Chapter V: Part 5

Junod's boot, 19th-early 20th century. Copper boot first introduced by Victor-Theodore Junod in the 1830s. The boot fits tightly about the foot and air is exhausted from it by means of a pump. John S. Billings described the boot as "An apparatus for enclosing a limb, and from which air can be exhausted so as to produce the effect of a large cupping glass." (_The National Medical Dictionary._ Philadelphia, 1890 p. 732.) On loan from the Armed Forces Institute of Pathology. L 280 mm, H 430 mm. Neg. 73-7885 (BW). (Figure 81.)

Barber pole, ca. 1890-1900. This small, red, white, and blue striped pole, with a newel post and no globe on the top, was used in Binghamton, New York. The colors are faded into an orange and tan color. Purchased 1974. Pole L 2600 mm, W at widest point 900 mm. NMHT 312616.

Barber pole, ca. 1920. A red, white, and blue striped pole full size. It has a silver wooden top. It was used in New Jersey. Pole: L 63 mm, W at widest point 20 mm. Top: L 33 mm. Gift of H. E. Green. NMHT 322,655.01.

Footnotes:

[A] _Audrey Davis, Department of History of Science, National Museum of History and Technology, Smithsonian Institution, Washington, D.C. 20560. Toby Appel, Charles Willson Peale Papers, National Portrait Gallery, Smithsonian Institution, Washington, D.C. 20560._

[B] "White metal" is the technical term for an undetermined silver colored metal alloy. See discussion of materials at beginning of index.

NOTES

[1] Julius Gurlt's bibliographical essay on bloodletting, originally published in 1898, is a prime source for tracing in detail the specific contributions of European and Asian authors in the ancient, medieval, and Renaissance periods. See JULIUS GURLT, _Geschichte der Chirurgie und ihrer Ausuebung_ (Hildesheim: Georg Olms, 1964), volume 3, page 556-565.

[2] GEORGE F. KNOX, _The Art of Cupping_ (London, 1836), page 30.

[3] For a general history of bloodletting, see TOWNSEND W. THORNDIKE, "A History of Bleeding and Leeching," _British Medical and Surgical Journal_, volume 197, number 12 (September 1927), pages 437-477. For a detailed account of ancient bloodletting, see RUDOLPH SIEGEL, "Galen's Concept of Bloodletting in Relation to His Ideas on Pulmonary and Peripheral Blood Flow and Blood Formation" (chapter 19 in volume 1 of _Science, Medicine and Society in the Renaissance_ edited by Allen Debus, New York: Science History Publications, 1973), pages 247-275.

[4] ROBERT MONTRAVILLE GREEN, "A Translation of Galen's Temperaments and Venesection" (manuscript, Yale Medical Library, New Haven, Connecticut), page 102.

[5] Ibid., page ii-iv.

[6] CELSUS, _De Medicina_, translated by W. G. Spencer (Cambridge: Harvard University Press, 1960), volume 1, book 2, page 155.

[7] HENRY E. SIGERIST, _A History of Medicine_ (New York: Oxford University Press, 1961), volume II, pages 317-335.

[8] GREEN, op. cit. [note 4], page 105.

[9] PETER H. NIEBYL, "Galen, Van Helmont and Blood Letting," (chapter 21 in volume 2 of _Science, Medicine and Society in the Renaissance_ edited by Allen Debus, New York: Science History Publications, 1972); PETER NIEBYL, "Venesection and the Concept of the Foreign Body: A Historical Study in the Therapeutic Consequences of Humoral and Traumatic Consequences of Diseases" (doctoral dissertation, Yale University, 1969), page 156.

[10] GREEN, op. cit. [note 4], page 171.

[11] Ibid., page 114.

[12] Ibid., page 173.

[13] Ibid., pages 174, 180.

[14] CELSUS, op. cit. [note 6], page 163.

[15] CHARLES H. TALBOT, _Medicine in Medieval England_ (London: Oldbourne, 1967), pages 127-131.

[16] CHARLES D. O'MALLEY, _Andreas Vesalius of Brussels 1514-1564_ (Berkeley and Los Angeles: University of California Press, 1964), pages 66-67.

[17] See, for example, M. DAVID, _Recherches sur la maniere d'agir de la saignee et sur les effets qu'elle produit relativement a la partie ou on la fait_ (Paris, 1762), page iv.

[18] LORENZ HEISTER, _Chirurgie, in welcher alles, was zur wund artzney gehoeret ..._ (Nuremberg, 1719).

[19] GREEN, op. cit. [note 4], page 179.

[20] JOSEPH T. SMITH, SR., "An Historical Sketch of Bloodletting," _Johns Hopkins Hospital Bulletin_, volume 21 (1910), page 312.

[21] MARSHALL HALL, _Observations on Bloodletting Founded upon Researches on the Morbid and Curative Effects of Loss of Blood_ (London, 1836), page 280.

[22] ROBLEY DUNGLISON, _Medical Lexicon--A Dictionary of Medical Science_ (Philadelphia, 1848), page 820.

[23] JAMES E. BOWMAN, "Blood," _Encyclopaedia Britannica_ (Chicago: William Benton, 1972), volume 34, pages 795-800.

[24] GREEN, op. cit. [note 4], page 187.

[25] KARL SUDHOFF, _Deutsche medizinische Inkunabeln_ (Leipzig, 1908); Studien zur Geschichte der Medizin heft 2/3. SIR WILLIAM OSLER, _Incunabula Medica: A Study of the Earliest Printed Medical Books, 1467-1480_ (Oxford: Oxford University Press, 1923).

[26] FRANCISCO GUERRA, "Medical Almanacs of the American Colonial Period," _Journal of the History of Medicine and Allied Sciences_, volume 16 (1961), pages 235-237. The number of veins illustrated in the vein man varied a great deal but became fewer after the seventeenth century.

[27] TALBOT, op. cit. [note 15], pages 127-131.

[28] GUERRA, op. cit. [note 26], pages 237; MARION BARBER STOWELL, _Early American Almanacs: The Colonial Weekday Bible_ (New York: Burt Franklin, 1977). The latter work contains numerous illustrations of "anatomies" from colonial almanacs.

