Before we knew what we know now, doctors didn’t really understand why people got sick. Germs? What’s that? Surgeons went straight from an autopsy to an operating table. No hand washing needed. Medical “professionals” believed the body was made up of four liquids, or "humors": yellow bile, phlegm, black bile, and blood. Any imbalance between these would cause illness. Whether physical or mental. Or so they thought. Because of this, a lot of the go-to treatments in the Middle Ages involved draining fluids to bring everything back in check. We’re talking forced bleeding, cupping and leeching. Medicine was a guessing game. Not a science.

So you can imagine the chaos that came when the world was hit with the Black Death pandemic in the 13th century. As this research paper states, “Healthy people panicked and did all they could to avoid the sick. Doctors refused to see patients; priests refused to administer last rites. Shopkeepers closed stores. Many people fled the cities for the countryside, but even there they could not escape the disease – it affected cows, sheep, goats, pigs, and chickens, as well as people. And many people, desperate to save themselves, even abandoned their sick and dying loved ones.”

Around October 1347, 12 ships docked in Europe. The vessels had come via the Black Sea. There was much excitement. Crowds flocked to welcome them. But something wasn’t right. Most of the sailors on board were dead. The surviving ones? Almost dead. They had fever, fatigue, and headaches. They were in pain. Shivering, vomiting, and delirious. Most mysterious though, they were covered in weeping black wounds. An unseen symptom of sickness. Until then.

The “death ships” were quickly ushered out of the port. But it was too little too late. The Black Death had arrived. And it would be a while before it left. The plague spread through Europe over the next couple of years. Leaving almost a third of the continent dead. It sporadically popped up a few times after that again.

Doctors were desperate to stop the pandemic. They tried every possible cure and prevention. From bloodletting – which is draining blood – to firing guns into the air. Bloodletting was considered the beast of all treatments back then. People truly believed it could cure just about anything. Epilepsy? Check. Mental illness? Check. Cancer? Check? Menstruation. 100%

But all it often did was make people weaker. Or even more ill. Not surprising that some patients died from blood loss. The sinister practice dates back to Ancient Egypt. Sharp thorns or animal teeth were once used. But later, there were knives or lancets involved. Basically, anything sharp enough would do. Because the point was to drain the sick person’s blood into a bowl, and bring their humors back into balance. Before (hopefully) stopping the bleeding.

There were other ways to drain blood that didn’t involve slicing the skin with a sharp object. People called on nature back then. In particular, leeches. Little blood sucking parasites. And lots of them at once. LabCE explains it like this: “Leeches could be directed toward the inflamed area. For example, the leeches could be placed on the trachea if the patient suffered from bronchitis or on the ear for an earache. Common practice was to place 20 or more leeches on adult patients.” Unfortunately, sometimes people would lose too much blood or they’d contract an infection and get scarring.

Believe it or not, bloodletting is still practiced today. Thankfully, in a safer and more sanitary way. And not to cure every ailment under the sun. It’s what we now know as “drawing blood”. According to WebMD, Phlebotomy therapy is a modern type of bloodletting. It’s used to diagnose illness (blood tests), and treat some others.

As this research paper states, “Leeches attach to the host body surface and cut the skin using hundreds of calcified teeth. They can then draw blood for up to one hour while secreting saliva into the wound. The secreted salivary proteins and peptides reach the vascular system of the host via thousands of tiny salivary gland cell ducts.” Some doctors and hospitals use live leeches to treat vascular disease, blood clotting or promote circulation. But there are now also mechanical ones, which are considered a bit safer. And less gross.

If leeches aren’t your thing, you might turn your nose up at maggots. Sometimes found wriggling on rotting meat, these fly larvae are being put to use in modern medicine. According to the Chelsea and Westminster Hospital, Maggot Therapy uses the slimy babies from the green-bottle fly. They are “put into a wound to remove necrotic, sloughy and/or infected tissue”. Maggots can also be used to keep wounds clean and prevent infection.

The maggots feed on a patient's dead tissue. Much like they feed on rotting meat. They then release special chemicals into the wound. It breaks down the tissue into a liquid form. The thirsty maggots drink the "juice" and digest it. Not sure about you. But it’s a hard no from us.

One of the oldest medical practices in history is still being used today. Trepanation, put bluntly, is the act of drilling holes into the skull. It was used to treat a bunch of things in ancient times. Most bizarrely, to pull evil spirits from a person’s body through a small hole in their head. Researchers have found evidence of trepanation being used as far back as prehistoric times. Various skulls were uncovered with signs of holes drilled into them.

Some people survived the procedure, others didn't. As this paper states, “Scraping trepanations evinced the highest survival rate; circular grooving, drilling and boring, and linear cutting were far less successful.” Today, trepanation or trepanning is used during modern surgery. It's also called a craniotomy. And it's used to relieve pressure on the brain, or to perform brain surgery.

While some of the historical medical practices were questionable. Others paved the way for modern medicine. But who knows? Maybe sometime in the future, medical professionals might look back on some of today’s treatments and wonder what in the name of Black Death we were thinking. What medical practices do you find mind-boggling? Let us know in the comments.