Bloodletting

Part 2
The Veins of Bloodletting
By Adam Tate

This is part 2 of an Article on Bloodletting
Bloodletting Part 1: Introduction to Bloodletting

















Bloodletting Diagram clearly
showing Veins like Meridians.
anonymous c. 1292
Bodleian library
Two Types of Bloodletting:
Major Veins and Minor Veins

Bloodletting as practiced in the West consists of 2 main types. Bleeding Major Veins of the Arm, and Bleeding numerous other minor points (veins) around the Body.

In the first instance, one of the three major veins of the crease of the elbow are bled. These were typically opened and allowed to freely bleed until several ounces of blood are removed.

In the second instance, various minor points are bled, and this may consist of only a few drops of Blood. It is these points that are particularly similar to the use of Acupoints.
How Many Veins?

In the Western Tradition, there were 32 primary Veins recognised, 16 on the Head, 16 on the Body. In the Arm, there are 3 Primary Veins: Cephalic (Head, along Large Intestine Meridian), Cardiac or Median (Heart, along Pericardium Meridian), Basilic (Liver along Heart Meridian). These are opened to clear Heat and Excess primarily of the Head and Upper Body.

In the Leg there are 3 Primary Veins: Ischiatica (outer ankle, under the Lateral Malleolus, GBL Meridian), Saphena (inner ankle, under the Medial Malleolus, Kidney Meridian) and Poplites (behind the Knee, Bladder Meridian). These are generally used for diseases of the Lower Body (below the Diaphragm). They move Blood downwards which opens Obstructions in the Lower Body, and promote Menstruation.
Diagram showing over 50 Bloodletting Points
Spiegel und Regiment der Gesundtheit, Ryff, 1544

The Three Arm Veins

Basilca
Great, Inward or Liver Vein
Travels along Heart Meridian

    -Jaundice; Liver or Spleen pain or disorders; Liver Heat, excess Bile
    -Fevers
    -all types of Edema
    -'good for all Evils in the Breast', difficulty breathing, asthma, bronchitis
    -aching of the Back, Shoulders, Sides, and Stomach
    -weakness of the eyes, poor sight
    -Toothache

Cephalica
Head Vein
Travels along Large Intestine Meridian
'Cephalica hath neither Artery or Sinew near it'.
This may be bled more often, taking smaller amounts of Blood.

    -Migraine, Headache, and Madness.
    -Aches, Pains, and Pressure of the Eyes, Teeth, Tongue.
    -Tinnitus, mid-ear infections
    -Tonsillitis, Sore Throat, and 'other Evils that come to the Throat'.
    -Phlegm in the Head or Chest.

Cardiac or Median
Common, Black or Heart Vein
Travels along Pericardium Meridian
'The Median hath a Sinew just under it'. be cautious and avoid deep needling.

    -'it is gentle Purgacious, for it draws Blood and Humors of all the Body'; evacuates all Humors
    -Primarily good for sickness of the Heart, Breast, Stomach, Liver and Lungs
    -strengthens  Stomach and increases Appetite
    -good for a Sad Heart, Depression, weak nerves
    -pain in the chest or Heart, use Right Vein
    -irregular Heart beat, fatty heart, risk of Heart attack
    -Pain in the Spleen
Bloodletting points
Fasciculus Medicine, Johannes de Ketham (in Latin), Venice, 1495.
Veins of the Head
Recta or Preparata
Forehead Vein, between the Eyebrows

        'The Vein between the Eyebrows in the Middle of
        the Forehead, called Recta or Preparata is opened
        against Old Infirmities, Foul Ulcers, the Leprosy,
        Scab, Morphew, Impetigo, Itch, diseases of the
        Eyes, old Headache, heaviness behind in the Head,
        diseases of the Brain, Madness'. (1)

-chronic Headache, Migraine, Paralysis, aching or heavy head
-Mental Illness, Madness, Frenzy, Mania, Insanity, Nightmares
-Scabs, Redness or Itchiness, Ulcers, Leprosy, and skin -Diseases of the Face or Abscesses of the Eyes, both Hot and Cold
-Chronic disease
Corresponding Acupoint:
Yin Tang (Extra Point)
    