[29] "Original Letters," General William F. Gordon to Thomas Walker Gilmar, 11 December 1832, _William and Mary Quarterly_, volume 21 (July 1912), page 67.

[30] TALBOT, op. cit. [note 15], pages 50, 51. For another view of the religious impact upon medieval medical and surgical practices, see JAMES J. WALSH, _The Popes and Science_ (New York: Fordham University Press, 1908), pages 167-198.

[31] THORNDIKE, op. cit. [note 3], page 477.

[32] MIGUEL DE CERVANTES SAAVEDRA, _Don Quixote de la Mancha_, translated by Walter Starkie (New York: Mentor, 1963), pages 91, 92.

[33] CHARLES ALVERSON, "Surgeon Abel's Exotic Bleeding Bowls," _Prism_, volume 2 (July 1974), pages 16-18; JOHN K. CRELLIN, "Medical Ceramics," in _A Catalogue of the English and Dutch Collections in the Museum of the Wellcome Institute of the History of Medicine_ (London: Wellcome Institute of the History of Medicine, 1969), pages 273-279.

[34] THORNDIKE, op. cit. [note 3], page 477; CAREY P. MCCORD, "Bloodletting and Bandaging," _Archives Environmental Health_, volume 20 (April 1970), pages 551-553.

[35] LEO ZIMMERMAN and VEITH ILZA, _Great Ideas in the History of Surgery_ (New York: Dover Books, 1967), page 126.

[36] WILLIAM HARVEY, _Works_, edited by Robert Willis (London: Sydenham Society, 1847), page 129. Harvey reaffirmed later: "I imagine that I shall perform a task not less new and useful than agreeable to philosophers and medical men, if I here briefly discourse of the causes and uses of the circulation, and expose other obscure matters respecting the blood" (page 381).

[37] HENRY STUBBE, _The Lord Bacons Relation of the Sweating-Sickness Examined ... Together with a Defense of Phlebotomy ..._ (London, 1671), page 102.

[38] FIELDING H. GARRISON, "The History of Bloodletting," _New York Medical Journal_, volume 97 (1913), page 499. Magendie was firmly opposed to bloodletting and ordered physicians working under him not to bleed. However, their belief in the practice was so strong that they disobeyed his instructions and carried out the procedure. See ERWIN ACKERKNECHT, _Therapeutics from the Primitives to the 20th Century_ (New York: Hafner, 1973), pages 111-112.

[39] AUDREY B. DAVIS, _Circulation Physiology and Medical Chemistry in England, 1650-1680_ (Lawrence, Kansas: Coronado Press, 1973), pages 135, 167, 219. For the history of injecting remedies into the blood, see HORACE M. BROWN, "The Beginnings of Intravenous Medication," _Annals of Medical History_, volume 1 (1917), page 182.

[40] ARTURO CASTIGLIONI, _A History of Medicine_, translated from Italian by E. B. Krumbhar, 2nd edition, revised and enlarged (New York: Alfred A. Knopf, 1958), page 444; NIEBYL, "Venesection" [note 9], page 414.

[41] JOAN LILLICO, "Primitive Bloodletting," _Annals of Medical History_, volume II (1940), page 137.

[42] C.J.S. THOMPSON, _Guide to the Surgical Instruments and Objects in the Historical Series with Their History and Development_ (London: Taylor and Francis, 1929), page 40.

[43] JOHN STEWART MILNE, _Surgical Instruments in Greek and Roman Times_ (New York: Augustus M. Kelley, 1970), reprint of 1907 edition, pages 32-35. A bronze knife of this type is illustrated in THEODOR MEYER-STEINEG, _Chirurgische Instrumente des Altertum_ (Jena: Gustav Fischer, 1912), page iv, figure 9. The instrument was donated by Dr. Nylin of the Kardinska Institute in Stockholm, who used a lancet until 1940. Replicas of the early bronze medical instruments were sold in 1884 by Professor Francesco Scalzi of Rome. He exhibited 45 of them at the Exposition Universelle de Paris in 1878. He won an honorable mention award, "Collezione di Istrumenti Chirurgici de Roma Antica," 1884.

[44] S. HOLTH, "Greco-Roman and Arabic Bronze Instruments and Their Medico-Surgical Use," _Skriften utgit an Videnskapsselskapet I Kristrania_ (1919), page 1 (below). Holth lists the content of lead, tin, zinc, iron, copper, and cobalt found in a number of ancient bronze medical items in his collection, which formerly belonged to Baron Ustinov of Russia. These instruments were unearthed in Syria and Palestine from 1872 to 1890.

[45] An occasional curious item like the spring lancet on display in the Welch Medical Library of the Johns Hopkins University is an exception.

[46] MILNE, op cit. [note 43], pages 35-36.

[47] LAURENCE HEISTER, _A General System of Surgery in Three Parts_, translated into English (London, 1759), 7th edition, page 294.

[48] GURLT, op. cit. [note 1], volume III, page 558.

[49] G. GAUJOT and E. SPILLMAN, _Arsenal de la Chirurgie Contemporaine_ (Paris: J. B. Bailliere et fils, 1872), pages 274-276.

[50] MILNE, op. cit. [note 43], page 33.

[51] GARRISON, op. cit. [note 38], page 433.

[52] SIR WILLIAM FERGUSON, _Lectures on the Progress of Anatomy and Surgery during the Present Century_ (London: John Churchill & Sons, 1867), page 284.

[53] JAMES EWELL, _The Medical Companion_ (Philadelphia, 1816), pages 405, 406.

[54] For an illustration of incisions, see HEISTER, (1759), op. cit. [note 47].

[55] MILNE, op. cit. [note 43], page 36.

[56] GURLT, op. cit. [note 1], volume III, page 556.

[57] P. Hamonic describes an eighteenth-century Naples porcelain figure of a woman being bled that illustrates the elegant manner in which the operation was performed. P. HAMONIC, _La Chirurgie et la medecine d'autrefois d'apres une premiere serie d'instruments anciens renfermes dans mes collections_ (Paris: A. Maloine, ed., 1900), pages 91, 93.

