When was venipuncture first carried out

Bloodletting today Today phlebotomy therapy is primarily used in Western medicine for a few conditions such as hemochromatosis, polycythemia vera, and porphyria cutanea tarda. Hemochromatosis is a genetic disorder of iron metabolism leading to abnormal iron accumulation in liver, pancreas, heart, pituitary, joints, and skin.

It is treated with periodic phlebotomy to maintain ferritin levels at a reasonable level so as to minimize further iron deposition. Polycythemia vera is a stem cell bone marrow disorder leading to overproduction of red blood cells and variable overproduction of white blood cells and platelets.

Its treatment includes phlebotomy to reduce the red blood cell mass and decrease the chance of dangerous clots. Porphyria cutanea tarda is a group of disorders of heme metabolism with an associated abnormality in iron metabolism. Phlebotomy is also used to decrease iron levels and prevent accumulation in various organs. Hirudo medicinalis can secrete several biologically active substances including hyaluronidase, fibrinase, proteinase inhibitors, and hirudin, an anticoagulant.

The leech can help reduce venous congestion and prevent tissue necrosis. In this way it can be used in the postoperative care of skin grafts and reimplanted fingers, ears, and toes. Why did it persist? We may wonder why the practice of bloodletting persisted for so long, especially when discoveries by Vesalius and Harvey in the 16th and 17th centuries exposed the significant errors of Galenic anatomy and physiology.

With our present understanding of pathophysiology we might be tempted to laugh at such methods of therapy. But what will physicians think of our current medical practice years from now? In the future we can anticipate that with further advances in medical knowledge our diagnoses will become more refined and our treatments less invasive.

We can hope that medical research will proceed unhampered by commercial pressures and unfettered by political ideology. And if we truly believe that we can move closer to the pure goal of scientific truth. Magner LN. A History of Medicine. New York: Marcel Dekker, Inc; McCormic S. Blood and magic—the evolution of phlebotomy. Seigworth GS. Bloodletting Over the Centuries. Adams SL. The medicinal leech. Ann Intern Med ; Parapia LA.

History of bloodletting by phlebotomy. Brit J Haemat ; North RL. Benjamin Rush, MD: Assassin or beloved healer? Proc Bayl Univ Med Cent ; The physician would perform the procedure by making an incision into the arteries or veins. The use of a 12 spring-driven blade that could make shallow cuts all at once known as a scarificator was considered a more humane way to retrieve blood from a human.

In some cases they also used cupping as a method. This method blistered the skin so that the blood could then be released via the blisters. At this time too, leeches were used to soak up the blood. Yes and no. Also, in cases were people had high iron levels, bloodletting could also offer them some relief.

Of course, there were also people who truly believed it would help them, so it did. Today, we call that the placebo effect. Naturally, releasing too much blood from the body can cause irreversible harm or even death, and this was the case for a lot of patients when traditional bloodletting methods were performed. One interesting case was that of George Washington in the United States. Bloodletting was a popular practice in the USA, especially by Pilgrims.

It is said that the death of George Washington was a result of too much bloodletting. It was thought that he had a throat infection, and the physician drained over eight pints of blood to treat the infection. This was too much for his body to handle and he died shortly after.

This is one of the most famous bloodletting gone wrong scenarios known today. Leeches were also used to suck up blood, as they can suck up ten times their body weight in blood. Bloodletting at the time was thought to cure conditions such as acne, asthma, cancer, cholera, coma, convulsions, diabetes, epilepsy and many more. There is very little evidence that bloodletting was an effective treatment, outside of edge -cases, where the patient had high blood pressure and releasing some blood, may have helped, or if a person had a high blood-iron level, in which case blood-letting may have reduced it.

It is far more likely that bloodletting had a placebo effect, with those receiving the treatment simply believing it was making them feel better. Of course, releasing too much blood from a body will do irreparable harm.

An excellent example of a failed blood-letting is the death of George Washington. In the days before his death, Washington had been complaining of a sore throat.