bloodletting

Bloodletting. England, 14th century. Miniature from the Luttrell Psalter .

The bloodletting that (to-vein) Allow or blood-letting , the phlebotomy ( Middle High German Laze Lazen, or Bluot Lazen and āderlāzen; Greek phlebotomia; medieval Latin venaesectio ) is since the ancient times known and until the 19th century common in people Healing method used and animals as well as the name for the method of obtaining blood from the bloodstream of vertebrates. When bloodletting for therapeutic purposes, between 50 and 1000 ml, nowadays usually a maximum of 500 ml, of blood are taken from (adult) people . A healing effect of bloodletting could only be proven in very few clinical pictures. As a result, it has largely disappeared from everyday medical practice.

Like cupping , bloodletting is one of the oldest forms of medical treatment. It was already known before the time of Hippocrates (approx. 460–370 BC) and, like the use of emetics and laxatives (such as enema ), was considered to be one of the most important, if not undisputed, medicinal products until the 19th century Standard forms of therapy for the elimination of harmful or excessive body fluids based on the ancient theory of humors ( humoral pathology ).

Colloquially, blood donation is sometimes referred to as bloodletting . Financial losses or losses in soldiers and material can also be meant in a figurative sense.

theory

The application of bloodletting was based on the system of the theory of the humors , which illness interpreted as an imbalance in the mixing (dyscrasia) of the juices (blood - cholera / yellow bile - melancholia / black bile - phlegm / mucus) or as the degeneration of some of these juices.

Two phlebotomy procedures were distinguished:

1. The derivation (derivatio) = derivation, which was based on the idea that the "spoiled juices" or the "faulty mixture of juices" must be removed from the body in a direct way. For this purpose, bloodletting was carried out near the diseased region with the drainage of large amounts of blood.
2. The revulsion (revulsio) = upheaval based on the fear that with the “derivation” the “good juices” would also be removed with the “bad juices”. In the "revulsion", bloodletting was carried out far away from the diseased region with the removal of small amounts of blood. The aim was to divert the “bad juices” that had accumulated in the diseased region and to replace them with “better juices” or “better mixed juices”.

The earliest precise information about suspected relationships between bloodletting and the position of the planets can be found in the Regimen sanitatis Salernitanum . It contains instructions to carry out the bloodletting primarily in April, May and September, as well as the statement that Jupiter and Venus are favorable to the intervention, whereas Saturn and Mars are unfavorable to it. In addition, the different phases of the moon must also be taken into account. However, it is expressly stated that these rules may be disregarded in urgent cases.

Zodiac man with signs of the zodiac in analogy to the body parts

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  Calendar and internships, 14th century

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  Iatromathematical house book. Ulm 1498

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  Calendar, Strasbourg 1518

Each of the 12 signs of the zodiac dominates a region of the human body:

1. Aries - head and face
2. Taurus - neck and throat
3. Twins - arms and hands
4. Cancer - breast
5. Leo - stomach and kidney
6. Virgo - the remaining viscera
7. Libra - backbone and buttocks
8. Scorpio - soft and pubic limbs
9. Sagittarius - hips and thighs
10. Capricorn - knee
11. Aquarius - shin
12. Pisces - ankle and sole of the foot

In this regard, the main principle was to avoid bloodletting when the moon is in that sign of the zodiac that governs the relevant part of the body. For example, it was considered contraindicated to drain your arms and hands when the moon moves under the sign of Gemini.

However, there are also other, more or less different instructions, such as the Salernitan doctor Archimatheus, who wrote around 1165: “Furthermore, when bleeding, pay attention to the time of the illness, the season, the strength and the age of the patient. From the beginning of autumn until spring, take the blood from the left arm, from the beginning of spring from the right arm. Because of a disease of the brain cut into the vena cephalica, with a disease of the respiratory organs into the vena mediana, with a disease of the nourishing organs into the vena hepatica; if you bleed the sick person, keep all worries away from him. "

Bloodletting tools. Encyclopédie méthodique 1798/99

practice

When bloodletting, the blood was usually removed by opening veins (phlebotomy). Since Galen at the latest (2nd century AD), bloodletting has also been practiced, albeit rarely, by opening arteries (arteriotomy). Whether the arteriotomy was already carried out by the Greeks can only be guessed, since it cannot be determined with certainty whether the term “arteries” really meant these vessels before Galen. Galen prescribed an arteriotomy on the temporal arteries for chronic headache. He described the procedure in detail. In the event that the bleeding after the procedure could not be stopped by simply compressing the blood vessel, he recommended excising part of the artery with subsequent double ligature of the vessel ends .

Antiquity

• Egypt . Based on the available sources, it seems that bloodletting in ancient Egypt was not performed within the framework of the originally magical medicine, nor by the priests and doctors who replaced it. Bloodletting in humans is neither in the Ebers Papyrus still in Papyrus Smith still in the medical papyri from Lahun mentioned.
• Bible . Bloodletting is not mentioned in the Bible. In contrast, it is mentioned several times in the Talmud as a treatment method. Jewish tradition forbids eating animal blood. However, the use of blood as fertilizer or for other purposes is allowed.
• Corpus Hippocraticum (6th century BC - 2nd century AD). In the publication On the Diet for Acute Diseases in the Corpus Hippocraticum , the "derivative" bleeding is mentioned in several places and recommended for various diseases, that is, a large amount of blood should be withdrawn by bleeding near the diseased region. In the Corpus Hippocraticum only a "revulsive" acting method was specified in the text On the Nature of Man . This treatise was ascribed to Polybos (around 400 BC), the son-in-law of Hippocrates. It recommended bloodletting in the hollow of the knee and under the ankles to treat pain in the loin and testicles.
• Medical school of empiricists (founded around 250 BC). The adherents of the medical school of empiricists were generally positive about bloodletting. However, they restricted it and instead used more enemas and purgatives . Diocles of Karystus (4th or 3rd century BC) belonged to the school of empiricists and recommended the "derivative" bloodletting to be carried out, especially for pleurisy and pneumonia. Also Heraclides of Tarentum (75 BC.) And Menodotus of Nicomedia (100 BC.) Belonged to the school of empiricists and were bloodletting generally positive about. Chrysippus of Knidos (around 365 BC) was an opponent of bloodletting and an empiricist. Instead, he recommended compresses and bandages.

Bloodletting. Figure on a Greek vase

• Alexandrian School . Erasistratos (around 305 BC to 250 BC) was, together with Herophilos (4th to 3rd century BC), the main representative of the Alexandrian Medical School. Erasistratos was an avowed anti-bloodletting agent. Herophilosus, however, was not an opponent of bloodletting.
• Methodologists' medical school (1st century BC). The followers of the medical school of the methodologists practiced the phlebotomy "revulsive" with regard to the choice of the location of the phlebotomy site, "derivative" with regard to the amount of blood left. So chose Themison of Laodicea (2nd to 1st century. BC.), A pupil of Asclepiades , though far away to be engaged by the disease site locations ( "revulsion"), withdrew the other hand, large amounts of blood until the occurrence of impotence ( " Derivation "). Soranos of Ephesus (1st century BC) was the only methodologist who showed a certain reluctance to use bloodletting.
• Celsus (around 25 BC - around 50 AD). In the tradition of the Alexandrian medical school, Celsus wrote his encyclopedia De Medicina , in Book II of which he devoted a special chapter to bloodletting. In doing so, he distinguished himself from the exuberant bloodletting practice of the methodologists. When determining the phlebotomy indications, he demanded a flexible assessment according to the age and strength of the sick person. If afterwards there was an excess of juices, with a red body and bulging veins, or if the juices themselves were spoiled, then there would be violent fever, diseases of the bowels, paralysis, tetanus, clonic convulsions, all violent breathing difficulties, the sudden loss of voice and all acute illnesses require bleeding. In the event that the illness requires bloodletting, but the general state of strength opposes this, for example in the case of an acute stroke and reduced state of strength, it is the duty of a good doctor to disclose the risk associated with the operation, but also to communicate that without bloodletting there is no hope. "Then it is better to use a dubious remedy than none at all" ("Satius est enim anceps auxilium experiri quam nullam"). As a rule, bloodletting should be spread over two days. In the case of general illnesses, leave the vein on the arm, and in the case of local illnesses on the affected part. Celsus warned of the risk of injury to the arteries and "nerves" (Latin nervi: nerves, also tendons) when bloodletting. He also gave advice on how to assess the blood left and how to treat the wound caused by bloodletting.
• Galen (2nd century AD) is considered to be the founder of the doctrine of abundance (plenitudo), on which he built an entire medical system that made "evacuating therapy", including bloodletting, the most important healing method. However, the guidelines for this procedure were also clearly stated: They were determined by the character of the disease, the state of strength and the age of the patient as well as by a possible pregnancy. The operation was not allowed to be performed on small children or on old and frail patients. Unlike Hippocrates, Galen usually prescribed the intervention “revulsively” at a point far from the source of the evil. In the case of pleurisy and pneumonia, the intervention has little or no benefit if it is carried out “derivative” on the arm of the diseased half of the body.

middle Ages

Arab Middle Ages

Illustration of knives for bloodletting on the forehead. Abulcasis (10th century). 16th century print of a Latin translation

• Rhazes (865-925). For prophylactic purposes, Rhazes (865–925) prescribed the procedure, e.g. B. at the time of the first maturity of the organism, since he was of the opinion that this time required a purification of the blood. In the case of chickenpox and diseases of the pharynx where there is a risk of suffocation, he thought it advisable to bleed the cephalic nerve.
• Avenzoar (1091-1161). Avenzoar recommended a "revulsive" technique by prescribing bloodletting for pleurisy in a location opposite the focus of the disease. He violently attacked those doctors who did not do this, claiming that bloodletting carried out at the source of the disease could result in the patient's death.
• Abulcasis (936-1013) and

Avicenna (around 980-1037). The remarks on bloodletting in the surgical section of At-Tasrif des Abulcasis and in the first book of the Avicenna's canon of medicine shaped the European bloodletting practice up into the 16th century, and sometimes into the 19th century. Abulcasis has already described various devices required for the procedure, such as the Lasseisen (German “fliete” from Greek-Latin “phlebotom”).

Latin Middle Ages

• Henri de Mondeville (1260-1320). In the introduction to the bloodletting chapter of his book on surgery, Henri de Mondeville wrote:

“Believing him beneath their dignity, doctors have long left the bloodletting to surgeons. Later, the surgeons left this operation to the barbers for the following reasons: 1. Because it brings little profit, 2. Because it is an unimportant and easy operation. ”In practice it is so that the rich, the nobles and the church people Have bloodletting carried out by the barber on the advice of a doctor, but the common people go straight to the barber.

Small distilling book. Illustration to chapter people blood water

• Guy de Chauliac (around 1298-1368). In the 7th Tractate, 2nd Doctrine, 1st Chapter of his Great Surgery , Guy de Chauliac wrote about bloodletting, cupping and the treatment of leeches. He quoted Hippocrates, Erasistratos, Galen, Rhases, Abulcasis, Avicenna ... He called bloodletting the noblest remedy. If necessary, it can be canceled at any time, while an ingested drug can no longer be removed from the intestines. With reference to his informants, he gave an overview of the indications, the technique and the precautionary measures of the procedure. The individual bloodletting sites were only mentioned in passing. He differentiated between “revulsive” bloodletting and “derivative” bloodletting and assigned specific indications to each of these procedures. He used astrology to determine the bloodletting time and he also named the forbidden (Egyptian) days. The conclusion of the treatise on bloodletting was an assessment of the appearance of the blood left.
• Johannes de Rupescissa (around 1310 - after 1365). The apocalyptic visionary Johannes de Rupescissa described in his book De consideratione quintae essentiae the representation of quintessences according to alchemical working methods. These quintessences should strengthen the Christian people in their defense against the rule of the Antichrist, which they believe will soon threaten. One of these quintessences should be made from human blood. For this purpose, the blood of a young, healthy male sanguine, obtained during bloodletting, had to be mixed with salt after the serum portion had been separated off. This mixture was buried in warm horse manure in a sealed glass vessel and, after it had liquefied there, distilled several times with an alembic .

