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Basic Information

Bloodletting is the practice of draining blood from a patient for medicinal reasons. Leeching is a subset of bloodletting that involves the application of hungry live leeches. Otherwise the bleeding was done by cutting with a knife or otherwise incising the patient. The classical practice of bloodletting is a dangerous pseudoscience, based on the now-discredited medical philosophy known as humorism. Bloodletting was traditionally performed by a Barber-Chirurgeon, and is the origin of the red-and-white striped pole commonly used as an identifying symbol of the barbershop. You don't have to be literate to recognize that red stripe represents blood and the white stripe represents bandages.

Bloodletting was often done with the express goal of removing enough blood to make the patient faint. The list of diseases and conditions it was supposed to cure is really long. Everything from a metaphorical broken heart to life-threatening tuberculosis. Bloodletting was even used as a treatment for open wounds and blood loss. Different illnesses called for draining different amounts of blood from different parts of the body.

Phlebotomy is the largely-unrelated modern practice of drawing blood for a blood test or legitimate therapeutic purpose.



Game and Story Use

  • In a fantasy game, real-world medical philosophy doesn't have to hold true. You could make a very memorable and flavorful magic system or healing skill based on draining blood. Maybe it does a random amount of damage to the patient, and if that doesn't kill them outright, they quickly heal double that damage roll or recover from 1 disease.
  • Who knows, maybe those pesky vampires are actually helping the populace survive a plague or something?
  • If bloodletting is nothing but dangerous nonsense, player-characters have a strange special awareness that NPCs lack. In most systems, the PC has infallible instant feedback about their health status. If the "medicine" is doing them harm, PCs usually figure that out right away. Be prepared for awkward scenes and incredulous players if you have NPCs insist on performing medical procedures that the PCs can debunk only by virtue of meta-gaming knowledge. Not an issue if you run a game where a legit healing potion is 5 quid at the corner chemist, but possibly a stumbling block if your goal is historical and scientific accuracy.
    • Might help if bloodletting is used to treat things that aren't hitpoint damage (and/or your system doesn't use hitpoints) but are used to treat poisoning, disease and similar things. Then the hitpoint damage may be the price they pay for the recovery roll…
  • For more ideas see humorism, leeching, and traditional medicine.
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