Half-Life of Facts: Medicine (Bloodletting)

By Claire Layton

In this series of artifacts of the week, we will examine the paradox that knowledge is in fact tentative in particularly consistent ways, through a number of examples right here in the house. We will trace how we come to understand particular things as ‘truth,’ and the importance of critical thought and openness to the precariousness of fact. The mission here is twofold, also acting as an example of the potential for valuable and relevant research within a historical library and archival collection; to not regard a museum as a static entity.

Being a medical museum, the Hillary House is a veritable treasure trove of examples of the way ‘facts’ have changed over time. In this installment we will consider the overturn of particular procedures in the medical practice. In particular we will consider blood-letting. In the Hillary House collection there are a few devices used for this purpose. These include the scarificator and the cupping devices pictured here.

Bloodletting was used up until the late 19th century, when it was finally discredited. It began around 3000 years ago in Egypt, continued worldwide and spreading through Europe during the Middle Ages and the Renaissance. The rationale for bloodletting was situated in the Hippocratic premise of balancing the four humors (blood, phlegm, black bile and yellow bile). Illness was perceived to be due to an imbalance of these humors, with excessive amounts being removed through processes such as bloodletting. Localized bloodletting would often involve scarification, which meant scraping the skin with a cube-shaped brass device containing multiple small knives (scarificator). This would be followed by cupping, which involved placing a glass cup over the skin and extracting the air by suction or heating [Gre10].

The propagation of this practice was largely due to the writings of Galen of Pergamum (129-200 AD). His immense effect on medicine was due primarily to the quantity of his writings, many of which declared blood as the most dominant humor. These practices of bloodletting were taken up in the Middle Ages as standard treatments for many conditions. The support of bloodletting fissured in the early 19th century, with some doctors holding to the notions of ‘depletion therapy’ rooted in the paradigm of disease that saw excessive blood and “irregular convulsive action of the blood vessels” [Gre10], as the cause of febrile diseases. The other camp was comprised mainly of newcomers to the discipline, bringing with them a critique of old practices, particularly with evidence from microscopic studies of inflamed tissues to refute the dangerous practice of bloodletting. Though it is not such a stark dichotomy of ‘old vs. new’ this tends to be the pattern; those who are mired in the ‘facts’ of the past while new practitioners are overturning these and establishing the new order. This represents an observed gap between the beliefs in empirical observation versus scientific verification.

This is a demonstration of the way that medical practices are rooted in ‘facts’ about causes of disease. However these ‘facts’ are changeable within the changes of diagnosis techniques and new understandings of the human body in general. One may wonder what allowed the practice of bloodletting to persist for so long, especially with discoveries since the 16th century that exposed significant errors within Galenic anatomy and physiology. As Kerridge and Lowe have stated, “that bloodletting survived for so long is not an intellectual anomaly–it resulted from the dynamic interaction of social, economic, and intellectual pressures, a process that continues to determine medical practice” (1995:631).
Derision of such methods would be missing the aim of this endeavour, rather we must become compelled to think about what physicians in decades and centuries to come will think of our current medical practices. The overuse of antibiotics or the bluntness of treatments like radiation and chemo­therapy could be called into question in the not-too-distant future, as treatments become more refined and less invasive.

Visit us and see if you can find these and any other examples from the past. If you have any questions about these items in our collection, please inquire or schedule an appointment to work with our curator to find out how other “facts” have changed over time.

Works Cited and Further Reading:

Greenstone, G. (2010). The History of Bloodletting. BC Medical Journal, 52 (1), 12-14.

Kerridge, I., & Lowe, M. (1995). Bloodletting: The story of a therapeutic technique. The Medical Journal of Australia, 163, 631-633.

Parapia, L. A. (2008). History of bloodletting by phlebotomy. British Journal of Haematology, 143, 490-495. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2141.2008.07361.x/pdf