In the 15th century, the Consideratio quintae essentiae was widespread in the south-west of Germany in the national language as the Book of the Fifth Being . Also Hieronymus Brunschwig used them as a source for his Little Destillierbuch . In it he recommended water distilled from human blood for external use in cases of paralysis, as a hair restorer and for the treatment of "fistulas", as well as for internal use in "consumption".

In the early Middle Ages and the High Middle Ages , monks initially practiced bloodletting as part of monastery medicine . However, after the 18th Canon of the resolutions of the Fourth Lateran Council of 1215 stipulated that "no subdeacon, deacon or priest may perform the part of surgery that includes cauterization and cutting", the bloodletting to the barbers living outside the monasteries became and surgeons delegated. In the late Middle Ages, monasteries again offered bloodletting.

Bloodletting men to the "twenty-four paragraph text". 14th to 16th centuries (selection).

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  … Cgm 32 ,… Calendar and internships, 14th century

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  ... Clm 2777 , ... Calendar 1469

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  Clm 18294 , 1471

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  … Cpg 291 , Bavaria,… 2nd half of the 15th century

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  … Clm 206 ,… calendar, 15th century

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  Fasciculus Medicinae . Venice 1491

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  Hans von Gersdorff : Field book of wound medicine , Strasbourg 1517

Bloodletting, cupping and leech treatment. Cgm 340, 15th century (bloodletting tract by Jakob Engelin)

From the Middle Ages to the early modern period, numerous bloodletting calendars and bloodletting tracts were written. For example in 1520 by Alexander Seitz . The (pseudo-Hippocratic) Phlebotomia Hippocratis , a phlebotomy treatise available as a quaestion's text, is considered to be an important script in the Middle Ages for practical implementation with regard to, for example, the cutting technique, the letting points (up to 25 phlebotomy sites were common) and the indications for phlebotomy can be traced back to the 8th century , was edited by Maurus von Salerno , edited and translated into German and influenced other medieval bloodletting texts. The Latin short treatise Laus phlebotomiae (praise of bloodletting), which was first documented in a Rhenish Franconian manuscript at the beginning of the 12th century, and passed on as De minutionis utilitate (literally: about the benefit of letting ), can be found in the appendix to Phlebotomia Hippocratis and also had a great influence on the late medieval medical literature.

In addition to therapeutic bloodletting, an often associated diagnostic bloodletting for blood testing already existed in the Middle Ages , the blood examination (hematoscopy), which was primarily shaped by Maurus von Salerno , based on the pseudohippocratic phlebotomia Hippocratis , which dates back to the 8th century , and in textbooks by Bernhard by Gordon , Heinrich von Mondeville and Ortolf von Baierland . For the blood test, the blood collected in a so-called Lassbecher (Middle High German lāzbecher ) was inspected by the doctor and the disease was determined for the patient from this. According to Friedrich Lenhardt, the blood show was developed “from the instructions for measuring the amount of bloodletting [...], as their criteria and a. The consistency and color of the fresh bloodletting ”.

Even in the Middle Ages, people were aware of the possible risks of bloodletting and had a repertoire for the treatment of undesirable side effects.

For the practically active physician of the (late) Middle Ages there were so-called Lass list and bloodletting book in which - mostly in the " pocket-sized " as in 1480 wrote Hague Aderlaßbüchlein in quarto - were listed the major bloodletting regulations (Let rules).

Instructions for both bloodletting and blood testing were often described in the phlebotomy booklet. A so-called Bavarian Aderlaßbüchlein written before 1480 (handed down in Heidelberg cpg 558 ) contains, like the Ghent Aderlaßbüchlein from about the same time (in the second third of the 15th century), among other things, excerpts from Ortolf von Baierland and served as a compiled reference work for quick information of the bleeding doctor. In the Asanger bloodletting book, compiled from late medieval sources in southern Bohemia around 1520 (between 1516 and 1531) , the authors (probably two surgeons) saw bloodletting as the "most important method of healing".

To treat the plague , for example , bloodletting was also carried out in self-therapy, i.e. without a doctor. So around 1400 Bavarian-Austrian and Swabian lay doctors published so-called Pestlassmännlein . The corresponding letting points were explained by means of drawn full-body figures ("Aderlassmann").

"Twenty-four paragraph text". In the 13th or early 14th century a treatise was written, which was mainly based on the Canon Avicennas and in which the locations of around 24 bloodletting sites and their indications were listed. In a practical way, they were presented in the order “from head to toe”. This "twenty-four paragraph text" was used in manuscripts and prints together with images of the bloodletting sites until the 16th century.

Jakob Engelin (around 1360 - before 1427), who is documented as personal physician to Leopold of Austria until 1406 , is assigned a bloodletting treatise that is documented in numerous manuscripts from the 15th century.

In a manuscript written between 1450 and 1470 in southern Germany ( Cpg 644 ), a bloodletting text is tangible for the first time, which formed the basis of the bloodletting part in the Fasciculus Medicinae from 1491. In 1517 Hans von Gersdorff translated essential parts of this treatise into German.

Modern times

Pierre Brissot - Andreas Vesal - Leonhart Fuchs - Lorenz Fries - Santorio Santorio

Bloodletting dispute . At the beginning of the 16th century, the French doctor and humanist Pierre Brissot initiated the “bloodletting dispute”, a controversy that flared up when, contrary to the doctrine of the time, he advocated bloodletting as close to the diseased organ as possible (“derivation” instead "Revulsion"). In particular, he represented this in the case of chest and lung infections, in which he was able to gain experience with his method on the occasion of an epidemic in 1514. He relied on the corresponding statements in the text About the diet for acute diseases in the Corpus Hippocraticum . Brissot stated that the "revulsion" in bloodletting was first introduced by the Arabs. Although some representatives of the Paris faculty followed the teachings of Brissot, their opponents managed to get a decree prohibiting the use of the derivative bloodletting. The struggle over bloodletting created a rift in the medical world. Brissot died in the Portuguese exile. However, his writings were commented on and, depending on the attitude of the commentator, highly praised or fiercely opposed. One of Brissot's opponents was Thomas Erastus (1524–1583). Pierre Brissot (1478-1522) Andreas Vesalius (1514–1564) Fig. The azygos vein in Vesalius Epistola . 1538 Leonhart Fuchs (1501–1566) Lorenz Fries (around 1490–1531 / 32) Santorio Santorio (1561-1636) Pierre Brissot (1478-1522). Brissot's conclusion for the practice was that the bloodletting should be performed in the crook of the elbow on the side of the disease seat, with significant amounts of blood being withdrawn. Andreas Vesal (1514-1564). Vesal examined the indications given by Hippocrates for bloodletting and found that the expression "dolor lateralis" used by Hippocrates does not only refer to pleurisy, but also to other diseases of the thorax. According to Vesal, the correct choice of the bloodletting site for pleurisy depends on the exact course of the azygos vein , which he was the first to recognize. The azygos vein runs to the right of the spine towards the vesal. Vesal's conclusion was that in left-sided and right-sided pleurisy the operation should always be performed on the vein of the right arm. Leonhart Fuchs (1501-1566). In German-speaking countries, Brissot's position was defended in particular by the humanist Leonhart Fuchs. Lorenz Fries (approx. 1490–1531 / 32). Fuchs's opponent, the Arabist Lorenz Fries, quoted in the section on bloodletting of his Spiegel der Arznei from the canon of medicine of Avicenna . Santorio Santorio (1561-1636). Santorio is considered to be the founder of the iatromechanical school . According to him, the bloodletting should take place “derivative” at the level of the diseased organ. But it doesn't matter on which side the intervention is carried out.

Paracelsus - Leonardo Botallo - Jan Baptista van Helmont

Paracelsus ... .. (1493–1541) Leonardo Botallo (1530-1570) Van Helmont….…. "Bloodletting again" JB v. Helmont (1580-1644) Paracelsus (1493-1541). In his treatise on bloodletting, Paracelsus polemicized against the "unskilled bloodletting doctors" who got all their wisdom from popular calendars. When bloodletting, he himself was guided by traditional rules - including the rules of astrology - but insisted that an individual diagnosis should be carried out before using them. In the treatment of mania z. B. For Paracelsus, bloodletting was an arcanum , while he regarded it as contraindicated in asthma . Leonardo Botallo (1530-1570). The surgeon and anatomist Leonardo Botallo (1530 - approx. 1570), who was born in Asti , is known as the "King of the Bloodletters". He spent most of his life in Paris. He was the personal physician of the French kings Charles IX. and Heinrich III. The Paris faculty condemned Botallo's methods of bleeding old people and children six times a year. His supporters wanted to prescribe the procedure for fever epidemics, pleuropneumonia, colic and flatulence and have also considered the possibility of curing consumption by taking two to three liters of blood. Jean Riolan the Younger (1580–1657) and Guy Patin (1601–1672) were among Botallo's most passionate followers . Johann Baptista van Helmont (1580-1644). Van Helmont fundamentally rejected bloodletting as an intervention that would necessarily lead to a loss of strength and thus delay or prevent healing. The bloodletting critics Théophile de Bordeu (1722–1776) and Johann Gottlieb Wolstein (1738–1820) referred to van Helmont's treatise on bloodletting in fevers .

William Harvey - Marcello Mapighi - Jean Riolan the Younger

William Harvey (1578-1657) Marcello Malpighi (1628-1694) Jean Riolan the Younger (1580–1657) William Harvey (1578-1657) and Marcello Malpighi (1628-1694). The experiments of William Harvey, which led to the representation of the blood circulation in 1628 , and the investigations of Marcello Malpighi based on them provided new foundations in the discussion of bloodletting, but did not call it into question. Jean Riolan the Younger (1580–1657). Harvey's doctrine of the blood circulation did not go unchallenged. So argued the Parisian surgeon Jean Riolan the Younger a. a. with the fact that in the event of the existence of a blood circulation, the bloodletting would largely lose its meaning, because “what is the point of a» derivatio «at the point of blood accumulation and inflammation, if what has accumulated is immediately replaced? Then what should a "revulsio" mean, a withdrawal of blood by bloodletting at a distant point on the foot, e.g. B. with plethora of the brain? "

Charles Bouvard - Molière

Charles Bouvard (1572-1658) JBP Molière (1622–1673) "The Imaginary Sick" 1673 Charles Bouvard (1572-1658). Charles Bouvard was from 1627 to 1643 " the king's supreme doctor (Premier médecin du roi)" and at the same time " superintendent of the royal garden ". In jest, and to make him look ridiculous, Nicolas Amelot de La Houssaye (1634–1706) wrote in his "Mémoiren" that Bouvard prescribed the king 215 medicines, 212 enemas and 47 bloodletting in one year. One could therefore claim that the young king "went through medical courses in all their possible forms." Molière (1622-1673). In the Molière comedy The Conceited Sick, which premiered on February 10, 1673, the hypochondriac Argan obeyed all of his doctor Purgon's orders. The name "Purgon" was derived from the Latin verb purgare or French purger (German purging ) with the meaning of "clean, purify". This cleansing was intended to free the sick person from the disease substance, and it was sought in three ways: by bloodletting, by laxatives and by emetics .

