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Bloodletting Tools

Set of bloodletting lancetsA Civil War surgeon used these bloodletting tools to try to relieve his patients' symptoms.

Bloodletting, or phlebotomy, is an ancient practice. Although we find the concept barbaric today, phlebotomy once was widely believed to save lives and restore good health.  As late as the early 20th century, physicians used a variety of tools to release blood from the bodies of sufferers.

The examples featured on this page were used by James Haller of the 38th Ohio Infantry during the Civil War. Haller was a doctor in Middletown, Ohio, before enlisting in 1861. His regiment participated in a number of battles, including Chickamauga, Mission Ridge, and Kennesaw Mountain. Haller was promoted to Assistant Surgeon of the regiment in 1863, a post which he held through the end of the war in 1865.

For centuries before the settlement of Kansas, almost anyone could practice medicine with little or no training. Even educated doctors had little information to help them diagnose and treat diseases. There were few good teaching institutions or laboratories, scarce books and supplies, and little information on how disease spread.

Scarificator with blades protruding from baseOut of Humor

Medical treatment essentially was based on the concept of four "humors" in the body; blood, phlem, yellow bile, and black bile. It was believed that physical and mental distress resulted when these humors were out of balance. Phlebotomy was used to re-establish the balance through the release of 16 to 30 ounces of blood. The body then was rebuilt through tonics and restoratives.

Bloodletting was accomplished by means of a variety of tools.  Haller's kit includes all of the following examples.

Lancets are surgical knives used to incise veins for the greatest yield of liquid. Cuts generally measured about 1/5 of an inch in length. Spring-loaded lancets were easiest to use because they made consistent cuts, an improvement over hand-controlled lancets  whose cuts varied depending on the skill of the physician.

Scarificators also offer a standardized depth and length of cut. The lever on top of the brass box releases a set of blades that snap out of the slits on the base. Most models have 12 blades, although some have up to 20.

Cupping cups are another method of bleeding a patient. The glass cup was heated and placed on the skin. Its cooling created a vacuum, causing the skin to become red and swollen and signalling to the physician that the blood had risen to the surface. Then a lancet was used to release the "bad" blood from the body. Cups also were used after lancing to promote bleeding.

Cupping cupHow Much Blood Was Enough?

Generally, blood was collected until the patient began to feel faint. It was caught in a bowl, and when the right amount was observed, pressure was applied over the incision to stop the bleeding. Phlebotomy seemed to relieve fevers because patients who initially were flushed and restless became pale and quiet after loss of blood. Physicians today understand these effects are not beneficial, and that the body is stressed when it has to replenish a depleted blood supply as well as fight illness.

Phlebotomy was in general decline by the time Kansas achieved statehood in 1861, and had fallen out of favor by the early years of the 20th century, although some physicians continued the practice for many decades.

These bloodletting tools are in the collections of the Kansas Museum of History.

Entry: Bloodletting Tools

Author: Kansas Historical Society

Author information: The Kansas Historical Society is a state agency charged with actively safeguarding and sharing the state's history.

Date Created: November 1998

Date Modified: January 2021

The author of this article is solely responsible for its content.