Venesection or Blood letting

.Venesection.

The practice of bloodletting has been used by almost all cultures and societies at some point in their medical history. The controversy over the usefulness of it has been raging since the fifth century B.C.E. It was considered to be part of the treatment for practically every ailment that you can think of: asthma, spitting blood, bruises, cough, consumption, contusion, convulsions, cramps, deafness, delirium, epilepsy, giddiness, gout, whooping cough, hydrocephalus, head ache, intoxication, lethargy, lunacy, measles, palsy, rheumatism, sciatica, shortness of breath, and sore throat. It was also, though not as commonly, used as a punishment and as a form of worship to a superior power. In seventeenth century England, for example, the use of bloodletting was very popular for the treatment of hysteria. It was believed that hysteria gave rise to an accumulation of "putrid humors" which impaired the organs whose function it was to purify the blood and caused this physical affliction. Bleeding and purging were the universal remedies for these humours and so they were employed for the treatment of hysteria as well. The patient would be bled and then administered medicines that "fortified" the blood, such as iron fillings. This practice continued into the eighteenth century. The idea for bloodletting was taken from the animal world. People observed that animals self-inflicted wounds and they assumed this was for medicinal practices. They also observed similar occurrences through human forms of spontaneous bleeding such as nosebleeds, menstruation, and injury. Bloodletting was very popular from ancient times until the Middle Ages. It experienced a great vogue in the eighteenth and nineteenth centuries. Beliefs about health and disease in the eighteenth century were based on those held by the ancient Greeks. For more on the humoral theory see the section on medical blood in Bloodlines .Blood was a humor and was believed to be made up of food. The idea was that if the humors were in balance then the body was healthy and if they were out of balance the result would be disease. One of these diseases was plethora. Plethora was an over-abundance of body humors and was characterized by fevers and inflammations. It was treated by the removal of the offending humours. This removal could be brought about by inducing vomiting, starvation, and bloodletting. The patient was often starved so that the veins would become empty of food and then the blood, which had escaped into the arteries, could be absorbed. This procedure was drawn out and very uncomfortable for the patient, so bloodletting was increasingly used instead as a quick way to relieve the patient of extra blood.

Venesection is often mentioned in connection with Anglo-Saxon leechcraft. But the importance seems to be placed on the timing of the operation rather than the procedure itself. This is an example of a diagnosis given for paralysis: "Scarify the neck after the setting of the sun, pour in silence the blood into running water, after that spit three time, then say, 'Have thou this unheal, and depart away with it': go again on a clean way to the house, and go either way in silence."(The Book of Anglo-Saxon Leechcraft) This pre-occupation with timing is seen over and over again. In the Leech Book of Bald there are precise directions given for the correct times for a patient to be bled. Here is another example: "...and there is no time for bloodletting so good as in early Lent, when the evil humours are gathered which be drunken in during the winter, and on the kalends of April best of all, when trees and worts first up sprout..."(The Book of Anglo-Saxon Leechcraft) As time went by the most scrutiny fell more and more on the actual removal of the blood and less and less on the particular timing of the event.

There were three main ways of letting blood. One was phlebotomy, which is the direct cutting of a vein to release blood. It was often done with a knife and then later the spring loaded lancet, which is basically a spring loaded knife. If the patient was too young, old, or weak to stand phlebotomy, Cupping was often used. This was the act of applying a cup, in which a vacuum had been created through the use of fire, to either intact skin to cause it to tumefy or to a place where small incisions had been made, to draw out blood. Another practice was Leeching . Leeching was popular because it required little skill; one could do it oneself in the home and the leeches were ready to suck blood at any time. An adult would use between twenty and fifty leeches. They were also popular because(click me for bigger image) they could be used in places that phlebotomy and cupping could not, such as internal membranes. They were often also applied inside the nose, ear, eyes, mouth, anus, and vagina.

ONE of the controversies surrounding bloodletting was how to judge how much blood to let. One of the general thoughts on the amount of blood to let was to bleed the patient until syncope. Syncope is defined here in this 1848 medical dictionary: "Complete and, commonly, sudden loss of sensation and motion, with considered diminution, or entire suspension of the pulsations of the heart and respiratory movements." In the current day, this condition is not very differently thought of than shock. This is why, as time moved on, bloodletting was practiced more and more by skilled surgeons who were thought to be better educated in how to bleed without death or permanent damage. In the Early Middle Ages bloodletting was almost entirely done by barber -surgeons. They identified themselves by putting a pole outside their business and hanging a blood collecting dish from it. The pole represented the the stick that the patient gripped to encourage the flow of blood, the white stripes represented the tourniquet and the blue or red stripes represented veins or blood. But once again as time moved on this practice became more and more the domain of skilled surgeons, especially during the aforementioned vogue of the eighteenth and nineteenth centuries. The use of bloodletting declined as better cures were found for the problems it treated. Some aspects of bloodletting still exist today. Leeches are used in limb re-attachment and re-constructive surgery to keep a steady flow of blood through the tissue, and it has been said that a man should give blood once a year to lower the risk of a heart attack.