Thomas Sydenham - Bernardino Ramazzini

Thomas Sydenham (1624-1689) Bernardino Ramazzini (1633-1714) Thomas Sydenham (1624-1689). As a friend of Robert Boyle and John Locke , Sydenham shared their ideas of the central role of direct observation. At the bedside he observed and documented the course of the disease, the behavior of the individual patient towards the disease and towards the medical measures. By working out the regularities of his observations, he created a preliminary draft for the structure of a nosology . He argued vehemently against the generally widespread opinion at the time that sweaty therapies should be used for febrile illnesses. In contrast, he called for therapeutic measures to reduce inflammation. He began his treatments with drainage procedures , with bloodletting of 10 ounces (approx. 300 g) being the standard remedy. He usually supplemented the bloodletting with the administration of laxatives . He prescribed emetics less often. After this Ausleerungsphase he gave painkillers and tonic means . The choice of his means was marked by a pronounced eclecticism . Sydenham used bloodletting in a differentiated manner. The age and state of strength of the patient, as well as the character of the disease, were criteria for him that determined whether and to what extent the procedure should be used. In the case of "podagra", a disease from which he suffered all his life, he found bloodletting contraindicated because the "harmful substances" had already settled on the joints and could not be removed by bloodletting or other draining procedures. In the case of "pleurisy", however, he recommended bloodletting of 10 ounces (approx. 300 g), which could be repeated up to two times after a one-day break. Bernardino Ramazzini (1633-1714). The Italian doctor Bernardino Ramazzini is considered to be the founder of occupational medicine and a pioneer of hygiene and social medicine. In his treatise on the diseases of craftsmen and artists, he warned that bloodletting and purging agents should only be used very carefully in therapy, taking into account the patient's state of strength. For example, in the treatment of peasant diseases: “Very often there is a lack of healing of the diseases that afflict the country folk because it is generally believed that, because of their strong powers, they could easily use more powerful means than the people living in the city. I often see that the poor peasants who are brought to the general hospitals are utterly exhausted by the young doctors through the use of strong purgers and repeated blood-letting, since their energies, weakened by work, do not refuse to use these means . "

Lorenzo Bellini - Jean-Baptiste Silva - Jean Claude Adrien Helvétius - Julien Offray de La Mettrie

Bellini's teaching. Lorenzo Bellini, a student of Marcello Malpighi and Francesco Redi , tried to reconcile the doctrine of "revulsion" and "derivation" with the laws of the cycle. On the basis of theoretical considerations, he made the assertion that after the resistance through the venous opening had been removed, more blood would have to flow into the wounded vessel with greater rapidity than into all other vessels, where the blood column opposed the speed of the venous blood. Because the speed and amount of blood in a vessel are generally inversely proportional to the resistances . This increased speed is gradually transmitted to the supplying artery and finally to the entire vascular system and lasts until the heart's strength is weakened. Even after the vein was occluded, the increase in speed continued for a while, and most of all in the emptied vessel. In this way, there is an inflow to the bloodletting point and a discharge from other parts. Lorenzo Bellini (1643-1704) Jean-Baptiste Silva (1682–1742) Traité de l'usage des différentes variety de saignées. 1727 JCA Helvétius (1685–1755) JO de La Mettrie (1709–1751) Lorenzo Bellini (1643-1704). Bellini's conclusion for the practice was that vigorous bloodletting carried out far from the location of the disease must have the greatest healing effect. Jean-Baptiste Silva (1682-1742). The Paris surgeon JB Silva based his system on Bellini's hypotheses and gave the terms “derivation” and “revulsion” a new meaning by opening up veins far away from the disease site, referring to the blood circulation, but allowing large amounts of blood to be emptied . When in 1721 he fell ill with King Louis XV. When asked for advice, he advised bloodletting on the foot, which would heal. Jean Claude Adrien Helvétius (1685–1755). For “petites véroles”, according to Helvétius, no therapy was more effective than bloodletting, if possible, carried out before the eruption. This would empty the pent-up poison. In order to subside the swelling of the brain caused by pent-up leaves, the bloodletting should be carried out according to the Bellini method. Julien Offray de La Mettrie (1709-1751). The French doctor and philosopher Julien Offray de La Mettrie practiced as a doctor in his hometown of Saint-Malo from 1735 to 1742 . He published the experiences he gained in two treatises on practical medicine, which were published in Paris in 1740 and 1743. In it he referred to his teacher Herman Boerhaave and to Thomas Sydenham , Jean-Baptiste Silva and Jean Claude Adrien Helvétius, whom he valued . When treating the "petites véroles", he followed the treatment principle established by Helvétius in 1722, in which bloodletting was carried out before the eruption of the eruption, based on the method given by Bellini. Georg Erhard Hamberger - François Quesnay - Jean-Baptiste Sénac - Anton de Heyde - Albrecht von Haller GE Hamberger (1697–1755) François Quesnay (1694–1774) Jean-Baptiste Sénac (1693-1770) Anton de Heyde (mid 17th century) Albrecht von Haller (1708–1777) A. v. Haller. Experiment on the corpse Georg Erhard Hamberger (1697–1755). Following Bellini, Hamberger did not recognize any difference with regard to the “derivatory” and “revulsory” and he explained that all the effects of bloodletting were based on the reduction in the amount of fluid and on the change in the speed of circulation. François Quesnay (1694-1774). The French doctor and economist François Quesnay contradicted Bellini's theses on the basis of hydraulic tests he had made in the laboratory. Jean-Baptiste Sénac (1693-1770). Sénac, the personal physician of King Louis XV. , published a pamphlet under a pseudonym in 1730 in which he attacked Bellini's theories. In Heister's anatomy, edited by him, and in his main work on the anatomy of the heart, he took up the theses from this pamphlet again. Anton de Heyde (mid 17th century). In 1686 the Dutch doctor Anton de Heyde from Middelburg refuted Bellini's theses by examining the blood circulation in the peritoneum of the living frog. Albrecht von Haller (1708–1777). In 1754 Albrecht von Haller de Heydes confirmed the results of his research from 1686 through his own observations on the peritoneum of living frogs and toads.

Friedrich Hoffmann - Georg Ernst Stahl

Friedrich Hoffmann (1660–1742) Georg Ernst Stahl (1659–1734) Friedrich Hoffmann (1660-1742). In Hoffmann's system, the therapy had the task of emptying the excess, supplementing the lacking, taming the violent movements and spurring on the slack movements. Because of the speed and reliability of its effect and because of its safe use, Hoffmann called bloodletting as a means of evacuating excess ( plethora ) a divine remedy. The withdrawal of blood is not debilitating in Plethora, since it removes an overabundance, which is precisely a source of weakness and, as an obstacle to movement, the immediate cause of stagnation. To prevent strokes, he bled people with a strong constitution two to three times a year. He saw further indications for bloodletting in the case of threatened abortion, rheumatism, gout, asthma, blood spitting - always provided that the constitution was plethoric. Georg Ernst Stahl (1659–1734). Georg Ernst Stahl's system was based on an "anima" which communicates life to dead matter, keeps all functions in balance in the normal body and counteracts decay. This decay and thus death can only occur when the “anima” leaves the body. The force that the “anima” uses for its functions in the body is movement, namely a movement that causes a certain “tone” of the parts or organs to be moved. Illness is thus an obstruction of the normal tone and the automatically triggered effort of the "anima" to restore it. It mainly effects this by influencing the organism's circulation, because its obstruction is one of the most important causes of inhibition of movement. For the etiology of the disease, “full bloodedness” plays a major role, for which the “anima” independently compensates for it in childhood through nosebleeds, in adolescence through blood spitting, in mature age in women through menstrual bleeding, in men through hemorrhoidal bleeding. Stahl's primary treatment principle is logically to support the "anima" in all of their endeavors. A very important remedy is bloodletting, which mimics the natural evacuation of blood.

Théophile de Bordeu - Paul Joseph Barthez - Johann Christian Reil

Théophile de Bordeu (1722–1776) Paul Joseph Barthez (1734–1806) Johann Christian Reil (1759-1813) Théophile de Bordeu (1722–1776). By Bordeu, Barthez, Louis de la Caze (1703-1765) and Gabriel François Venel (1723-1775) was in Montpellier alignment of vitalism founded, the Albrecht von Haller's irritability school and that of Georg Ernst Stahl established system of animism took up and further developed. Bordeu, who is considered to be the initiator of the Montpellier School, started from the principle that the laws of inorganic nature: chemistry and physics are not applicable to the living body, that rather the organism exists under the influence of an immaterial force known as not define such, but must deduce from their utterances. He also turned against the mechanical-chemical view, which viewed the blood simply as a liquid which led to pathological phenomena only through quantity and chemical transformations. Rather, he saw in the blood a part of the whole organized form, which is just as gifted with sensitivity as any other organ. This explains Bordeu's reservations about the indications and the practice of bloodletting. Paul Joseph Barthez (1734-1806). According to Barthez, acute inflammation of an organ has to be treated “revulsively” (upheaval), and with chronic inflammation “derivative” (dissipative). Johann Christian Reil (1759-1813). In his main work On the Knowledge and Cure of Fever , Johann Christian Reil commented in detail on the indications and contraindications of phlebotomy therapy, which he generally assessed positively (Volume I, Chapter 14, § 189 - § 201): “§ 190. Bleeding is a very effective remedy, which in some cases alone must save, in others it must pave the way for the other remedies. Just because of this effectiveness, it can destroy life as quickly as it receives it. "

Philippe Pinel - François Simonnet de Coulmier - Joseph Gastaldy

Philippe Pinel (1745-1826) FS de Coulmier (1741-1818) Joseph Gastaldy (1741–1805) Philippe Pinel (1745-1826). Pinel was a supporter of the vitalistic school of Montpellier and, together with Marie François Xavier Bichat , is one of the leading figures of the Paris clinical school of medicine . Early on he put through a medical treatment without coercion , which later became known as no restraint , and put his idea of ​​the curability of the “insane” into practice. In 1801 he wrote about the use of bloodletting in psychiatry (translation by M. Wagner): “Blood-letting can often be prescribed with so little understanding, and so frequently, that one is often in doubt as to which of the two is the more insane, the one to whom it is administered or the one who prescribes it. ... Regardless, I am far from completely banishing bloodletting; I just oppose the abuse of it. " François Simonnet de Coulmier (1741-1818) and Joseph Gastaldy (1741-1805). In the Charenton hospice located just outside Paris, the religious and chief administrator ("régisseur général") de Coulmier and the doctor and gourmet Gastaldy practiced treatment from 1797, which largely avoided repressive measures. More “moral” than “physical” means were used and so the use of “physical means” (cold baths, medication and bloodletting) could be reduced to a minimum. The most important "moral means" in the Charenton hospice was the use of the theater as a therapeutic means, with the patient D. A. F. de Sade participating as a director and actor from 1803 .

Herman Boerhaave - Gerard van Swieten

Herman Boerhaave (1668-1738) Gerard van Swieten (1700–1772) Herman Boerhaave (1668-1738). Herman Boerhaave, the most successful clinician and medical teacher of the 18th century, did not found a school, but rather combined the knowledge of iatrochemists and iatromechanics with his own observations. His pathology teaching divided disorders of the functions into diseases of the solid parts, diseases of the juices, and diseases of both. He explained inflammation primarily as a stagnation of the arterial blood and as a sticking together of its parts in the finest canals. Bloodletting was an important therapeutic tool for him. Gerard van Swieten (1700-1772). Van Swieten was initially a student and deputy of Boerhaave in Leiden, from 1745 personal physician to the Austrian Empress Maria Theresia in Vienna and founder of the Older Medical School in Vienna . He prescribed bloodletting sparingly. He spoke out against prophylactic bloodletting, since, in his opinion, these tended to increase the plethora . On the other hand, he recommended vigorous bloodletting at the beginning of febrile illnesses. With reference to Celsus , van Swieten recommended bloodletting in the acute phase of a stroke , "because it is better to use a dangerous aid than none".

William Cullen - John Brown - Giovanni Rasori

William Cullen (1710-1790) John Brown (1735–1788) Giovanni Rasori (1766-1837) William Cullen (1710-1790). The Scottish doctor and chemist William Cullen enjoyed a great reputation during his lifetime for the methodological clarity of his teaching and for the versatility of his knowledge. His textbooks were soon translated into French and German. In particular, his treatises on the materia medica and his beginnings in practical medical science were widely regarded as guides for medical practice. He also had a great influence on the bloodletting practice of his contemporaries. He wrote in detail about the bloodletting in the "breast inflammation with inflammatory fever" . In this disease, the first bloodletting is crucial for healing. It should be done as hard as possible until the pain subsides, or until it is easier to breathe, possibly until the patient faints. Similar to Gerard van Swieten , Cullen also recommended bloodletting in the early stages of the stroke . This should preferably be done from the jugular vein , alternatively from a vein in the crook of the elbow or from the temporal artery , possibly by applying bloody cupping to the temples and neck. Cullen saw the prevention of epileptic seizures in full-blooded people as another indication for bloodletting . Bloodletting is also helpful for selected cases of narrow chest . In order to “restore drowned persons” , in addition to general warming and ventilation of the lungs by blowing into a nostril, bloodletting in the head area should also be carried out. Finally, in the case of frenzy , Cullen first recommended the action of fear , which could be achieved through the execution or threat of lashes and canes. In addition, bloodletting should also be carried out, preferably in the head area. John Brown (1735-1788). In the illness concept of the Scottish Cullen student John Brown, therapy was reduced to the use of stimulating agents for "asthenic" diseases and of depressant agents for "sthenic" diseases. He considered bloodletting to be the strongest of the depressant agents for "sthenic" diseases. The amount of blood to be let was determined by the difference in age, sex, strength of the body, and the severity of the harmful effects. At the vigorous adult age, the amount should be 10 to 12 ounces (approximately 300-360 grams). As the best rule, however, Brown stated that the amount of blood to be released is determined based on the effect of the bloodletting. Giovanni Rasori (1766-1837). Giovanni Rasori developed Brown's system into a theory of “stimulo and contrast stimulo ”, in which bloodletting played a central role and was also used as a test agent. In one case of pneumonia, he drew a total of 4230 grams of blood in four days.