Functions: Calms Spirit, Opens the Orifices, Stops Pain, Clears Wind and Heat.
-Headache, Dizziness, Mental Illness, Rhinitis.
-this is bled in TCM also, although some authorities state that bleeding here can drain the Brain Qi. It is not bled in large amounts, or often.    
Upper Forehead Vein
Just below the hairline
    
-all diseases of the Head and Brain, especially when Chronic
-acute Leprosy
Corresponding Acupoint:
Shen Ting (GV 24)
    
-Stops Wind: Epilepsy, Insomnia, Vertigo, Headache
-Calms Heart and Mind: Anxiety, Insomnia, Palpitation
-This is likewise bled in TCM
Temple Vein
Vein of the Temples

        'The two twisting Veins in the Temples are opened
        either of them against the half Headache
        [Migraine], great Headache, and long Sickness, old
        sore Eyes, blear Eyes, mists in the Eyes, spots, films,
        tears and webs in the Eyes, scabs in the Eye-Lids,
        Nyctilops, and to make Barrenness'. (1)

-Migraine, Vertigo, Headache, ‘Headache of the Eyes, and hath long lasted’.
-‘Cloudy dullness of mind’ (Phlegmbotomiographia, 1658)
-great heat of the Temples
-sickness or pain in the Eyes; Poor Sight
-diseases of the Ears
-opening this vein was said by Hippocrates to ‘Make a Man barren’.
Corresponding Acupoint:
Tai Yang (Extra Point)








Functions: Opens the Orifices, Stops Pain, Clears Wind and Heat
-used for Headache, Eye diseases, Facial Paralysis
-this is also bled in TCM.
Nose Vein
Vein in the Tip of the Nose

        'The Vein in the Tip of the Nose between the two
        Gristles is opened Against Frenzy, sharp Fevers, Old
        Headache, old red Faces, diseases in the Eyes and
        bleareyedness, heaviness of the Head, Hemorr-
        hoids, itching of the Nose, Apostem of the Nose, 
        Bothor'. (1)

-Purges the Brain; for Frenzy, chronic Headache; dullness or heaviness of the Head
-good for aching, itchiness, abscess or discharge from the Eyes or Nose
-redness of the Face
-Acute Fevers
-Hemorrhoids
-Aids Hearing and Memory
Note: this Vein lies deep, and to be bled properly, deep insertion is required; However, a shallow prick will also relieve the Point
Corresponding Acupoint:
Su Liao (GV 25)
    







Functions: Opens the Nose Orifice, moves the Blood, moves the Qi
-nose disorders, rhinitis etc;
-loss of consciousness etc
-this is also bled in TCM.
Ranulles
Veins under the Tongue

        'The two visible Veins under the Tongue are
        opened against Impostumations [abscesses] of the
        Throat and mouth, and other distempers there, and
        Quincy ... of imposthumes in the Almonds [Tonsils],
        heaviness of the Tongue, Apoplexy, Toothache, and
        diseases in the Gums, Catarrhs, Pannus, Cough,
        and distempers in the Jaws and Cheeks'. (1)

-all types of disorders of the Mouth, Throat, and Tongue, including swelling, Abscesses and Toothache; difficulty swallowing, Tonsillitis (after the Cephalica)
-'strong against pain of the Teeth and Gums'.
-Impediments of Speech
-for Abscesses, Rheum, or discharges of the Head
-Scrofula
-all types of Eye disorders
Corresponding Acupoint:
Jinjin Yuye (Extra Points)
    








Functions: Diseases of the mouth and throat including acute Sore Throat, Glossitis and Tonsillitis.
-As with their use in the West, they are only bled in TCM.
Veins of the rest of the Body

Cubit
Vein between the Thumb & Forefinger

This is a branch of the Cephalic vein, and was used very similarly to it. It was also opened 'in the Upper part of bending of the Arm' (Qu Chi, or LI 11).

