Lancets and Leeches and Cupping! Oh, My! Bloodletting Practices in Early Modern England
Bloodletting practices were ubiquitous in early modern England. Both the healthy and the sick had their blood let for medicinal purposes. For many medical practitioners, it was the preferred treatment for countless ailments. One physician declared:
Bloodletting ‘clears the mind, strengthens the memory, cleanses the stomach, dries up the brain, warms the marrow, sharpens the hearing, stops tears, encourages discrimination, develops the senses, promotes digestions, produces a musical voice, dispels torpor, drives away anxiety, feeds the blood, rids it of poisonous matter, and brings long life’.
The practice itself was based on the Galenic view of the humoral body, which posited that the blood—containing all four homours—was the product of food. When consumed, food was liquefied in the stomach and then delivered to the liver, where it was subsequently turned into blood. Occasionally, the body produced an excess of blood, which according to Galenic practitioners, caused fevers, headaches, and even apoplexy. Alternatively, noxious humours within the blood could lead to localised disorders, such as tumours and inflammation. In many cases, bloodletting was used to rid the patient’s body of the ‘corrupt’ blood.
Physicians often called upon surgeons and barber-surgeons to let blood from their patients, as they believed the ‘cutter’s art’ was inferior to the practice of physic. In fact, the barber’s pole, with its bloodied rags tied around it, advertised the barber’s services as a blood-letter. [For more on the barber’s pole, click here].
Surgeons and barbers used a variety of methods to bleed patients during the early modern period. Most commonly, they performed venesection. This involved opening up a person’s vein using a double-edged knife called a lancet. It was also possible to let blood from the arteries (arteriotomy); however, this was far more dangerous and required great care and skill on the part of the practitioner.
A surgeon or barber might also use heated cups and an instrument known as a scarificator to bleed a patient. When applied to the skin, the cups created blisters which were then sliced open using a multi-blade instrument that inflicted wounds on the vessels just beneath the skin. Although painful, this approach carried less risk than venesection as the cut was often more superficial.
Another common method for bloodletting involved the use of leeches. This type of worm can suck several times its own body weight in blood and is a lot safer than cutting open a vein. During the first half of the 19th century, this bloodletting technique became so popular that it led to a ‘leech craze’. Throughout England, ‘leech collectors’ (mostly women) would wade into leech-infested ponds with bare legs in order to attract the slimy bloodsuckers. Once the leeches had had their fill, they would fall off leaving the collector to then sell them to medical practitioners for profit.
But why did bloodletting remain so popular for so long? Despite advances in anatomy and diagnostics during the 18th and 19th centuries, therapeutics did not evolve quickly enough to match new understandings of the body. Many practitioners believed it was better to do something than to do nothing. That said, by the mid-19th century, bloodletting had largely fallen from fashion as new therapeutic techniques began to be developed.