Bedside Manners 2: Bleed ‘em Dry

and very minimal security. The papers reported that on the nine of October thirty one, nineteen fifty seven, a man stepped through the Spokane Blood Banks doorway and approached Billy Evelyn Miller, the only medical technician on duty. He saw her, and she saw him. The man then calmly produced a pistol. This wasn't a typical bank robbery, though. He wasn't there after some quick cash. No, he was there to find

something far more valuable to him, human blood. In a steady voice, he asked for five units of typo negative and four sets of transfusion equipment. Based on the words he used, Billy Evelyn thought that he must have had a higher degree of medical understanding than your average run of the mill thief. He was also polite and, in her words, very calm and sweet, telling her, I won't hurt you, my dear, just don't be frightened. Do what

I tell you. And although he was brandishing a gun, he was careful not to aim it at Billy Evelyn, so she obliged handing the items over. He packed his bag full of blood and tubes and needles and asked her not to watch as he left, and to wait five minutes before calling the police. She complied, and he quietly made his smooth escape. What drove the man to rob the blood bank would remain a mystery. Six detectives were assigned to the case, but they turned up nothing.

The police speculated that the robber could have needed the blood for something that occurred outside the law, a gunshot wound, or perhaps in abortion. They noted the typo negative blood is often characterized as a universal donor, meaning that it can be used in all cases, and is often deployed in the direst of situations in which a perfect match may take longer to find the value of blood is

not to be understated. Globally and in a metaphorical sense, it represents life itself, the sticky force that keeps us all on this earth. Blood is an important component in our world religions and foundational tales of civilizations. It's been used in rituals across the world as offerings to the

gods and appeasements to forces beyond our understanding. It's found its way from our arteries into larger than life symbolism that we live with every day, and the English language is ripe with common phrases that invoke the idea of blood. These blood born idioms illustrate some of our most intense human experiences. For example, something terrifying might make your blood kurdle. To have blood on your hands means that you've done something irrevocably harmful. To be after blood means that you

might stop at nothing to get what you want. And these are just a few. The list is seemingly endless. We can't understand who we are as humankind without first understanding more about the substance that flows through our veins and keeps us living. We need to wrap our minds around how it's been understood and misunderstood across time and place. And what happens when that blood is spilled. I'm Aaron Manky, and welcome to bedside Manners. Close your eyes and come

with me. Picture this. You're sitting in a room. It's musty, but bright and full of conversation and the occasional moan. Beside you. A man is working near someone's head with a pair of scissors. You hear the sharp shearing sound of metal on metal as he works. Fine hairs catch the lights as they fluttered to the ground. Nearby, another man is bent over and peering into the gaping mouth of a wincing woman. You can smell, even from some

feet away, that her insides have gone rancid. A shrill cry escapes her throat as the metal implement scrapes deeper. Looking toward the windows, you spy bowls lined up like neat and tidy soldiers, all arranged by size. They're filled with a liquid that seems to swallow the sun. Then the smell of iron hits you, and you realize that those bowls are filled with blood. The scene might have the ingredients of a torture chamber, but all of the

people are there, quite willingly still sitting. You see that your hand is stretched out and clutching onto a pole. The pole has a dual purpose that helps you keep your arms straight and serves as an object to grasp tightly, all to make what's about to happen easier. A man in an apron approaches you in his hands, he holds a small, flat silver box with a hinged top. He sets it on the table, then wraps a piece of cloth around your arm a tourniquet. The veins in your

arms start to bulge. The man then opens the box he set down, pulls out an instrument, and unfolds it. They resembles something like a pocket knife, a white handle and a short, double edged metal blade. The practitioner easily positions the blade at just the right angle he wants. He's done this many times before. But before he makes any cuts, he places an ornate pewter bowl beneath your arm, and then he slices into your bulging vein. Blood runs down your forearm. It feels warm as it begins to

drip into the bowl in clips and plops. As you and the man your barber surgeon watch, your head feels light, the room fades, and finally you slump over because you have passed out. When you awake, the barber surgeon is smiling at you with satisfaction, knowing that he has done his job perfectly. You have a bandage on your arm and the bleeding has ceased. You'd come to him after all because you were ill, and now, with the excess blood removed and your humors restored, you are on the

