Science and medicine has come a long way since the days of the ancient and medieval world. Each advancement is achieved through observation and experimentation with whatever knowledge and resources are available at the time. Many medical practices date back to the physicians of ancient China, India, the Middle East, Greece, and Rome. Some are still used and appreciated today, whereas some are considered erroneous and dated. One popular treatment from the past that has since been rejected by modern physicians and scientists is bloodletting. The treatment was popularized by Hippocrates who incorporated this into his routine medical practice. The idea came from the theory of the humors, which describes a bodily composition of four humors – each in homeostasis with eachother. The origin of disease, therefore, is an imbalance of any one of the four humors. Hippocratic medicine’s goal was to restore balance in the humors. Bloodletting achieved this goal by reducing the dominance of the humor blood in the homeostatic system.
Bloodletting was a frontline treatment for any and all etiologies in western medicine except for in the field of obstetrics. Childbirth was largely monopolized by female midwifes who had extensive knowledge and experience in the subject which was often ignored by the male dominated medical field. However, the nineteenth century saw great social changes that caused male physicians to turn their interests to applying their ‘expertise’ to obstetric practice. Bloodletting soon became the frontline treatment for every known complication or symptom of pregnancy until the turn of the twentieth century. A physician named Benjamin Rush was a vocal supporter of bloodletting and observed in his experience that the treatment reduced pain, nausea, and blood pressure, and promoted sleep and relaxation in his patients. He also noted that it could accelerate labor and prevent “after pains, obstructed lochia, retained placenta, prolapse of the uterus, inflamed breasts, colics, madness, and fever”. One not uncommon case noted a woman who had 30-40 ounces of blood drawn which subsequently caused her to faint. When she awoke, her child was already delivered. Volumes of blood ranging from 10 to over 100 ounces could be withdrawn and the syncope commonly experienced by the patients was viewed as marvelous pain treatment.
Pregnant women’s blood was seen as having increased powers of life, so the restoration of balance in this humor further gave justification to the treatment. Not only was it used for common symptoms such as headache, vertigo, nausea, insomnia, swelling, etc., but it was also a highly coveted treatment for major complications including, ironically: hemorrhage, infection, and eclampsia. The role of blood cannot be understated in the treatment of these complications. Today, it is well known that hemorrhage is incredibly dangerous which will obviously made worse by the further loss of blood through bloodletting. The antibodies and immune cells within blood are the body’s best defense against infection, not to mention the fact that bloodletting increases risk of infection. In the case of eclampsia, delivery of oxygen to the brain and other major organs is vital to avoid death of the mother and the fetus. In one case of using bloodletting to address major complications, a patient suffered three gross hemorrhages and each one was treated by bloodletting. She fainted multiple times over the course of her labor, delivered a stillborn infant, and was blind for six weeks postpartum. The physician bragged over the success of his treatment, simply because the mother lived. In a case of
eclampsia, the physician ordered the bloodletting of 120 ounces over a few hours and shaved the patient’s head in order to place leeches on her scalp to subside the seizures. Though the practice of bloodletting was once the predominant treatment for obstetric complications and complaints, medical advancements in the years following revealed the dangers of the practice and new, empirically tested and upheld treatments replaced it.
Reference:
SIDDALL, A. C. (1980). BLOODLETTING IN AMERICAN OBSTETRIC PRACTICE, 1800-1945. Bulletin of the History of Medicine, 54(1), 101–110. http://www.jstor.org/stable/44441234
King Lab at Creighton University 