A brief history of phlebotomy

5 MINS

By Skills for Health | 9 February 2023

We all experience blood being taken at some point in our lives, but what you might not know is how the person withdrawing your blood does that for a living, and how the career of a phlebotomist has transformed over the years. This article delves into a brief history of phlebotomy to provide you with better insight. Let’s begin with a definition; Phlebotomy is the act of drawing or removing blood from the circulatory system through a cut (incision) or puncture in order to obtain a sample for analysis and diagnosis. Phlebotomy is also done as part of the patient’s treatment for certain blood disorders.

Phlebotomy was known as bloodletting when it was first used and dates back to the ancient Egyptians, around 1000 BC. They believed that the process of releasing blood from the body would cure various diseases, such as the plague and acne. Some even believed that it could cast out evil spirits. In this case, the procedure would be performed by a priest, who was also the official “physician” during that time.

Bloodletting in Greece and beyond

In Greece, a prominent Greek physician known as Galen of Pergamon, discovered that arteries as well as veins had blood. Previously it was thought that arteries were filled with air. It was commonly believed at the time that blood didn’t circulate through the body. Instead, they thought that it stagnated in the extremities. During this time, treatment involved giving the patient an emetic to encourage vomiting. Galen of Pergamon developed quite a complex system for the quantity of blood which should be removed and from what specific areas of the body. Interestingly, he believed that blood should be drained as close to the diseased area of the body as possible, as this was the “diseased blood”.

As time moved on, bloodletting became quite a common practice throughout Europe, and it was believed that the disease left your system along with the blood. The reality was that it simply spread the infection to everyone else. Pre-nineteenth century, blood was simply thought to be something that caused lots of the conditions associated with sickness and ailments. Often, people would have leeches placed onto their skin to “rid” them of the disease they were suffering from.

Not only that, but actual barbers were in the “bloodletting” trade. These so-called barber-surgeons also performed teeth extractions and amputations. Interestingly, the red stripe associated with a barber pole originated from the time when barbers performed bloodletting, as the red stripe was an indication and representation of the bloodletting portion of their job.

At some point during the 16th century, surgery started to become slightly more sophisticated and the job of bloodletting went back to the physicians. By the 1800s the popularity of bloodletting was reaching an all-time high. The physician would perform the procedure by making an incision into the arteries or veins. In some cases, in an attempt to “improve” their technique, they used a device called a fleam, which was a wooden stick that drove a blade into the vein. The use of a 12 spring-driven blade that could make shallow cuts all at once (known as a scarificator) was considered a more humane way to retrieve blood from a human. In some cases they also used cupping as a method. This method blistered the skin so that the blood could then be released via the blisters. At this time too, leeches were used to soak up the blood. Bloodletting was used to “cure” diabetes, acne, cholera, asthma, cancer, conclusions, coma, epilepsy and much more!

In today’s world, we now know that losing too much blood is definitely not helpful and that, especially in historical circumstances such as the Plague, bloodletting actually only contributed to the illness and made it much worse.

Did bloodletting work?

Yes and no. It didn’t “cure” any diseases, but it did offer some relief for those individuals who suffered from high blood pressure. Also, in cases were people had high iron levels, bloodletting could also offer them some relief. Of course, there were also people who truly believed it would help them, so it did. Today, we call that the placebo effect.

Naturally, releasing too much blood from the body can cause irreversible harm or even death, and this was the case for a lot of patients when traditional bloodletting methods were performed.

One interesting case was that of George Washington in the United States. Bloodletting was a popular practice in the USA, especially by Pilgrims. It is said that the death of George Washington was a result of too much bloodletting. It was thought that he had a throat infection, and the physician drained over eight pints of blood to treat the infection. This was too much for his body to handle and he died shortly after. It’s no surprise since the body holds around ten pints of blood. This is one of the most famous bloodletting gone wrong scenarios known today.

What is phlebotomy today?

It’s amazing to think that these practices were still being conducted in the early 1900s. Thankfully, modern bloodletting is a completely different scene today. Phlebotomy in today’s medical sphere has a different use. It isn’t used to simply release blood from the body, but rather to take a sample of blood from a patient for diagnostic purposes which is under the direct order of a physician. Thankfully, today the process of taking a blood sample is safe, quick and pain-free when performed by a certified phlebotomist with the use of sterile tools in a healthcare environment.

Today, a phlebotomist has a variety of roles including:

– Drawing blood from blood donors and patients
– Evaluate a patient’s ability to withstand procedures
– Explain various blood-drawing procedures to patients and answer any questions they may have
– Perform basic care testing, such as blood glucose levels
– Prepare urine, blood, and other specimens for testing
– Maintain medical equipment such as test tubes, needles, and blood vials

Sources:

https://en.wikipedia.org/wiki/Bloodletting
http://www.surgeryencyclopedia.com/Pa-St/Phlebotomy.html
https://hubpages.com/education/Long-History-of-Phlebotomy
https://info.nhanow.com/blog/the-weird-history-of-phlebotomy
https://academic.oup.com/labmed/article-abstract/13/12/776/2642689?redirectedFrom=PDF

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