A U-tube contains mercury, on which floats a rod supporting a scratching point, which makes a “tracing” on blackened paper wrapped round a revolving drum. Between the manometer and the cannula which is introduced into the central end of a cut artery is a three-way cock, which leads to a pressure-bottle containing a half saturated solution of sodic sulphate. This solution prevents blood from clotting. Before it is connected with the artery the apparatus is filled from the pressure-bottle. The cock is then turned into the second position, and the bottle raised until the mercury in the manometer stands at a level somewhat higher than that which it may be expected to attain under the influence of blood-pressure. The cannula being then inserted into an artery, the cock is turned into the third position, which places the manometer in connection with the blood, and excludes the pressure-bottle. As the mercury is a little higher than blood-pressure, some of the sodic sulphate solution enters the artery, but no blood enters the cannula. The scratching point, rising and falling with every variation in blood-pressure, makes a record on the soot-blackened paper, which is subsequently removed from the drum, and varnished.
A, An ivory button which is pressed on the skin over the radial artery by a metal spring.
B, A continuous screw which works against the cogwheel
C. By rotating B, the lever
D is raised to a position in which its point scratches the travelling-plate
E (covered with blackened paper).
F, A box containing clockwork which moves E.
G, A screw by means of which the pressure of the spring is adjusted to the force of the pulse.
Thirteenth-Century Hospital Interior (Tonerre)
From “The Thirteenth: Greatest of Centuries,” by J. J. Walsh
This was built by the sister of Louis IX of France, Marguerite of Bourgogne, who retired to it herself to spend her life caring for the ailing poor.
Surgical instruments of the Arabs, according to Abulcasim
After plates in Gurlt’s “Geschichte der Chirurgie”
1. A pincher for extracting foreign bodies from the ear
2. An ear syringe for injections
3. A tongue depressor
4. Concave scissors for the removal of tonsils
5. Curved pinchers for foreign bodies in the throat
6 to 29. Instruments for the treatment of the teeth
19 and 20. Forceps
21 to 25. Levers and hooks for the removal of roots
26. Strong pinchers for the same
27. A tooth saw 28 and 29. Files for the teeth
Surgical instruments of Guy de Chauliac, nos. 1, 2, 3, and 4 (fourteenth century);
and surgical apparatus of Hans von Gerssdorff, nos. 5, 6 and 7 (fifteenth century)
After plates in Gurlt’s “Geschichte der Chirurgie”
2. Balista used for extraction of arrows
3. Cauterizing shears with cannula for cauterization of the uvula
5. Extension arrangement for reducing upper arm dislocations, called “The Fool”
6. Screwpiece for extending a knee contracture
7. Extension apparatus in the form of armour-arm and armour-leg plates
(“harness instruments”) for contractures of the elbow and knee joints
From Gurlt’s “Geschichte der Chirurgie”
Hans von Gerssdorff and Hieronymus Brunschwig, who flourished in the latter half of the fifteenth century in Germany, have both left early printed treatises on Surgery which give excellent woodcuts showing pictures of instruments, operations, and costumes, at the end of the medieval period.
This is the first picture of an amputation known
From Gerssdorff’s woodcut, reproduced in Gurlt’s “Geschichte der Chirurgie”
Wet cupping for a headache. (From Frederik Dekkers, Exercitationes Practicae Circa Medendi Methodum, Leyden, 1694.)
W. D. Hooper’s patent cupping apparatus with tubular blades. (From patent specifications, U.S. patent no. 68985.)
Scarification without cupping in Egypt in the 16th century. To obtain sufficient blood, 20 to 40 gashes were made in the legs and the patient was made to stand in a basin of warm water. (From Prosper Alpinus, Medicina Aegyptorum, Leyden, 1719.
R. J. Dodd’s patent cupping apparatus. Figs. 4 and 5 are the tubes for cupping the uterus. Fig. 3 is the flexible match scarifier. (From patent specifications, U.S. patent no. 3537.)
Patent for a complex cupping pump, J. A. Maxam, 1916. (From patent specifications, U.S. patent 1179129.)
Paré’s scarificator, 16th century. (From The Workes of that Famous Chirurgeon, Ambrose Parey, translated by Thomas Johnson, London, 1649.)
