Introduction. Therapeutic bloodletting has been practiced at least 3000 years
as one of the most frequent methods of treatment in general, whose value was
not questioned until the 19th century, when it was gradually abandoned in
Western medicine, while it is still practiced in Arabic and traditional
Chinese medicine. Content. In modern medicine bloodletting is practiced for
very few indications. Its concept was modeled on the process of menstrual
bleeding, for which it was believed to ?purge women of bad humours.? Thus,
bloodletting was based more on the belief that it helps in the
reestablishment of proper balance of body ?humours? than on the opinion that
it serves to remove excessive amount of blood as well as to remove toxic
?pneumas? that accumulate in human body. It was indicated for almost all
known diseases, even in the presence of severe anemia. Bloodletting was
carried out by scarification with cupping, by phlebotomies (venesections),
rarely by arteriotomies, using specific instruments called lancets, as well
as leeches. In different periods of history bloodletting was practiced by
priests, doctors, barbers, and even by amateurs. In most cases, between one
half of liter and two liters of blood used to be removed. Bloodletting was
harmful to vast majority of patients and in some of them it is believed that
it was either fatal or that it strongly contributed to such outcome. In the
20th century in the ?Western? medicine bloodletting was still practiced in
the treatment of hypertension and in severe cardiac insufficiency and
pulmonary edema, but these indications were later abandoned. Conclusion.
Bloodletting is still indicated for a few indications such as polycythemia,
haemochromatosis, and porphyria cutanea tarda, while leeches are still used
in plastic surgery, replantation and other reconstructive surgery, and very
rarely for other specific indications.
Experimental portal hypertension and portocaval anastomosis