road toward healing. Blood letting, you see, was fundamental to caring for the human body. For over two thousand years throughout history, it was practiced in some form by almost all cultures and societies. Though it seems like a total counterintuitive practice, blood is our life force, after all, For a long time the practice was considered to be cutting edge, and yes, that pun was intentional. For a large part of history, quality and quantity of blood were thought to

govern the quality and quantity of a person's years. The practice of phlebotomy, the letting of blood, is thought to have originated in ancient Egypt, with the first evidence of the practice appearing around fift b C. It's believed that the earliest proponents of therapeutic blood letting took their cues from spontaneous forms of blood letting, such as menstruation and

nose bleeds. It was with thanks to the ancient physician Hippocrates, though, that this specific healing modality gained a lot of momentum over two thousand, three hundred years ago. Hippocrates hypothesized that illnesses stemmed from natural mother than supernatural causes. He proposed that healing was a matter of proper bodily maintenance and

not from tributes to the gods. He adapted his ideas on some pre scientific thought that originated before his time, and after some percolating, he came up with his theory of the four humors. Hippocrates believe that nature is represented in four elements earth, air, water, and fire. It made sense to him then that humans also might be comprised of four corresponding liquids called humors, and he decided that

these were blood, phlegm, black bile, and yellow bile. Each humor was ascribed to a certain organ and related to one of four certain personality types. Illness was attributed to humoral imbalance, too much of one thing and not enough of another. In order to get yourself back in balance, a doctor would be prescribing any number of things blood letting, purging, diarresus and fasting. Of course, there were folks who completely disagreed with Hippocrates, but his ideas would be built upon

and gain wider acceptance long after his time. The physician Galen inherited these ideas. He was born in Turkey in one d and twenty years later he took to the road to study with some of the most pre eminent medical teachers of the time. He settled permanently in Rome in the early one sixties, stirring up business with public demonstrations and lectures. By this time he had become wholly fixated on blood, becoming phlebotomy's most prolific proponent. That said,

he knew it wasn't something to be taken lightly. Cutting a person was something to be done with much precision and care. He deemed blood letting to be an essential remedy to all that ailed folks, and as a safeguard against what might afflict them in times to come. Blood, Galen thought, was the root of all sickness. Sometimes you had bad blood, and sometimes you might have too much of it. This, according to him, could be diagnosed from

external observations. One just had to look for a ruddy complexion. Uh, sluggishness or maybe a rapid pulse. He and his contempt braries became quick to prescribing blood letting as a remedy for just about everything. Galen would go on to become one of the most prolific authors in Western antiquity, his total writing output exceeding two million words. He wrote on a variety of topics, but he's best remembered for his outsized impact on medicine, and as the Empire expanded, so

too did the reach of Galen's medical theories. Blood Letting, it seems, was here to stay. So next time you reach for an aspirin or have to run out for more cold medicine, just think this could all be so much worse, because for a very long time it was. King Charles the Second of England was having a rough go of it in the winter of his feet ached, and despite tending to them, they continued to be a nuisance. So he decided to cancel his daily walk and go

for a carriage ride instead. As you'll see, it would be his last. The king retired to bed early that night, but his sleep would be anything but RESTful. By morning, he awoke moaning and barely able to speak, His aids hustled in alarm. He was soon struck by a seizure. Doctors from the Royal College of Physicians quickly arrived at his bedside and deployed an arsenal of treatments. They took out their enemies, the purgatives, the laxatives. They ground up

sugar and pearls for a tonic. They put the irons in the fire literally, and of course they brought out their lancets. This was top tier medical technology. There would be nothing but the best for their king. With these tools in hand, the metal of the king was put to the test. The old adage what doesn't kill you makes you stronger, it seems like it was particularly applicable here. He drank boiled spirits from a human skull, hoping that