[58] THOMAS DICKSON, _A Treatise on Bloodletting with an Introduction Recommending a Review of the Materia Medica_ (London, 1765), page 1.

[59] SIR D'ARCY POWER, editor, _British Medical Societies_ (London: The Medical Press Circular, 1939), page 23.

[60] Wakeley was a heretic wealthy doctor who led the campaign in Britain against the monopoly of surgical training and practice held by the Royal College of Surgeons of London. ALAN ARNOLD KLASS, _There's Gold in "Them Thar Pills"_ (Baltimore: Penguin Books, 1975), pages 158-159.

[61] JOHN HARVEY POWELL, _Bring Out Your Dead_ (Philadelphia: University of Pennsylvania Press, 1949), page 123.

[62] See, e.g., RICHARD SHRYOCK, _Medicine and Society in America: 1660-1860_ (New York: New York University Press, 1960), pages 67, 111-112.

[63] JAMES T. FLEXNER, _George Washington: Anguish and Farewell_ (Boston: Little, Brown, 1972), pages 457-459.

[64] BARBARA DUNCUM, _The Development of Inhalation Anesthesia_ (The Wellcome Historical Medical Museum, Oxford University Press, 1947), page 195.

[65] HAMONIC, op. cit. [note 57], pages 95-96.

[66] DONALD D. SHIRA, "Phlebotomy Lancet," _Ohio State Medical Journal_, volume 35 (1939), page 67.

[67] HEISTER, (1719) loc. cit. [note 18].

[68] _Encyclopedia or Dictionary of the Arts and Sciences_, 1st American edition (Philadelphia, 1798).

[69] RISTELHUEBER, "Notice: sur la flammette, phlebotome des Allemands, Fliete, Schnepper oder gefederte Fliete, phlebotomus elasticus, Flamme ou flammette," _Journal de Medecine, chirurgie et pharmacologie_, volume 37 (Paris, 1816), pages 9-17.

[70] JOHN SYNG DORSEY, _Elements of Surgery: For the Use of Students_, volume 2 (Philadelphia, 1813), pages 279-281.

[71] Patent specifications, U.S. patent 16479.

[72] M. MALGAIGNE, "Esquisse historique sur la saignee consideree au point de vue operatoire; extrait des lecons du Professeur Malgaigne," _Revue Medico Chirurgicale de Paris_, volume 9 (1851), page 123.

[73] GARRISON, op. cit. [note 38], page 501.

[74] Some of these studies are cited in B. M. RANDOLPH, "The Bloodletting Controversy in the Nineteenth Century," _Annals of Medical History_, volume 7 (1935), page 181.

[75] Quotation cited by LESTER S. KING, "The Blood-letting Controversy: A Study in the Scientific Method," _Bulletin of the History of Medicine_, volume 35 (1961), page 2.

[76] MARTIN KAUFMANN, _Homeopathy in America_ (Baltimore: Johns Hopkins Press, 1971), pages 1-14. Other references on the decline of bloodletting include: LEON S. BRYAN, JR., "Blood-letting in American Medicine, 1830-1892," _Bulletin of the History of Medicine_, volume 38 (1964), pages 516-529; B. M. RANDOLPH, op. cit. [note 74], pages 177-182; JAMES POLK MORRIS, "The Decline of Bleeding in America, 1830-1865" (manuscript, Institute for the Medical Humanities, University of Texas Medical Branch, Galveston, Texas), 11 pages.

[77] HENRY I. BOWDITCH, _Venesection, Its Abuse Formerly--Its Neglect at the Present Day_ (Boston: David Clapp & Son, 1872), pages 5, 6.

[78] W. MITCHELL CLARKE, "On the History of Bleeding, and Its Disuse in Modern Practice," _The British Medical Journal_ (July 1875), page 67.

[79] HENRY LAFLEUR, "Venesection in Cardiac and Arterial Disease," _The Johns Hopkins Hospital Bulletin_, volume 2 (1891), pages 112-114.

[80] See, for example, JOHN REID, _"Bleeding," Essays on Hypochondriasis and Other Nervous Affections_ (London, 1821), essay 22 page 334.

[81] AUSTIN FLINT, _A Treatise on the Principles and Practice of Medicine_, 3rd edition (Philadelphia, 1868), page 150.

[82] MARTIN DUKE, "Arteriosclerotic Heart Disease, Polychthenic and Phlebotomy--Rediscovered," _Rhode Island Medical Journal_, volume 48 (1965), page 477.

[83] SAMUEL LEVINE, Editorial, "Phlebotomy, An Ancient Procedure Turning Modern?," _Journal of the American Medical Association_ (January 26, 1963), page 280.

[84] GEORGE BURCH and N. P. DEPASQUALE, "Phlebotomy Use in Patients with Erythrocytosis and Ischemic Heart Disease," _Archives of Internal Medicine_, volume 3 (June 1963), pages 687-695. See also GEORGE BURCH and N. P. DEPASQUALE, "Hematocrit, Viscosity and Coronary Blood Flow," _Diseases of the Chest_, volume 48 (September 1965), pages 225-232.

[85] HEINRICH STERN, "A Venepuncture Trocar (Stern's Trocar)," _Medical Record_ (December 1905), pages 1043, 1044.

[86] DELAVAN V. HOLMAN, "Venesection, Before Harvey and After," _Bulletin New York Academy of Medicine_, volume 31 (September 1955), pages 662, 664.

[87] SAMUEL BAYFIELD, _A Treatise on Practical Cupping_ (London, 1823), page 11.

[88] CELSUS, _De Medicina_, op. cit. [note 6], page 169. For bibliography on cupping, see WILLIAM BROCKBANK, _Ancient Therapeutic Arts_ (London: William Heinemann, 1954); JOHN HALLER, "The Glass Leech: Wet and Dry Cupping Practices in the Nineteenth Century," _New York State Journal of Medicine_ (1973), pages 583-592; BROCHIN, "Ventouses," _Dictionnaire encyclopedique des sciences medicales_, series 5, volume 2 (1886), pages 750-752; and, the _Index Catalogue of the Library of the Surgeon-General's Office, U.S. Army_.

