CUP′PING

This method of topical bleeding is performed as follows:— The skin being softened by means of a sponge and warm water, and the hair and other extraneous substances being previously removed, one of the small bell-like gla es ( CUPPING-GLASSES ; CUCURBITU′LÆ ), having the air contained in it rarefied by being pa ed over the flame of a spirit-lamp, is immediately applied to the part. From the formation of a partial vacuum beneath the cup, the pre ure of the air on the surrounding surface causes that portion immediately under the cup to swell, and the ve els to become turgid. When this has taken place the cup is removed, and several incisions are instantly made by means of a scarificator, an instrument containing numerous lancets, which, by means of a spring, make a number of incisions at the same moment; the depth of these incisions being regulated by means of a screw which protrudes or withdraws the lancets, according to the vascularity of the part, or the quantity of blood to be abstracted. The cupping gla is now again applied. When a sufficient quantity of blood has been collected in the cup, it is removed by gently introducing the nail of one of the fingers under the upper edge, by which means, air being allowed to enter, the cup becomes detached. The part being washed with warm water to remove any clots of blood, another cup is applied as before, and the operation continued until a sufficient quantity of blood is withdrawn. Sometimes, especially when applied to the scalp, the cups fill so rapidly with blood as to become detached almost immediately on being applied. This method of local bleeding is frequently called ‘ CUPPING WITH SCARIFICATIONS ,’ When cupping-gla es are applied without the use of the lancet or scarificator, the operation is called ‘ DRY CUPPING ,’ and is much used to cause a speedy irritation of the skin and reaction, for the relief of oppre ive breathing, local pains, . To obtain the full benefit from this operation, the cups should be suffered to remain upon the part until they cause an exudation of a small quantity of serum, or a considerable amount of irritation of the part. Dry cupping has been found extremely beneficial in poisoned wounds; as it acts not only by abstracting the poison, but also, by the pre ure the gla es exercise on and around the part, in preventing the absorption of it. Obs. For the operation of cupping, a basin of hot water, sponges, and clean, soft towels, should be provided. In clumsy hands, cupping is occasionally a severe and painful operation; but this is not the case with the skilful operator. A good cupper does not exhaust much of the air in the cup before applying it, but simply pa es its mouth rapidly over the flame of the lamp. When it is held over the flame even for a few seconds, the compre ion of the edge of the cup upon the skin is so great, that it checks the flow of the blood to the scarified part. A good cupper also removes the cup without spilling the contents, and completes the whole operation quickly and neatly. There are, however, few persons, who are not profe ional cuppers, who are sufficiently expert to exhaust the air in the cup by means of the common lamp; although it is by far the best. A good plan is to rarify the air in the cup by means of a small cone of paper, dipped in spirits of wine, or strong brandy; this is ignited and thrown in the cup, which is instantly to be applied to the proper spot. Where cupping-gla es and the scarificator are not to be had, wine-gla es, or any very small tumblers, may be substituted for the first; and small incisions by means of a thumb lancet will answer the purpose of the other. The cicatrices of the scarification leave permanent marks on the skin; on which account, when blood is to be drawn from the head or neck, the gla es should be applied behind the ears, and a portion of hair removed in such a manner that the part may be covered by what remains. A most convenient cupping apparatus is manufactured by Mr Bigg, the eminent surgical instrument maker of Leicester Square, consisting of cups and an exhausting syringe, so arranged that the use of the spirit-lamp is rendered unnece ary, and the operation of cupping may be performed nearly as expertly by an inexperienced nurse as by the most accomplished profe ional operator. It is invaluable in places remote from town.