17th century bloodletting tool

He believed that existence was represented by the four basic elements—earth, air, fire, and water—which in humans were related to the four basic humors: blood, phlegm, black bile, yellow bile. Each humor was centred in a particular organ—brain, lung, spleen, and gall bladder—and related to a particular personality type—sanguine, phlegmatic, melancholic, and choleric.

Being ill meant having an imbalance of the four humors. Therefore treatment consisted of removing an amount of the excessive humor by various means such as bloodletting, purging, catharsis, diuresis, and so on.

By the 1st century bloodletting was already a common treatment, but when Galen of Pergamum — AD declared blood as the most dominant humor, the practice of venesection gained even greater importance.

Galen was able to propagate his ideas through the force of personality and the power of the pen; his total written output exceeds two million words. He had an extraordinary effect on medical practice and his teaching persisted for many centuries. His ideas and writings were disseminated by several physicians in the Middle Ages when bloodletting became accepted as the standard treatment for many conditions. Methods of bloodletting Bloodletting was divided into a generalized method done by venesection and arteriotomy, and a localized method done by scarification with cupping and leeches.

Venesection was the most common procedure and usually involved the median cubital vein at the elbow, but many different veins could be used. The main instruments for this technique were called lancets and fleams. Thumb lancets were small sharp-pointed, two-edged instruments often with an ivory or tortoise shell case that the physician could carry in his pocket.

Fleams were usually devices with multiple, variably sized blades that folded into a case like a pocketknife. Leeches used for bloodletting usually involved the medicinal leech, Hirudo medicinalis. At each feeding a leech can ingest about 5 to 10 ml of blood, almost 10 times its own weight. He was a great proponent of leech therapy along with aggressive bloodletting. He believed in placing leeches over the organ of the body that was deemed to be inflamed.

By the late s, however, enthusiasm for leech therapy had waned, but leeches are still used today in select situations. Famous bleedings When Charles II — suffered a seizure he was immediately treated with 16 ounces of bloodletting from the left arm followed by another 8 ounces from cupping. He had more seizures and received further treatment with herbs and quinine.

In total he had about 24 ounces of blood taken before he died. After riding in snowy weather, George Washington — developed a fever and respiratory distress. Under the care of his three physicians he had copious amounts of blood drawn, blisterings, emetics, and laxatives.

He died the next night of what has been diagnosed retrospectively as epiglottitis and shock. Warring physicians The practice of bloodletting aroused deep emotions in both practitioners and detractors, with intense argument about the benefit and harm of venesection.

He was arrogant and paternalistic but dedicated to eradicating illness wherever he saw it. He worked tirelessly during the yellow fever epidemics in Philadelphia in and and devoted much time to the problem of mental illness. He was known to remove extraordinary amounts of blood and often bled patients several times. He aroused both extremely positive and negative reactions in those around him, including many physicians.

However, Rush Medical College in Chicago was named in his honor and gained its charter in The former was a dignified old-timer and strong believer in bloodletting, while the latter was an arrogant newcomer and resolute debunker of bloodletting. Whereas Dr Alison followed the old tradition of clinical experience and empirical observation, Dr Bennett believed in the new methods of pathology and physiology supported by the microscope and the stethoscope.

Both were implacable in their point of view, thereby underlining the significant gap between their beliefs in empirical observation versus scientific verification. The fleams used for veterinary purposes were placed over the jugular vein of the neck most commonly and inserted with the help of a fleam stick. The Spring Lancet A much more elegant bloodletting method was used for humans. While fleams were sometimes used, it was more common to use a spring loaded device in the 18th and 19th centuries when the spring lancet was developed though its origins go back earlier than this.

The German example shows a spring lancet in its simplest form. The case is brass and the blade is steel. The blade was cocked by the hook at end and released with the button on the side. Note the small size of the blade for human use.

Single blade spring lancets came in many sizes and shapes. Most were brass and steel but some were made of iron or silver. Devices with larger blades were probably for veterinary use. Note the one with the depth adjuster. One wonders if the bleeder was anxious over the politics of the time as he bled his patients, whether human or animal! As long ago as the 17th century there were multi-bladed bleeders called scarificators.

These became very popular in the late 18th and 19th centuries. Like spring lancets, they came in every size and description. Shown are basic octagonal English scarificators. The cases are brass and the mechanism and blades are steel.

Many had a depth adjuster for the blades on the top and the blades would be cocked by the lever on top. The release switch is on the side. This allowed the blades to swing around, making multiple cuts at once. Scarificators with pointed V-shaped blades are probably pre Those with slightly rounded blades are later.

Round scarificators are usually French in design and post often around ! Scarificators that have a mechanism allowing the blades to stay in the half-cocked position are probably post Cupping Once a scarificator was used to slice and dice the patient, a cup was often placed over the wound as a receptacle for the blood. Cups were made of tin, brass, rubber, horn, and most commonly glass.

There were often suction devices attached to the cup to allow the removal of blood. Human lips, rubber bulbs, and brass syringes were all used as sources for suction. This technique entailed creating suction in a cup placed over the skin without cutting the skin. Often a wad of burning material or the end of a heat lamp was placed in the cup to heat it. The cup was placed on the skin and a suction was created as it cooled.

The skin then became engorged, presumably with evil humors that could improve health by coming to the surface. These sets often had multiple cups, suction devices, scarificators, spare blades, etc. By the s, straight knives became more popular because they made it easier to leave a flap of skin that could be used to cover the exposed stump. Amputation Saw s While some surgeons chose to flaunt their wealth with elaborately decorated saws like this, the crevices in the intricate engravings proved to be a breeding ground for germs.

Arrow Remover s Not much is known about this tool, but it is hypothesized that it was inserted into the wound in a contracted position, with the central shaft used to grasp the arrow.

The blades, which appear to have their sharp edges facing outward, were then expanded using the scissor-like handles, thus expanding the flesh around the arrow to prevent the arrowhead from ripping through the meat as it was pulled out. Artificial Leech s Bloodletting with leeches was such a popular treatment for a range of medical conditions that an artificial leech was invented in and was used frequently in eye and ear surgery.

Extractors like this one had a screw tip that could be inserted in the wound and lengthened to pierce the bullet so that it could be pulled out. Such dilators fell out of favor because they often caused the cervix to tear. Circumcision Knife s Ritual circumcision is performed around the world in varying extents and for varying reasons, but few instruments used in the process are as intimidating as this European knife from the 18th century.

Ecraseur s This ecraseur was used to sever hemorrhoids and uterine or ovarian tumors.