Bloodletting from the Ankle Vein to Treat Sciatic Pain

Abstract

The most renowned physicians through the Middle Ages and the Renaissance up to the Modern practiced bloodletting from the “sciatic vein” (saphena minor or small saphenous vein, which runs behind or under the external ankle) as a cure for sciatic pain. Here we review historic descriptions of this procedure carefully selected from medical literature in Latin language from the Middle Ages and the Renaissance and hazard a guess as to why phlebotomy of the sciatic or saphenous veins was conceived of as a possible remedy. In the early Middle Ages, Mesue (Ibn Masawaih, 777–857) (Assyrian Christian physician) was the first to report bloodletting from the “sciatic vein” (saphena minor or small saphenous vein) for: “ De dolore anche et sciatico ”: “pain in the hip and sciatic” [1]. He wrote: “ Galienus comendavit et ex venis quae flobotomantur est vena inter minimum, et secundum pedis, si materia in inferioribus iam existit flobotomia, enim huius vene est maius iuvamentum quam sciatice et saphene in hoc casu …”: “Galen recommended phlebotomy, and among the veins that may be bled, there is a vein between the little toe and the second toe of the foot, for matters in the lower parts. In fact, in this case, the benefit of this vein is greater than that of the sciatic and saphenous veins.” Isaac Judaeus (Ishaq ibn Sulaiman, c 850–ca. 932) (Egyptian Jewish physician) introduced wrapping the leg, when he wrote: “ Sciatica que sub talo est exterior: cum phlebotomanda fuerit: totam coxam et tibiam usque ad spacium quattuor digitorum a talo fortiter ligari convenit … phlebotomo vena aperiatur …”: “The vein sciatica, which is external and inferior to the ankle, when it has to be bled, it is appropriate that the whole thigh and tibia are strongly wrapped at four fingers above the …