The Cutter’s Art: A Brief History of Bloodletting


V0011195 An ill man who is being bled by his doctor. Coloured etching

When King Charles II suffered a sudden seizure on the morning of 2 February 1685, his personal physician had just the remedy. He quickly slashed open a vein in the king’s left arm and filled a basin with the royal blood. Over the next few days, the king was tortured by a swarm of physicians buzzing around his bedside. They gave enemas and urged him to drink various potions, including boiled spirits from a human skull. The monarch was bled a second time before he lapsed into a coma. He never awoke.

Even without his doctors’ ministrations, the king may well have succumbed to whatever ailed him, yet his final days were certainly not made any easier by the relentless bloodletting and purging. By the time of Charles II’s death, however, bloodletting was standard medical practice.

Bloodletting dates back to the Roman physician, Galen, who lived in the 2nd century AD. Galen taught that blood was the product of food. After reaching the stomach, food was liquefied and then sent to the liver, where it was turned into blood. Occasionally, the body produced an excess of blood, which according to Galenic practitioners, caused fevers, headaches, and even seizures. The only recourse was to rid the body of this superfluous fluid.

BarberAs vital as bloodletting was felt to be, many physicians believed the “cutter’s art” was beneath their station. Instead, they referred those in need of bleeding to barber-surgeons, who carried out this duty in addition to a diverse range of other personal services.

The traditional striped barber’s pole harks back to that era, when it served as an advertisement for their proficiency as bloodletters. The pole represents the rod that the patient gripped to make their veins bulge, and the brass ball at the top symbolizes the basin used to collect the blood. The red and white stripes represent the bloodied bandages. Once washed and hung to dry on the rod outside the shop, they would twist in the wind, forming the familiar spiral pattern adorning modern poles.

While bloodletting seems barbaric to modern eyes, it was considered a standard part of medical treatment, demanded by many people when they felt ill in the same way we might ask for antibiotics when visiting the doctor’s office today. Take George Washington (below), who woke on the morning of 14 December 1799 complaining that he couldn’t breathe. Fearing his doctor would not arrive in time, Washington asked for the overseer of his slaves to step in and bleed him. The cut was deep, and Washington lost nearly half a pint before the wound was closed. Eventually, the physicians arrived and proceeded to bleed Washington four more times in the next eight hours. By evening, America’s first president was dead. One of his physicians, James Craik, later admitted that he thought the blood loss was partly responsible.


Bloodletting reached its apogee in the early 19th century. By then, people were not just bled when they were ill. It was also used for preventative purposes, typically in the spring, seen as a time of rebirth and rejuvenation. During this period, leeching was the preferred method. This type of worm can suck several times its own body weight in blood and is a lot safer than cutting open a vein. Leeching became so popular that it led to a “leech craze.” Throughout England, leech collectors (mostly women) would wade into leech-infested ponds with bare legs in order to attract the slimy bloodsuckers. Once the leeches had had their fill, they would fall off leaving the collector to then sell them to medical practitioners for profit.

L0057148 Pewter box for transporting leeches, Europe, 1801-1900

Unsurprisingly, leech collectors commonly suffered from headaches as a result blood-loss, and sometimes contracted diseases from contact with the leeches

But why did bloodletting remain so popular for so long? Despite advances in anatomy and diagnostics during the 18th and 19th centuries, therapeutics did not evolve quickly enough to match new understandings of the body. Many practitioners believed it was better to do something than to do nothing.

In the cases of Charles II and George Washington, they were most definitely wrong.

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By | 2016-07-28T11:58:28+00:00 July 28th, 2016|Casebooks|10 Comments


  1. coldhandboyack July 28, 2016 at 5:57 pm - Reply

    Great job for a fictional character; leech collector.

  2. […] A brief history of bloodletting. […]

  3. Brian Ford August 1, 2016 at 7:57 pm - Reply

    Glad you included George Washington on this issue. This is just one of the scenarios where science has claimed to always be on the cusp of the advancement of truth, only to discover they were just as wrong then as they probably are now in some areas. Scientists want to be the only source of all truth for mankind and they come out smelling foul too many times.

    • The Chirurgeon's Apprentice August 1, 2016 at 8:06 pm - Reply

      I think you’re right. Many scientists think they have unmitigated access to the “truth” – when really, our understanding of our bodies, medicine, the world around us, etc is always evolving. This is why most medical historians like myself aren’t usually interested in retrospective diagnosis – using medical knowledge from today to diagnose people from the past. We’re far more interested in how people in their own time understood illness and treated it. For instance, we might diagnose Abraham Lincoln with Marfan’s Syndrome today, but undoubtedly, our understanding of what Marfan’s is will change in the next few decades, and therefore render that diagnosis useless. It’s far better to focus on how people in their own time conceptualized health and illness if we’re going to get a more accurate picture of the past as it really was. I always hope that people who read my blog understand that medicine/science is always evolving and what we “know” today will undoubtedly be different from what we “know” tomorrow.

  4. flannelpj August 6, 2016 at 5:21 pm - Reply

    Reblogged this on the Peripatetic Acupunk and commented:
    Here’s a marvelous post on Western bloodletting, where the quantites sought were PINTS, not drops (i.e., acupuncture bloodletting). Plus great trivia on the etymology of barbers’ pole design!

  5. […] (source: The Chirurgeon’s Apprentice) […]

  6. […] (source: The Chirurgeon’s Apprentice) […]

  7. […] (source: The Chirurgeon’s Apprentice) […]

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