Bloodletting as a cure for dropsy: heart failure down the ages

Dropsy was a term used to describe generalized swelling and was synonymous with heart failure. Its treatment options were scanty and were aimed to cause "emptying of the system" or to relieve fluid retention. These remedies were rudimentary, erratic in action, and associated with inconvenient side effects.

Bloodletting, either by venesection or by leeches, was a popular way to alleviate symptoms from dropsy. Although bloodletting, purgatives, cauterization, and Southey tubes were drastic, their use demonstrated that physicians were not powerless to help people with severe heart failure. Several centuries of intensive investigations in different areas of heart failure ended with the development of new therapeutic strategies that made bloodletting obsolete.

In an era when adequate treatment of heart failure has become a reality, it is appropriate to acknowledge those who paved the way to such great progress.