Bloodletting

Anon, Aristotle's Compleat Masterpiece (1771)

This is a Zodiac Man. These were created to show the relationship between parts of the body and the zodiac – from Aries at the top of the head, to Pisces at the feet. Stories were told to explain these connections – the heart was Leo because lions were brave, Cancer was the chest wall because crabs have hard shells.

The Zodiac Man determined when surgery could be carried out, when medicine should be taken, or even when toenails could be cut. But most importantly, it told you when you could be bled. When the moon was in Gemini, you could not bleed from the arms, when it was in Taurus, it was dangerous to bleed from the neck.

Barber’s Pole (c.1930s)

For hundreds of years barber-surgeons cut hair, removed lice and carried out bloodletting. Barber’s poles, like this one from Ballymena in Northern Ireland, advertised their craft. It was a model of the rod which customers would grasp to bring up a vein.

There are different explanations for the colour combination. One suggests that it represents the red of the blood and the white of the bandages, another suggests that it depicts the services on offer – teeth pulling and bloodletting. In medieval times bloodletters would advertise their services by displaying a bowl filled with their customer’s blood. In England, after the Barber-Surgeons Company was set up in 1540, law required that barbers use blue and white poles, while surgeons use red and white ones.

James Gillray, Breathing a Vein (1804)

The English caricaturist James Gillray produced a series of engravings which explored medical treatment in Georgian Britain. In these prints the unfortunate patient can be seen receiving laxatives, vomits and foul-tasting medicines before he begins the course of bloodletting shown in this image.

It was common to bleed from a major vein in the forearm or the neck. Bleeding into a bowl, like the one in this image, allowed the exact quantity of blood to be measured while the tourniquet, which can be seen on the patient’s upper arm, would prevent dangerous levels of blood loss. The clothes of this bloodletter – especially the spurs on his boots – suggest he was more likely to be a rural veterinarian rather than a city doctor.

Prospero Alpini, De Medicina Aegyptiorum (1645)

Bloodletting was far from just a European practice and was carried out in parts of South America, Africa and across both South and East Asia. This illustration depicts bloodletting in 1500s Egypt. This book is a study of a range of Egyptian medical practices, including cauterisation, the removal of bladder stones and the ingredients of medicines.

The book’s author, Italian physician Prospero Alpini, recorded significant differences between Egyptian and European medicine, including the fact that women were permitted to work as physicians in Egypt.

In Europe, bloodletting was most often carried out by venesection (cutting a vein) or applying leeches, while in Egypt, as this image shows, the usual method was scarification, where the skin was scraped or cut with small knives.

Illustration of Bloodletting Wound (1839)

Bloodletting could cause ulceration, abscesses and infection. This image shows the arm of James Donachy, a 79-year-old patient at the Royal Infirmary of Edinburgh. Donachy was being treated for a rib fracture when his doctor decided to bleed him. Three days after blood was first taken, his arm became inflamed and the wound opened. This drawing was made a week later.

There were many risks to bloodletting. If a leech was reused it could carry blood-borne diseases like syphilis from one patient to another. Unclean lancets could also introduce infection. An overeager or inexperienced bloodletter could sever a vein or accidentally open an artery instead. Some surgeons even attempted what they called ‘heroic’ bloodletting – removing dangerously large quantities of blood.

James Rawlins Johnson, Treatise on the Medicinal Leech (1816)

This book, by English doctor James Johnson, examines the medicinal uses of leeches. He believed that leeches were not only useful for bloodletting but could be used as barometers to predict the weather, given their aversion to the cold. The book also describes experiments on different types of leeches to see how easily they could be ‘tamed’. The horse leech, it says, is the most wild and unpredictable.

This book was written at the height of ‘leech mania’. In the 1800s, France alone was importing over 50 million leeches per year. These leeches were used to treat everything from headaches to tuberculosis. Leeches are still used by the NHS today to restore blood flow and to break up blood clots.