Great perspectives on the clinical relevance of bloodletting. Bloodletting is one of the major clinical therapies of Tibetan medicine, along with moxibustion. In tracing the history, both bloodletting and moxibustion pre-date acupuncture (or were an early conception of "acupuncture").
The Tibetans are quite sophisticated about bloodletting and its practice is typically reserved for senior physicians. The Four Tantras say bloodletting is contraindicated for vāta, but is indicated in pitta and blood disorders. Sushruta considered "blood" to be a fourth dosha, and this idea is definitely maintained in the Tibetan Tantras. There are 77 bloodletting points identified, and only some overlap with acupuncture points. Tibetan doctors also administer a triphala decoction days before bloodletting to separate the pure blood from the impure blood, so that only the impure blood is released in the actual procedure. Then there are the issues of choosing the best location to bleed, the duration of bleeding, and knowing when to stop bleeding based on the color of the blood.
Although the Tibetans consider deficiency conditions a contraindication for bloodletting, I think the "micro-bleeding" practiced in acupuncture should be seen as an exception to this rule. For one, micro-bleeding is much more minor a procedure than the complex bloodletting procedures of the Tibetans. The concept of removing "wind" via blood is also found in Tibetan medicine, where bloodletting is indicated to remove excess or trapped "vapors". This is seen as a form of venting the channels, not to release blood but to release "steam".
Tibetan medicine is an unlicensed profession in the US, which means bloodletting is not within the scope of practice. This means Western-trained practitioners of Tibetan medicine are losing their grasp on a significant clinical paradigm. However, acupuncturists are well-poised to explore this modality further, with Tibetan approaches to bloodletting a valuable inquiry to consider.
Great perspectives on the clinical relevance of bloodletting. Bloodletting is one of the major clinical therapies of Tibetan medicine, along with moxibustion. In tracing the history, both bloodletting and moxibustion pre-date acupuncture (or were an early conception of "acupuncture").
The Tibetans are quite sophisticated about bloodletting and its practice is typically reserved for senior physicians. The Four Tantras say bloodletting is contraindicated for vāta, but is indicated in pitta and blood disorders. Sushruta considered "blood" to be a fourth dosha, and this idea is definitely maintained in the Tibetan Tantras. There are 77 bloodletting points identified, and only some overlap with acupuncture points. Tibetan doctors also administer a triphala decoction days before bloodletting to separate the pure blood from the impure blood, so that only the impure blood is released in the actual procedure. Then there are the issues of choosing the best location to bleed, the duration of bleeding, and knowing when to stop bleeding based on the color of the blood.
Although the Tibetans consider deficiency conditions a contraindication for bloodletting, I think the "micro-bleeding" practiced in acupuncture should be seen as an exception to this rule. For one, micro-bleeding is much more minor a procedure than the complex bloodletting procedures of the Tibetans. The concept of removing "wind" via blood is also found in Tibetan medicine, where bloodletting is indicated to remove excess or trapped "vapors". This is seen as a form of venting the channels, not to release blood but to release "steam".
Tibetan medicine is an unlicensed profession in the US, which means bloodletting is not within the scope of practice. This means Western-trained practitioners of Tibetan medicine are losing their grasp on a significant clinical paradigm. However, acupuncturists are well-poised to explore this modality further, with Tibetan approaches to bloodletting a valuable inquiry to consider.