Monday, July 23, 2012

Medical Mondays: Bloodletting--Humour me!

What is bloodletting? 

We've seen it in movies, and read about it in books. A poor, sick person has their arm cut and the blood gathered in a bowl (remember that scene from Ang Lee's Sense and Sensibility? Poor Marianne!) This is supposed to cure them of their ailments. Meanwhile, the reader or movie watcher is batting their head, going, "Are you crazy? Trying to kill them faster, or what?"

Bloodletting has been around since ancient times. The Egyptians, Mayans, Mesopotamians all used it to treat illnesses. One ancient Greek physician, Erasistratus, believed that illness occurred because of "plethoras" or overabundances in the body, that could be relieved by bloodletting, diuretics (medicines that make you urinate like crazy), or vomiting.

Apparently, some thought that women had the concept down without trying. It was believed that menstruation was the model way to remove bad humors from the blood. 

Speaking of bad humors, we turn to this guy, Aelius Galen (129 AD- 199 AD). Not a stale stand up comedian. Sorry.

Photo credit


He was a Roman philosopher, physician, and surgeon who first coined the terms "humors" to describe the human temperaments and their representative elements in the universe:

blood (sanguine) = air = social, extroverted
black bile (melancholic) = earth = kind, creative
yellow bile (choleric) = fire = lots of passion and energy
phlegm (phlegmatic) = water = dependable and affectionate


(It's funny that blood is the "air" humor. Galen finally figured out that blood, not air, flowed through people's arteries and veins. The phrase "full of hot air" has new meaning to me now.)

He also promoted the idea of bloodletting to maintain the proper balance of humors.  Depending on the ailment, blood would be removed from the left or right side of the body, at a particular time, in a particular quantity, from particular vessels that corresponded to certain organs.

What a fussy doctor, that Galen.

Bloodletting was used to treat every disease under the sun, and persisted into the early 1900s, even being recommended by Sir William Osler. (You know this guy. He helped found Johns Hopkins Hospital and helped define what became 3 hellish years of not sleeping or eating, aka medical residency. Oh, he also said that people are pretty useless over age 40 and recommended "chloroform at age sixty" but we'll skip over that for now. #OslerFail)

Anywho.

Two last fun tidbits about bloodletting before we stop.

You know the barbershop pole above? Though bloodletting was often prescribed by physicians, it was the barbers who did the deed. The red stripe represented blood; the pole was the stick that patients gripped during bloodletting to make the veins stick out, and the white was the cloth tourniquet used.

And finally, will all this laughing over how archaic bloodletting seems, maybe you'll be surprised to hear that bloodletting is still used today for very specific diseases.

Hemochromotosis is a condition where people have iron overload in their body. As red blood cells are a principal carrier of iron, regularly scheduled phlebotomy (the modern word for bloodletting or removing blood from the veins, for lab tests for example) can cause a relative iron deficiency, which treats the disorder.

Polycythemia vera is a condition where people make too many red blood cells. It is treated the same way.

Bloody cool.

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34 comments:

Al Penwasser said...

You take blood from me, I see nothing humorous about that.
Especially from a dude who gets his hats from the same place Chico Marx shops.
Pretty interesting stuff, though.

Roland D. Yeomans said...

If you take away bloodletting, I would be without a job!!

I have always felt that 100 years from now, those physicians will shudder in revulsion and shock at some of the things done to us in hospitals now.

But you work with what you have, right? As always a great post, Roland

Shelly said...

I am glad Aelius is not my physician-

Old Kitty said...

It's good to have a sense of humour(s)!!! Yay! Take care
x

Jenny Woolf said...

Extraordinary that so many people believed in this and did it for so many years. This is one reason (of many) that I am sceptical about so many of the alternative medicines people swear by. I wonder when bloodletting was discontinued and how it happened.
Although I have heard that leeches can in some cases be medically useful. You'd know more about that than me.

Rachna Chhabria said...

You know Lydia, for many years whenever I would see blood I would vomit. Blood would make me queasy.I have finally managed to get over that habit.

Shelley Munro said...

I'm so glad they got over bloodletting and moved on to the next thing! I prefer not to see blood :)

Alex J. Cavanaugh said...

In other words, he was a little sick.

Em-Musing said...

Too bad there's no phlegm-letting. I could do that versus taking so many sinus pills. Guess that's why there are tissues.

Miranda Hardy said...

I always cringe when I think of blood letting. I'd have died.

elizabeth seckman said...

You make the informative fun! Love it.

Karen Lange said...

