Fun Fact: What Was a Common Treatment for Mental Illness in the 17th and 18th Centuries?

Question: What was a common treatment for mental illness in the 17^th and 18^th centuries?

Answer: Bloodletting

The treatment of mental illness has long been a quandary for medical professionals throughout history. But historically, mental illness has been more loosely defined than it is today.

In 17^th century France, a physician named Jacques Ferrand wrote a book on cures for the mental ailment of heartbreak. One such cure included in the book was bloodletting. He noted specifically that bleeding the heartbroken to the point of heart failure was key, adding that “the opening of the hemorrhoids is the surest remedy.”

Bloodletting has been applied to the treatment of numerous ailments throughout history, with the practice beginning in ancient Rome and continuing on throughout the medieval period. During this time, it was often the clergy who would practice bloodletting amongst themselves and for others.

This practice continued until the 12^th century when Pope Alexander III forbade the clergy from involving themselves in studies of the human body. The canon explained that “the church abhor blood,” which rendered bloodletting a practice the clergy could no longer provide.

Seeing an opening in the market, the barber-surgeon took over the practice. In order to best diagnose patients, the barber-surgeon would begin by using the taste, touch, and smell of a patient’s blood. This diagnostic process also allowed the barber-surgeon to assess the extent of bloodletting needed.

Following working with a patient, the barber-surgeon would then place the bowls of blood on their windowsill to attract other paying customers to their shop. Eventually, enough people spoke out against the practice that placing bowls of blood on windowsills was made illegal. However, the barber-surgeons still needed to unload the blood somehow, so it became common to instead dispose of the blood into a nearby river.

By the 18^th century, the practice of bloodletting was adopted to treat the mentally ill in psychiatric hospitals. One famous example is that of St. Mary of Bethlehem in London, which was nicknamed “Bedlam” for their horrific treatment of patients and the conditions in which they kept the hospital.

One patient, writer Alexander Cruden, was institutionalized at St. Mary of Bethlehem multiple times for behaviors that included attempting to date widows and getting upset upon learning of the occurrence of incest. He wrote following one such visit that “the common prescriptions of a Bethlemitical doctor are a purge and a vomit, and a purge and a vomit over again, and sometimes a bleeding.”

Around this time in the United States, the physician and founding father Benjamin Rush also wrote of bloodletting’s benefits for the treatment of the mentally ill. He described the method as “heroic depletion therapy,” which he recommended specifically for patients suffering from mania.

Rush wrote, “20 to 40 ounces of blood may be taken at once. Early and copious bleeding are wonderful in calming people.”

REFERENCE

Kang L, Pedersen N. Quackery: A Brief History of the Worst Ways to Cure Everything. New York, NY: Workman Publishing; 2017.