Here is that incident from Treasure Island by Robert Louis Stevenson, where Billy Bones had a 'minor' heart attack or a stroke (according to R.L. Stevenson).

To give a little background about Billy Bones, he was a pirate, a toughened and hardened person who has gone through the deadly and unethical ordeals of life. He was an alcoholic and used to drink rum a lot. Dr. Livesey had previously warned him of taking any rum at all. But its quite a daunting task to let go a life long bad habit. Another thing worthy to be mentioned is that (to me it felt) Billy Bones had a very short temper which is indicative that he is a very likely candidate of high blood pressure.

In one incident, Billy Bones had a fight with an old foe of him. His foe escaped after collecting some major injuries caused by Billy Bones namely known as the Captain in Admiral Benbow inn. As the fugitive left the vicinity, Billy Bones gasping called out for rum and immediately he fainted.

I heard a loud fall in the parlour, and running in, beheld the captain lying full length upon the floor. ...He was breathing very loud and hard, but his eyes were closed and his face a horrible colour.

Jim called in Dr. Livesey downstairs who was treating Jim's father upstairs.

“Oh, doctor,” we cried, “what shall we do? Where is he wounded?”

“Wounded? A fiddle-stick's end!” said Dr. Livesey. “No more wounded than you or I. The man has had a stroke, as I warned him... I must do my best to save this fellow's terribly worthless life; Jim, you get me a basin.”

When I got back with the basin, the doctor had already ripped up the captain's sleeve and exposed his great sinewy arm. It was tattooed in several places...

“Prophetic,” said the doctor, touching this picture with his finger. “And now, Master Billy Bones, if that be your name, we'll have a look at the colour of your blood. Jim,” he said, “are you afraid of blood?”

“No, sir,” said I.

“Well, then,” said he, “you hold the basin”; and with that he took his lancet and opened a vein.

My question is about Dr. Livesey's little surgery. R.L. Stevenson writes after this 'surgery',

A great deal of blood was taken before the captain opened his eyes and looked mistily about him.

It almost had an immediate positive effect on the patient. My question is about Dr. Livesey's little surgery. What did he do here? Was it any form of valid treatment?

  • $\begingroup$ Welcome to Biology.SE! Thank you for taking the tour, but please also go through the help pages starting with How to Ask questions effectively on this site. ——— I think this question is too speculative for this site since answers to it will necessarily be "primarily opinion-based". You might want to investigate whether this is an acceptable question for Medical Sciences. In addition, we encourage you to do some research on your own and then, informed by what you have learned, ask any questions you still have (ideally with references to reliable sources). Thanks! 😊 $\endgroup$
    – tyersome
    Jan 1, 2020 at 0:58
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    $\begingroup$ @tyersome This question is only primarily opinion based to people who aren't familiar with the topic, which is perhaps more about history than biology. $\endgroup$
    – De Novo
    Jan 1, 2020 at 4:05
  • $\begingroup$ @DeNovo — Since the question is based on event in a work of fiction, there can be no criteria for declaring an answer "correct". Therefore I can't see how this question (as written) could get an answer that was anything other than opinion based speculation ... $\endgroup$
    – tyersome
    Jan 1, 2020 at 4:15
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    $\begingroup$ OP, are you interested in whether venesection is currently a valid treatment for stroke, or whether it was when treasure island was written or set? $\endgroup$
    – De Novo
    Jan 1, 2020 at 4:16
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    $\begingroup$ @tyersome The question is about whether venesection is an appropriate treatment for stroke, which is readily answered. The primarily opinion based close is often an "I'm not familiar with the topic" close. A common mistake. Biological is a broad field. I wouldn't worry about it. $\endgroup$
    – De Novo
    Jan 1, 2020 at 4:18

1 Answer 1


The procedure described here is called venesection. It is no longer standard of care, but was when Treasure Island was written.

Here is an excerpt from the first edition of Cecil's Textbook of Medicine (1927):

During the acute apoplectic attack the following therapy may be employed: The patient should be put to bed with the head elevated. If he has fallen to the ground the clothing around the neck must be loosened. Difficulty in swallowing contraindicates the administration of nourishment by mouth. An enema may be given. When the face is puffy, the pulse full and strong, and there is reason to suspect hemorrhage, venesection is advisable. It should be employed only for plethoric individuals, not for patients who seem asthenic or arouse suspicion of thrombosis. Usually 250 to 300 cc. of blood are removed.


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