The methods for bloodletting during the medieval period were somewhat similar to those used by the Greeks and Romans. Generally, bloodletting was divided into three methods. The most extreme was by venesection of the median cubital vein, but other veins or even arteries might be used. The primary instruments used for this type of bloodletting were lancets. Lancets were small sharp-pointed two-edged instruments. The primary danger with this method was the possibility of the patient loosing too much blood. Less extreme, in so far as blood loss, were scarification and the application of leeches. Scarification during the Middle Ages involved scraping the skin primarily using an instrument called a fleam. Fleams were much like a pocket knife with multiple different size blades. This was followed by cupping which was accomplished by placing a dome-shaped glass over the scraped skin and inducing the area to bleed by creating a vacuum either by suction or prior heating of the cupping device.
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