its former vitality would reinvigorate him. He was scalded from head to toe by white hot irons and bled from his jugular vein, but he knew the end was near. The king apologized to his doctors for having such an unconscionable time, dying after six days, King Charles the Second slipped from this life. In total, he had about twenty four ounces of blood taken over the course of his treatment. What we have since learned is that a human body

can replace sixteen ounces of the stuff within two days. This, though, is assuming that the body is healthy. It seems that Charles probably needed all the blood he could get, and it's likely that his body couldn't keep up with the reproduction of it, and due to the number of physical ailments, it seems that his body simply gave out. He was beyond repair. In the centuries following Galen, blood letting continued to be widely considered as a cure all and was

incredibly common. For a while, the practice was in the hands of the clergy, which actually made a lot of sense. They were an educated class and were often tasked with caring for the sick. But after Pope Alexander the Third banned his holy men and women from the practice in eleven sixty three, avoid appeared and the barber surgeons would fill that role. Once upon a time, the local barber surgeon was a stop shop for various kinds of bodily maintenance, haircutting,

teeth pulling, and of course, blood letting. Their job was to tend to things considered to be dirty and deeply personal. These practitioners were tradesmen rather than high society physician types. They worked with bodies, something that was considered to be uncouth, whereas physicians looked but didn't touch. In England, it was common to see candy cane striped poles outside of barber surgeon shops, with the red representing blood and the white

representing the tourniquet. Bowls of blood were even set in the windows as advertising. Remember that the next time you go and see the same pole outside your own barber shop. Over the years, their tools of the trade evolved. Animal teeth, sharpened wood and shells gave way to spring lancets and razor sharp instruments known as scarificators. But as theories around the practice grew more complex, the tools became more precise. One of the most popular aids and bleeding were small, soft,

and sentient leeches. They were placed on the problem area, both on the outside and on the inside of the body. If you have never heard of a leeching chair and wonder why it might have a hole in the seat, well, consider yourself lucky. The popularity of leeches peaked in France in the eighteen thirties, when it was thought that about

thirty five million of them were used per year. The most popular variety, the Herudo Medicinalis, was capable of ingesting ten times its own weight of blood at each feeding. They were housed in ornate jars and apothecary windows, which were filled with comfortable beds of pebbles and moss for the leeches to retire upon between gigs. In fact, for a very long time they were believed to have gone

extinct thanks to this high demand. They're actually still around today, but they are a protected species, and of course they've had to go back to finding their own meals, but not before taking the blame for the deaths of some very famous historical figures. George Washington had really taken to retirement. He found a lot of satisfaction in watching the seasons change at his estates at Mount Vernon, Virginia. His time and attention had shifted away from public service, and now

he spent his hours tending to his land. Thursday, December twelfth of sev started off with light snow, then hail, and then rain. Conditions weren't kind, to say the least. Nevertheless, Washington hopped on his horse to supervise his plantation activities. It was a long, cold, wet day in the saddle. When he returned home that evening, he was chilled to his core. Guests said just to arrive for dinner. A

friend suggested that he changed into something warm and dry. Washington, however, was a stickler for punctuality and chose not to do so. He chose to take a seat at the meal, still freezing. The next morning, Washington woke up with a sore throat and later complained of a cough and a running nose. Still, there were chores to do outside and three fresh inches of snow to contend with, So despite the frigid air and his sore throat, Washington headed out to mark trees

that he wanted to have cut down. His voice grew more hoarse throughout the day, and by the time he returned to read his evening newspapers allowed he could barely manage. He chose to retire for the nights, but he wouldn't sleep for long. He woke up around two am, clutching his chest, short of breath, and with a raging fire in his throat. Even so, he wouldn't allow Martha to get up and call for help. She was recovering from a cold herself, and he didn't want her to have

to leave the warm comforts of their bed. At daybreak, Caroline Brandham, one of the people enslaved by the Washington's, came to light a fire in the bedroom. It was then that Martha sent for washington Secretary Tobias Lear. He arrived quickly and was startled to find the former president in such bad shape. He sent for George Rawlins, and overseer at Mount Vernon, as well as Washington's personal doctor

