Bloodletting

Bloodletting ( phlebotomy Greek or Latin Missio sanguinis ) is a well known since ancient times and until the 19th century spread Applied remedies. When bleeding the patient a partially significant amount of blood is taken. Today there is evidence that the blood-letting in only a few diseases has a positive effect, so that it has largely disappeared from the everyday medical practice.

Colloquially, the blood donation or blood sampling for examination purposes is referred to as phlebotomy occasionally. Also, financial losses or loss of soldiers and material can be meant in a figurative sense.

History

Bloodletting is one of the oldest medical treatments. He was known since the time of Hippocrates and was to the 17th century as one of the most important medical therapies.

The benefits of bloodletting was based on two ideas:

• Firstly, it was assumed blood can accumulate in the limbs and spoil. "Bad Blood " should be removed.
• On the other diseases have been attributed to an imbalance of the humors (blood, yellow bile, black bile, phlegm ). By Exit in blood volume and fever the balance could be restored after this performance.

Galen believed that blood was the dominant juice and must be strictly controlled. He set up a comprehensive system that derived the amount of blood to be taken from the patient's age, his state and out of season and weather conditions.

Even in Islamic medicine, bloodletting was known, probably by the Greek authors. The historically important medical texts of Al - Qanun of Ibn Sina ( Avicenna ), and in particular Al - Tasrif li -man ' ajaza ' to al - ta'lif recommend bloodletting. Ayurvedic medicine also knew the bloodletting, as shown in the Sushruta Samhita. Even in the far east, he is one of the classic standard therapies.

In the Middle Ages, the bloodletting by doctors and Bader common practice. The blood was used by close inspection ( Hämatoskopie, blood show) for diagnostic purposes. A wide range of diseases treated by blood-letting; one can almost speak of a universal method. The times for the bloodletting and the corresponding points on the body were determined by astrological criteria. Proven by the numerous representations of so-called " bleeding - males." The bloodletting calendar called Lass panel or Get list among the earliest products of the printing press. They made soon for satires and parodies.

In the 16th century it came within the European medical profession to a run with great violence, bloodletting controversy after Pierre Brissot deviating from the teachings of the Arabs method (which he attributed to Hippocrates ) propagated.

Even after William Harvey had refuted the basics of bloodletting in 1628 by the discovery of blood circulation and the first steps were made ​​in a manner based on scientific methods, medicine, bloodletting was a common treatment method. Even the famous physician Christoph Wilhelm Hufeland recommended bloodletting still in the early 19th century. The detection of Pierre -Charles -Alexandre Louis in 1828 that the bloodletting in pneumonia and various fevers was ineffective ( la méthode numérique ), had little impact on the overall application.

In the U.S., the physician Benjamin Rush favored an extensive bloodletting. George Washington were removed more than 1.5 liters of blood because of a throat infection; this loss may have contributed to his death. Even the death of the Emperor Leopold II accelerated, so the criticism of Samuel Hahnemann, a four-time bloodletting within 24 hours by his personal physician Lagusius the death of the ruler.

Methods

The Bader of the Middle Ages used bloodletting knife, called Flieten, or from the 15th century, a device that snaps back to its special knife to a scored line of the vein, the Schröpfschnepper.

Nowadays venous blood is drawn with a larger cannula. The amount of collected blood is between 50 and 500 ml

Another method of depletion is the use of leeches. The special composition of the saliva of the leech prevents the clotting of blood. However, the removed blood volume is quite low.

Use in modern medicine

The bloodletting play today only a few diseases an important role:

• Leads In polycythemia vera, a disease particular to a pathologically increased formation of erythrocytes (red blood cells) and thus to an increase in blood viscosity. To treat the disease often 6-8 bloodletting at weekly intervals be performed initially (up to 500 ml) to lower the life-threatening high hematocrit (some over 60%) to a normal value (about 45 %). Thereafter, this operation is carried out in a 6 - to 12 - week intervals if no other medical action is taken.
• In hemochromatosis, a disorder of iron metabolism, blood-letting to reduce the iron content can be carried out in the body for life.
• In a polycythemia can improve the flow properties of blood by phlebotomy may be necessary, for example, if a central venous thrombosis threatens in the eye or has already occurred.
• In porphyria cutanea tarda, a disturbance in the synthesis of hemoglobin heme iron can be reduced by venesection, which in the liver wreaks otherwise damage.
• All diseases with venous stasis, particularly the entire varicose symptom complex. Here especially the local bloodletting is employed.

In Japanese phlebotomy ( blood-letting or even micro Shiraku ) are pierced with a knife or lancet varicose veins or spider veins. It will address the lower leg. The application is carried out at blood congestion associated with an expansion of blood vessels.

In alternative medicine, bloodletting (as well as cupping ) to the diverting process counts.

Curiosities

• In earlier centuries wore the January designation Let month. This stemmed from the fact that this period was regarded by the baths as the most suitable month for bloodletting.
• Bloodletting by Hildegard of Bingen to rid the body through the removal of "bad blood " of toxins, which are caused by overeating, diet mistakes, stress, worry, fear and disappointment. The blood shall be cleaned of " sickening waste and rotting substances ". This " power " to offer some medical practitioners.