        'Against Hot pains of the Heart, half Headache,
        Madness, Flux of the Eyes, Epilepsy, all Diseases in
        the Ears, Tumours in the Head, all hurts in the
        Tongue and distempers of the Stomach, and Fevers
        if it be opened in both hands'. (1)

-Headache, Migraine, pain of the Head, Frenzy, Madness, Sickness of the Head, Epilepsy
-Ear and Eye disorders, Tumors and swellings of the Head
-Heart pain from Heat
-Stomach disorders
-Fevers
-This vein in the Left hand is opened for Lethargy
Corresponding Acupoint:
Hegu (LI 4)
    










Functions: Clears Wind and Heat, Stops Pain, Opens the Brain and Clears the Senses, Moves the Qi and Blood.
-Headache, Toothache, Neurasthenia, Hypertension, Ear and Ear diseases, Mental and Nervous diseases, Fainting, Fever, Arm, shoulder and neck pain, sore and swollen throat etc
Splenatique, Salvatella (Spleen Vein)
Vein between Little and Ring Fingers
Sometimes found between mid and ring fingers

        ‘It is oftentimes opened, because it cleanse the       
        Spleen, Liver and Breast, clears the Voice        
        preserves the Internal parts [organs] but especially
        the Stomach and mouth from all accidents
        [diseases] whatsoever, eases the pain of the Heart,
        and takes away the superfluous Blood of the
        before-named inward parts. The Later Physicians
        make this distinction: they call this vein on the left
        hand Splenetica, the Spleen vein; and on the right
        hand Salvatella; for this cause have diverse opened         that on the left side, letting it bleed till of itself it
        staunches, supposing thereby to heal all infirmities
        of the Spleen [Melancholy]. It is also opened in
        Blood spittings, in obstruction of the Spleen, and in
        the French Pox. That on the right hand in infirmities
        of the Liver, in Shaking Palsies [Parkinsonism], in
        contractures of the Mouth, in all manner of stitches,
        in the Gout, in the Pocks, and in fine, almost in all
        other diseases’. (2)

-opened for Abscesses, and sickness of the Stomach (Right)
-all Evil Humors of the Liver, Jaundice, paleness, yellow eyes, excess or bad Blood; Liver obstruction (Right)
-for Evil Humors of the Spleen, Black Jaundice; Spleen obstruction (Left)
-Syphilis
-Parkinsonism (shaking palsy)
-Also Kidney and Uterus disorders (Left)
-all Fevers
Corresponding Acupoint:
Zhong Zu (TW 3)
    



















Functions: Clears Wind and Heat, Clears the Meridians, Pushes Circulation, Clears and Opens the Eyes and Mind
-used for Fevers
-Red eyes, blurred vision, Tinnitus, Headache
-used to Tonify the Organs
Popliteal, Apoplectique
Vein behind the Knee
    
-helps the Knees
-lower Back pain, pain of the thighs, feet and joints of the lower body; Sciatica
-promotes Menstruation
-Bladder pain, pain of the Testicles
-Arm Pain
Corresponding Acupoint:
Wei Zhong (BL 40)
    
Functions: Strengthens the Kidney and Spine, Clear the Meridian, Push the Circulation, Stops Pain.
-primarily used for lower Back pain and Sciatica; also for pain of the leg or knee.
-this is also often used for bleeding in TCM, especially if small veins are present.
Saphena (Womb Vein)
Vein under the Medial Malleolus
This vein travels along the Spleen Meridian and was mostly opened under the Medial Malleolus (Kid 6 point).

        'The Saphena under the inward ankle of both feet,
        sometimes upon the ankle, or on the sides of it, is
        often opened Against all passions of the Mother
        [Uterus], and of the Stones [testicles]; against old
        Scabs, and salt Phlegm, pains of the Hips and Legs,
        to provoke the Terms [menses], and Hemorrhoids,
        to purge the Womb, Afterbirth, to take away
        Barrenness [Infertility]; against diseases of the Yard
        [penis] and Stones, to draw blood from the Mother
        [uterus], Yard [penis] and Stones [testicles]'. (1)