Johann Gottlieb Wolstein - Christoph Wilhelm Hufeland - Samuel Hahnemann - Johann Gottfried Rademacher

Johann Gottlieb Wolstein (1738-1820) Chr. W. Hufeland (1762–1836) Samuel Hahnemann (1755–1843) JG Rademacher (1772-1850) Johann Gottlieb Wolstein (1738-1820). With reference to van Helmont's treatise on fever, Johann Gottlieb Wolstein stated in his remarks on bloodletting in 1791 ... that bloodletting is also harmful in the case of acute fever and acute inflammation and for prophylactic purposes. Wolstein's writing sparked a general discussion about the benefits of bloodletting, and this discussion led to the indications for bloodletting being narrowed. Christoph Wilhelm Hufeland (1762-1836). Hufeland described general bloodletting as the most powerful, "directly debilitating method". It should only be used in the highest degree of general or localized inflammation and in plethora . For an adult, a pound of blood is the rule. The amount of blood ultimately to be released depends on the change in symptoms and the change in pulse that occur during the treatment. Hufeland thus followed the recommendations formulated by his teacher August Gottlieb Richter . Samuel Hahnemann (1755-1843). Hahnemann's polemics were primarily directed against the prescribing and dispensing habits of doctors and pharmacists. His fundamental criticism of the contemporary practice of bloodletting can therefore initially only be found in the margins of his treatises, for example in his 1809 work Monita on the three viable types of cure . In the context of the bitter struggle for the purity of his teaching that fell in the 1830s , Hahnemann took a sharp stand against any attempt to combine homeopathy with conventional, especially debilitating, remedies such as bloodletting or laxatives . Johann Gottfried Rademacher (1772–1850). Rademacher was not an opponent of bloodletting. In his system of "organ remedies" and "universal remedies", of "artificial healing" and "natural healing", bloodletting as a "hostile attack on the entire organism" was a means of "artificial healing."

Jean-Nicolas Corvisart - François Broussais - René Laënnec - Jean-Baptiste Bouillaud

Jean-Nicolas Corvisart (1755-1821) FJV Broussais (1772-1838) René Laënnec (1781–1826) Jean-Baptiste Bouillaud (1796-1881) Jean-Nicolas Corvisart (1755-1821). Corvisart, the founder of the French medical clinic, described a cure with reference to Hippolito Francesco Albertini and Antonio Maria Valsalva , which was supposed to prevent the harmful influence of full blood on the progression of the onset of heart failure (the "active aneurysms of the heart"). This was done “By repeated bloodletting and a continued strict diet the patient was so brought down that he could hardly lift his hands from the bed. The aneurism diminished as the patient became weaker, and one did not increase one's strength through a richer diet until the aneurismatically enlarged parts had contracted again through their natural, now no longer hindered, contractility, and the organ was approximately restored had returned to its original state. " For pericarditis and carditis , Corvisart recommended starting therapy with general and local bleeding and repeating this for each subsequent exacerbation. Local bleeding should be done by using leeches in the chest region or on the anus. For cardiac insufficiency in an advanced stage ("passive aneurysms of the second degree of the heart"), he recommended bloodletting using the method of Giovanni Battista Morgagni : “Namely, the immersion of the arms in warm water, the foot baths, in a word, everything that causes the blood to flow to the limbs, an emptying of the heart and large vessels, is also of great use in this period, all the more since it can to a certain extent represent the place of bloodletting, where frequent use of them would be questionable. " François Joseph Victor Broussais (1772-1838). According to Broussai's system of "physiological medicine" ("doctrine physiologique"), all forms of disease are based on inflammation, and the higher degrees of this cause irritation of other organs in a sympathetic manner; This is how the fever develops and most febrile illnesses are based on gastroenteritis. Mucous soups and extensive local applications of leeches in the epigastric region were used for therapy . Stimulated by Broussais and his students, the treatment with leeches became particularly popular in France in the first half of the 19th century. The demand for leeches could soon no longer be met and so devices were developed with which the action of the leeches could be imitated. René Laënnec (1781-1826). The diagnostician and systematist René Laënnec was not an opponent of bloodletting. However, he used this therapeutic agent cautiously and deliberately. He followed the findings of his medical colleagues and added corrections sparingly. In his treatise on diseases of the lungs and heart, which he wrote as a Corvisart student, he mentioned the use of bloodletting in the following diseases: acute pulmonary catarrh, dry catarrh, wet catarrh, croup, bronchial bleeding, pulmonary emphysema, pulmonary embolism, pneumonia, nervous bronchial asthma, less severe Pulse, hypertrophy of the heart, diphtheria, nervous palpitations Jean-Baptiste Bouillaud (1796-1881). The clinical researcher Jean-Baptiste Bouillaud, who was the first to describe the connection between acute rheumatoid arthritis and endocarditis and the location of the language center in the frontal lobe , called his teacher Broussais a "messiah of medicine". He treated acute inflammations such as pneumonia , typhoid , rheumatic fever , tonsillitis and facial erysipelas with "forced bloodletting" ("saignés coup sur coup").

Pierre Charles Alexandre Louis - Marshall Hall - Joseph Dietl

PCA Louis (1787–1872) Marshall Hall (1790-1857) Joseph Dietl (1804-1878) Pierre Charles Alexandre Louis (1787–1872). Pierre Charles Alexandre Louis developed the "numerical method" , a form of statistics. He conducted the first study with his new method on the treatment by bloodletting in a group of 77 patients with a very similar form of pneumonia . He determined when the disease began, how long it lasted, and what death rate it was, and whether the bleeding was either early (1-4 days since the onset of the disease) or late (5-9 days in the course). Based on this, Louis found that those treated early recovered earlier but had a higher death rate. From this he concluded that bloodletting was only effective in the later stages of the disease. His observations were published in book form in the "Archives générales de médecine" in 1828 and in Paris in 1835, and they marked the end of the phlebotomy routine. How firmly rooted bloodletting therapy was at that time is evident from the fact that Louis could only discuss the lesser or greater use of bloodletting. But he couldn't question the bloodletting itself. Marshall Hall (1790-1857). The English doctor Marshall Hall, the founder of the doctrine of the reflexes , dealt in detailed studies with the consequences of blood loss during phlebotomy. Hall demonstrated that serous effusions and pulmonary edema are aggravated by bloodletting and that bloodletting is useless as a prophylaxis against apoplexy . He was of the opinion that all kinds of weaknesses forbid the intervention, but advocated that it should be indicated in delirium associated with fever or local inflammation. Joseph Dietl (1804-1878). In 1849, the Viennese clinician Joseph Dietl explained the successes achieved in pneumonia by bloodletting with a short-term relief of shortness of breath caused by this intervention, which, in his opinion, was bought at the cost of increased mortality. He had observed the influence of bloodletting on the individual symptoms of pneumonia. He had statistically evaluated the collected observations. Dietl concluded: “According to our experience, bloodletting is never indicated in pneumonia ; H. never necessary to restore health. ... it increases ... the lethality of pneumonic disease. Pneumonia, on the other hand, is most regular, fastest and cheapest when left to its own devices; H. is only treated with dietetic means . "

Bloodletting and acupuncture

See also: history of acupuncture

China

In traditional Chinese medicine , therapeutic blood sampling is used as "tract pricking" ( luòcì絡 刺) as part of acupuncture . The treatment is based on the basic principle of "revulsion", that is, the therapeutic effect takes place far away from the disease site and the "spoiled blood" ( yūxuè瘀血) is only removed from the capillaries drop by drop . Two examples:

1. In the treatment of lumbar pain, superficial veins are opened in the hollow of the knee to draw small amounts of blood.
2. To treat the onset of a sore throat, a small needle is used to make a prick on the inner edge of the nail of the index finger, through which a few drops of blood are drawn.

The sources suggest that “pricking the tract to take blood” is older than the form of therapy that we now call acupuncture .

Europe 17th to 19th centuries

AP Demours 1819. Cupping device. It allowed cupping and bloodletting at the same time, or cupping and acupuncture at the same time

In the 17th and 18th centuries acupuncture was made famous in Europe by two doctors from the Dutch East India Company : Willem ten Rhijne and Engelbert Kaempfer . It was obvious that they compared this therapy method, which was new to them, with the bloodletting they were familiar with from Europe. As meridians (Jingluo) lines connecting the acupuncture points designated compared with enables them to establish blood vessels. When assessing the mechanism of action of acupuncture, they fluctuated between a “derivative” effect (ten Rhijne) and a “revulsive” effect (Kaempfer).

Acupuncture was only introduced into European practice at the beginning of the 19th century by the French doctor Louis Berlioz . He reported on his experiences with this therapeutic agent since 1810 in a memorandum on chronic diseases, bloodletting and acupuncture . From 1819 - mainly around 1825 under Jules Cloquet - ending in the 1830s - acupuncture became a frequently used form of therapy in France. At the same time, bloodletting and treatment with leeches were excessively practiced by François Broussais and his students.

In this early European practice, acupuncture was understood as a "derivative" acting method, i. That is, points in the vicinity of the site of the disease with great pricking depth and long dwell times of the needles were treated. Only the Parisian ophthalmologist Antoine Pierre Demours used a "revulsive" method, which he derived from the European treatment of eye diseases using the hair rope .

Japan

Stimulated by the bloodletting presented by doctors of the Dutch East India Company and practiced on Europeans in Japan, doctors of the "school of old practice" (ko-ihōha), which emerged in the 18th century, attacked the "tract pricking" already described in the classical Chinese scripts “( Shiraku , 刺 絡 ) again. Actually, a few drops of "spoiled blood" ( oketsu , 瘀血 ) were taken from the capillaries and some places on the fingernails and toenails . But now pioneers such as the Tenno's court doctor, Ogino Gengai , took quantities from a tea bowl in cases where immediate measures were needed to save the patient. Ogino, who was not a supporter of the “Holland Studies” ( Rangaku ), wrote an influential “book on tract stitching” ( Shiraku-hen , 1771) in which he combined Western techniques and traditional disease concepts. Since 1994, a scientific society ( Nihon Shiraku Gakkai , Japan Association for Shiraku Acupuncture) has been dedicated to modernizing and spreading this approach.

Bloodletting in Ayurvedic Medicine

The Ayurvedic medicine knew the phlebotomy also, as in the Sushruta Samhita (Book III, Chapter 8) is illustrated. For example, bloodletting has been used in the treatment of "blood-created" ulcers.

Involuntary bloodletting

Seneca's death by bloodletting in Schedel's world chronicle

“... Seneca was told by Nerone that he would die in Elbs. Seneca do recognize the will Neronis he begeret which he placed into a water lawes ime vnd all veins geo ^e Solten be ffent to ime of entgienge Gaist. maynende that there is even one ſu ^e ß sex of death who. alſo of the opening of the veins. vnd alſo he ends ſa life ... "

- Hartmann Schedel : Weltchronik , 1493, sheet 105r

Aulus Gellius reported in his Noctes Atticae that blood-letting was one of the most shameful punishments to which the Roman soldiers could be sentenced. An involuntary bloodletting is also mentioned in the Tristan of Gottfried von Strasbourg .

