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Figure 15.—Fox’s glass leech. Cupping set contains two hanging “glass leeches,” a scarificator, a bottle of alcohol, and a torch with a ring handle such as the cupper Knox recommended. (Set held by the Academy of Medicine, Toronto. Photo courtesy of the Academy.)

Several inventors tried to improve upon the scarificator. The defects of the ordinary scarificator were widely recognized. It was too bulky and heavy, and it cost too much—the most inexpensive scarificator offered by George Tiemann & Co. in 1889 cost $4.50.[144] A strong hand was required to trigger the blades, and when the trigger was released, the force of the spring was so great that the lever moved back with great force and produced a loud, unpleasant click. The force of the lever moving against the case of the scarificator made it impossible to use any but expensive materials (brass and German silver) in making the scarificator casing. Furthermore, the springs were liable to break. Finally, the scarificator was difficult to clean.[145] Late in the century, when sterilization became important, some cuppers went back to the lancet because the scarificator could not be surgically cleansed. The surprising thing is, that despite all the defects, the same scarificator was sold in 1930 as in 1830. Either the claims of the inventors of improved scarificators were unjustified, or cuppers were unwilling to try novel instruments in what was becoming an old-fashioned and increasingly less popular operation. (Figure [16].)

A few British and American surgical supply companies sold special models of scarificator, but always in addition to the common scarificator. The special models were generally higher in price. For example, the Englishman, James Coxeter, announced in 1845 a new scarificator with a rotating lever on the side instead of a cocking lever on the top. The roto-lever, according to Coxeter, could be turned to set the scarificator by a child of six. Furthermore, the scarificator was so constructed that when the spring was released only internal parts moved. There was no lever that snapped back and no resounding click. This special model of scarificator continued to be sold by Coxeter and Son (London) until late in the nineteenth century.[146]

Coxeter did not patent the roto-lever scarificator. In fact, through 1852 there were no British patents on scarificators. In contrast, there were eight French patents on scarificators before 1860.[147] Of these, the most important was the 1841 patent of Joseph-Frédéric-Benoit Charrière (1803-1973), a Swiss-born cutler who founded a major surgical supply company in Paris. Charrière’s octagonal scarificator substituted two flat coiled springs (like watch springs) for the two cantilever springs normally found in “reversible” scarificators. One end of each coiled spring was attached to the scarificator casing and the other to one of the support rods. As the cocking lever was pulled, the support rods turned and wound the springs more tightly about the rods. According to Charrière, these springs were more efficient and less likely to break than the ordinary springs.[148]

Charrière’s company later employed the coiled springs in the making of a circular scarificator. The circular scarificators, associated particularly with French manufacture, were the most elegant of nineteenth-century scarificators and a fitting complement to the Charrière cupping sets.[149] They were generally not sold by British and American surgical supply companies, but a number of them appear to have reached the hands of American physicians.

In America, there were five patents on scarificators, of which the Smithsonian possesses three patent models. The most significant American patent was that of George Tiemann in 1846. Tiemann’s scarificator had a flattened base and an ebony handle, which contained a coiled spring. The blades were moved by a rack and pinion mechanism, and triggered by a knob at the end of the handle. The advantages claimed by the inventor were ease in handling, ease in cleaning, and the diagonal cut of the blades that allowed the blood to flow more freely and the wounds to heal more readily. Tiemann & Co. was still selling their patent scarificator as late as 1889 for a price of $7.00.[150] The Smithsonian possesses a marketed version in addition to the patent model.

The two other patent scarificators in the Smithsonian collection were both invented by Frederick M. Leypoldt of Philadelphia. The first, patented in 1847, was similar in external appearance to the common scarificator. The novelty consisted of a new arrangement of the cocking lever and cantilever spring that allowed use of a lighter and cheaper casing. Although the patent model was made of brass, Leypoldt claimed that with his improvements in the internal mechanism, the case could, with safety, be made of tin.[151]

Leypoldt’s second patent, issued in 1851, was for a scarificator with a greatly simplified inner mechanism allowing for a substantially smaller and lighter case. The cocking lever was placed horizontally in the casing and engaged the blade rods through a rack and pinion mechanism. According to Leypoldt, this scarificator was more convenient, more portable, cheaper, safer, and more reliable than the common scarificator.[152] Leypoldt probably marketed his scarificators, there being in the Smithsonian collection other bloodletting instruments with his name, but he did not form a major surgical supply company as did George Tiemann.