The word "phlebotomy" is now, in the modern day, defined as the practice of removing or "letting" blood for diagnostic, rather than therapeutic reasons. This is now the only form of medicinal bloodletting that is generally practiced. Phlebotomy is done with a syringe. The piston-and-cylindersyringe was first used on wounds to extract pus. The invention of this device is attributed to the son of a barber in Alexandria, Egypt around 280 B.C. The use of an evacuated blood collection system became popular in 1943 with the marketing of the VACUTAINER Brand system. The National Phlebotomy Association was established in 1948. The founding of this organization spurred on the search for better and better ways to collect blood. Today phlebotomy is a distinct professional field.

BIBLIOGRAPHY

Appel, Toby and Audrey Davis. Bloodletting Instruments in the National Museum of History and Technology. Smithsonian Institution Press. Washington, 1979.

Burroughs and Wellcome, The Book of Anglo-Saxon Leechcraft: An Historical Sketch of Early English Medicine. Burroughs and Wellcome Co. London, 1912.

Pendergraph, Garland E. Handbook of Phlebotomy. Lea and Febiger. Philadelphia, 1984.

Veith, Ilza. Hysteria:The History of a Disease. University of Chicago. Chicago, 1965.

LINKS

Encyclopedia Britannica: Bloodletting -The encyclopedia definition of bloodletting and related topics.

Images from the History of Medicine - This gives you access to a collection of images of tools and medicinal practices from the history of medicine. Using the search word "bloodletting" will bring up 67 images.

barber's history

The barbers' poles and the reasons for their colors

—Word Info image © ALL rights reserved.

The history of the barber pole is intertwined with the history of barbers and their bloodletting practices. Patients would tightly grasp a rod or staff tightly so their veins would show, and the barbers would cut open their arms and bleed them until they fainted. Later, when leech therapy became popular (they allowed for more controlled bleeding), leeches were applied directly to the vein areas.

After the procedure, the barbers "washed" the bandages which were hung outside on a pole to dry, and to advertise the therapeutic specialities offered in the barbershop. Flapping in the wind, the long strips of bandages would twist around the pole in the spiral pattern we now associate with barbers.

This early barber pole was simply a wooden post topped by a brass leech basin. Later the basin was replaced by a ball and painted poles of red and white spirals took the place of the pole with the bloodstained bandages, and these poles became permanent outdoor fixtures.

In fact, after the formation of the United Barber Surgeon’s Company in England, barbers were required to display blue and white poles, and surgeons, red ones. In America, however, many of the barber poles were painted red, white and blue.

There are several interpretations for the colors of the barber pole. One is that red represented blood and white, the bandages. Another interpretation says red and blue respectively stood for arterial and venous blood, and white was for the bandages. A third view suggests that the spiral pattern represents a white bandage wrapped around a bloody arm. The bowls represented the basin of leeches as well as the blood-collection bowl.

Barbers and barber poles: red and white stripes and a ball on the top and bottom

At some time in the past, you may have seen the revolving pole outside a shop, painted red and white, and sometimes blue as well. For many of us, this will stir images of the high-backed chairs and white-draped figures, shaving foam, and old-fashioned razors of barber shops. Even after most of these shops have been replaced by the more fashionable "hair saloons", most of them still sport the candy cane-striped pole in one form or another.

• The barber’s art of shaving beards and cutting hair is an ancient trade.
• Long before there was history, there were razor blades, found among the relics of the Bronze Age.
• It began with primitive men who believed that both good and bad spirits entered individuals through the hair and inhabited the body, and that the only way to drive the bad ones out was by cutting one’s hair.
• Elaborate rituals were constructed around marriages and baptism to ward off bad spirits and retain the good ones.
• Hair, it seems, had been a very important social and religious issue throughout all of the history of mankind, especially since many ancient superstitions revolved around it
• It is known that the Egyptians were very picky people where hair was concerned; ancient monuments and papyrus showed people being shaved, Egyptian priests were de-haired every three days.
• Barbers in Greece have had an important niche in society since the fifth century B.C.; in fact, the Greeks seemed to be so fastidious where facial hair was concerned that one prominent Greek politician was defeated by an opponent who had a neater beard trim.
• The Romans had had barbers since 296 B.C, when Ticinius Mena came from Sicily, bringing with him the art of shaving.
• These shops prospered among the chatter of free men, who were set apart from the slaves by the absence of beards.
• In fact, the art of shaving seemed to have military strategy value as well. The Persians defeated Alexander the Great’s men because the Macedonians then had beards, which the Persians could grab and pull their enemies to the ground before spearing them to death.
• After such attacks, "Alexander the Great" ordered his troops to be shaved so their enemies could not use the same tactics again.