Use in today's medicine

Course of the two vein trunks of the arm

Today, bloodletting plays an important role in a few diseases:

• For polycythemia vera , a disease that leads in particular to an abnormally increased formation of erythrocytes (red blood cells) and thus to an increase in blood viscosity , bloodletting is the treatment of choice. To treat the disease, initially six to eight bloodletting are often performed at weekly intervals (each up to 500 ml) in order to lower the life-threatening high hematocrit value (sometimes over 60%) to a normal value (approx. 45%). Thereafter, this measure takes place every six to twelve weeks, unless other medical steps are initiated.
• In hemochromatosis , a disease of the iron metabolism, blood-letting is carried out for life to reduce the iron content in the body.
• In the case of polyglobules, it may be necessary to improve the flow properties of the blood by bloodletting if, for example, a central vein thrombosis in the eye is threatened or has already occurred. In reactive forms of polyglobulia, bloodletting therapy is contraindicated, as the patients need the increased oxygen carrier.
• In Porphyria cutanea tarda , a disruption of the synthesis of the red blood pigment heme , bloodletting can remove iron, which otherwise causes damage to the liver.
• Clinical studies indicate that frequent blood donations show a not only temporary, clearly blood pressure lowering effect in high blood pressure . However, this observation has not been verified by sufficiently large randomized controlled trials .
• In cardiac pulmonary edema , bloodletting of 300 to 500 ml can be indicated, especially if there is also polyglobulia.

Use in alternative medicine

• In alternative medicine, bloodletting (like cupping ) is one of the draining procedures .
• The so-called bloodletting according to Hildegard von Bingen , who published the advantages of this procedure in the 12th century, is supposed to free the body of poisons by taking "bad blood" (cf. humoral pathology ), which are caused by overeating, diet errors, stress, Worries, fear and disappointments arose. According to an article in Welt Online, the blood is to be cleaned of "pathogenic waste products and putrefactive substances".

Retrospect and Prospect

“We may wonder why the practice of bloodletting persisted for so long. ... With our current understanding of pathophysiology , we might be tempted to laugh at such methods of therapy. But what will doctors think of our current practice 100 years from now? Perhaps they are amazed at our overuse of antibiotics , our propensity for polypharmacy and the clumsiness of treatments such as radiation therapy and chemotherapy . "

- Gerry Greenstone : The history of bloodletting . In: British Columbia Medical Journal , Vol. 52 (2010), No. 1 (January / February), pp. 12-14

Therapeutic concepts associated with bloodletting for the treatment of cardiovascular diseases have survived to this day. The bloodletting treatment of incipient heart failure (the "active aneurysms of the heart") introduced in the 18th century by Albertini , Valsalva and Corvisart has been replaced today by the prescription of thiazide diuretics , which ties in with the hydraulics-based therapy concept of the 18th century: by reducing blood volume (and by lowering the blood pressure ) the development of heart failure is to be prevented.

See also

• Bloodletting as a medical measure for pulmonary edema due to acute left heart failure
• Medical leech
• Leech treatment
• cupping
• Blood collection

literature

• Erwin Heinz Ackerknecht : Therapy. From the primitives to the 20th century. Enke, Stuttgart 1970, ISBN 3-432-01621-2 .
• Josef Bauer: History of bloodletting. EH Gummi, Munich 1870 (digitized version) ; Reprint: Munich 1966.
• Arturo Castiglioni : The bloodletting. In: Ciba-Zeitschrift 66. Volume 6, Wehr / Baden 1954, pp. 2186-2216.
• P. Eichenberger: Johann Jakob Wepfer and his attitude to blood letting. A draft letter to Georg Frank von Frankenau . In: Gesnerus. Swiss Journal of the History of Medicine and Sciences. Volume 24, 1967, pp. 108-134 (digitized version ) .
• Konrad Goehl , Johannes Gottfried Mayer, Gundolf Keil: The Aderlaßmann from Michelstadt - A poster from the Middle Ages. In: Wolfgang Schmitz (Hrsg.): Preserving and exploring. Contributions from the Nicolaus Matz Library (Michelstadt church library, special offer for Kurt Hans Staub on his 70th birthday). Michelstadt 2003, pp. 56-74.
• Gundolf Keil : Phlebotomy (bloodletting). In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil, Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 1155.
• Friedrich Lenhardt, Gundolf Keil: Praise of bloodletting. Laus phlebotomiae , Utilitas phlebotomiae and De minutionis utilitate. In: Author's Lexicon . 2nd Edition. Volume 5, Columns 862-865.
• Antoine Louis , Louis de Jaucourt : Saignée. In: Denis Diderot : Encyclopédie, ou Dictionnaire raisonné des sciences, des arts et des métiers. Volume 14, 1751, pp. 501-516 (digitized version ) .
• Franz Xaver Mezler : Attempting a history of bloodletting. Wohler, Ulm 1793 (digitized version) .
• Karl Sudhoff : Laßafelkunst in prints of the 15th century. In: Archive for the History of Medicine I, 1907, pp. 219–288, Textarchiv - Internet Archive
• Karl Sudhoff: Contributions to the history of surgery in the Middle Ages, graphic and textual examinations in medieval manuscripts. J. A. Barth, Leipzig 1914-1918. Volume 1 (1914) (digitized version) . In it pp. 144–197: memorized images and memorized image texts for the choice of bloodletting points in diseases of the individual body organs (digital copy ) ; Pp. 198–219: Teaching and memorable figures to illustrate the influence of the zodiacal stars on the human body (digitized version ) .
• Ortrun Riha : Bloodletting in Medieval Medicine. In: Medicine in Society and History 8, 1989 (published 1991), pp. 93-118.
• Bloodletting . In: Meyers Großes Konversations-Lexikon . 6th edition. Volume 1, Bibliographisches Institut, Leipzig / Vienna 1905, pp.  107–108 .

Web links

Commons : Bloodletting  - collection of images, videos and audio files

Wiktionary: Aderlass  - explanations of meanings, word origins, synonyms, translations

• Bloodletting in Medieval Medicine
• Bloodletting lancet: 3D model in the culture portal bavarikon

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !

