Ancient Medical Procedures

BLOODLETTING - AN ANCIENT PRACTICE THAT HAS NOT BLED OUT I came across the term ‘bloodletting’ recently in a National Geographic article. Bloodletting is defined as a practice of withdrawing blood from a person in order to prevent and cure a wide-range of disease and illness, spanning from acne to asthma to fever to smallpox and hypertension.

Reading on - though conscious of the fact that I had mentally diminished the concept as ancient quackery or “pseudoscience”, it seemed inconceivable to me that such a practice persisted as a legitimate medical treatment for the entire span of about 2000 years right into the 19th century. Modern science has taught us that the circulation of blood in our bodies keeps our organs alive. Having too little blood would therefore leave us with a weakened immune system unable to fight illnesses and render us prone to more severe forms of disease.

This disbelief, however, only lasted for no more than a few seconds as I soon was forced to confront the perplexing truth that bloodletting in its ancient form still exists this very day (right alongside smartphones and wireless internet!).


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The birth of bloodletting in ancient Egypt around 1000BCE arose from a belief that disease and illness were earthly manifestations caused by evil spirits entering a body. The Egyptians saw bloodletting as a cleansing mechanism; a way to physically drain and expel the evil from the patient’s body.

By the 5th century BC, bloodletting had spread to the Greeks and Romans. While the act of bloodletting remained the same, physicians during this time explained the practice by drawing empirical links with the natural world.

The ancient Greeks believed that analagous to how an imbalance in the 4 classical elements (air, water, fire and earth) sowed disharmony in nature, disease in the body was caused by an imbalance in the 4 “humors” (or bodily fluids) - blood, phlegm, black bile and yellow bile. After all, the idea of removing blood for relief seemed recurrent in nature. Hippos and other animals would scratch their infected wounds till they bled and cured. Even humans demonstrated bleeding, Hippocrates theorised, understanding menstruation in women to be effective in “purging bad humors”.

Following on from Hippocrates’ teachings, the Greek physician Galen during the Roman Empire propagated that bloodletting was an effective treatment in alleviating ailments based on his belief that blood was created and used up, as opposed to circulated. The popularity of bloodletting which seeped into the Mediterranean world were primarily founded on these Galen-espoused convictions.

It didn’t take much longer for the rest of civilisation to latch onto what seemed like an evidence-backed method of dealing with illness. Islamic writers, having witnessed the effectiveness of bloodletting in action, fervently advocated for the practice, leading to it prevailing throughout Eurasia and Arabia. Ancient Greek humorism was adopted by Islamic cultures and adapted in the form of Unani during the 10th century. Notably, prior to that, the Indian bloodletting technique, Sravana, was used in the Ayurvedic surgery treatise during the 6th and 7th centuries.


Trepanation has consistently remained a tedious and wearisome area of study/interest for the Western Academic World. Discoveries associated with such a procedure does present explicit evidence that continue to befuddle historians, archaeologists, forensic pathologists and others who dedicate their lives to extract truth from physical proof(remnants of ancient past). An article posted on WordPress had alleged that the name of this medical procedure, trepanation, itself means ‘to bore’, in Latin. This wholly covers the entire process as essentially, that would be the outcome. However, this had been challenged(E.G. Princeton University) that the origin of this term supposedly hailing from Greek - from during Hippocrates's time the terms terebra and trepanon (from the Greek trupanon.). Moreover, it had varied and allowed for diversity in the ways to be carried out though the eventual result would be to surgically remove a piece of skull. Skull being the most vulnerable component of our skeletal system - guarding our most vital organ- any sensible person today would assume fatality. However, this is actually untrue.

Trepanation is quickly singled out and distinguished from damaged skulls by the substantially wide holes in a skull, “usually in the parietal or frontal bones”. Based on the means employed and the manner with which was used to remove a designated portion of a skull, the hole can be either “circular or rectangular”.


The part of the bone intended to be removed can be done so through “drilling with a trephine or drill, scraping with an abrasive instrument, cutting with an incisive instrument, or using a combination of tools.” A handful of reasons subsist through records and findings corresponding to archaeological evidence of Trepanation. They include 1) surgery on the cranial bone which is usually  treatment, 2) the antidote for hysteria and other behaviour that stem of mental unevenness 3) Epilepsy. However, in some instances, this medical surgical procedure may have been done as part/segment of a religious procession, maybe ritualistic in nature – 4) Ritual significance. As mentioned earlier, as a result of rudimentary understanding of our skulls’ functions and defenceless area(on our bodies), one would obviously view trepanation as a fatal procedure. Anyhow, a baffling number of survivors throughout history have supplied archaeologists their evidence of being restored to good health. A number of trepanned skulls reveal that the edges of the wound were bowed and new bone has grown, proving that the individual had been ‘healed’ from the incident which required this surgery.


It is curious that despite, lacking detailed and thorough knowledge of anatomy, such a surgical procedure had endured thorough as a reliable means of cure to inconsistencies in mental health and neurological complications. Peru(3000 BCE), France(5000 BCE), China(5000 BCE – Dawenkou culture) were mainly from where the skulls which had seemingly undergone this surgery were extricated. Anatolia, on the other hand, was where the skulls salvaged expose 10,000 years of distribution ranging in age and gender.