Bloodletting 1854
Abstract
I sometimes peruse old AJP archived articles for some guidance, pearls of wisdom, or inspiration from early practitioners of our profession. I came across an April 1854 article in the American Journal of Insanity (forerunner of AJP) that made me feel much pride as a psychiatrist. The work, "Bloodletting in Mental Disorders" by Pliny Earle, M.D., is a 119-page article authored by one of the 13 superintendents of mental health facilities who were founders of the group that eventually evolved into the American Psychiatric Association. The article showed not just attention to the clinical aspects of the topic but also a sensitivity to the political and historical issues relating to it. I found myself trying to empathize with the perspective of the author, Dr. Earle. The stage was set by 1854 with the historical impact of the iconic Benjamin Rush, who had advocated a broad, vigorous use of bloodletting despite the influence of a number of New England mental health institution superintendents who were critics of the practice. Dr. Earle started his article with a literary association: "To bleed, or not to bleed: that's the question." He then proceeded to articulate opinions on the topic from over 100