Individual evidence

1. ↑ Luttrell-Psalter, London, Brit. Mus., Add. Ms. 42130, fol. 61r (digitized version ) .
2. ^ Gundolf Keil : Phlebotomy (bloodletting). In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil, Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin 2005, ISBN 3-11-015714-4 , p. 1155.
3. ↑ Kurt Engert: History of bloodletting in domestic animals up to the establishment of scientific care centers for veterinary medicine. Dresden 1912. See also blood (food) .
4. ^ Robert Jütte : History of Alternative Medicine. From folk medicine to today's unconventional therapies. Beck, Munich 1996, ISBN 3-406-40495-2 , pp. 12, 21, 28 and 108.
5. ↑ Lorenz Fries : Spiegel der Artzny. Strasbourg 1518, sheets 21v – 22r (digitized) .
6. ^ Arnoldus 'de Villa Nova': Regimen sanitatis Salernitanum. With commentary by Pseudo-Arnaldus de Villanova and the Doctores Montispessulani regentes, 1480 (?), [Lyon], [approx. 1486/87], chapter 92 (digitized version) .
7. ↑ Cgm 32, Calendar and Internships, 14th century (digitized version) .
8. ^ Calendar, iatromathematic house book. Ulm 1498, sheet 28v (digitized version ) .
9. ^ Karl Sudhoff : Contributions to the history of surgery in the Middle Ages, graphic and textual examinations in medieval manuscripts. JA Barth, Leipzig 1914-1918. Volume 1 (1914) (digitized version) . In it, pp. 198–219: Teaching and memorized figures to illustrate the influence of the zodiacal stars on the human body (digitized version ) .
10. ↑ The writing 'De adventu medici ad aegrotum' after the Salernitan doctor Archimatheus. Edited, translated and introduced by Hermann Grensemann . In: Würzburg medical history reports. Volume 14, 1996, pp. 233-251; cited here, p. 245.
11. ↑ Recueil des planches du dictionnaire de Chirurgie [the "Encyclopédie méthodique]" . Panckoucke, Paris to VII (1798/99). (Digital copy ) Fig. 1-3: Bloodletting lancet (Italy and France); Fig. 4-8: Aderlassschnepper (Germany); 9-10: Blood-letting snipers with several blades for bloody cupping; 11: Jugular vein compress (according to Chabert) for squeezing the jugular vein during bloodletting; Fig. 12: Device for attaching the hair rope (after Jean-Louis Petit ).
12. ↑ Explication des planches . Following Volume 2, Surgery, of the “Encyclopédie méthodique” (digitized version) .
13. ↑ Galen. Edition Karl Gottlob Kühn. Leipzig 1821, Volume X, De methodo medendi 13, p. 940 (digitized version) . Volume XI, pp. 312-315 (digitized version ) .
14. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, p. 76 (digitized version) . Arturo Castiglioni: The bloodletting. In: Ciba-Zeitschrift 66, Volume 6, Wehr / Baden 1954, p. 2195.
15. ^ Arturo Castiglioni : The bloodletting. In: Ciba magazine 66, volume 6, Wehr / Baden 1954, p. 2187 91.
16. ↑ Tracts Nedarim 54b, Shabat 129a, Kidushin 82a.
17. ↑ Rabbi Samson Hirsch, Commentary on Leviticus 17:13.
18. ↑ Richard Kapferer: The works of Hippocrates. The Hippocratic collection of writings in a new German translation. Vol. 1–5, Hippokrates, Stuttgart / Leipzig, 1934–1939, VII, 29–30 (quoted from Castiglioni 1954, p. 2191).
19. ^ Karl Friedrich Heinrich Marx : Herophilus. A contribution to the history of medicine. Karlsruhe 1838, pp. 51-52 (bloodletting) .
20. ^ Galeni de venae sectione adversus Erasistratum liber. In: Karl Gottlob Kühn (Ed.): Claudii Galeni Opera Omnia. Leipzig 1821, Volume XI, pp. 147–186, here: p. 163: (digitized version) .
21. ↑ Aulus Cornelius Celsus: Aur. Corn. Celsi De Medicina: Libri Octo; Cum Notis Integris Joannis Caesarii, Roberti Constantini, Josephi Scaligeri, Isaaci Casauboni, Joannis Baptistae Morgagni. Ac locis parallelis; Cura & Studio Th. J. from Almeloveen ,… Accedunt J. Rhodii vita C. Celsi, Variae Lectiones ex tribus antiquis editionibus, itemque Loci aliquot Hippocratis Et Celsi From Henrico Stephano parallelōs concinnati. Thurneisen, Basel 1748 (digitized version ) therein : Celsi Medicina. Book II, Chapter 10, pp. 77-82: De sanguinis detractione per venas (digitized version ) .
22. ↑ Eduard Scheller (transl.): Aulus Cornelius Celsus. About Medicinal Science in Eight Books. After the text edition by Charles Victor Daremberg . 2nd Edition. Vieweg, Braunschweig 1906. In it: Book II, Chapter 10, pp. 81–86: Vom Aderlaß (digitized version) .
23. ↑ Ivan Bloch . In: Max Neuburger and Julius Pagel (eds.): Handbook of the history of medicine. (Founded by Theodor Puschmann ). Fischer, Jena 1902, Volume I, pp. 422–423: Celsus… General Therapeutics, Dietetics and Hygiene. (Digitized version) .
24. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 68-76 (digitized version ) . - Arturo Castiglioni: Der Aderlaß , in: Ciba-Zeitschrift 66 , Volume 6, Wehr / Baden 1954, p. 2195.
25. ↑ Claudij Galen Pergameni Medici Praestantissimi. De curatione per sanguis missionem, libellus. Johann and Franciscus Frellonius, Lyon 1546 (digitized version ) . - Claudij Galeni Pergameni, Medicorum facile Principis, aliquot opera. Birckmann & DuPuis, Paris 1550; therein: pp. 254v – 290r: Claudii Galeni Pergameni, de Ratione curandi per sanguinis missionem. Leonharto Fuchsio Medico interprete (digitized version ) ; Pp. 290r – 293r: Claudii Galeni pergameni, de hirudinibus, revulsione, cucurbitulae et Scarificatione Libellus. Leonharto Fuchsio Medico interprete (digitized version ) .
26. ↑ Abulcasis. Surgery. Part II, Chapter 97: De phlebotomia venarum. Druck Schott, Strasbourg 1532, p. 262 (digitized version) .
27. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 99-102 (digitized version ) . - Arturo Castiglioni: Der Aderlaßi , in: Ciba-Zeitschrift 66 , Volume 6, Wehr / Baden 1954, p. 2197. - Liber Rasis ad Almansorem, Venice 1497, Tract 7, Cap. 21 (digitized version) .
28. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, p. 109 (digitized version) . - Kitāb at-Taisīr fī l-mudāwāt wa-t-tadbīr (Book of Simplification / Preparation of Therapy and Dietetics), Book I, Tract 16, Chapter 3 (digitized version ) .
29. ↑ At-Tasrif Abulcasis: Chirurgia. Lib. Tres. Schott, Strasbourg 1532, Pars secunda. De phlebotomia Venarum. Caput XCVII, pp. 259–270 (digitized version ) --- Aboul Kasim Al Zahravi / Abulcasis / Abulcasis: - La chirurgie d'Abulcasis…, trad. [De l'arabe] par le Dr. Lucien Leclerc . J.-B. Baillière, Paris 1861 Livre II, Chapitre LXXXXVII De la section des vaisseaux sanguins (digitized version ) .
30. ↑ Avicenna: Canon of Medicine . Book I, Fen IV, Chapter 20 (Andrea Alpago edition 1556) (digitized version) .
31. ↑ Michael R. McVaugh : Medicine before the plague. Practitioners and their patients in the Crown of Aragon, 1285-1345. University Press, Cambridge 1993 pp. 152-153 ISBN 0-521-41235-8 . - Julius Pagel : Heinrich von Mondeville's surgery according to Berlin, Erfurt and Paris codices published for the first time . August Hirschwald, Berlin 1892, pp. 365–382: Aderlass (digitized version ) . - Edouard Nicaise: Chirurgie de maître Henri de Mondeville, chirurgien de Philippe le Bel, roi de France. Composée de 1306 à 1320. Baillière, Paris, 1893, pp. 532–555: Aderlass (digitized version ) . - Max Neuburger : History of Medicine. Enke, Stuttgart 1911, Volume II, Part 1, pp. 488–495: Literary historical overview. Henri de Mondeville. (Digitized version) .
32. ↑ Chirurgia Magna . La grande chirurgie de Guy de Chauliac, surgeries, maître en médecine de l'Université de Montpellier composée en l'an 1363. 7th treatise, 1st doctrine, 1st chapter. Venice, December 23, 1499 pp. 62v – 64r: Aderlass (digitized version ) . Lyon 1585, pp. 358-366 (digitized) . - Transcribed and annotated by E. Nicaise, Alcan, Paris 1890, pp. 555-570: Aderlass (digitized) .
33. ↑ Cpg 233 , West Germany, 4th quarter of the 15th century. Sheet 1r – 31r: Johannes de Rupescissa. De consideratione quintae essentiae. (Dyß is daz bůche of the fifth being. To latyne quinta essentia.) Sheets 7v – 8r: The fifth being of human beings to make blood (digitized version ) . - Udo Benzenhöfer : Johannes' de Rupescissa 'Liber de consideratione quintae essentiae omnium rerum' German. Studies on Alchemia medica from the 15th to 17th centuries with a critical edition of the text. Steiner, Stuttgart 1989 (= Heidelberg studies on naturopathy in the early modern period. Volume 1); P. 109–110: How to draw the fifth being… to the first human bleeding… - Hieronymus Brunschwig: Kleines Distillierbuch. Johann Grüninger, Strasbourg 1500, sheet 77r: people blood water (digital copy) .
34. ^ Claudius F. Mayer: A medieval english leechbook and its 14th century poem on bloodletting. In: Bulletin of the history of medicine. Volume 7, 1939, pp. 380-391.
35. ↑ Gerhard Jaritz: Bloodletting and cupping in the Klosterneuburg women's choir monastery (1445–1533). In: Yearbook of Klosterneuburg Abbey. New series, Volume 9, pp. 67-108.
36. ↑ Manuscript Census , Munich, State Library, Cgm 32 (digitized version) .
37. ↑ Cgm 32, Calendar and Internships, 14th century (digitized version) .
38. ↑ Clm 2777 sheet 17r, calendar 1469 (digital copy ) .
39. ↑ Clm 18294, 1471, sheet 282v (digitized version ) .
40. ↑ Cpg 291, Bavaria, 2nd half of the 15th century (digitized version) .
41. ↑ Clm 206, sheet 35, calendar, 15th century (digitized version) .
42. ↑ Fasciculus Medicinae . Gregoriis, Venice July 26th 1491, sheet 2v – 5v (digitized version ) .
43. ↑ Hans von Gersdorff: Field book of the wound medicine . Schott, Strasbourg 1517, sheets 14r – 18r (chapters 13–16) (digitized) .
44. ↑ Cgm 340, mid-15th century, sheet 129r (digital copy ) .
45. ↑ For printed bloodletting calendars cf. about bloodletting calendar. Strasbourg 1492, or in the Bamberg State Library, VI. F. 15, the Würzburg moon phase and bloodletting calendar to the year 1488.
46. ↑ Alexander Seitz: The treatise on bloodletting. Landshut 1520.
47. ↑ Konrad Goehl , Johannes Gottfried Mayer : Variations on the Phlebotomy treatise ›Venarum minutio‹. The submission of the so-called ›24-paragraph text‹. In: Konrad Goehl. Johannes Gottfried Mayer (Hrsg.): Editions and studies on Latin and German specialist prose of the Middle Ages. Festival ceremony for Gundolf Keil. Königshausen & Neumann, Würzburg 2000, ISBN 3-8260-1851-6 , pp. 45-65.
48. ^ Gundolf Keil: 'Phlebotomia Hippocratis'. In: Werner E. Gerabek, Bernhard D. Haage, Gundolf Keil, Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin 2005, ISBN 3-11-015714-4 , p. 1154 f.
49. ^ Friedrich Lenhardt: 'Phlebotomia Hippocratis' ('Epistula de phlebotomia I'). In: Author's Lexicon . 2nd Edition. Volume 7, Col. 616-620.
50. ↑ Middle High German (bluot) lâzen stood for Latin (sanguine) minuere; see. Gundolf Keil: Phlebotomy (bloodletting). In: Encyclopedia of Medical History. 2005, p. 1155.
51. ↑ Friedrich Lenhardt, Gundolf Keil: 'Praise of the bloodletting'. In: Author's Lexicon . 2nd Edition. Volume 5, Col. 862-865.
52. ↑ Gundolf Keil: 'Praise of bloodletting'. In: Werner E. Gerabek, Bernhard D. Haage, Gundolf Keil, Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 859.
53. ↑ Irmgard Müller: Hematoscopy. In: Encyclopedia of Medical History. 2005, p. 525.
54. ^ Friedrich Lenhardt: Blood show. Studies on the development of hematoscopy. (Medical dissertation, Würzburg 1980) Pattensen with Hann. (now Königshausen & Neumann, Würzburg) 1986 (= Würzburg medical-historical research. Volume 22).
55. ↑ Johannes Gottfried Mayer : The blood show in the late medieval German diagnostics. Supplements to Friedrich Lenhardt from the handwritten tradition of the 'Pharmacopoeia' Ortolf von Baierland. In: Sudhoff's archive. Volume 72, 1988, pp. 225-233.
56. ↑ Friedrich Lenhardt: Hematoscopy tracts (blood review tracts). In: Burghart Wachinger u. a. (Ed.): The German literature of the Middle Ages. Author Lexicon . 2nd, completely revised edition. Volume 3. De Gruyter, Berlin / New York 1981, ISBN 3-11-007264-5 , Sp. 422-425.
57. ^ Gundolf Keil: Hematoscopy tracts (blood review tracts). In: Encyclopedia of Medical History. 2005, p. 525 f.
58. ↑ Friedrich Lenhardt: “When ain man willingly let go”. Instructions for the therapy of complications in bloodletting. In: Gundolf Keil (ed.): "Gelêrter der arzeniê, ouch apotêker". Contributions to the history of science. Festschrift for the 70th birthday of Willem F. Daems. Horst Wellm Verlag, Pattensen / Hannover 1982, published 1983 (= Würzburg medical-historical research. Volume 24), ISBN 3-921456-35-5 , pp. 269-300.
59. ↑ Gerrit Bauer: The "Hague Aderlaßbüchlein". (= Studies on the medical vademecum of the late Middle Ages. Volume 1). (Medical dissertation Würzburg), Wellm, Pattensen, now with Königshausen & Neumann, Würzburg, 1978 (= Würzburg medical historical research. Volume 14). ISBN 3-921456-20-7 .