[89] HIPPOCRATES, _Aphorisms_, V, page 50.

[90] THOMAS MAPLESON, _A Treatise on the Art of Cupping_ (London, 1813), opposite page 1.

[91] GURLT, op. cit. [note 1], volume 3, page 151.

[92] CHARLES COURY, "Saignees, ventouses et cauterisations dans le medecine orientale a l'epoque de la Renaissance," _Histoire de la medecine_, volume 11 (November-December 1961), pages 9-23.

[93] W. A. GILLESPIE, "Remarks on the Operation of Cupping, and the Instruments Best Adapted to Country Practice," _Boston Medical and Surgical Journal_, volume 10 (1834), page 28.

[94] Letter from Rev. Robert Richards to Dr. Sami Hamarneh, 1 September 1966 (Division of Medical Sciences, Museum of History and Technology).

[95] On ancient cups, see CELSUS, op. cit. [note 6], pages 165-167; MILNE, op. cit. [note 43], pages 101-105 and plates; and BROCKBANK, op. cit. [note 88], pages 65-72. The Institute of the History of Medicine, Johns Hopkins University, has several metal cups dating from about A.D. 100.

[96] CASTIGLIONI, op. cit. [note 40], page 380.

[97] PIERRE DIONIS, _Cours d'operations de chirurgie demonstrees au Jardin Royal_ (Paris, 1708), page 584.

[98] RENE JACQUES CROISSANTE DE GARENGEOT, _Nouveau Traite des Instrumens de Chirurgie les plus utiles_ (The Hague, 1725), page 342.

[99] DIONIS, op. cit. [note 97], page 585.

[100] MAPLESON, op. cit. [note 90], pages 27-28. See also GEORGE FREDERICK KNOX, op. cit. [note 2], page 29.

[101] MAPLESON, op. cit. [note 90]; BAYFIELD, op. cit. [note 87]; KNOX, op. cit. [note 2]; and MONSON HILLS, "A Short Treatise on the Operation of Cupping," _Boston Medical and Surgical Journal_, volume 9 (1834), pages 261-273.

[102] KNOX, op. cit. [note 2], page vi.

[103] BAYFIELD, op. cit. [note 87], page 125.

[104] DIONIS, op. cit. [note 97], page 587 and figure 57 on page 583.

[105] KNOX, op. cit. [note 2], page 33.

[106] JOHN H. SAVIGNY, _A Collection of Engravings representing the Most Modern and Approved Instruments Used in the Practice of Surgery_ (London, 1798), plate 7. For the earlier grease lamp, see J. A. BRAMBILLA, _Instrumentarium Chirurgicum Viennense oder Wiennerliche Chirurgische Instrumenten Sammlung_ (Vienna, 1780), plate 2.

[107] BAYFIELD, op. cit. [note 87], page 123; KNOX, op. cit. [note 2], page 33; HILLS, op. cit. [note 101], page 263.

[108] See DIONIS, op. cit. [note 97], page 587 and figure 58 on page 583; and LAURENCE HEISTER, op. cit. [note 47], page 329 and plate 12. The parallel incisions were described in antiquity by Oribasius (ca. A.D. 360), the most important medical author after Galen and the friend of the emperor Julian. See GURLT, op. cit. [note 1], volume 3, page 563.

[109] AMBROISE PARE, _The Collected Works of Ambroise Pare_, translated by Thomas Johnson (London, 1634). Reprint edition (Pound Ridge, New York: Milford House, 1968), page 446. The drawing first appeared in Pare's treatise "Methode de traiter des playes de la teste" in 1561.

[110] PAULUS AEGINETA, _Medicinae Totius enchiridion_ (Basileae, 1541), page 460.

[111] ALBERT WILHELM HERMANN SEERIG, _Armamentarium chirurgicum oder moeglichst vollstaendige Sammlung von Abbildungen und Beschreibung Chirurgischer Instrument alterer und neuerer Zeit_ (Breslau, 1838), page 598.

[112] JACQUES DELECHEMPS, _Chirurgie Francoise Recueillie_ (Lyon, 1564, page 174); HELLKIAH CROOKE. _Micrographia: A Description of the Body of Men ... with an Explanation of the Fashion and Use of Three & Fifty Instruments of Chirurgy_ (London, 1631).

[113] GARENGEOT, op. cit. [note 98], pages 347, 351.

[114] HEISTER (1719), op. cit. [note 18], page 329. Lorenz Heister _... Chirurgie ..._ (Nuremberg, 1719) includes the same picture of the scarificator as the 1759 English translation.

[115] HEISTER (1759), op. cit. [note 47], page 330.

[116] See BRAMBILLA, op. cit. [note 106], plate 2; DENIS DIDEROT, _Dictionnaire risonne des sciences, arts et metiers. Recueil des planches_ (Lausanne and Berne, 1780), volume 2, plate 23; and BENJAMIN BELL, _A System of Surgery_, 5th edition (Edinburgh, 1791), volume 1, plate 5.

[117] JAMES LATTA, _A Practical System of Surgery_ (Edinburgh, 1795), volume 1, plate I; BENJAMIN BELL, _A System of Surgery_, 7th edition (Edinburgh, 1801), volume 3, plate 7.

[118] JOHN WEISS, _An Account of Inventions and Improvements in Surgical Instruments Made by John Weiss, 62, Strand_, 2nd edition (London, 1831), pages 12-13. A Mr. Fuller introduced a similar improvement, which Weiss claimed Fuller had pirated from him. The only difference between Weiss's Improved Scarificator and Fuller's Improved Scarificator was that the blades in Weiss's were arch shaped and those of Fuller's crescent shaped. The cupper, Knox, preferred the crescent blades because they gave a sharper cut. In any case, most nineteenth-century scarificators were made with crescent-shaped blades. On Fuller's scarificator, see BAYFIELD, op. cit. [note 87], pages 99-100; and, SEERIG, op. cit. [note 111], pages 604-605 and plate 56.

[119] _Extract du Catalogue de la maison Charriere_ (Paris, 1843), page 30; KNOX, op. cit. [note 2], pages 39, 40.

