared quackery.
A variety of devices were used to draw blood:
Bloodletting came to the U. S. on the Mayflower. The practice reached unbelievable heights in the 18th and early 19th centuries. The first U.S. president, George Washington, died from a throat infection in 1799 after being drained of nine pints of blood within 24 hours. The draining of 16-30 ounces (one to four pints) of blood was typical. Blood was often caught in a shallow bowl. When the patient became faint, the "treatment" was stopped. Bleeding was often encouraged over large areas of the body by multiple incisions. By the end of the 19th century (1875-1900), phlebotomy was declared quackery.
A variety of devices were used to draw blood:
The lancet was first used before 5th Century B.C. The vein was manually perforated by the practitioner. Many shallow cuts were sometimes made.
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Spring loaded lancet
Spring loaded lancets came into use during the early 18th Century. The device was cocked and a "trigger" fired the spring-driven blade into the vein.
The fleam was heavily used during the 18th and 19th centuries. Many varieties exist. Sometimes a wooden "fleam stick" was used to hit the back of the blade and drive it into the vein. (Ouch!) The fleam was often used by veterinarians.
Spring loaded lancets came into use during the early 18th Century. The device was cocked and a "trigger" fired the spring-driven blade into the vein.
The fleam was heavily used during the 18th and 19th centuries. Many varieties exist. Sometimes a wooden "fleam stick" was used to hit the back of the blade and drive it into the vein. (Ouch!) The fleam was often used by veterinarians.
One American user of the spring lancet, J. E. Snodgrass of Baltimore, was inspired to compose a poem about the instrument, which appeared in the Baltimore Phoenix and Budget in 1841. He wrote:
To My Spring-Lancet
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Years have passed since first we met,
Years have passed since first we met,
Pliant and ever-faithful-slave!
Nobly thou standest by me yet,
Watchful as ever and as brave.
O, were the power of language thine,
To tell all thou hast seen and done,
Methinks the curious would incline,
Their ears to dwell they tales upon!
I love thee, bloodstain’d, faithful friend!
As warrior loves his sword or shield;
For how on thee did I depend
When foes of Life were in the field!
Those blood spots on thy visage, tell
That thou, thro horrid scenes, hast past.
O, thou hast served me long and well;
And I shall love thee to the Last!
A thousand mem’ries cluster round thee
In all their freshness!
thou dost speak
Of friends far distant-friends who found thee
Aye with thy master, prompt to wreak
Vengeance on foes who strove to kill
With blows well aim’d at heart or head—
Thieves that, with demon heart and will,
Would fain have on they vials fed.
O, They have blessed thee for thy aid,
When grateful eyes, thy presence, spoke;
Thou, anguish’d bosoms, glad hast made,
And miser’s tyrant sceptre broke.
Now, when ’mong strangers, is our sphere,
Thou, to my heart, are but the more
Endear’d—as many a woe-wring tear
Would plainly tell, if from me tore!
Scarificator
The scarificator, a series of twelve blades, was also in vogue during the 18th Century, This device was cocked and the trigger released spring-driven rotary blades which caused many shallow cuts. The scarificator seems more merciful than the other blood-letting instruments.
The scarificator, a series of twelve blades, was also in vogue during the 18th Century, This device was cocked and the trigger released spring-driven rotary blades which caused many shallow cuts. The scarificator seems more merciful than the other blood-letting instruments.
Flint Cup
Blood was caught in shallow bowls. During the 17th to 19th centuries, blood was also captured in small flint glass cups. Heated air inside the cups created a vacuum causing blood to flow into the cup - a handy technique for drawing blood from a localized area. This practice was called cupping.
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