Bloodletting

After walking into the room of solitary confinement, you will notice many different tools scattered around the room. Upon peering onto the lone bed, you may notice what is called a spring lancet. This sharp, yet tiny blade would be used to target specific veins in the body of melancholic people to try and remove the imbalance of the four humors. The amount of blood actually taken out would vary based on the person, but it could range up to almost 1 liter. Bloodletting has been around for hundreds of years and has had various reasons for being used.

According to Mary Katherine Keblinger Hague Yearl, the practice of bloodletting, or phlebotomy, began as a way to try and treat patients who were prone to diseases of plethora. The treatment was also to be used for people who had a superabundance of the four humors, these include blood, phlegm, yellow bile, and black bile. She also wrote about how this practice grew over time. As time moved into the Middle Ages, phlebotomy grew with it. It became more of a science, with its own terminology and different types to target different illnesses. Whether the blood would be cut from a vein or from a different part of the body. During this time, more emphasis was also put onto seasonal and astral calendars to determine how much blood needed to be taken and from where. Gerry Greenstone, MD, wrote about some of the most notable cases of bloodletting throughout history in the BC Medical Journal. In this article, he focuses on two main cases. The first being Charles II in the mid 1600s. During this time, Charles II suffered from a seizure, so doctors drew 1/2 a liter of blood to try and alleviate the issue. This resulted in many medical issues, including more seizures, resulting in the doctors taking another 1/4 of a liter of blood. This inevitably lead to the death of Charles II. The other example Dr. Greenstone gives is George Washington. Washington began having a fever and respiratory distress, resulting in 3 physicians taking around a liter of blood over the course of a few days. This lead to Washington going into shock and passing away. When examining bloodletting more in today's world, it is only partially seen in Western medicine. It is specifically used for diseases such as hemochromatosis, polycythemia vera, and porphyria cutanea tarda. In each of these methods, the amount of blood taken is very precise and it can only be done a certain amount of time apart.