Localized bloodletting often involved scarification, which meant scraping the skin with a cube-shaped brass box containing multiple small knives, followed by cupping, which involved placing a dome-shaped glass over the skin and extracting the air by suction or prior heating. Fleams were usually devices with multiple, variably sized blades that folded into a case like a pocketknife. Thumb lancets were small sharp-pointed, two-edged instruments often with an ivory or tortoise shell case that the physician could carry in his pocket. The main instruments for this technique were called lancets and fleams. Venesection was the most common procedure and usually involved the median cubital vein at the elbow, but many different veins could be used. His ideas and writings were disseminated by several physicians in the Middle Ages when bloodletting became accepted as the standard treatment for many conditions.īloodletting was divided into a generalized method done by venesection and arteriotomy, and a localized method done by scarification with cupping and leeches. He had an extraordinary effect on medical practice and his teaching persisted for many centuries. Galen was able to propagate his ideas through the force of personality and the power of the pen his total written output exceeds two million words. By the 1st century bloodletting was already a common treatment, but when Galen of Pergamum (129–200 AD) declared blood as the most dominant humor, the practice of venesection gained even greater importance. Therefore treatment consisted of removing an amount of the excessive humor by various means such as bloodletting, purging, catharsis, diuresis, and so on.

He believed that existence was represented by the four basic elements-earth, air, fire, and water-which in humans were related to the four basic humors: blood, phlegm, black bile, yellow bile.Įach humor was centred in a particular organ-brain, lung, spleen, and gall bladder-and related to a particular personality type-sanguine, phlegmatic, melancholic, and choleric.īeing ill meant having an imbalance of the four humors. To appreciate the rationale for bloodletting one must first understand the paradigm of disease 2300 years ago in the time of Hippocrates (~460–370 BC).

It reached its peak in Europe in the 19th century but subsequently declined and today in Western medicine is used only for a few select conditions. The practice of bloodletting began around 3000 years ago with the Egyptians, then continued with the Greeks and Romans, the Arabs and Asians, then spread through Europe during the Middle Ages and the Renaissance. With a history spanning at least 3000 years, bloodletting has only recently-in the late 19th century-been discredited as a treatment for most ailments.

Medieval last names related to doctors