NUMBER 41 35 , mM m.;;! f 11 ^ ^ v Ik '• il^-> k;>^i^^^M it^' FIGURE 18.—Junod's boot applied to a baby in the cradle. (From Vifctor ^Theodore Junod, A Theoretical and Practical Treatise on Maemespasia. London, 1879. Photo courtesy ,pf NLM.)
34 SMITHSONIAN STUDIES IN HISTORY AND TECHNOLOGY with either large doses of tartar emetic, a strong purgative, or with cupping.i^^ Breast pumps were small glass cups with fluted edges made to accommodate the nipple. While some surgeons, as the American Samuel Gross, recommended using a bottle with a long neck in which the air had been rarified by means of hot water,i6^ most breast pumps were exhausted by mechanical means. For reasons of modesty, the pumps were usually designed so that the woman could draw her breasts herself. Perhaps the simplest design of a breast pump was a glass cup having a long spout extending in such a way that the woman could perform suction herself. Such all-glass cups were illustrated in the eighteenth century.i^^ A few, reputedly made centuries earlier, are found in the Wellcome Historical Medical Museum. Early in the nineteenth century, breast pumps, just as glass cups for bleeding, were attached to brass syringes, and were often included among the variety of cups in cupping sets provided with syringes. Read's and Weiss's patent syringe as well as Thomas Machell's cupping device were adapted for breast pumping. With the invention of vulcanized rubber, the breast pump was frequently attached to a large rubber bulb. A glass protuberance was often added to pumps exhausted by syringes or rubber bulbs, in order to collect the milk so that it could be fed to the infant. In the 1920s some breast pumps were attached to electric motors.16^ Breast pumps have continued to be employed up to the present day. Of all instruments employing the principle of the cupping device, breast pumps were the most frequently patented. From 1834 to 1975, more than 60 breast pumps were patented, the majority in the period from 1860 to 1920.168 The Decline of Cupping Cupping died out in America in the early twentieth century, but its disappearance was gradual and scarcely noticed. Some of the most complex of cupping devices were invented in a period when most physicians regarded cupping as ineffectual. Patents for cupping devices continued to be issued as late as 1916 when Joel A. Maxam of Idaho Springs, Colorado, patented a motorized pump, which by means of various sizes of cups, could subject a part of the patient's body to either a prolonged suction or a prolonged compression.i^s One of America's last advocates of bloodletting, Heinrich Stern, writing in 1915, also advocated the use of an electrical suction pump to evacuate cups. With an electric motor, he declared, one could prolong hyperemia for 15, 30, or more minutes. Stern also invented a theory to account for the therapeutic effects of his inventions, namely, the theory of phlebostasis. Instead of pumping air out of a device, Stern pumped air into a device, for the same purpose of removing a portion of blood from the general circulation. His "phlebostate," manufactured by Kny-Scheerer of New York, was quite similar to a sphygmomanometer. It consisted of a set of cuffs that fit about the thighs, rubber tubes, a manometer, and a suction bulb or an electric force pump. For stubborn cases, such as migraine headaches. Stern recommended using the cuffs for 30 minutes or more. To facilitate the application of the cuffs, Stern invented a "phlebostasis chair," one of the most complex "cupping" devices ever made. Like an electric chair, the phlebostasis chair was supplied with cuffs for both arms and legs. Air was pumped into the cuffs by means of an electric motor. According to Stern, compression of the upper segment of both arms withheld 300 cc of blood from circulation, while compression of the thighs withheld as much as 600 cc.i'^° In addition to these sophisticated devices, simple cupping, especially dry cupping, continued well into the 1930s. Although cupping was no longer generally recommended by physicians, most surgical companies advertised cups, scarificators, and cupping sets in the 1920s and even the 1930s. The last bastions of cupping in the United States were the immigrant sections of large cities. In the lower East Side of New York, in particular, cupping was still flourishing in the 1920s. By then cupping was no longer performed by the physician, but had been relegated back to the lowly barber, who advertised in his shop window, "Cups for Colds." I'^i Leeches Leeching The word "leech" derives from the Anglo-Saxon loece, "to heal." Thus, the Anglo-Saxon physician was called a "leech" and his textbook of therapeutic methods a "leechdom." The animal itself was already known to the ancients under its Latin
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