Interesting! I’m learning so much about medical terms that Ive never heard in my life since dx! I was aware about using leaches in the 19th century for medical purposes, but never heard the medical term “bloodletting”. Thank you!

Bloodletting and phlebotomy are very similar in some ways but quite different in others. Bloodletting was done to "balance the blood" based on a theory that illness was due to imbalanced blood humors. Bloodletting was not the sterile procedure it is now. Nor was it a precise process. Various techniques were used, including lancets, leeches and cupping. Therapeutic phlebotomy is a sterile procedure done by medical professionals with precise goals and protocols. The intent is to reduce iron levels to control erythrocytosis in the case of PV. The procedure is based on a scientific understanding of physiology.

There is a similarity in that both involve intentionally bleeding the patient. There is a hope amongst some MPN experts that we will be able to move away from phlebotomy as treatment options expand and improve (e.g., rusfertide). Some do compare the use of therapeutic phlebotomy to bloodletting as an outdated approach. Given that there are adverse effects associated with phlebotomy-induced iron deficiency, we will hopefully be able to move to other techniques to control erythrocytosis.

Phlebotomy is just bloodletting re-branded.

Bloodletting has some genuinely useful applications but bloodletting sounds gruesome and has a gruesome history, people won't go for it if their frightened of it so it got a makeover!