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Figure 17.—Venus and Adonis with marks showing where Baunscheidt’s Lebenswecker should be applied. (From Carl Baunscheidt, Baunscheidtismus, by the Inventor of the New Curing Method, Bonn, 1859(?). Photo courtesy of NLM.)

Dry cupping stimulated much theoretical debate in the nineteenth century as well as a number of physiological experiments.[157] Although physicians generally agreed that dry cupping had curative value if employed properly, they disagreed widely on when to employ the remedy, and on the manner in which the remedy operated. Did application of cups affect only the surface vessels, or could cupping affect the entire nervous system, and through the nerves, the action of the secretory organs? Were the effects of dry cupping of only a temporary nature, or were they permanent? An interesting series of investigations in Europe and America sought to ascertain the value of dry cupping in checking the absorption of poison. An American, Dr. Casper Wistar Pennock, replying to investigations performed by Martin Barry, an Edinburgh physician residing in Paris, carried out an impressive series of physiological experiments in 1827, in which he administered strychnine and arsenic under the skin of dogs and rabbits and then cupped over the wounds. He concluded that while dry cupping prevented almost certain death from the poisons, once the cups were removed, death would ensue, unless the poisons were surgically removed.[158]

Interest in dry cupping led to attempts to apply the therapeutic effects of the operation to larger areas of the body than could be accommodated by a cup. In France, Victor-Théodore Junod (1809-1881) adapted cupping to entire limbs. Shortly after receiving his degree in medicine in 1833, Junod presented at the Academy of Sciences his apparatus, known thereafter as Junod’s boot. Junod believed that actual extraction of blood was a dangerous remedy and that the benefits of bleeding might as easily be obtained by his “derivative method,” which withdrew blood from the general circulation but allowed it to be returned at will. Junod’s boot and Junod’s arm, which sold for as much as $25.00 apiece,[159] were constructed of metal and secured against the limb by a silk, and later a rubber, cap. To the boot was attached a flexible tube, stopcock, pump, and if desired, a manometer for measuring the vacuum produced. In chronic illnesses, Junod recommended that the boot be applied for an hour. So much blood was withdrawn from the circulation by use of the apparatus that the patient might easily faint. To explain how his boot worked, Junod invented a theory that he called “hemospasia,” meaning the drawing of blood.[160] This was typical of a number of attempts to introduce sophisticated terminology into discussions of traditional remedies. Junod’s arm and boot were widely available through American surgical supply companies. As late as 1915, Heinrich Stern, previously mentioned as a latter-day proponent of bloodletting, had no doubt that application of the boot to the foot would relieve congested states of the abdominal viscera.[161] (Figure [18].)

Americans patented a number of modifications of the arm and boot, and in addition they patented a number of whole body devices called “depurators.” Junod had introduced such a device along with his boot—a metal casing in which a patient would be placed leaving only his face showing. The air inside would then be exhausted by means of a gigantic syringe. In America such “depurators” may have been regarded more as quackery than as a legitimate extension of cupping, for despite the fact that Americans patented some twenty of these devices, surgical supply houses did not sell them and little was written about them.

In the last decade of the nineteenth century, Dr. August Bier, professor at the University of Bonn, developed another sophisticated theory supporting the use of blood-suction devices, known as the theory of hyperemia, meaning “excess of blood.” According to the doctrine, lesions are always accompanied in nature by hyperemia, “the most widespread of auto-curative agents.”[162] If we, therefore, wish to imitate nature, we create an artificial hyperemia. Bier recommended several means of increasing the blood supply of an affected part, including hot-air baths, suction devices such as Junod’s boot, and dry cupping. Several American surgical suppliers sold Bier’s Hyperemic Cups in the early twentieth century. These were glass cups, of a great variety of shapes and sizes including some with curved rims, each fitted with a rubber tube and bulb for exhausting the air. A major function of these cups was to collect wound secretions from boils or furuncles.[163]

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Figure 18.—Junod’s boot applied to a baby in the cradle. (From Victor Theodore Junod, A Theoretical and Practical Treatise on Maemespasia. London, 1879. Photo courtesy of NLM.)