Page 9 - Pharmacy History 23 July 2004

Machell’s instrument for cupping and bleeding.
syringe’s piston. This was the method favoured by Machell.
He adapted his original machine by replacing the forcing syringe with an exhausting one (b), so that operating it produced a partial vacuum in the tank instead of positive pressure. The stop-cock (now labelled E) at the base of the tank had a flexible tube (F) attached to it, and this terminated in a glass or metal bell. To this was fixed a circular plate
(H) fitted with a number of lancet points. A vacuum was created in
the tank by about 40 strokes of the syringe piston. When the stop-cock was opened as the skin was sucked into the bell it was punctured by
the lancet points, and then, as it
rose further, it pressed a button that activated a spring and released the plate (H). The blood could then be sucked from the wounds into the tank by way of the flexible tube. The tank would hold about a pint and a halt; and was fitted with a glass panel, graduated in half-ounces, so that the amount of blood withdrawn could be measured. When the required volume had been taken (c) was unscrewed to release the vacuum, stop-cock (E) was closed, and the apparatus detached from the patient.
The depth of penetration by the lancets could be predetermined by adjusting the spring operated by the button.
Machell believed that the greatest advantages of his apparatus lay in the fact that it could be applied to any part of the body under any circumstances, and that it was
not necessary to have the manual dexterity of a trained cupper, or even to see the part to which it was being applied, a particularly important factor for sensitive female patients.
He observed:
“There is no alarming preparation, no harassing change of apparatus, no exposure. Cleanliness, decency, and the quiet and mental tranquillity of the patient, are in no way infringed upon.”
I cannot share his optimism, and feel that in the hands of an untrained person the whole process could have been quite traumatic.
Of course the apparatus could be used for dry cupping (in which no blood was drawn) if applied without the plate that carried the lancets.
The idea behind dry cupping was to remove blood from the affected part to the surface of the skin where the cups were applied. If the cups were left on for more than 10 minutes, the capillaries had a tendency to burst, and the treatment was thought to be a counter-irritant.5
Dry cupping on the back was used to treat influenza well into the 20th century, and I believe that it is still used in some rural areas in Europe.
The breast reliever
The literature an infant feeding reveals that one of the main problems associated with breast-feeding has always been the pain caused by inverted, cracked or excoriated nipples. Nipple shields have been used for hundreds of years and innumerable formulae for lotions or salves to relieve this condition have been published. Nowadays there is
a growing tendency to use a breast pump or reliever to draw the milk from the breasts, and use this rather than an artificial formula to bottle- feed the child. Sucking glasses have been used to draw the breasts from the 16th century, and the use of a
cupping glass attached to a syringe was used from the 1780s onwards.
An early example of such an appliance was that invented by Mr Machell, though after the discovery of the vulcanisation of rubber many breast pumps were made in which the suction was provided by the use of a rubber bulb.
In order to convert Machells’s apparatus to a breast reliever the only action necessary was to replace the cupping glass (H) by a nipple glass (I) that had a glass flask to receive the milk. This was fitted with a stop-cock at the point where the flexible tube was attached. In use, stop-cock (E) was closed, a partial vacuum created with three or four strokes of the pump, the nipple glass (I) was placed in position and (E) opened. Then the mother or operator could regulate the amount of suction applied by turning the stop-cock attached to the receiver to a greater or lesser degree, the milk drawn from the breast being collected in the receiver itself. The Monthly Gazette of Health here became almost lyrical:
“The breast which, from the ulcerated or excoriated nipple, cannot be emptied of its fluid by suction of the infant, but with almost insufferable agony to the mother, can, by this contrivance, be drawn without pain, and without the perpetual renewed irritation to the ulcerated part, which is the exclusive impediment to the process of healing.”
When the operation was completed, the suction could be released by unscrewing (c ), and the nipple cap removed.
I have not found any surviving examples of the apparatus for cupping and drawing the breasts, but The Thackray Medical Museum in Leeds does possess an example
of the enema syringe. This is now rather fragile, and much of the japanning has flaked off, but it is good to know that this, at least, was manufactured and sold. I think that these devices can be regarded as early examples of the rapidly growing technological advances used to treat medical conditions that arose initially in France, at the end of the 18th century, largely in the crowded hospitals of Paris. The
volume 2 ■ no 24 ■ November 2004
Pharmacy History Australia ■ 9