[120] This statement is based on the perusal of a wide variety of nineteenth-century trade catalogs. See "List of Trade Catalogs Consulted."

[121] KNOX, op. cit. [note 2], page xii.

[122] Ibid., pages 14-15.

[123] HILLS, op. cit. [note 101], page 266.

[124] BAYFIELD, op. cit. [note 87], page 116.

[125] KNOX, op. cit. [note 2], pages 53-64.

[126] Ibid., page 68.

[127] HERO OF ALEXANDRIA, _The Pneumatics of Hero of Alexandria_, translated by Bennet Woodcroft (London, 1851).

[128] GURLT, op. cit. [note 1], volume 2, page 565 and plate X.

[129] BRAMBILLA, op. cit. [note 106], page 42, mentioned but did not picture a cup with air pump. One of the earliest illustrations of a cup with pump is found in SAVIGNY, op. cit. [note 106], plate 7.

[130] MAPLESON, op. cit. [note 90], page 63.

[131] KNOX, op. cit. [note 2], page 32.

[132] JOHN READ, _A Description of Read's Patent Syringe Pump_ (London, no date). See also JOHN READ, _An Appeal to the Medical Profession on the Utility of the Improved Patent Syringe_, 2nd edition (London, ca. 1825).

[133] WEISS, op. cit. [note 118], page 87; CHAS. TRUAX, GREENE & CO., _Price List of Physicians' Supplies_, 6th edition (Chicago, 1893), pages 989-1010.

[134] "Notice sur l'acupuncture et sur une nouvelle espece de ventouse armee de lancettes, inventee par A.-P. Demours," _Journal universal des sciences medicales_, volume 15 (1819), pages 107-113; BAYFIELD, op. cit. [note 87], pages 73-81.

[135] THOMAS MACHELL, "Description of an Apparatus for Cupping, Dry Cupping, and Drawing the Breasts of Females; With some Observations Respecting Its Use," _London Medical and Physical Journal_, volume 42 (1819), pages 378-380; BAYFIELD, op. cit. [note 87], pages 81-89.

[136] BAYFIELD, op. cit. [note 87], pages 92-93.

[137] ROBERT J. DODD, "Improved Cupping Apparatus," _The American Journal of the Medical Sciences_, new series, volume 7 (1844), page 510. See also patent specifications, U.S. patent 3537.

[138] Patent specifications, U.S. patent 68985.

[139] HILLS, op. cit. [note 101], page 261.

[140] GILLESPIE, op. cit. [note 93], page 29.

[141] FRANCES FOX, JR., "A Description of an Improved Cupping Glass, with Which from Five to Eight Ounces of Blood May Be Drawn, with Observations," _The Lancet_, volume 12 (1827), pages 238-239. KNOX, op. cit. [note 2], pages 36-37, recommended these glasses especially for use on young ladies who feared scars left by cupping. One of the "glass leeches" fixed below the level of the gown could draw all the blood necessary.

[142] See JOHN GORDON, "Remarks on the Present Practice of Cupping; With an Account of an Improved Cupping Glass," _The London Medical Repository_, volume 13 (1820), pages 286-289. J. WELSH, "Description of a Substitute for Leeches," _The Edinburgh Medical and Surgical Journal_, volume 11 (1815), pages 193-194; P. MOLONEY, "A New Cupping Instrument," _Australia Medical Journal_, new series, volume 1 (1879), pages 338-340. At least two American patents were given for improved cups, one to C. L. Myers in 1884 (U.S. patent 291388) and one to Jaime Catuela in 1922 (U.S. patent 1463458).

[143] SAVIGNY, op. cit. [note 106], plate 18, illustrated in 1798 "elastic bottles" that could be attached to glass cups for drawing the breasts; however, not until Charles Goodyear's discovery of the vulcanization process in 1838 was rubber widely used in cupping. An American surgeon, Samuel Gross, wrote in 1866 that the glass cup with a bulb of vulcanized rubber was the "most elegant and convenient cup, by far." See SAMUEL GROSS, _A System of Surgery_, 4th edition, 2 volumes (Philadelphia, 1866), volume 1, page 451.

[144] GEORGE TIEMANN & CO., _American Armamentarium Chirurgicum_ (New York, 1889), page 825.

[145] For one listing of the disadvantages of the common scarificator, see BLATIN, "Scarificator nouveau," _Bulletin de l'Academie Royale de Medecine_, volume 11 (1845-1846), pages 87-90. Blatin patented a new scarificator in 1844 that supposedly overcame the difficulties he listed.

[146] JAMES COXETER, "New Surgical Instruments," _The Lancet_ (November 15, 1845), page 538; JAMES COXETER & SON, _A Catalogue of Surgical Instruments_ (London, 1870), page 48. Coxeter sold his scarificator for 2 pounds, 2 shillings, while he offered his "best scarificator, with old action" for two pounds.

[147] GREAT BRITAIN PATENT OFFICE, _Subject-Matter Index of Patents of Invention_, 1617-1852, 2 volumes (London, 1957); U.S. PATENT OFFICE, _Subject Matter Index of Patents for Invention (Brevets d'invention) Granted in France from 1791 to 1876 Inclusive_ (Washington, 1883).

[148] CHARRIERE [firm], _Cinq notices reunies presentees a MM. les membres des jurys des expositions francaises de 1834, 1839, 1844, et 1849, et de l'exposition universelle de Londres en 1851_ (Paris, 1851), page 56.

[149] MAISON CHARRIERE, ROBERT ET COLLIN, SUCCESSEURS, [Catalogue generale] (Paris, 1867), pages 42, 44, and plate 9.

[150] Patent specifications, U.S. patent 4705; TIEMANN & CO., op. cit. [note 144], page 115. Tiemann was awarded an earlier patent for a scarificator in 1834 (unnumbered U.S. patent, 26 August 1834), which seems to have employed a coiled spring similar to that found in the Charriere scarificator. The fifth U.S. patent for a scarificator was issued in 1846 to A. F. Ahrens of Philadelphia (U.S. patent 4717) for a circular scarificator in which all the blades were attached to a movable plate.

[151] Patent specifications, U.S. patent 5111.

[152] Patent specifications, U.S. patent 8095.

