This compound noun (haima + ekchysis) literally means "blood-shedding" or "pouring out of blood." The author of Hebrews uses it in Hebrews 9:22 in the theological statement "without shedding of blood there is no forgiveness." The term emphasizes the sacrificial principle running through the Old Testament cult: atonement requires the violent outpouring of life-blood. The word combines the physical reality of blood being poured out with the theological significance of life offered to God. This isn't merely blood being spilled accidentally but the deliberate shedding of sacrificial blood as the means of covenant making and sin cleansing.