As a treatment for angina, the reduction of circulating blood by venesection was inconvenient. A diet low in iron is generally recommended, but has little effect compared to venesection. The mammouthes (practical nurses) assisted during childbirth, and also used cupping (cazia) and venesection (vlotomes). There were doctors, midwives and practical doctors, who were practicing venesection, cautery, purging, and sniffing. In 1539 he also published his Venesection letter on bloodletting. Chloroquine, hydroxychloroquine, and venesection are typically employed in the management strategy. Where venesection is not possible, long-term administration of desferrioxamine mesylate is useful. A maternal peripheral blood sample is taken by venesection at about ten weeks gestation.