[153] DYCE DUCKWORTH, "On the Employment of Dry-Cupping," _The Practitioner: A Monthly Journal of Therapeutics_, volume 2 (1869), page 153.

[154] Ibid., page 155. For more information on counter-irritation, see BROCKBANK, op. cit. [note 88]. Blisters were substances (including mustard and cantharides) that when applied to the skin, occasioned a serous secretion and the raising of the epidermis to form a vesicle. Cautery was the application of a red-hot iron to the skin. A seton was a long strip of linen or cotton thread passed through the skin by a seton needle. Each day a fresh piece of thread was drawn through the sore. Moxa were cones of cotton wool or other substances which were placed upon the skin and burned.

[155] CHARLES BAUNSCHEIDT, _Baunscheidtismus, by the Inventor of the New Curing Method_, 1st English edition, translated from the 6th German edition by John Cheyne and L. Hayman (Bonn., 1859?).

[156] The patent models are in the Smithsonian collection. See "Catalog" herein. The Aima Tomaton, a device invented and manufactured by Dr. L. M'Kay, was yet another American variation on the Lebenswecker. See L. M'KAY, _Aima Tomaton: Or New Cupping and Puncturing Apparatus_ (Rochester, 1870). An example can be found in the collection of the Armed Forces Institute of Pathology.

[157] See DUCKWORTH, op. cit. [note 153]; ISAAC HOOVER, "An Essay on Dry Cupping," _Transactions of the Belmont Medical Society for 1847-48-49-50_ (Bridgeport, 1851), pages 30-32; MARSHALL HALL, _Practical Observations and Suggestions in Medicine_ (London, 1845), pages 51-53; and B. H. WASHINGTON, "Remarks on Dry Cupping," _The New Jersey Medical Reporter and Transactions of the New Jersey Medical Society_ (1852-53), pages 278-281.

[158] CASPER WISTAR PENNOCK, "Observations and Experiments on the Efficacy and Modus Operandi of Cupping-Glasses in Preventing and Arresting the Effects of Poisoned Wounds," _The American Journal of Medical Sciences_, volume 2 (1828), pages 9-26. For a discussion of the debate over absorption, see KNOX, op. cit. [note 2], pages 21-24.

[159] TIEMANN, op. cit. [note 144], pages 116, 800.

[160] VICTOR-THEODORE JUNOD, _A Theoretical and Practical Treatise on Hemospasia_, translated by Mrs. E. Howley Palmer (London, 1879).

[161] HEINRICH STERN, _Theory and Practice of Bloodletting_ (New York: Rebman Co., 1915), pages 71-72.

[162] AUGUST BIER, _Hyperemia as a Therapeutic Agent_ (Chicago, 1905), page 21.

[163] WILLY MEYER and VICTOR SCHMIEDEN, _Bier's Hyperemic Treatment_, 2nd edition (Philadelphia, 1909).

[164] HALLER, op. cit. [note 88; see also note 72], page 585.

[165] GROSS, op. cit. [note 143], volume 2, page 906.

[166] Such a breast pump was illustrated by HEISTER (1719), op. cit. [note 17], plate 14. All glass breast pumps were probably more typical of the eighteenth than the nineteenth century. In the nineteenth century the glass tube was replaced by a flexible tube with a mouthpiece.

[167] For example, see THE J. DURBIN SURGICAL SUPPLY CO., _Standard Surgical Instruments_ (Denver, 1929), page 59.

[168] Data on the numbers of breast pumps patented was obtained from the files of the U.S. Patent Office in Arlington, Virginia.

[169] Patent specifications, U.S. patent 1179129. For other illustrations of late nineteenth- and early twentieth-century patents for cupping devices, see HALLER, op. cit. [note 88].

[170] STERN, op. cit. [note 85], page 74.

[171] MABELLE S. WELSH, "'Cups for Colds': The Barber, the Surgeon and the Nurse," _The American Journal of Nursing_, volume 19 (1918-19), pages 763-766. See also HALLER, op. cit. [note 88], and J. EPSTEIN, "The Therapeutic Value of Cupping: Its Use and Abuse," _New York Medical Journal_, volume 112 (1920), pages 584-585.

[172] THORNDIKE, op. cit. [note 3], page 477. For bibliography on leeching, see BROCKBANK, op. cit. [note 88]; MERAT, "Sangsue," _Dictionnaire des sciences medicales_, volume 49 (1820), pages 520-541; G. CARLET AND EMILE BERTIN, "Sangsue," _Dictionnaire encyclopedique des sciences medicales_, 3rd series, volume 6 (1878), pages 660-681; and the _Index Catalogue of the Library of the Surgeon-General's Office_, U.S. Army.

[173] ALFRED STILLE AND JOHN M. MAISCH, _The National Dispensatory_, 2nd edition (Philadelphia, 1880), page 713; JAMES THACHER, _The American Dispensatory_, 2nd edition (Boston, 1813), page 230; C. LEWIS DIEHL, "Report on the Progress of Pharmacy," _Proceedings of the American Pharmaceutical Association_, volume 25 (1876), page 205.

[174] W. H. SCHIEFFELIN & CO., _General Prices Current_ (New York, 1887), page 39.

[175] DIEHL, op. cit. [note 173]; JOHN C. HARTNETT, "The Care and Use of Medicinal Leeches in 19th Century Pharmacy and Therapeutics," _Pharmacy in History_, volume 14 (1972), page 133.

[176] Broussais offered the following explanation for the effectiveness of leeching. Congestion of blood vessels in a healthy person gives rise to a sympathetic irritation in the mucous surfaces of bodily orifices. Equilibrium may be restored naturally by hemorrhage through the nose. Without this release of blood, congestion builds up into an inflammation. Local bloodletting relieves the congestion when applied on a portion of the skin corresponding to the inflamed organ. Broussais's favorite remedy was the application of leeches to the stomach and head. For this purpose he ordered hundreds of leeches daily. See F.J.V. BROUSSAIS, _A Treatise on Physiology Applied & Pathology_, translated by John Bell and R. La Roche, 2nd American edition (Philadelphia, 1828), page 414, and Castiglioni, op. cit. [note 40], page 609.

