Part 10

Counter-irritation device, patent model, 1866. Patented by Friederich Klee of Williamsburg, New York (U.S. Patent 55775), this instrument is another modification of Baunscheidt's _Lebenswecker_. It is made of wood and brass, and is much shorter than the _Lebenswecker_ but operated in the same manner. A screw on the handle served to regulate the length of the needles. A further innovation was the addition of a diaphragm of leather through which the needles pass. The leather could be saturated with oil before the operation, thus again saving the need to apply oil afterwards. Transferred from the U.S. Patent Office 1926. L 92 mm. Neg. 72-11274. NMHT 89797 (M-4305). (Figure 123.)

Barber-surgeon's kit, late 18th-early 19th century. Kit includes a teakettle lamp (M-6991), a deck of playing cards to amuse customers, four standard glass cupping cups (M-6686), two scarificators (M-6687, M-6688), two rectangular spring lancets in a case (M-6689), a dental kit, a barber kit, a tourniquet (M-6692), and a comb. Scarificators are both 16 blade square models. One is unusual in that only the bottom is detachable as in octagonal scarificators. The spring lancets are of an unusual shape, with straight edges and curved tops and bottoms. Donated by Mrs. Frank J. Delinger, Jr., through Mrs. Paul J. Delinger, 1953. Lamp: D of base 65 mm, W 145 mm, H 95 mm. Spring lancets: L 49 mm, W 18 mm. Tourniquet: L 1260 mm, W 35 mm. Neg. 73-4207, entire kit plus barber's basin (NMHT 225114 [M-9399]), which is not part of kit; 73-4225, cups; 73-4219, two scarificators; 73-4221, dental set; 73-4222, barber set; 73-4223, deck of cards; 73-4224, tourniquet; 73-4234, set of spring lancets; 73-4218, teakettle lamp. All negatives BW, CS. NMHT 199536 (M-6684 to M-6693).

Barber-surgeon's sign (replica). Reproduction of a 1623 barber-surgeon's sign (original is in Wellcome Medical Museum) illustrating the various specialties of the barber-surgeon of the period. Phlebotomy is shown in the upper right hand corner. Made by Richard Dendy of London and donated by him 1958. L 724 mm, W 624 mm. Neg. 44681 (BW). NMHT 215690 (M-7343). (Figure 32.)

Greek votive tablet (replica). Reproduction of a Greek votive tablet found on the site of the Temple of Aesculapius. The original is in the Athens Museum. Illustrated are two metal cupping cups and a case containing six scalpels. Replica made by Dorothy Briggs of the Smithsonian Institution 1960. W 400 mm, H 295 mm, Thickness 30 mm. Neg. 73-4217 (BW, CS). NMHT 233055 (M-9617). (See Figure 54.)

Greek vase (replica). Reproduction of a small Greek vase depicting a 5th century B.C. medical "clinic," including a Greek physician bleeding a patient. Original is in the Louvre. Made by Dorothy Briggs of the Smithsonian Institution 1960. H 85 mm, W 75 mm. Neg. 73-4216 (BW, CS); 73-4216-A (CS), red background. NMHT 233055 (M-9618). (Figure 26.)

Bloodletting manikin, 15th century. Pen and ink drawing in black and red inks on a folded sheet of paper with the watermark "Ochsenkapf mit Krone" reportedly made in Southern Germany in 1480. The paper is backed at the fold by a piece of vellum. Drawing is of a man with astrological signs and instructions in German in balloons pointing at 25 points of his body, of which 4 are symmetrical. Such a drawing used in conjunction with a dial would be used to determine when and where to bleed. On the reverse are astronomical tables. According to analysis by the Conservation Laboratory at the Smithsonian, the paper might well date from the 15th century and the ink has been applied at various times. Purchased 1962. L 310 mm, W 225 mm. Neg. 76-13536 (BW). NMHT 243033 (M-10288).

Surgeon's kit, late 18th century. Revolutionary War surgeon's kit includes a leather case with brass handle, three pewter cupping cups, a spring lancet, syringe, two trocars, knife, probe, and scraper. There is space for two other missing instruments, one of which may have been a scarificator. Lancet has an unusual boot shape and is decorated with a floral design. It is made of brass and has a steel lever release. Purchased 1969. Neg. 73-4237-A (CS). NMHT 285125 (M-12352).

Baunscheidt's _Lebenswecker_, mid 19th-early 20th century. Carl Baunscheidt of Bonn exhibited his _Lebenswecker_ ("Life Awakener") at the Great Exhibition in London in 1851. It consists of a long hollow tube made of ebony and containing a coiled spring attached to a handle. A cap covers a plate with some thirty sharp needles. Pushing upon the handle injects the needles into the skin. The devise was used with Baunscheidt's special oil, which was applied to the skin after the needles had irritated it. Donated by Grace Sutherland 1970. L 250 mm, W 30 mm. Neg. 76-7751 (BW). NMHT 287885 (M-12936). (Figure 79.)

Baunscheidt's _Lebenswecker_, mid 19th-early 20th century. Another example of the previous instrument. Donated by Mrs. William F. Press 1970. L 245 mm, W 20 mm, H 25 mm. NMHT 290304 (M-13832).

Baunscheidt's _Lebenswecker_, mid 19th-early 20th century. Another example of the previous instruments. Purchased 1976. NMHT 1977.0789.

Alcohol lamp, late 19th-early 20th century. Glass lamp with glass cap and cotton wick, used in exhausting air from cups. Used by Dr. F. L. Orsinger of Chicago (1852-1925). Donated by Dr. William H. Orsinger 1973. H 100 mm, D 83 mm. Neg. 74-4086 (BW, CW). NMHT 308730.08.

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.