Bloodletting is one of the more horrific aspects of doctoring in history to the modern mind, the exact opposite of the prescription, ‘first do no harm’.

In Starz production of Pillars of the Earth, set in the 1100s AD in England, an early scene shows a doctor bloodletting a patient.  This surprised me because I thought it too early for that particular method of harming a patient.

I was wrong.

Bloodletting has been practiced for thousands of years and was common among the ancients.  “‘Bleeding’ a patient to health was modeled on the process of menstruation. Hippocrates believed that menstruation functioned to “purge women of bad humors”.  Galen of Rome, a student of Hippocrates, began physician-initiated bloodletting.”

“Prior to the time of Hippocrates (460 to 377 B.C.), all illness was attributed to one disease with variable symptoms. Careful clinical observations by Hippocrates led to the recognition of specific disease states with identifying symptoms. It was during this time that the concept of body humors developed. The four fluid substances of the body were blood, phlegm, yellow bile, and black bile. Health depended on the proper balance of these humors. Bloodletting was, therefore, a method used for adjusting on of the four body humors to proper balance. This clinical concept led to the decline in the doctrine of evil spirits in disease.

It was thought that blood carried the vital force of the body and was the seat of the soul; body weakness and insanity were ascribed to a defect in this vital fluid.”

The Christian Church, although supporting bloodletting in the early days, prohibited it at the Council of Tours in 1163, saying:  “The church abhors bloodletting,” perhaps because it was associated with astrology.

George Washington was effectively murdered by bloodletting:  he died from a throat infection in 1799 after being drained of (some say 4, some say 9) pints of blood within 24 hours.

Again from PBS:  “Most bloodletters would open a vein in the arm, leg or neck with small, fine knife called a lancet. They would tie off the area with a tourniquet and, holding the lancet delicately between thumb and forefinger, strike diagonally or lengthwise into the vein. (A perpendicular cut might sever the blood vessel.) They would collect the blood in measuring bowls, exquisitely wrought of fine Venetian glass.

Bleeding was as trusted and popular in ancient days as aspirin is today. The Talmudic authors laid out complex laws for bloodletting. Medieval monks bled each other several times a year for general maintenance of health. Doctors devised elaborate charts indicating the most favorable astrological conditions for bleeding.

It wasn’t until well into the 19th century that people began to question the value of bloodletting. Scientists such as Louis Pasteur, Joseph Lister, and Robert Koch showed that germs, not humors, were responsible for disease. Furthermore, medical statisticians tracking case histories began to collect evidence that bloodletting was not effective. Eventually the practice died, although it continued in some parts of rural America into the 1920s.”