of over forty years, Dr James Craik. At around seven thirty a m. While waiting for Dr Craik to arrive, Rawlins, at the request of Washington, and despite Martha's vocal opposition, bled the former president, taking about fourteen ounces of blood Over the course of the morning. Panic set in. Another doctor was called, who also opted to bleed an additional eighteen ounces of blood. A third blood letting occurred at eleven am, drawing out another eighteen ounces, and then they

sent for yet another doctor. Washington's condition unsurprisingly continued to deteriorate. A fourth position was called for, who conducted one final thirty two ounce bleeding. The doctors tried giving him tease, They tried having him gargle various tonics. They tried administering enemas, they blistered him with Spanish fly, They even induced vomiting. As you can imagine, it was all a pretty gruesome sight. And if you were wondering if Washington knew that he

was dying, the answer unequivocally yes. At four thirty PM, he called for his wills. He gave directions on how to settle his books and accounts. He thanked his doctors and asked to be decently buried, and specified that his body not be put into his vault any less than three days after he had died, for fear that he might mistakenly be buried alive but die he did just a few hours later, at the age of sixty seven. Washington, though, wasn't the only high profile person to possibly be bled

to death. There were others too. It's thought that Wolfgang Amadeus, Mozart and Lord Byron both succumbed with the aid of bleeding. Conversely, there was the case of Marie Antoinette, in which it was suggested that blood letting may have actually saved her life. The four A time you see. In seventeen seventy eight,

Marie was pregnant with her first child, Marie Theress. When it came time for the then Queen of France to give birth in December of that year, Marie's bedroom in the Palace of Versailles was filled with onlookers, eager to see the birth of the queen's first child, who everyone hoped would be a male heir to the crown. At that time, it was customed to have public births in

the French court. People wanted to witness the heir's corporeal debut, so the Queen's room was packed with gawkers, so many, in fact, that they not only hindered the work of the attending doctors, but they also made the room itself loud, suffocating, and unbearably hot. People stood on cabinets, climbed tapestries, and crowded all around just to get a glimpse. King Louis the sixteenth ordered that the tapestry screens around the Queen's bed be secured with strong cords so that they wouldn't

collapse on her. Due to the rush of people clamoring to get a glimpse of the birth, The scene was chaotic and overwhelming. This was all amplified when Marie did eventually give birth, not to a son, which she had so deeply hoped for, but to a daughter. All of this was too much for Marie, it seems, and she passed out as if she hadn't already lost enough blood for the day. The doctors sprung into action. They sliced an incision in the Queen's foot. Sure enough, she opened

her eyes and stirred once more. Blood letting in this case seems to have helped revive her. Or it could also be that the pain of the incision had brought her back around, or that the crowd was dispersed and the king frantically opened all the windows to let in some fresh air. But this, of course, would not be

the last time that Marie Antoinette would be bled. Fourteen years later, a much more shall we say, comprehensive session of blood letting would occur at the gallows when Marie was executed after a trial found her guilty of high treason. Blood Letting may or may not have saved her before, but the second instance certainly did what it was designed to do, and it brought her life to an end.

You might be wondering to yourself, with all of these cases of blood letting potentially having gone wrong, why did so many think it was right. The advent of germ theory in the eighteen sixties dealt a hard blow to humorl theory. Even still, it's been documented that blood letting didn't reach its peak in Europe until around the same time. Books on the topic continued to be published into the next century. For poor old George Washington, it's unknown to

this day exactly what killed him. Almost immediately after his death, doctors began debating what had dealt America's first president the final blow. Some suggested an abscess in his mouth, while others believed it was a blockage in his throat. Some even attributed his death to pneumonia and strep. Whatever the true reason, they removed about eighty ounces of blood, or around forty of the amount of blood in the average adult, all in twelve hours, and this surely could not have

helped the man. The practice of blood letting progressively dwindled in the nineteenth century in the West, and in retrospect seems barbaric to our modern minds. It has not vanished altogether, though, and It's still used to treat certain conditions related to bone marrow and metabolism disorders. But on a more basic, fundamental level, think about your annual physical They take your heights, your weight, your blood pressure, and they also bleed you,

drawing your blood through needles and into tubes. Science has gotten a lot better, of course. The blood is no longer drawn for its own therapeutic sake, but for the purpose of running various tests on it. We now look at taking blood as a means to an end, rather than the therapy itself, a first nest sary step toward a more precise diagnosis and treatment. And I'm sure you'd be happy to know that the use of medical leeches is making a comeback in modern medicine, particularly in microsurgery.