-good for Abscesses, Scabs, Swellings, Aches and Pains, and other Evils which 'come to Man's body from the Head to the Foot'.
-Back pain, Sacral Pain, Sciatica
-Sore Eyes
-Madness, Nightmares, Paralysis, Epilepsy
-Spitting Blood
-diseases of the Testicles and Penis, Sterility
-good to promote urine, for the Stone, and for abscesses of Testicles
-promotes Menstruation, and benefits the Uterus; Infertility; purges Uterus after Birth; Suffocation of the Uterus; Hysteria
-Plague; Epidemic Diseases
-Hemorrhoids
Corresponding Acupoint:
Zhao Hai (Kid 6)
    













Functions: Balance the Lower Warmer, Tonify the Kidneys, Balances Qi and Blood.
-Irregular Menstruation, dysmenorrhea, amenorrhea, and various reproductive disorders
-Dysuria, Kidney weakness
-blurred vision, fainting spells
Ischiadique, Sciatique (Hip Vein)
Vein under the Lateral Malleolus

-opened to draw the Blood down in diseases of the Kidneys and Womb (opened as the same side as the pain or disorder)
-aching Thighs; pain and Arthritis in the Hip, Legs, Feet, or Hands
-Scabs, Leprosy
-Varicose Veins
-Bladder pain, difficulty passing Urine, Ulcers and Tumors of the Kidneys
-Ulcers and Swellings of the Testicles
-'it helpeth most the aching of the Thighs and Joints that is called Sciatic passion [Sciatica]'.
Corresponding Acupoint:
Shen Mai (BL62)

Functions: Clears the Meridians, Calm the Spirit, Clears the Orifices, Stops Wind
-lower back pain, leg pain, ankle pain
-Dizziness, Headache, Insomnia, Epilepsy, Mania
Notes

(1) Culpeper, N., Rulund, M., Cole, A., 'Two Treatises: the First of Blood-Letting and the Diseases to be cured thereby. The Second of Cupping and Scarifying and the diseases to be cured thereby, London, 1663'.
(2) Wirtzung, Chrisopher, The General Practice of Physick, 1654 (first translated into English from German in 1598)


Bibliography & Further Reading

-Bacon, Roger, The Cure of Old Age and Preservation of Youth, translated by Edw. Madeira Arrais, London, 1683.
-Baptista Verna, Johannes, Princeps Medicaminum Omnium Phlebotomia, 1716
-Clutterbuck M.D., On the Proper Administration of Bloodletting, London, 1840
-Culpeper, N., Rulund, M., Cole, A., Two Treatises: the First of Blood-Letting and the Diseases to be cured thereby. The Second of Cupping and Scarifying and the diseases to be cured thereby, London, 1663.
-Dickson, M.D., Thomas, A Treatise on Bloodletting, Physician to the London Hospital, 1765
-Gyer, Nicholas, The English Phlebotomy, , 1592
-de Ketham, Johannes, Fasciculus Medicine (in Latin), Venice, 1495.
-Khosrow et al, Comparison Biochemistries of Obtained Blood Products between The Hijama and Phlebotomy Techniques of Traditional Islamic Remedy;Healthy Young Adults at Fasting State, Journal of Hospital and Medical Management, Aug. 2016
-Louis, P., Researches on the Effects of Bloodletting in some Inflammatory Diseases ... translated by C.G. Putnam, 1836
-Pinder, Ulrich, Speculum Phlebothomyae, 1510
-de Plumis Campi, David, Phlegmbotomiographia, A Treatise of Phlebotomy, London, 1658
-Ruland, Martin, De phlebotomia morbisque per eam curandis, 1567
-Stahl & Hoffman, Dissertatio Inauguralis Chirurgico Medica de Phlebotomia, 1701
-Stern, M.D., Theory and Practice of Bloodletting,  New York, 1915
-Stubbe, Henry, An Epistolary Discourse concerning Phlebotomy, 1671
-Tate, Adam, Lantern Magazine, Bloodletting and Acupuncture, Adam Tate, Jan. 2017
-Therapeutic effects on rheumatoid arthritis treated with shu-deep needling and bloodletting techniques.
-Wirtzung, Christopher, General Practice of Physick, 1598
-Wong Lun, Prof., Course Notes: Academy of Traditional Chinese Medicine, Melbourne, Australia, 1990–94