Barbers and Surgeons

• Historically, barbers were also dentists and surgeons, versatile performers of tooth extraction and enemas, bloodletting and wound surgery.
• These barber-surgeons formed their first official organization in France in the year 1096, after the archbishop of Rouen prohibited the wearing of a beard.
• Later, as medicine became more defined as a field of its own, efforts were made to separate the academic surgeons from these barber-surgeons.
• In Paris, about 1210 A.D., identification of the academic "surgeons as surgeons of the long robe" and the barber-surgeons as "surgeons of the short robe" was established.
• In 1308, the world’s oldest barber organisation, still known in London as the “Worshipful Company of Barbers” was founded.
• In an effort to systematically instruct barbers in surgery, a school was set up in France in the middle of the 13th century by the Brotherhoods of St. Cosmos and St. Domains.
• The guild of French barbers and surgeons was established in 1391, and by 1505, barbers were allowed entrance to the University of Paris.
• The father of modern surgery, Ambroise Pare (1510-1590), was himself a common barber-surgeon before he embraced medicine and became the most famous surgeon of the Renaissance Period.
• Pare was a surgeon in the French army and was the chief surgeon to both Charles IX and Henri III.
• In England, barbers were chartered as a guild called the Company of Barbers in 1462 by Edward IV.
• The surgeons established their own guild 30 years later.
• Although these two guilds were merged as one by statute of Henry VIII in 1540 under the name of United Barber-Surgeons Company in England, they were still separated: barbers displayed blue and white poles, and were forbidden to carry out surgery except for teeth-pulling and bloodletting; surgeons displayed red and white-striped poles, and were not allowed to shave people or cut their hair.
• Also, Louis XV of France decreed in 1743 that barbers were not to practice surgery.
• In 1745, George II passed several acts to separate surgeons from barbers.
• The surgeons went on to form a corporation with the title of “Masters, Governors and Commonalty of the Honourable Society of the Surgeons in London”, which was eventually dissolved in 1800 during the reign of George III and replaced by the Royal College of Surgeons.

Barbers and the practice of blood-letting to cure diseases

• To understand this practice, we must first go back further in time to the golden age of the Greeks.
• Hippocrates, the father of modern medicine, is given credit for being the first to conceive the notion that disease had a rational cause and therefore a rational cure.
• From borrowed knowledge apparently from China and India, he brought together the concept that bodies had four types of humours: blood, phlegm, black bile, and yellow bile.
• From this knowledge, his theory that disease caused imbalance in these fluids; others thought that it was the imbalance of these humors that caused disease.
• Hippocrates concluded that it was bad diet, absence of exercise, poor air, and injuries that were responsible for illnesses.
• Hippocrates, although a Greek, has been a hero of the Western medical world.
• Spurred by his teachings, the Roman Empire built intricate aqueducts that supplied fresh water, bath houses and efficient sewage removal systems to almost every major Roman city; a course of action that has surely saved hundreds of thousands of lives from water-borne infectious diseases.
• Unfortunately, he also had a shortcoming in that he was wrong about the four humors, Hippocrates also had the mistaken notion that bloodletting could eliminate an “overbalance” of blood.
• From the theory of relating diseases with the imbalances of the four humors, came the theories that diseases could be cured if a balance could be restored.
• The four humors (blood, phlegm, yellow bile, and black bile) were compared to the basic elements of air, water, fire, and earth; and bodily fluids were thought to consist of various combinations of these elements.
• The grisly art of bloodletting flourished during the Dark Ages, when medicine degenerated, people were mostly illiterate and the physicians of the time were monks and priests, whose thinking was deeply ingrained in religion. Barbers were first appointed assistants to the physician-clergy.
• Later, in 1163 at the council of Tours, it was declared sacrilegious for the clergy to draw blood from the human body, and these ministers of God were then banned from medical practices.

The Decline of Barbering and Bloodletting

• It was barbers, who were after all, masters of the razor, who continued this bloodletting tradition.
• For awhile they were given free rein in the business; until people started complaining that they were getting sicker instead of better.
• Although barbers were becoming handicapped with the rise of medicine and developments in surgery, they still pursued their bloodletting ractices.
• Finally in London, in 1745, after a series of investigations, a bill was passed to separate barbers and surgeons for good.
• This marked the decline of barbers as practitioners of medicine and by the end of the 18th century, most barbers had given up their rights to perform surgery; except in small towns where surgeons were still not available.
• Today’s barbers consist of both males and females, again occupying an important niche in society as the barbers of old had, cutting and styling hair to meet the demands of the public. Only today’s barbers no longer carry out bloodletting practices.