I did not know that bloodletting was still practiced today. Thanks for the info!

Connie Keller said...

Poor Marianne! Whenever I watch that scene I want to yell, "No, don't do it!"

BTW, I've been told that bloodletting does cause the immune system to become more active. But that doesn't make a lot of sense to me. Is that an old wives' tale?

Carol Kilgore said...

"Bloody Cool" indeed :)
Glad I didn't live back then.

Lydia Kang said...

Connie, I think that's an old wive's tale. Generally when you're sick (let's say, with a fever) the fact that you have a fever is already a sign that your immune system is revved up. When you lose blood, you also lose white blood cells (immune system cells) so you're losing your army! The actual volume loss would stress your body out even more. Stress will affect your immune system, but bloodletting is the wrong way to do it, and chances are, your body is already stressed as it is. :)

Jennifer Shirk said...

So Sir William thinks I'm useless, huh? LOL
Fun and interesting post, as usual. :)

Dianne K. Salerni said...

"Chloroform at age 60" -- what a guy! I wonder if he felt that way once he reached that age (if he did). Was he willing to do the deed on himself?

lbdiamond said...

Lady, I was gonna do a humours post...glad I didn't cuz yours is FAB!

Coleen Patrick said...

Funny, I don't think I've ever seen phlegm and affectionate in the same sentence before :) Very interesting Lydia!

Krispy said...

I've learned SO MANY things from this post today! I think the most fascinating has to be the barbershop pole. I hadn't an inkling that bloodletting was involved. I suppose this makes Sweeney Todd's murderous ways somewhat less surprising?

Nancy Thompson said...

Very interesting, as always. Perhaps you can do a spot on maggots and how they were used to eat putrid flesh away from festering wounds to help speed healing. Yum-o!

Lydia Kang said...

Hey Nancy...already done!
http://lydiakang.blogspot.com/2012/02/medical-mondays-squirmiest-therapy.html

Linda Gray said...

When you got to the explanation of the barbershop pole, Sweeney Todd flashed before my eyes. I never saw the play (because it seemed too gruesome!), but I think it involved a barber and lots of bloodletting(but not from a vein in an arm, ick.)

Leslie S. Rose said...

This may be the most informative/entertaining post ever. Love the deets on the 4 humors and barber pole.

Shelley Munro said...

This blood letting business has always intrigued me. I did not know about the barber poles. Very interesting.

Sarah said...

I'm still laughing over #Oslerfail. Great info as always, Lydia, delivered in a way guaranteed to cause snorting and hazardous (to keyboards and screens, at least) coffee-spitting.

Rose Munevar said...

I just found your blog and immediately joined! Sooo glad I didn't live back then. I'd already be dead, or soon to be, since I'm 40 and that was about the average life span back then right?

Catherine Stine said...

Good post! Yup, I just came back from Istanbul where bloodletting is alive and well. In the Bazaar, folks sell leeches to nibble away at excema and other nasty skin disorders!

Jennifer Hillier said...

I will never look at a barbershop pole the same way again.

I like all this blood talk. Not that you should be surprised. :)

Lorelei said...

I put this over on my favorites, as I never know when I may need to look some of this up.

Well, now I know why barber poles are red and white/what it means!

Great question/post, Lydia!

Matthew MacNish said...

You always cover the most fascinating medical topics.

Susan Flett Swiderski said...

First, thanks for stopping by my blog to read the interview with Anne. I do appreciate it, and figured I'd return the favor. LOVE the title of your blog, and this post drew my attention. (quickly followed by several other posts) I love the idea of medical Mondays, and will look forward to seeing what other info you come up with in the future. (BTW, I worked at Hopkins... back in the dark ages. Ninth floor, Blalock building.) Great post. Count me in as your newest groupie.

Jenny Woolf said...

I think bloodletting is a rather good illustation of why I am not very keen on alternative medicine. For hundreds of years people thought it would make you well, based on some crazy idea. One has to assume they didn't secretly think it was useless, and that they did believe it worked. So what was really going on?

Whatever it was, I believe it's the same process that makes people trot off to Chinese doctors and homeopaths today.

Tylor Hermanson said...

It's interesting that bloodletting went from being recommended for everything under the sun (from acne to leprosy), to completely discredited as a legitimate medical practice, to finally regaining its validity in some cases.

http://www.medtech.edu/blog/the-history-progression-and-modern-stance-on-bloodletting

I have read that blood transfusions are following the same pattern. It will be interesting to see what the medical community 100 years from now says about our current treatments.

 
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