[177] THORNDIKE, op. cit. [note 3], page 477. See also KARL-OTTO KUPPE, _Die Blutegel in der Aerztlichen Praxis_ (reprint, Stuttgart: Hippocrates-Verlag, 1955), pages 9-11.

[178] HARTNETT, op. cit. [note 175], page 132.

[179] JONATHAN OSBORNE, "Observations on Local Bloodletting, and on Some New Methods of Practicing It," _Dublin Journal of Medical and Chemical Science_, volume 3 (1833), pages 334-342.

[180] See, for example, MAISON CHARRIERE, ROBERT ET COLLIN, op. cit. [note 149], page 42 and plate 9.

[181] JOHN BERRY HAYCRAFT, "On the Coagulation of the Blood," 9 pages, extracted from _Proceedings of the Royal Society of London_, volume 231 (1884).

[182] THORNDIKE, op. cit. [note 3], page 477. MERAT, op. cit. [note 172], page 528, cited an extreme case in which a woman suffering from peritonitis was given a total of 250 leeches in 24 hours. She died soon after.

[183] STILLE AND MAISCH, op. cit. [note 173], page 715; THACHER, op. cit. [note 173], page 231.

[184] HARTNETT, op. cit. [note 175], page 132; J. K. CRELLIN, op. cit. [note 33], pages 127-134.

[185] ANDREW H. SMITH, "An Artificial Leech," _Medical Record_, volume 4 (1869-70), page 406.

[186] In addition to the references below, articles on artificial leeches include DR. MONTAIN, "Considerations therapeutiques sur l'emploi du pneumo-derme, nouvel instrument destine a remplacer les sangsues et les ventouses," _Bulletin General de therapeutique_, volume 11 (1836), pages 311-315; J. J. TWEED, "A Description of the Apparatus for Employing the Mechanical Leeches," _Medical Times_, volume 21 (1850), pages 36-37; and SAMUEL THEOBALD, "An Improved Method of Applying the Artificial Leech," _American Journal of Medical Science_, new series, volume 70 (1875), pages 139-142.

[187] SARLANDIERE, "Ventouse," _Dictionnaire des sciences medicales_, volume 57 (Paris, 1821), pages 174-178; PAULET, "Bdellometre," _Dictionnaire encyclopedique des sciences medicales_, series 1, volume 8 (Paris, 1868), pages 632-633; L. GRESELY, "Dissertation sur les sangsues, le nouveau scarificateur, et sur leur emploi en medecine" (Paris: Faculty of Medicine, 1820), dissertation no. 202.

[188] ROBLEY DUNGLISON, _Medical Lexicon: A New Dictionary of Medical Science_, 3rd edition (Philadelphia, 1842). The bdellometer was listed in later editions of this dictionary throughout the nineteenth century.

[189] DAMOISEAU, _La terabdelle ou machine pneumatique operant a volonte la saignee locale et la revulsion aux principales regions du corps humains_ (Paris, 1862), 60 pages. See also GAUJOT and SPILLMAN, op. cit. [note 49], pages 194-195.

[190] L. WECKER, "De la sangsue artificielle (modele du baron Heurteloup), et de son emploi dans le traitment des maladies des yeux." _Bulletin general de therapeutique medicale et chirurgicale_, volume 62 (1862), pages 107-116. For price information, see CASWELL, HAZARD & CO. (W. F. Ford), _Illustrated Catalogue of Surgical Instruments and Appliances_ (New York, 1874), page 18. An example of Heurteloup's leech as well as a larger, modified Heurteloup's leech can be found in the collection of the Armed Forces Institute of Pathology.

[191] SMITH, op. cit. [note 185], page 406; TIEMANN, op. cit. [note 144], page 116; Patent specifications, U.S. patent 100210. An example of this artificial leech can be found in the collection of the Armed Forces Institute of Pathology.

[192] TIEMANN, op. cit. [note 144], page 506.

[193] WILLIAM REESE, "Uterine Leech and Aspirator," _Medical Record_, volume 11 (1876), page 596.

[194] OTTO RAUBENHEIMER, "Leeches--How to Dispense Them," _Journal of the American Pharmaceutical Association_, volume 12 (1923), page 339. THORNDIKE, op. cit. [note 3], page 477, notes that in 1927, leeches still could be had in Boston for 75c apiece. In Cleveland they were still obtainable in the 1950s.

[195] _Dictionnaire usuel de chirurgie et de medicine veterinaire_, 2 volumes (Paris, 1835-36), articles "Ventouses" and "Sangsues."

[196] Ibid., article "Saignee."

[197] _Encyclopedie methodique: Medecine_, volume 9 (Paris, 1816), page 478.

[198] _Dictionnaire usuel_, op. cit. [note 195], volume 2, page 605.

[199] WEISS, op. cit. [note 118], page 100, plate 27.

[200] Patent specifications, U.S. patent 6240.

[201] Patent specifications, U.S. patent 236084.

LIST OF TRADE CATALOGS CONSULTED

Aloe, A. S. Company. _Illustrated and Priced Catalogue of Surgical Instruments, Physicians' Supplies and Hospital Furnishings._ 6th edition. St. Louis, 1891.

----. _Catalogue of Superior Surgical Instruments and Physicians' and Surgeons' Supplies._ 6th Edition. St. Louis, 1895.

Becton, Dickinson & Co. _Trade Catalogue of Gold, Silver and Plated Instruments for Surgeons and Veterinarians._ New York, 1904.

----. [Catalogue.] Rutherford, N.J., 1911.

----. _Illustrated Catalog of Druggists, Surgical, and Veterinary Specialties._ Rutherford, N.J., 1917.

Caswell, Hazard & Co., W. F. Ford. _Illustrated Catalogue of Surgical Instruments and Appliances._ New York, 1874.

Ch. Dubois. _Catalogue illustre des instruments de chirurgie._ Paris, 1884.

Charles Lentz & Sons. _Illustrated Catalogue and Price List of Surgical Instruments._ 3rd edition. Philadelphia, ca. 1888.