60. ^ Gundolf Keil: 'Hague Aderlaßbüchlein'. In: Werner E. Gerabek u. a. (Ed.): Encyclopedia of medical history. 2005, p. 521.
61. ^ Gundolf Keil: Supplements to the author's lexicon : Aderlassbüchlein. In: Studia neophilologica. Volume 43, No. 2, 1971, pp. 377-383.
62. ↑ Gundolf Keil, Gerrit Bauer: 'Hague Aderlaßbüchlein'. In: Burghart Wachinger u. a. (Ed.): The German literature of the Middle Ages. Author Lexicon . 2nd, completely revised edition. ISBN 3-11-022248-5 , Volume 3: Gert van der Schüren - Hildegard von Bingen. Berlin / New York 1981, Col. 357 f.
63. ^ Wolfgang Wegner: Bavarian Aderlaßbüchlein. In: Werner E. Gerabek, Bernhard D. Haage, Gundolf Keil, Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 133. cpg 558 , medical composite manuscript, Northern Bavaria, around 1470 - around 1485, sheets 27v – 30r (digitized version ) .
64. ↑ Gundolf Keil: 'Genter Aderlaßbüchlein'. In: Encyclopedia of Medical History. 2005, p. 476.
65. ^ Friedrich Lenhardt, Gundolf Keil: Genter Aderlaßbüchlein. In: Burghart Wachinger u. a. (Ed.): The German literature of the Middle Ages. Author Lexicon . 2nd, completely revised edition. ISBN 3-11-022248-5 , Volume 2: Comitis, Gerhard - Gerstenberg, Wigand. Berlin / New York 1980, Col. 1192 f.
66. ↑ Wolfgang Wegner: 'Asanger Aderlaßbüchlein'. In: Werner E. Gerabek u. a. (Ed.): Encyclopedia of medical history. 2005, p. 109.
67. ↑ Gerhard Eis , Wolfram Schmitt: The Asanger Aderlaß- and recipe booklet (1516-1531). Stuttgart 1967 (= publications of the International Society for the History of Pharmacy. New Series, Volume 31). With edition of the text.
68. ^ Friedrich Lenhardt: Upper German Aderlaßbüchel. In: Author's Lexicon . 2nd Edition. Volume 6, Col. 1274-1276.
69. ^ Gundolf Keil: 'Bavarian Aderlaßbüchlein'. In: Author's Lexicon . 2nd Edition. Volume 1, Col. 581 f.
70. ^ Gundolf Keil: 'Asanger Aderlaßbüchlein'. In: Author's Lexicon . 2nd Edition. Volume 1, Col. 507.
71. ↑ Cf. Heinz-Jürgen Bergmann, Gundolf Keil: Das Münchner Pestlaßmännchen. Standardization tendencies in late medieval German plague literature. In: Gundolf Keil, Peter Assion, Willem Frans Daems, Heinz-Ulrich Röhl (eds.): Specialized prose studies. Contributions to medieval science and intellectual history. (Festschrift Gerhard Eis) E. Schmidt, Berlin 1982, ISBN 3-503-01269-9 , pp. 318-330.
72. ↑ Gundolf Keil: 'Pestlaßmännlein'. In: Author's Lexicon . 2nd Edition. Volume 7 (1988), Col. 416-418.
73. ↑ Avicenna: Canon of Medicine . Book I, Fen IV, Chapter 20 (Andrea Alpago edition 1556) (digitized version) .
74. ^ Karl Sudhoff : Contributions to the history of surgery in the Middle Ages, graphic and textual examinations in medieval manuscripts. J. A. Barth, Leipzig 1914-1918. Volume 1 (1914) (digitized version) . In it pp. 144–197: Memo images and memorized image texts for the choice of bloodletting sites in diseases of the individual body organs (digital copy ) .
75. ↑ Gundolf Keil: 'Twenty-four Paragraph Text'. In: Author's Lexicon . 2nd Edition. Vol. 10 (1999), Col. 334-339.
76. ↑ Manuscript Census . Twenty-four paragraph text (digitized) .
77. ↑ Manuscript Census . Engelin, Jakob: "Blood-letting tract" (digitized version ) .
78. ↑ Gundolf Keil: Engelin, Jakob (Jacobus de Ulma). In: Encyclopedia of Medical History. 2005, p. 355.
79. ↑ Friedrich Lenhardt: “When ain man willingly let go”. Instructions for the therapy of complications in bloodletting. In: “gelêrter der arzeniê, ouch apotêker”. Contributions to the history of science. Festschrift for the 70th birthday of Willem F. Daems. Edited by Gundolf Keil, Horst Wellm Verlag, Pattensen / Hannover 1982 (= Würzburg medical-historical research, 24), ISBN 3-921456-35-5 , pp. 269-300, here: pp. 280-281.
80. ^ Giovanni Manardi: Galeni ars medicinalis. Rome 1525. (digitized version) .
81. ^ Emilio Campolongo: De arthritide liber unus ... Meietus, Venice 1586, p. 49: Qua vena in arthriticis secanda. (Digitized version) .
82. ↑ Lorenzo Bellini: … de missione sanguinis… Antonius Pisarius, Bologna 1683, pp. 76–214 (digitized version ) … de morbi pulmonis et pectoris. Antonius Pisarius, Bologna 1683, pp. 562–603 (digitized version ) .
83. ↑ Pierre Brissot: Apologetica disceptatio, qua docetur per quae loca sanguis mitti debeat in viscerum inflammationibus. Simon Colina, Paris 1525 (digitized) .
84. ^ Andreas Vesalius: Epistola, docens venam axillarem dextri cubiti in dolore laterali secandam. Löwen 1538 (digitized version) .
85. ↑ Leonhart Fuchs: Errata recentiorum medicorum, LX. Numero adiectis eorundem confutationibus. Hagenau March 1530. Error 37 (wrong: 38), pp. 46–51: In interiorum membrorum inflammationibus incidenda est vena quae directo est. (Digitized version) . - Leonhart Fuchs: Apologia Leonhardi Fuchsii contra Hieremiam Thriverum Brachelium, Medicum Lovaniensem, qua monstratur quod in viscerum inflammationibus, pleuritide praesertim, sanguis e directo lateris affecti mitti debeat. Peter Braubach, Hagenau August 1534 (digitized version) .
86. ↑ Lorenz Fries: Mirror of Medicine . Grüninger, Strasbourg 1518, sheet 71v – 76v (digitized version ) . - Lorenz Fries: Defensio medicorum princeps Avicennae, ad Germaniae Medicos. Johann Knoblauch, Strasbourg August 24, 1530 (digitized version) . Partial translation by: Felix Klein-Franke: Classical antiquity in the tradition of Islam . Darmstadt 1980 ( Results of Research , Vol. 136.), pp. 24-28. - Theodor Meyer-Steineg , Karl Sudhoff : History of medicine at a glance with illustrations. 4th edition. Fischer, Jena 1950, pp. 268-269.
87. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 149-150 (digitized version ) . - Santorio Santorio: Methodi vitandorum errorum omnium, qui in arte medica contingunt libre quindecim. Franciscus Barilettus, Venice 1603. In it: Liber XIV (pp. 204r – 215r) De Revulsione & derivatione. (Digitized version) .
88. ^ First part of the books and writings of the noble / highly learned and reinforced Philosophi and Medici, Philippi Theophrasti Bombast von Hohenheim ... ( Huser edition ) Conrad Waldkirch, Basel 1589, p. 86: (digitized) .
89. ↑ Third part of the books and writings of the noble / highly learned and reinforced Philosophi and Medici, Philippi Theophrasti Bombast von Hohenheim ... (Huser edition) Conrad Waldkirch, Basel 1589, p. 402 (digitized version) .
90. ^ Appendix of the fifth part of the Operum Theophrasti. ... (Huser edition) Conrad Waldkirch, Basel 1589, pp. 45–98: Aderlassens Underricht: Also vom Schrepffen: Through the highly educated Mr. Th. Von HH. beyder Artzney Doctorn (digitized version ) .
91. ↑ Leonardo Botallo: De curatione per sanguinis missionem. De incidendae venae cutis scarificandae, & hirudinum amplicandarum modo. Joan. Huguetan, Lyon 1577 (digitized version) .
92. ^ Johannis Baptistae von Helmont… Schrifften. J. A. Endters Sons, Sultzbach 1683. - p. 6.8: Blood letting again ... (digitized version ) , pp. 311–318: Treatise on fever. ... the fourth chapter. The bloodletting in fevers is examined (digitized) .
93. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 153-155 (digitized version ) . - William Harvey: Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus or De Motu Cordis for short ("Anatomical studies on the movement of the heart and blood"), Frankfurt 1628 (digitized version) .
94. ↑ John Bohn and Marcello Malpipghi: D. Johannis Bohnii, Prof. Lips. Circulus Anatomico-Physiologicus, Seu Oeconomia Corporis Animalis: Hoc est, Cogitata, Functionum Animalium potissimarum Formalitatem & Causas concernentia. Dicatus Dn. Marcello Malpighio… Gleditsch, Leipzig 1668. Therein: pp. 97–114 De sanguinis circulatione (digitized version ) .
95. ^ Karl Eduard Rothschuh : Jean Riolan jun. (1580–1657) in dispute with Paul Marquart Schlegel (1605–1653) about Harvey's blood movement. A Contribution to the History of the Psychology of Scientific Error. In: Gesnerus. Swiss Journal of the History of Medicine and Sciences. Volume 21 (1964), pp. 72-82, here: p. 80 (digitized version) .
96. ^ Jean Riolan the Younger: Opuscula Anatomica Nova, quae nunc primum in lucem prodeunt. Instauratio magna physicae et medicinae per novam doctrinam de motu circulario sanguinis in corde. Accessere notae in J. Wallaei duas epistulas de circulatione sangunis. London 1649, p. 60 (digitized version) .
97. ^ Abraham Nicolas Amelot de la Houssaye (1634-1706): Mémoires historiques, politiques, critiques et littéraires. Zacharias Chatelain, Amsterdam 1737, Volume II, pp. 193-194 (digitized version ) .
98. ↑ Pierre Sue: Notice et extrait raisonné d'un livre de médecine devenu si rare qu'on n'en connaît que deux ou trois exemplaires, avec des notes historiques, littéraires et critiques, par P. Sue… Migneret, Paris 1807, p 8 (digitized version) .
99. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 164-167 (digitized version ) . - Theodor Meyer-Steineg : The reform of practical medicine by Thomas Sydenham. In: Theodor Meyer-Steineg, Karl Sudhoff : History of medicine at a glance with illustrations. 4th edition. Jena 1950, pp. 325-328. - Erwin H. Ackerknecht : History of Medicine. 3. Edition. Enke, Stuttgart 1977, pp. 108-109.
100. ^ Thomas Sydenham: Medical writings in the translation of J. Krafft. Ulm 1839, Volume 1, p. 296 (digitized version) , Volume II, p. 161 (digitized version ) and Volume II, p. 326-332: List of some aids used in practice. Digitized .
101. ^ Johann Christian Gottlieb Ackermann (translator): Bernard Ramazzini`s treatise on the diseases of artists and craftsmen. Franzen & Grosse, Stendal 1780, p. 308 (digitized version) .
102. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 155-156 (digitized version ) . - Lorenzo Bellini: De sanguinis missione. In: De urinis et pulsibus, de missione sanguinis, de febribus, de morbis capitis, et pectoris. Antonius Pisarius, Bologna 1683, pp. 76-214 (digitized version ) .
103. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 156-157 (digitized version ) . - Jean-Baptiste Silva: Traité de l'usage des differentes sortes de saignées, principalement de celle du pied. Anisson, Paris 1727, Volume I (digitized version) ; Volume II (digitized version)
104. ^ Jean Claude Adrien Helvétius: Idée générale de l'économie animale, et observations sur la petite-vérole . Paris 1722, p. 250 (digitized version) .
105. ↑ Julien Offray de La Mettrie: Traité de la Petite Vérole avec la manière de guérir cette maladie, suivant les principes de Mr. Herman Boerhaave , & ceux de plus habiles Médecins de notre tems . Huard, Briasson and Durand, Paris 1740 (digitized version ) therein, pp. 62–68: De la Saignée (digitized version ) .
106. ↑ Albrecht von Haller. Deux mémoires sur le mouvement du sang… Lausanne 1756. Cover picture
107. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, p. 156 (digitized version) . - Dionys Krägel and Georg Hamberger: De Venaesectione quatenus motum sanguinis mutat. 2nd edition Jena 1737 (1st edition 1723) (digitized version) .
108. ↑ François Quesnay: Observations sur les effets de la saignée, tant dans les maladies du ressort de la médecine que de la chirurgie, fondées sur les lois de l'hydrostatique: avec des remarques critiques, sur le traité de l'usage des différentes sortes de saignées, de Monsieur Silva. Osmont, Paris 1730 (digitized version ) .
109. ↑ Under a pseudonym : Lettres de Julien Morisson sur le choix des saignées. Paris 1730.
110. ^ Anton de Heyde: Anatome Mytuli, Belgicè Mossel, Structuram elegantem ejus motumque mirandum exponens. Nec non Centuria observationum medicarum. Jansson-Waesberg, Amsterdam 1683. Therein: pp. 172-174: Observatio LXXXV. Experimenta sanguinis circulationem spectantia. (Digitized version) .
111. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 179-180 (digitized version ) . - Albrecht von Haller: Venae sectionis in mutando motu sanguinis effectus. In: Commentarii Societatis Regiae Scientiarium Gottingensis Tomus IIII. Ad annum 1754 , pp. 396-483: Alberti von Haller. De sanguinis motu experimenta anatomica. D. 8. Octobris 1754 , pp. 446-459 (digitized) .
112. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 170-172 (digitized version ) . - Friedrich Hoffmann: Consideration of the wonderful benefit / one can promise oneself from bloodletting / for maintaining a healthy and long life / . In: Thorough instruction on how a person can maintain their health / and protect themselves from all kinds of illnesses / through an orderly lifestyle / . Part 2 Halle 1716, pp. 407–464 (digitized version ) .
113. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 172-175 (digitized version ) . - Theodor Meyer-Steineg : System formation in medicine of the 18th century. In: Theodor Meyer-Steineg and Karl Sudhoff . History of medicine at a glance with illustrations. 4th edition Jena 1950, pp. 340-350. - Georg Ernst Stahl: Herr George Ernst Stahls ... Thorough discussion of bloodletting: as well as its use and abuse as well as its special application on the foot and other certain parts of the body; Along with a detailed report on what to think of bleeding in heated fevers. Eyssel, Leipzig 1719 (digitized version ) .
114. ^ Franz Xaver Mezler: Attempt at a history of bloodletting. Wohler, Ulm 1793, pp. 197-209 (digitized version ) . - Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 180-183 (digitized version ) .
115. ↑ Barthez: Nouveaux éléments de la science de l'homme . Baillière, (1st edition 1773) Paris, 1838, Volume II, pp. 342–343 (digitized) .
116. ^ Johann Christian Reil: About the knowledge and cur of the fever . Curtsche Buchhandlung, Halle 1799, Volume I, Allgemeine Fieberlehre, Chapter 14, § 189 - § 201 (pp. 354–369) On bleeding. (Digitized version) .
117. ^ Philippe Pinel: Traité médico-philosophique sur l'aliénation mental ou la manie. Paris An IX (1801), p. 262: Dans quelles bornes doit être circonscrit l'usage de la saignée. (Digitized version) . - Michael Wagner (translator): Philosophical-medical treatise on mental aberrations or mania. Schaumburg, Vienna 1801, p. 279: Within what limits must the use of bloodletting be restricted? (Digitized version) .
118. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 177-179 (digitized version ) .
119. ↑ Phlebotomes. In: Institutiones medicae in usus annuae exercitationis domesticos digestae from Hermanno Borhaave. 2nd edition (1st edition 1708) Johann van der Linden, Leiden 1713, p. 454 (digitized version) .
120. ↑ Des Freyherrn Gerhards van Swieten… Explanations of the Boerhaavian theorems… Volume I, pp. 314–315 (digitized version ) .
121. ↑ Des Freyherrn Gerhards van Swieten… Explanations of the Boerhaavian theorems… Volume II, pp. 254–255 (digitized version ) .
122. ↑ Van Swieten: Explanations of the Boerhaave theorems. (Digitized version) . - Quote from Celsus: "If there is severe paralysis in all the limbs of the body, bloodletting will either make the patient healthy or kill them." Eduard Scheller (transl.): Aulus Cornelius Celsus. About Medicinal Science in Eight Books. After the text edition by Charles Victor Daremberg . 2nd edition Vieweg, Braunschweig 1906, p. 83 (digitized version) .
123. ^ William Cullen: Beginnings of Practical Medicine Science. C. Fritsch, Leipzig 1778, Volume I, No 69: Classification into inflammatory and nerve fever (digital copy) ; Volume I, No. 348–353: breast inflammation (digital copy ) ; Volume III, No. 1069: From the stroke flow (digitized version) ; Volume III, No. 1264-165: Falling Addiction (digitized version ) ; Volume III, No. 1326: Periodic narrowness (digitized version ) ; Volume III, p. 332: Recovering drowned persons (digital copy) ; Volume IV, No. 1504: Raserey (digitized version ) .
124. ↑ John Brown's System of Medicine. Translated from the latter, which has been greatly enlarged by the author and enriched with notes, and accompanied by a critical treatise on Brownian principles by C. H. Pfaff… Prost and Storch, Copenhagen 1796 (digitized version) . In it: pp. 269–270: healing method of the sthenic form of disease. (Digitized version) .
125. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 207-211: The doctrine of the contrast stimulus: (digitized version) . - Giovanni Rasori: Storia della febbre epidemica di Genova negli anni 1799 e 1800. Pirotta e Maspero, Milan 1801 (anno IX) (German Vienna 1803; French Paris 1822) (digitized version) .
126. ^ Carl Ferdinand von Graefe , Christoph Wilhelm von Hufeland and Dietrich Wilhelm Heinrich Busch : Encyclopedic Dictionary of Medicinal Sciences. Volume I, Boike, Berlin 1828, p. 376-403: Aderlass (digitized version ) , p. 386: Wolstein (digitized version ) . - Johann Gottlieb Wolstein: Notes on the blood-letting of humans and animals . Trummer, Vienna 1791 (digitized version) .
127. ↑ Christoph Wilhelm Hufeland: System der practical Heilkunde, a manual for academic lectures and for practical use. Jena 1800, Volume I, p. 480 ff. (Digitized version) . - Carl Ferdinand von Graefe , Christoph Wilhelm von Hufeland and Dietrich Wilhelm Heinrich Busch : Encyclopaedic dictionary of the medical sciences. Volume I, Boike, Berlin 1828, p. 389 (digitized version) . - Georg August Richter and August Gottlieb Richter : The special therapy . Doll, Vienna, Volume I, 1817, pp. 100-107: Simple inflammatory fever, From the blood evacuations (digitized version ) .
128. ↑ Monita on the three possible types of cure. Printed in: Small Medical Writings by Samuel Hahnemann. Collected by D. Ernst Stapf. Arnold, Dresden 1829 Volume I, pp. 91–125, therein pp. 108–109: about Aderlass (digital copy ) . Originally in Hufelands Journal , Volume 11, 4th issue 1809.
129. ↑ Samuel Hahnemann: Organon der Heilkunst von Samuel Hahnemann. Introduction to the fifth improved and enlarged edition. Arnoldische Buchhandlung, Dresden / Leipzig 1833, pp. 11-14 (digitized version) . - Karl Kammerer: Homeopathics heals without bleeding. Baumgärtner, Leipzig 1834 (digitized version) .
130. ↑ JG Rademacher: empirical healing theory. 3rd edition, Reimer, Berlin 1848, Volume II, pp. 525-532 (Aderlass) (digitized version ) ; P. 781 (Register - Bloodletting) (digitized version) .
131. ↑ Experiment on the diseases and organic injuries of the heart ... Berlin 1814, p. 171 (digitized version) . - Jean Nicolas Corvisart: Essai sur les maladies et les lésions organiques du coeur et des gros vaisseaux. Extrait des leçons cliniques . Migneret, Paris 1806, pp. 154-156 (digitized version ) .
132. ↑ Experiment on the diseases and organic injuries of the heart ... Berlin 1814, p. 386 (digitized version) .
133. ↑ Experiment on the diseases and organic injuries of the heart ... Berlin 1814, p. 392 (digitized version) . - Jean Nicolas Corvisart: Essai sur les maladies et les lésions organiques du coeur et des gros vaisseaux. Extrait des leçons cliniques. Migneret, Paris 1806, pp. 157–158 (digitized version ) .
134. ^ Antoine Pierre Demours : Notice sur l'acupuncture et sur une nouvelle espèce de ventouse armée de lancettes… In: Journal universel des sciences médicales. Volume XV, Paris 1819, pp. 107-113 (digitized version ) . - Jean-Baptiste Sarlandière : Bdellomètre. In the article: Ventouse (cupping glass). In: Dictionnaire des sciences médicales. Panckoucke, Paris 1821, Volume 57, pp. 174–189 (here: pp. 180–185), text (digitized version ) , illustration (digitized version ) . - Charles Louis Stanislaus Heurteloup (1793–1864): Artificial leech . (Digitized version) .
135. ↑ Friedrich Ludwig Meissner (translator): RTH Laennec's, Prof. der Med. Etc. Treatise on the diseases of the lungs and the heart and the indirect auscultation as a means to their knowledge. August Lehnhold, Leipzig 1832, Volume I, p. 117 (digitized version ) .
136. ^ Volume I, p. 140 (digitized version) .
137. ^ Volume I, p. 160 (digitized version) .
138. ↑ Volume I, p. 197 (digitized version) .
139. ↑ Volume I, p. 202 (digitized version) .
140. ↑ Volume I, p. 244 (digitized version) .
141. ↑ Volume I, p. 306 (digitized version) .
142. ↑ Volume I, pp. 380-385 (digitized version ) .
143. ↑ Volume II, p. 73 (digitized version) .
144. ↑ Volume II, p. 372 (digitized version) .
145. ↑ Volume II, p. 573 (digitized version) .
146. ↑ Volume II, p. 588 (digitized version) .
147. ↑ Volume II, p. 590 (digitized version) .
148. ↑ Essai sur la philosophie médicale et sur les généralités de la clinique médicale… Paris 1856, p. 352ff (digitized version ) .
149. ↑ Erwin Heinz Ackerknecht : The therapy of the Paris clinicians between 1795 and 1840. In: Gesnerus. Swiss Journal of the History of Medicine and Sciences. Volume 15 (1958), pp. 151-163, here p. 159 (digitized version ) . - Pierre Charles Alexandre Louis: Recherches sur les effets de la saignée dans plusieurs maladies inflammatoires . In: Archives générales de médecine . November 1828, pp. 321-336 (digitized) . - Pierre Charles Alexandre Louis: Recherches sur les effets de la saignée dans quelques maladies inflammatoires, et sur l'action de l'hémétique et des vésicatoires dans la pneumonie. Baillière, Paris 1835 (digitized version) .
150. ^ Josef Bauer: History of bloodletting. EH Gummi, Munich 1870, pp. 218-219 (digitized version ) . - Marshall Hall: Observations on blood-letting founded upon researches on the morbid and curative effects of loss of blood. Sherwood Gilbert and Piper, London 1836 (digitized) .
151. ↑ Joseph Dietl: The bloodletting in pneumonia. Kaulfuss, Vienna 1849 (digitized version) . - August Dreyer (Moscow): Bloodletting in pneumonia, with special reference to the text 'Bloodletting in pneumonia, by Dr. Joseph Dietl, Vienna 1849 ' . In: Medicinische Zeitung Russlands, 11th vol. (1854). Pp. 249–254 (digitized version ) , pp. 257–262 (digitized version ) and p. 265–271 (digitized version ) .
152. ↑ Lu Gwei-Djen, Joseph Needham . Celestial lancets. A history and rationale of acupuncture and moxa . Cambridge University Press, London 1980, pp. 5, 8, 129.
153. ↑ Gerhart Feucht: Comparison of some bloodletting points and acupuncture points . In: German journal for acupuncture. 10 (1961) H. 1, pp. 10-18.
154. ^ Bleeding Peripheral Points: An Acupuncture Technique .
155. ^ Journal universel des sciences médicales. Volume XV, Paris 1819, pp. 107-113. (Digitized hathitrust) .
156. ^ Louis Berlioz: Mémoire sur les maladies chroniques, les évacuations sanguines et l'acupuncture. Croullebois, Paris 1816.
157. ↑ Michael Eyl: Sino-Japanese acupuncture in France (1810-1826) and its theoretical basis (1683-1825) . Dissertation. Zurich 1978.
158. ↑ W. Michel Zaitsu: interactions - to Traité de l'inédit acupuncture et du Moxa chez les Japonais in JB Sarlandières Mémoires sur l'Électro-Puncture (1825). In: German journal for acupuncture . Vol. 58 (4), 2015; Vol. 59 (3), 2016; Vol. 59 (4), 2016.
159. ↑ Japanese website Nihon Shiraku Gakkai .
160. ↑ An English translation of the Sushruta Samhita… Volume II. Calcutta 1911, pp. 198–208, Textarchiv - Internet Archive .
161. ^ Heinrich Wallnöfer: The doctor in Indian culture. J. Fink, Stuttgart 1966; Special edition Esslingen a. N., p. 50.
162. ^ Hartmann Schedel: World Chronicle. 1493, sheet 105r (digitized version) .
163. ↑ X. Book, Chapter 8. Translation Fritz Weiss. Leipzig 1875, Textarchiv - Internet Archive .
164. ↑ Gerhard Eis: The bloodletting in Gottfried's Tristan. In: Medical monthly. 2, 1948, p. 162 ff.
165. ↑ Polycythemia Vera (PV). Guideline . (PDF) German Society for Hematology and Medical Oncology , p. 10.
166. ↑ Hemochromatosis therapy . ( Memento from May 18, 2015 in the Internet Archive ) Ulm University Hospital.
167. ↑ Bloodletting . Essen-Mitte clinics.
168. ↑ D. Koehler, D. Dellweg: Polyglobulie . In: German Medical Weekly . 135 (46), 2010, pp. 2300-2303. doi: 10.1055 / s-0030-1267515 .
169. ↑ How can PCT be treated? ( Memento of May 18, 2015 in the Internet Archive ) European Porphyria Initiative (EPI).
170. ↑ Michalsen u. a .: Effects of phlebotomy-induced reduction of body iron stores on metabolic syndrome: results from a randomized clinical trial. In: BMC Medicine. 10.1186 / 1741-7015-10-54.
171. ↑ Manco, Fernandez-Real: Back to past leeches: repeated phlebotomies and cardiovascular risk . In: BMC Medicine. doi: 10.1186 / 1741-7015-10-53 .
172. ↑ Sundrela Kamhieh-Spleen a. a .: Regular blood donation may help in the management of hypertension: an observational study on 292 blood donors. In: Transfusion , Volume 56, Issue 3, March 2016, pp. 637–644.
173. ↑ Carola Halhuber, Karl-Adolf Bungeroth, Bernd Landauer: Cardiological emergencies. Urban & Schwarzenberg, Munich / Vienna / Baltimore 1984, ISBN 3-541-00979-9 , p. 179.
174. ↑ Natural healing: Really happy and relaxed after bloodletting. Welt Online , July 14, 2012.
175. ↑ Gerry Greenstone. The history of bloodletting . In: British Columbia Medical Journal , Vol. 52 (2010), No. 1 (January / February), pp. 12-14 (digitized version) .
176. ^ Cochrane Hypertension Group. Cochrane Database Systematic Reviews. May 29, 2014. Blood pressure-lowering efficacy of monotherapy with thiazide diuretics for primary hypertension. (Digitized version) .