Bloodletting is the withdrawal of quantities of blood from a patient to cure or prevent illness and disease. It was the most common medical practice performed by doctors from antiquity up to the late 19th century, a time span of almost 2,000 years. In the overwhelming majority of cases, the historical use of bloodletting was harmful to patients.
Though the bloodletting was often recommended by physicians, it was carried out by barbers. This division of labour led to the distinction between physicians and surgeons. The red-and-white-striped pole of the barbershop, still in use today, is derived from this practice: the red represents the blood being drawn, the white represents the tourniquet used, and the pole itself represents the stick squeezed in the patient’s hand to dilate the veins.
Bloodletting was used to “treat” a wide range of diseases, becoming a standard treatment for almost every ailment. One British medical text recommended bloodletting for acne, asthma, cancer, cholera, coma, convulsions, diabetes, epilepsy, gangrene, gout, herpes, indigestion, insanity, jaundice, leprosy, ophthalmia, plague, pneumonia, scurvy, smallpox, stroke, tetanus, tuberculosis, and for some one hundred other diseases. Before amputation, it was customary to remove a quantity of blood equal to the amount believed to circulate in the limb that was to be removed.
A number of different methods were employed for the procedure. The most common was phlebotomy, or venesection (often called “breathing a vein”), in which blood was drawn from one or more of the larger external veins, such as those in the forearm or neck. In arteriotomy, an artery was punctured, although generally only in the temples. In scarification (not to be confused with scarification, a method of body modification), the “superficial” vessels were attacked, often using a syringe, a spring-loaded lancet.
There was also a specific bloodletting tool called a scarificator, used primarily in 19th century medicine. It has a spring-loaded mechanism with gears that snaps the blades out through slits in the front cover and back in, in a circular motion. The case is cast brass, and the mechanism and blades steel. One knife bar gear has slipped teeth, turning the blades in a different direction than those on the other bars. The last photo and the diagram show the depth adjustment bar at the back and sides.
Leeches became especially popular in the early nineteenth century. In the 1830s, the French imported about forty million leeches a year for medical purposes, and in the next decade, England imported six million leeches a year from France alone. Through the early decades of the century, hundreds of millions of leeches were used by physicians throughout Europe.