Charles Henry Truax. _The Mechanics of Surgery, Comprising Detailed Descriptions, Illustrations and List of the Instruments, Appliances and Furniture Necessary in Modern Surgical Arts._ Chicago, 1899.

Codman and Shurtleff. _Illustrated Catalogue of Surgical Instruments and Appliances._ Boston, 1879.

----. _Illustrated Catalogue of Surgical Instruments and Appliances._ Boston, 1886.

----. _Illustrated Catalogue of Surgical Instruments and Appliances._ Boston, 1890.

Coxeter, J., & Son. _Surgical Instruments Catalogue._ London, 1870.

Down Bros. _Catalogue of Surgical Instruments and Appliances._ London, 1885.

Dubois, Ch. See Ch. Dubois.

Durbin, J., Surgical Supply Co. (Catalogue.) Denver, 1929.

Feick Bros. _Illustrated Catalogue and Price List of Surgical Instruments._ Pittsburgh, 1896.

Fred Haslam & Co. _Standard Surgical Instruments._ Brooklyn, 1922.

Fr. Lindstaedt. _Illustrirter Catalog chirurgischer Instrumente._ Bremen, 1882.

George Tiemann & Co. _American Armamentarium Chirurgicum._ New York, 1879.

----. _The American Armamentarium Chirurgicum._ New York, 1882.

----. _The American Armamentarium Chirurgicum._ New York, 1889.

Haslam & Co. See Fred Haslam & Co.

John Reynders & Co. _Illustrated Catalogue and Price List of Surgical Instruments, Orthopaedical Apparatus, Trusses, etc._ 5th edition. New York, 1884.

John Weiss. _An Account of Inventions and Improvements Made by John Weiss._ 2nd edition. London, 1831.

John Weiss & Son. _Weiss and Son's Catalogue of Surgical Instruments for 1836._ London, 1836.

----. _A Catalogue of Opthalmic Instruments and Appliances, etc._ London, 1863.

----. _A Catalogue of Opthalmic Instruments and Appliances._ Manchester, 1898.

Kennedy, J. E., & Co. _Illustrated Catalogue of Surgical Instruments and of Allied Lines._ New York, 1917.

Kny-Scheerer Co., The. _Illustrated Catalogue of Surgical Instruments._ 3 volumes. New York, 1899.

----. _Illustrated Catalogue of Surgical Instruments._ 16th edition. New York, no date (20th century).

Krohne & Sesemann. _Catalogue of Surgical & Orthopedic Instruments._ London, 1878.

Lentz & Sons. See Charles Lentz & Sons.

Lindstaedt, Fr. See Fr. Lindstaedt.

Maison Charriere, Robert et Collin, Successeurs. [Catalogue.] Paris, 1867.

----. _Catalogue generale illustre._ Paris, 1879.

----. _Catalogue generale illustre._ Paris, 1885.

----. _Catalogue generale illustre._ Paris, 1890.

----. _Catalogue generale illustre._ Paris, 1894.

Maison Luer (H. Wulfing-Luer). _Catalogue generale Illustre._ Paris, ca. 1904.

Mathay Hospital Supply Co. _Surgical Instruments._ Los Angeles, ca. 1937.

Maison Mathieu. _Arsenal Chirurgical._ 15th edition. Paris, ca. 1905.

Matthews Bros. _A Catalogue of Surgical Instruments._ London, ca. 1875.

Maw, S., Son & Thompson's. _Surgical Instruments, etc._ London, 1882.

Obstetrical Society of London. _Catalogue and Report of Obstetrical and Other Instruments Exhibited at the Converzatione of the Obstetrical Society of London_, 1867.

Pittsburgh Physicians' Supply Co. _Illustrated Catalogue._ Pittsburgh, 1908.

Reiner, H. _Catalog medicinisch-chirurgischer Instrumente und Apparate._ Vienna, 1885.

Reynders, John, & Co. See John Reynders & Co.

Robert et Collin. See Maison Charriere.

Scheffelin, W. H., & Co. _General Prices Current._ New York, 1887.

Sharp and Smith. _Surgical Instruments._ 16th edition. Chicago, ca. 1892.

Shepard & Dudley. _Descriptive Catalogue._ New York, 1873.

Tiemann, George, & Co. See George Tiemann & Co.

Truax, Charles Henry. See Charles Henry Truax.

Truax, Green & Co. _Price List of Physicians Supplies._ 6th edition. Chicago, 1893.

Weiss & Son. See John Weiss & Son.

W. H. Wigmore. _Surgical, Dental and Veterinary Instruments._ Philadelphia, no date (pre-1895).

W. Windler. _Preis-Verzeichniss der Fabrik chirurgischer Instrumente und Bandagen._ Berlin, 1888.

Figures 26-124

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Passages in italics are indicated by _underscore_.

Passages in bold are indicated by =bold=.

Underlined passages are indicated by +underline+.

Superscripted letters are shown in {superscript}

Punctuation has been corrected without note.

The following misprints have been corrected:
missing "a" added (Abstract)
"sacrificator" corrected to "scarificator" (page 2)
"Ristelheuber" corrected to "Ristelhueber" (page 14)
"Pheonix" corrected to "Phoenix" (page 14)
missing note marker 127 added
"canula" corrected to "cannula" (page 38)
"rachet" corrected to "ratchet" (page 41)
"ocilloscope" corrected to "oscilloscope" (page 41)
"NHMT" corrected to "NMHT" (page 44)
"Divison" corrected to "Division" (page 47)
"Pennyslvania" corrected to "Pennsylvania" (page 48)
"Federick" corrected to "Frederick" (page 48)
"has has" corrected to "has (page 48)
"sacrificator" corrected to "scarificator" (page 48)
"Sacrificator" corrected to "Scarificator" (page 48)
"cylindical" corrected to "cylindrical" (page 53)
"Septemper" corrected to "September" (Note 3)
"Hypochrondriasis" corrected to "Hypochondriasis" (Note 80)
"chirurguscher" corrected to "chirurgischer" (page 63)

"Joseph-Frederic-Benoit Charriere (1803-1973)" is presented as in the original text.

Other than the corrections listed above, printer's inconsistencies in spelling and hyphenation usage have been retained.