BLOODLETTING IN MONGOLIA

Mongolian herders employ a pluralistic approach to medicinal treatment, often accompanying bloodletting with other measures, such as medicinal herbs, moxibustion (the burning of herbs), bone massage, ritual ceremony (em dom) and, if available and affordable, modern medicine. The more traditional forms of treatment stem from ancient nomadic practices, often a combination of both shamanic and Buddhist philosophical principles.

In 2017, I spent the Mongolian spring and autumn in the countryside documenting different forms of medicine used beyond humans, including the bloodletting of horses.

When enquiring about health practitioners in the region, herders kept mentioning the knowledgeable elder Dogsom and his bloodletting skills. I travelled to visit him at his spring encampment.

Dogsom talked about how he regularly travels to other herding encampments to let the blood of horses—‘like a lama’ (Buddhist monks who specialise in traditional medicine).

According to Dogsom, ‘the Mongolian traditional method is mainly the letting of blood and treatment with medicinal herbs’.

Bloodletting is generally performed when there is new grass in spring and before the air becomes too wet, from late May until mid-July.

Although the timing was right, as it was spring and a warm fine day, Dogsom did not want to perform a procedure without one of the horses actually requiring treatment. He explained: ‘I blood-let on a warm, sunny day like today. On a cold, rainy day the blood becomes thicker and doesn’t flow. Horse blood is only let on a good, auspicious day for the horse.’

Dogsom willingly demonstrated key points on one of the horses that was already saddled for herding the sheep and goats: ‘Horses with blood accumulating in the lower leg tend to stumble.’

Dogsom learnt bloodletting through a form of apprenticeship and by practical application as a herder. He initially learnt the skill from his father and has continued the practice for over 40 years. He admitted that he has only passed on the fundamental skills to his youngest son, who has remained in the same encampment. Dogsom’s young grandson watched his demonstration on the horse with interest.

According to Dogsom, his son ‘practices the basics: the hard palette, the forelegs, the bottom of the hoof. He doesn’t try hard though, maybe because I’m still around. I hope he will continue to learn.’

This section features herder Galsandorj arriving to carry out bloodletting on a horse that had been shedding his coat too early, losing condition and stumbling as it walked.

Because of the strong, biting wind, the herder sat down in the lee of the yurt and began sharpening the knife he would use to puncture the horse’s legs. While using the grindstone, Galsandorj explained: ‘In theory, there are four kinds of bloodletting knives.’

The young herder watching Galsandorj’s knife preparation joked with him: ‘You haven’t been sharing your secrets. You’re better than me after herding horses for so long.’ Galsandorj replied in jest: ‘How could I compete with you all?’

The young herders reminded me of reckless cowboys, but were respectful to the knowledgeable herder, viewing him as a skilled elder. When instructed, they caught individual horses by throwing a leather lasso. The herd was restless in the spring wind, resistant to the energetic antics of the young men.

Galsandorj commented: ‘Shirhdene means moulting and losing hair, a condition when the grass is poor in spring. This horse is getting bad blood from the poor grass and losing hair when he shouldn’t. That’s called Shirhdene. Secondly, blood is accumulating in both legs. So we’ll let the blood out now.’

Galsandorj jabbed the upper leg until the blood flowed properly, expelling ‘bad blood’ from the body. After puncturing in four places, he massaged the legs to encourage the flow of fluid.

To treat injuries from heavy riding or a poorly placed saddle, a different knife is used to puncture deep into the shoulder. ‘In the upper body, between the shoulder blades, the blood vessels are not easy to find’, Galsandorj explained.

As an experienced herder, Galsandorj was sure that with the Shirhdene bloodletting technique—letting fluids flow from the upper legs—the horse would be healthy again. After release, the horse did not move away in a hurry but remained nearby with the rest of the herd.

Galsandorj commented: ‘After a month, he will return to his usual horse self. He’ll look well and gain fat easily. When horses are in the previous state, they don’t gain any fat or strength regardless of whether they’re given supplementary feed. Horses with bad blood do not gain weight at all.’

Galsandorj had emerged, seemingly out of nowhere, on the windy steppe. After completing his task and instructing the herd to be released, he promptly mounted his horse and cantered away.

In contrast to biomedicine, a significant aspect of Mongolian medicine among the herding community is its focus on prevention rather than cure. For the herders, it is better to build up the immunity of herd animals through appropriate herding practices and attention to the seasons and surrounding ecology, rather than wait to heal an individual once it has become sick.

It was spring and the ground was muddy from recently melted snow. Brothers Ganbaa and Sumiya often worked together on herding tasks. Both learnt bloodletting skills from their father. Their extended family herd comprised the largest number of horses in the river valley. Across the generations, their family has been known as horse specialists.

Usually, when an animal is slaughtered for food, great care is taken to avoid any blood being spilt. Instead of cutting the throat, the Mongolian technique is to make an incision in the chest. The herder deftly snaps the aorta to the heart, then women carefully collect blood from inside the body cavity with a bowl for later consumption. In the case of bloodletting, because it is ‘bad blood’ (discoloured or not the correct viscosity), it is expelled and left to soak into the ground.

On this occasion, Ganbaa was bloodletting as a favour to a neighbouring herder. A young, two-year-old horse hadn’t been drinking enough water and it was evident that his coat was moulting in patches.

Ganbaa also let blood from two of the extended family’s horses, with the intention of boosting their immunity and to get them into better condition for racing during the summer Naadam festival season. Ganbaa intended to repeat the bloodletting procedure on the three horses after a 15 day rest.

He commented that ‘only those that come through the spring fat and strong will be jabbed.’

Ganbaa punctures the third ridge along the roof of the mouth to let blood out from the correct point. He jabs the palate again when he finds that blood is not flowing enough. He then leaves the blood to spurt out, until its colour turns ‘pink’ and is no longer dark or viscous.

Ganbaa shows me the old, handcrafted knife he used for the bloodletting procedure. The knife is shared by the extended family. It was initially used by his father, but now is used by Ganbaa and his brother. In the future, it will be used by their sons. The knife is wrapped in a rag to ensure that the roof of the mouth is punctured at the correct depth.

Bloodletting knowledge would have been expected of most male herders in the past. Ganbaa is modest about his skills and explains how he only knows the core bloodletting techniques.

Mongolia is one of the few places where bloodletting remains an ongoing medical practice across species. Bloodletting is viewed as a necessary skill to ensure that individual horses retain a good level of immunity in spring, and also to ensure that they become strong and healthy during the season of growth. Prevention of illness is crucial to the herding family and the herd’s survival in an extreme environment. This is seasonal bloodletting.