Bloodletting: An Ancient Practice with Modern Health Benefits
The surprising benefits of bloodletting
When you think of bloodletting you probably get horrifying visions of a medieval doctor lunging at your veins with a barbaric torture device.
Bloodletting doesn’t need to be that barbaric. We are civilized. We have the technology.
While it’s often written off as outdated quackery, there have always been benefits to bloodletting in the appropriate context. We will discuss that context today.
In ancient medicine, bloodletting was common. It is the practice of removing blood from the patient to treat ailments. It was used for just about everything you can imagine over thousands of years.
This treatment was based on the idea that our health was based on the 4 “humors,” and maintaining perfect balance between them. The 4 humors are blood, phlegm, yellow bile, and black bile. These roughly correspond to blood, mucus, bile, and perhaps lymph (the black bile is difficult to understand).
The 4 humors were said to directly influence our temperament. When there was an abundance of black bile, for example, it was supposed to represent melancholy. It was Hippocrates who brought this idea into the human realm and applied it to the practice of medicine.
In ancient times, bloodletting was brutal. They used various different tools to make small cuts in the skin or vessels and allow the blood to drain. They didn’t understand Germ Theory and therefore risked infection. In some cases, they utilized leeches as the method of bloodletting. This is an example of such a tool known as a scarificator.
Bloodletting in ancient times was common and not particularly safe. Because they used poor sanitary techniques the risk of infection was very high. They didn’t have modern antibiotics so a septic infection was often deadly.
There were also risks from the loss of blood itself. If done incorrectly, bloodletting can be deadly. Losing too much blood in a short period of time risks hypovolemic shock. This is especially true if you cut an artery. Chronic bloodletting can increase the risk of anemia due to the loss of red blood cells faster than they can be regenerated.
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We call this phlebotomy because it sounds less scary. But modern-day phlebotomy isn’t that much different than ancient bloodletting. It turns out, there are actually health benefits to frequent phlebotomy. Nowadays we reuse blood via donation, rather than discarding it in the dirt.
First and foremost, phlebotomy is way safer today than it used to be. Not only do we extract the blood in a sterile fashion, but we also have better technology. There are basically no risks associated when this is done correctly.
Additionally, our access to blood work helps mitigate side effects. If you’ve ever donated blood you’ve probably noticed they prick your finger or use a monitor. They are usually checking your iron levels or hemoglobin. If you are low on these you may be anemic and they usually won’t let you donate.
Frequent blood donation is correlated with a reduced risk of heart disease. The reason for this seems to be the reduction in blood viscosity. The heart works like a pump. As you can imagine, it’s easier to pump water through pipes than it is jelly.
When you reduce the amount of red blood cells in the system the body quickly replaces it with fluid, making it less viscous. This puts less strain on the heart and improves outcomes over the long term.
This one is pretty self-explanatory. When you remove some fluid from the system, the force needed to propel the blood is reduced. When there is less blood in the blood vessels, blood pressure drops. This reduces your risk of negative outcomes like stroke and heart disease over the long term.