Junod’s boot applied to a baby in the cradle. (From Victor Theodore Junod, A Theoretical and Practical Treatise on Maemespasia. London, 1879.
Instruments for bleeding from the arm, 1708: a, a serviette to cover the patient’s clothing; b, a cloth ligature to place around the arm; c, a lancet case; d, a lancet; e and f, candles to give light for the operation; g, a baton or staff for the patient to hold; h, i, and k, basins for collecting blood; l and m, compresses; n, a bandage to be placed over the compress; p, eau de la Reine d’Hongrie that can be used instead of vinegar to revive the patient if he faints; q, a glass of urine and water for the patient to drink when he revives; r, s, t, implements for washing the hands and the lancets after the operation. (From Pierre Dionis, Cours d’opérations de chirurgie demontrées au Jardin Royal, Paris, 1708.
Instruments and technique of phlebotomy: Fig. 1 shows an arm about to be bled. A ligature has been applied to make the veins swell. The common veins bled—cephalic, basilic, and median—are illustrated. Fig. 2 shows several types of incisions. Fig. 3 is a fleam, Fig. 4 a spring lancet, and Fig. 5 a “French lancet.” (From Laurence Heister, A General System of Surgery, London, 1759.
Dry cupping for sciatica. (From Frederik Dekkers, Exercitationes Practicae Circa Medendi Methodum, Leyden, 1694.
Depurator patented by A. F. Jones, 1866.
(From patent specifications)
Demours’ device for combining cup, scarifier and exhausting apparatus. (From Samuel Bayfield, A Treatise on Practical Cupping, London, 1823.)
Damoiseau’s terabdella. (From Damoiseau, La Terabdelle ou machine pneumatique, Paris, 1862.
Cupping instruments illustrated by Dionis, 1708: a, cups made of horn; b, lamp for exhausting air; c, fleam for making scarifications; d, horns with holes at the tip for mouth suction; e, balls of wax to close the holes in the horn cups; f, g, glass cups; h, candle to light the tow or the small candles; i, tow; k, small candles on a card which is placed over the scarifications and lit in order to exhaust the cup; l, lancet for making scarifications; m, scarifications; n, plaster to place on the wound. (From Pierre Dionis, Cours d’opérations de chirurgie demontrées au Jardin Royal, Paris, 1708.)
An early illustration of the octagonal scarificator, 1801. This plate also includes one of the earliest illustrations of the syringe applied to cupping cups. (From Benjamin Bell, A System of Surgery, 7th edition, volume 3, Edinburgh, 1801.)
Advertisement for phlebotomy and cupping instruments. Note the rubber cups. (From George Tiemann & Co., American Armamentarium Chirurgicum, New York, 1889.)
A man employing leeches to reduce his weight, 16th century. (From P. Boaistuau, Histoire Podigieuses, Paris, 1567. )
Woman using leeches, 17th century. (From Guillaume van den Bossche, Historica Medica, Brussels, 1639.)
Chair to assist in straightening of the spine
Where frequent lying down on a sofa in the day-time, and swinging frequently for a short time by the hands or head, with loose dress, do not relieve a beginning distortion of the back; recourse may be had to a chair with stuffed moveable arms for the purpose of suspending the weight of the body by cushions under the arm-pits, like resting on crutches, or like the leading strings of infants. From the top of the back of the same chair a curved steel bar may also project to suspend the body occasionally, or in part by the head, like the swing above mentioned. The use of this chair is more efficacious in straightening the spine, than simply lying down horizontally; as it not only takes off the pressure of the head and shoulders from the spine, but at the same time the inferior parts of the body contribute to draw the spine straight by their weight.
Steel Bow to diminish curvature of the spine
I have made a steel bow which receives the head longitudinally from the forehead to the occiput; having a fork furnished with a web to sustain the chin, and another to sustain the occiput. The summit of the bow is fixed by a swivel to the board going behind the head of the bed above the pillow. The bed is to be inclined from the head to the feet about twelve or sixteen inches. Hence the patient would be constantly sliding down during sleep, unless supported by this bow, with webbed forks, covered also with fur, placed beneath the chin, and beneath the occiput.