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Bloodletting Is Still Happening, Despite Centuries of Harm

An illustration of a bloodletting, circa 1675.
An illustration of a bloodletting, circa 1675.
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In the shadow of India’s largest mosque, the gutters run red with blood.

It’s a bizarre scene, if you’ve never seen a modern-day bloodletting. First, men wrap patients’ arms and legs with straps as tourniquets, to control the blood flow. Then they use razor blades to make tiny pricks in the hands and feet, and blood trickles into a concrete trough stained red with the day’s work.

The bleeding people look pretty happy, though. After all, they’ve paid for the service. They come to be cured of everything from arthritis to cancer.

(Video: Meet the bloodletters of Delhi and their patients.) 

But why? How has the bloodletting business, which many doctors today would rank along with reading bumps on the head as olde timey quackery, managed not to dry up?

The appeal seems to be in its simple logic.

Muhammad Gayas runs his bloodletting business in the garden of the Jama Masjid mosque in Old Delhi. He says pain and illness happen “when the blood goes bad,” which is pretty much the same basic premise that bloodletters have sold the public since Hippocrates advocated balancing the four humors—blood, black bile, yellow bile, and phlegm—more than 2,000 years ago. 

Bloodletting has been practiced around the world even longer than that, tracing at least 3,000 years ago to the Egyptians. It remained an obsession among many Western doctors through the 19th century, and was still a recommended treatment for pneumonia in a 1942 medical textbook—lest you think it went out after the Middle Ages along with the laying on of leeches. (Oh, and leeches still get some play, too, mainly for drawing down pockets of blood after plastic surgery or vascular microsurgery.)

So Does Bloodletting Ever Work?

It may be helpful for people with a few particular blood abnormalities. Doctors still use bloodletting, for instance, in cases of polycythemia—an abnormally high red blood cell count—and in a hereditary disease called hemochromatosis, which leaves too much iron in the blood.

I also came across a preliminary study suggesting vascular benefits in some diabetics with high iron levels, but this is far from a general treatment for the disease. Another small study in BMC Medicine got a lot of press in 2012 for showing that 33 people who gave up to a pint of blood had improved cholesterol ratios and blood pressure six weeks later compared with people who didn’t give blood, which the doctors also attributed to a reduction of iron levels. (Note that the amount of blood removed in the study was fairly low—a pint is about as much as you’d give when donating blood, which for the record is  a great thing for healthy people to do and is not the same thing as bloodletting.) 

When George Washington developed a swollen sore throat in 1799, doctors drained nearly half his blood and created blisters in his throat. Within a day, he died.
When George Washington developed a swollen sore throat in 1799, doctors drained nearly half his blood and created blisters in his throat. Within a day, he died.
Life of George Washington, Junius Brutus Stearns, 1851

But the design of that study doesn’t rule out a placebo effect—which has certainly contributed to bloodletting’s popularity in the past. What’s more, other studies suggest that too little iron is bad for cardiovascular health, so again, the potential benefit of removing blood is unclear.

Meanwhile, depleting the body’s blood supply can be risky. Not only is there the risk of losing too much blood, causing a dangerous drop in blood pressure and even cardiac arrest, but people who are already sick take their chances with infection or anemia. Not to mention that in most cases, bloodletting doesn’t cure what ails you.  

So no, we don’t need to revive the tradition of the neighborhood bloodletter. In a sense, though, their legacy is still around: Red-and-white barber poles represent blood, bandages, and the stick that patients would grip during barbers’ days as bloodletters.

How Bloodletting Bled Out

It took the great bloodletting wars of the 1800s to begin turning the tide against the practice. The prominent doctor Benjamin Rush (a signer of the Declaration of Independence) set off a fury when he began bleeding people dry during the 1793 yellow fever epidemic in Philadelphia. By all accounts, Rush was a bloodletting fanatic and in general a real piece of work: “unshakable in his convictions, as well as self-righteous, caustic, satirical, humorless, and polemical,” writes doctor Robert North in a biography.

Rush recommended that up to 80 percent of his patients’ blood be removed, and during the yellow fever outbreak, North recounts that “so much blood was spilled in the front yard that the site became malodorous and buzzed with flies.”

Bloodletting’s detractors grew in numbers after that, and eventually Pierre Louis, the founder of medical statistics, began convincing doctors to rely on statistical evidence over anecdotal “recoveries” of patients who had been bled. A particularly impressive analysis showed that bloodletting did not help pneumonia victims in Europe, and after bitter disputes among doctors in the 1850s, the practice began dying out.

In fact, one history of bloodletting refers to the stamping out of the practice—over the objections of the medical establishment, no less—as a triumph of reason and “one of the greatest stories of medical progress.”

16 thoughts on “Bloodletting Is Still Happening, Despite Centuries of Harm

  1. It would be great to watch the video but your video never loads quite annoying sad that nothing works since faux took over 🙁

      1. Hi,
        We have been having trouble replicating the problem, since the video is working on most computers. Could anyone who can’t see the video reply to this comment and let us know what browser version you are using, and whether you’re using a mobile device? Thanks so much!