It appears that the leeches release various biological substances that can help reduce venous congestion and prevent tissue necrosis. If you'll pardon the pun. It's pretty common for folks today to think the health care practitioners of your well sucked, But as their leeches seem to have taught us, it

turns out they were onto something. Blood and guts. That's a term we've heard often as a general description of what's inside our bodies, and hopefully today you've gained new insights into the long and winding journey that blood has traveled throughout history. But as you might expect for something so ubiquitous, there are plenty of stories of blood out there waiting to be retold, and if you stick around through this brief sponsor break, you'll get to hear one

more of them. M hmm. Right in the mummified body of an eleventh century Italian saint was discovered in a church in Luca, Italy. Saint Venus of Armenia had died in a hospital annexed to the church in the year ten fifty. During a complete study of the body, scientists located two significant wounds on a skull, thought to be

produced by a serrated blade and a blunt instrument. They noticed precise scarifications around the wound, which appeared to indicate that while he was alive, it had been cleaned and cauterized. Researchers believe that this is the first physical evidence of a case of post surgical medieval cauterization. Therapeutic treatments based on humoral theory extended far beyond blood letting, or perhaps extended to other practices ten gently related to blood letting,

and one of those practices was treatment by fire. Cattery, like blood letting, has a pronounced historical lineage. The first culture to use it is unknown, but what we do know is that from very ancient times, a wide variety of civilizations across the world believed that fire contained therapeutic properties. Hippocrates himself prescribed red hot irons to incinerate hemorrhoids, to be followed up with the healing poultice of lentils and vegetables.

Of course, he believed that burning was a panacea, and if something couldn't be healed by the red hot end of a poker or a slow burning oil, then it was likely it probably couldn't be healed at all. Pottery was then later used by its proponents for just about everything, cauterizing temples for headaches, as well as under the chin or on the neck or on the chest for things

like upper respiratory distress. Cattery was also thought to be an aid for emotional and psychological maladies in the same way the blood letting was part of the rationale behind cattery and blistering was something called counter irritation that essentially means intentionally irritating an area of the body to distract from the already wounded area. They were working under the assumption that this new irritation would draw away the sickness

from the original wound and allow it to heal. One practitioner who advocated cattery was a New York physician named Dr. A. R. Carmen. In two when a young woman who had been bedridden for weeks due to headaches, insomnia, and overall malaise came to him for help. He treated her by way of creating a series of burns down or spine. Interestingly, the young woman recovered quickly and was able to go back

to work. To him and to her family, this case was considered proof of the efficacy of counter irritation cattery. These days, folks are still being cauterized in medical settings, but it takes a far less gruesome form than you might imagine. Gone are the days of the stench of singed burning flesh. Today, the instruments are a lot more precise, center deployed in far fewer circumstances than days gone by,

and people still willingly employ counter irritation methods. In fact, you can pick them right up at your local drug store. So the next time you go out for a run and find that your muscles are sore, rub in some icy hot or some tiger bomb, anything that might contain menthal or capsicum. The mag it is an abstraction and the subsequent peace of mind that they give you something that I highly doubt an iron poker ever could. Grim and Mild Presents Bedside Manners was executive produced by Aaron

Manky and narrated by Aaron Manky and Robin Minat. Writing for this season was provided by Robin Minater, with research by Sam Alberty, Taylor haggerd Orn and Robin Minater. Production assistance was provided by Josh Thane, Jesse Funk, Alex Williams, and Matt Frederick. You can learn more about this show, the Grim and Mild team, and all the other podcasts that we make over at Grim and Mild dot com, and as always, thanks for listening.