Page 8 - Pharmacy History 23 July 2004

Machell’s enema syringe, cupping glass and breast reliever
By WA Jackson
As a follow up to the story about Enemas in the July 2004 (23), edition , by Catherine Bartho, here is an interesting multi functional apparatus, researched by British Pharmacy Historian, Bill Jackson.
At the beginning of the 19th century the predominant type of medicine practised
was humoral medicine, and many conditions were treated by depletive therapies such as purging, blood- letting and/or vomiting. These
were sometimes achieved by the oral administration of drugs, but mechanical means were often employed. Mr Machell was an ingenious London surgeon who invented a number of medical devices. The following examples were used for purging by the administration of enemata, blood- letting by cupping and the removal of milk by drawing the breasts.
The enema syringe
In 1818, The Monthly Gazette of Health1 published the details of an enema syringe, or in the language
of the day, lavement apparatus, that Mr.Machell had devised for the purpose of ‘injecting a fluid into the lower portion of the intestine’.
He believed that the French were,
on the whole, a healthier race than the ‘Sons of Albion’ (Englishmen), and that this was partially due to
the ‘preservation of the alimentary canal in a regularly open state, by the constant and almost daily exhibition of domestic glysters’, that is by the daily administration of enemata.
It was reported that Dr Hamilton of Edinburgh had:
‘by the most legitimate reasoning founded on incontrovertible facts, shown the importance in the prevention and cure of diseases which attaches to the removal of accumulated feces (sic), and the too long detention (sic) of indigestible colluvies,2 and vitiated intestinal secretions.’
Machell claimed that
after many experiments and alterations he had produced a machine
that he considered to
be satisfactory in every respect. Not only had
he tried it himself, but could refer to many of the most eminent physicians and surgeons in London, under whose direction
it had been successfully employed.
Machell’s enema syringe.
The notice was accompanied
by a diagram of the apparatus, which is reproduced here, and with instructions for its use.
The body was a metallic case ‘of a convenient shape, and ordinary size’, with two apertures on the upper surface. One of these could be closed by means of a metallic screw, and the other was fitted with a forcing syringe. An outlet at the bottom was controlled by a stop-cock leading
to an ivory pipe. With the stopcock in the closed position, the necessary amount of solution to be injected,
at the required temperature, was introduced into the case through the top aperture that was closed with
the screw stopper afterwards to form an airtight seal. The piston of the forcing syringe was moved briskly
up and down for approximately 30 strokes, and the handle could then be unscrewed if it was found to be in the way. The ivory pipe was inserted into the patient’s anus, and the stop- cock gently turned until the operator or the patient felt that sufficient pressure had been achieved. Self- administration of enemata could be made possible by replacing the ivory pipe with a flexible tube fitted with a rectal nozzle.
A further report in the The Monthly Gazette of Health3 showed that by the following year Mr Machell had had further thoughts about his machine, and devised a means by which it could be used for other purposes. This was to prove to be a trend adopted by other manufacturers of syringes throughout the nineteenth century.
The cupping glass
‘There is no alarming preparation, no harassing change of apparatus, no exposure...’
Bleeding was still regarded as being the best treatment for inflammatory diseases and was employed for many complaints, particularly up
to the middle of the century. The commonest way to do this was to open a vein and collect the required amount of blood in a bleeding bowl, but alternative methods were to apply leeches or to scarify the skin and suck out the blood using a cupping glass. This was known as wet cupping.
A vacuum was formed in the glass by heating it, placing it on the scarified skin and allowing it to cool, but sometimes glasses were devised that could be fitted to a syringe, and the vacuum produced by raising the
8 ■ Pharmacy History Australia
volume 2 ■ no 24 ■ November 2004