was often added to pumps
exhausted by syringes or rubber bulbs, in order to collect the milk so
that it could be fed to the infant. In the 1920s some breast pumps were
attached to electric motors.[167] Breast pumps have continued to be
employed up to the present day. Of all instruments employing the principle
of the cupping device, breast pumps were the most frequently patented.
From 1834 to 1975, more than 60 breast pumps were patented, the majority
in the period from 1860 to 1920.[168]

_The Decline of Cupping_

Cupping died out in America in the early twentieth century, but its
disappearance was gradual and scarcely noticed. Some of the most complex
of cupping devices were invented in a period when most physicians regarded
cupping as ineffectual. Patents for cupping devices continued to be issued
as late as 1916 when Joel A. Maxam of Idaho Springs, Colorado, patented a
motorized pump, which by means of various sizes of cups, could subject a
part of the patient's body to either a prolonged suction or a prolonged
compression.[169] One of America's last advocates of bloodletting,
Heinrich Stern, writing in 1915, also advocated the use of an electrical
suction pump to evacuate cups. With an electric motor, he declared, one
could prolong hyperemia for 15, 30, or more minutes.

Stern also invented a theory to account for the therapeutic effects of his
inventions, namely, the theory of phlebostasis. Instead of pumping air out
of a device, Stern pumped air into a device, for the same purpose of
removing a portion of blood from the general circulation. His
"phlebostate," manufactured by Kny-Scheerer of New York, was quite similar
to a sphygmomanometer. It consisted of a set of cuffs that fit about the
thighs, rubber tubes, a manometer, and a suction bulb or an electric force
pump. For stubborn cases, such as migraine headaches, Stern recommended
using the cuffs for 30 minutes or more. To facilitate the application of
the cuffs, Stern invented a "phlebostasis chair," one of the most complex
"cupping" devices ever made. Like an electric chair, the phlebostasis
chair was supplied with cuffs for both arms and legs. Air was pumped into
the cuffs by means of an electric motor. According to Stern, compression
of the upper segment of both arms withheld 300 cc of blood from
circulation, while compression of the thighs withheld as much as 600
cc.[170]

In addition to these sophisticated devices, simple cupping, especially dry
cup