  2. Fascinating to learn that barbers used to be bloodletters, that’s so Sweeney Todd (“I can guarantee the closest shave you’ll ever know”). Great article, Erika.

  3. Interesting. My husband has hemochromatosis (iron overload syndrome) and his only form of treatment is therapeutic phlebotomy which seems like a form of bloodletting.

    1. I can concur. I have Hemochromatosis as well and have a pint taken out every other week. This genetic mutation cause highly elevated ferritin (blood iron) levels that wreak havoc with almost every bodily system: heart, lungs, kidneys, gonads, pancreas, nervous system, vascular system ….
      Every fortnight I got to the local hospital, tell them to take a pint of the top and for several days after I feel great. My blood is less viscous, energy is up, lethargy is down, sleep is better, mood is better. Therapeutic phlebotomy is a great, simple treatment and it works.

  4. In a time when people eat to much salts such as the Romans did and the people in the Middle Ages and they haven’t had a good medicine against high blood pressure, than it would be a good alternative. And don’t forget they often used blood sucking worms who used a blood diluting albumen and that would help against the fats in human blood. Anyway they felt them selfs often better for a period of 6 weeks to 2 months.

  5. Blood letting happens to be a fine art. It was used in many civilizations around the world for SPECIFIC health conditions. By the time it reached the West, in the hands of quacks and overzealous adherents, it was applied on almost anything, resulting in many deaths.
    The art of bleeding by the application of leeches is a indispensable tool in Ayurveda, the oldest system of medicine. The species of leech to be used, its characteristics, its care and the health conditions in which it is applied are all finely described in the medical texts.
    These are ancient and extremely delicate subjects and only the correct people should apply them in the correct condition. Otherwise, the inevitable results.

    1. I have heard about bloodletting used effectively in snake bites and saved lives. I neither know the details of the process nor have I tried it.
      However, it is my own experience that a lot of old medical practices that function without pharmaceutical prescriptions or unnecessary surgeries work wonders. The secret lies in the accurate knowledge of “how, how much and when” to apply. And of course faith is the x factor in that equation.

  6. Video mentions significant diet restrictions and in my experience “miracle cures” can occur in 1-3 days after a subject eating a pro-imflammatory diet is changes to a low inflammatory diet. Was this accounted for?

  7. What they are showing here seems to be a form of bloodletting, but I think this should not be confused with the tradition of cupping in the East, which is far more common. Bloodletting was a Medieval European practice, whereas cupping was more common outside that region

    Cupping they also gather the blood (no using ropes, but rather using suction. There are certain points they gather it, and they slowly increase the suction, and thereafter makes small slits in the skin. Where the points are, how many to have, etc are based upon your temperament (hot, cold, dry, wet) and based on your temperament will also determine how many times they have to suction the fluid out. What comes out is not a liquidy runny blood (when that comes it means they are done), but rather a thick liquid. The different temperaments appear to produce different types and amounts of this liquid, hence why the different number and location of spots. They also take into account how large, muscular, etc the person to make it effective. The process is not as fast as the video makes it appear and it takes about 1-3 hours, usually 3 for a practitioner to complete.

    The practice seems to arise from a perspective of medicine that idea tries to link the various aspects of a person: his mind, body, soul, environment, etc. It tries to synthesize reality as we find it, as opposed to analyze and deconstruct it as we find in Western Medicine. It would be tough for Western medicine to approve of this type of practice for a few reasons
    1) due to the customization of practitioner to the patient it would be very very hard to run a randomized control trial and hence getting consistent groups and results would not be feasible. In other words it would be hard to do a comparison. If it cannot be quantified, then it cannot be measured, and hence cannot be analyzed. This is one of the limitations of Modern Science in that it struggles very hard to acknowledge anything that is not quantifiable, but most of our experiences in life are qualitative.
    2) it does not come from the same paradigm. All historical worldviews/paradigms tried to synthesize what they observed outwardly and hence based themselves upon synthetic world views. Unless it makes sense to a “modern scientific” perspective, it cannot accept it – unfortunately modern science is very intolerant in that way – unless it agrees with our way of looking at things, it isn’t a way worth looking at. An easy example is acupuncture. Let’s assume it works, even so Modern Science has trouble understanding that as the idea of Chi in the body appears irrational and hence relegated as mythological (not in the traditional understanding of a myth, but the modern one as a story that did for a people at a time, but is essentially meaningless and a lie). They did try to come up with scientific acupuncture using a scientific explanation regarding nerve points, etc, but it was not seen as successful.
    3) to practice it would require teaching practitioners and the art, like most traditional sciences, of Eastern Medicine, which incorporates cupping cannot be taught on a mass scale produce x number of practitioners per y number of people. Rather it is a qualitative teaching and hence from teacher to student where the student is never done learning, for every patient is similar, but also uniquely different. Here the student would only be taught if they had a good character, good morals and strong personal integrity, and then step by step they would be taught along the way not in a fixed number of years, but rather at a rate proportionate to that person’s aptitude. This would make it very difficult to teach on a mass scale of standardized curriculums that our institutions of learn now, but not always use to, work upon.

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