Poor Mr Austen.

The early 19th century methods of blood-letting were more likely to finish you off rather than precipitate a cure.

Bloodletting or phlebotomy, was a mainstay of medical therapy until the mid 19th century. This practice was guided by the belief that health derived from a balance of the four humors in the body . Physicians and apothecaries focused upon restoring the system's equilibrium or balance, usually by draining or purging the system of excess humors.

The theory that the body consisted of four bodily humors: blood, phlegm, yellow bile, and black bile derived back to Greek medicine practised in ancient times. Bloodletting, or bleeding, was an accepted practice from the time of the Greek physician Galen who lived from 130–200 AD, until the middle of the nineteenth century.

As the ancient Greeks considered that disease was caused by an imbalance of these humors, it was, therefore considered that the duty of a physician was to employ treatment that would restore this delicate balance.

Thus treatments consisted of curing the symptoms of the disease rather than the disease itself. Prescribed therapies were limited to diet, exercise, rest, bath, and “heroic medicine.” Despite its name,Heroic medicine was IMHO anything but. It consisted of purging, starving, vomiting, or bloodletting, and was thought to relieve the body of symptoms like fever or inflammation by relieving it of various excess humours.

The theory behind bloodletting was that disease caused blood to stagnate in certain parts of the body and that it needed to be released in order to revitalize the patient and effect a cure.

Blood was therefore drawn off from the diseased area by applying leeches, cutting open a vessel, or using suction cups to form blood blisters, which were then lanced, or cut. Typically, 16-30 ounces of blood were drained from a patient and caught in a shallow bowl. Treatment was stopped when a patient felt faint. Bloodletting was used to treat toothaches, fevers, headaches, pain, mental illness, coughs, and colds. Indeed, bloodletting was seen as a remedy for almost every complaint.

Look at this illuminating passage from my copy of the 1819 edition of Domestic Medicine etc by William Buchan regarding the treatment he prescribed for headaches:

WHEN the head-ach is owing to excess of blood, or an hot bilious constitution, bleeding is necessary. The patient may be bled in the jugular vein, and the operation repeated if there be occasion. Cupping also, or the application of leeches to the temples, and behind the ears, will be of service. Afterwards a blistering-plaster may be applied to the neck, behind the ears, or to any part of the head that is most affected. In some cases it will be proper to blister the whole head. In persons of a gross habit, issues or perpetual blisters will be of service. The body ought likewise to be kept open by gentle laxatives.

BUT when the head-ach proceeds from a copious vitiated serum stagnating in the membranes, either within or without the skull, with a dull, heavy, continual pain, which will neither yield to bleeding nor gentle laxatives, then more powerful purgatives are necessary, as pills made of aloes, resin of jalap, or the like. It will also be necessary in this case to blister the whole head, and to keep the back part of the neck open for a considerable time by a perpetual blister. pp370-1

Apothecaries and physicians of JA's era would not have had in their "armoury" many medical instruments with which to treat patients that we would recognise today :no stethoscopes, thermometers, blood pressure equipment, or other diagnostic tools that we now consider fundamental.

But they would have possessed a cupping kit.

And here are some pictures of one from the late 18th century which may be similar to the one used on poor, ailing Mr Austen.

This picture shows a brass European cupping lamp from the late 18th Century with two bronze cups. These pieces would have made up part of a cupping set along with various lancets and scarificators (see explanation below) This picture is taken from the German edition of "Histoire de la Médicine, de la Pharmacie, de l´Art Dentaire et de l´Art Vétérinaire"). A similar set can also be seen in the Josephinum Museum in Vienna.

There were two cupping methods. "Dry cupping" was undertaken as follows: a small piece of tow, or lint, was lit and then placed in the cup. The cup was then applied to the patient’s skin. When the hot cup was placed on the patient’s skin, a vacuum was produced by the burning tow’s consumption of oxygen. When it cooled and the air inside contracted, and a partial vacuum resulted, causing the skin to be sucked into the vessel and producing a rounded area of inflammation-a blister. Believers in this treatment thought the inflammatory response was therapeutic as it brought to the surface all those nasty humours which had been troubling the patient deep in his body.

Wet cupping was very unpleasant,IMHO. It involved cutting the skin with a lance or spring loaded lancet ( to make one cut) or by making many incisions using a multi-bladed bleeder called a "scarificator". These became very popular in the late 18th and 19th centuries. Like spring lancets, they came in every size and description. Once a scarificator was used to slice the patient open, a cup was often placed over the wound as a receptacle for the blood. Cups were made of tin, brass, rubber, horn, and most commonly glass, as shown above. There were often suction devices attached to the cup to allow the removal of blood. Human lips, rubber bulbs, and brass syringes were all used as sources for suction.

YUK.

And people wonder why I never want to time-travel back to the early 19th century.......