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Bloodletting (or blood-letting) is the withdrawal of often considerable quantities of blood from a patient to cure or prevent illness and disease. Bloodletting was based on an ancient system of medicine in which blood and other bodily fluid were considered to be "humors" whose proper balance maintained health. It was the most common medical practice performed by doctors from antiquity up to the late 19th century, a time span of almost 2,000 years.[1] The practice has been abandoned for all except a few very specific conditions.[2] It is conceivable that historically, in the absence of other treatments for hypertension, bloodletting could sometimes have had a beneficial effect in temporarily reducing blood pressure by a reduction in blood volume.[3] However, since hypertension is very often asymptomatic and thus undiagnosable without modern methods, this effect was unintentional. In the overwhelming majority of cases, the historical use of bloodletting was harmful to patients.[4]

Today, the term phlebotomy refers to the drawing of blood for laboratory analysis or blood transfusion (see Phlebotomy (modern)).[5] Therapeutic phlebotomy refers to the drawing of a unit of blood in specific cases like hemochromatosis, polycythemia vera, porphyria cutanea tarda, etc., to reduce the amount of red blood cells.[6][7]


In the ancient world

Bloodletting is one of the oldest medical practices, having been practiced among ancient peoples including the Mesopotamians, the Egyptians, the Greeks, the Mayans, and the Aztecs.[3] In Greece, bloodletting was in use around the time of Hippocrates, who mentions bloodletting but in general relied on dietary techniques.[8] Erasistratus, however, theorized that many diseases were caused by plethoras, or overabundances, in the blood and advised that these plethoras be treated, initially, by exercise, sweating, reduced food intake, and vomiting.[9] Herophilus advocated bloodletting. Archagathus, one of the first Greek physicians to practice in Rome, also believed in the value of bloodletting.[10]

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