the skin and allowed to cool, thus
sucking blood from a wound made by the scarificator, a long metal tube
that was rotated to make a circular incision. One of the patentees
explained the advantages of the device:

In all previous attempts at an artificial leech the vacuum has been
produced by the action of a piston. This renders the instrument too
heavy to retain its position, and necessitates its constantly being
held. This precludes the application of any number at once, even if
the cost of half-a-dozen such instruments were left out of the
account. But in the case of this leech, the tubes, being exceedingly
light, attach themselves at once, remaining in position until filled;
and as the cost of them is but a few cents, there is no limit to the
number which may be applied.[191]

To take the place of leeches in the uterus, quite a number of uterine
scarificators were sold. These were generally simple puncturing
instruments without spring mechanisms. If insufficient blood flowed from
the scarification, Thomas's Dry Cupper, a widely available vulcanite
syringe, could be inserted into the vagina to cup the cervix before
puncturing.[192] At least one attempt was made to combine puncture and
suction in a device for uterine application. This was Dr. William Reese's
"Uterine Leech," introduced in 1876. It consisted of a graduated glass
cylinder 190 mm long and 12 mm in diameter containing a piston and a rod
with a spear point. The rod was surrounded by a spring that withdrew the
blade after it punctured the cervix. Several American companies, including
George Tiemann & Co., offered the device for sale.[193]

[Illustration: FIGURE 21.--Damoiseau's terabdella. (From Damoiseau, _La
Terabdelle ou machine pneumatique_, Paris, 1862. Photo courtesy of NLM.)]

Despite all the efforts to find a suitable substitute, the use of natural
leeches persisted until the practice of local bloodletting gradually
disappeared in America. By the 1920s leeches were difficult to find except
in pharmacies in immigrant sections of large cities like New York or
Boston. One of the last ailments to be regularly treated by leeches was
the common black eye. Leeches commanded rather high prices in the 1920s,
if they could be found at all. One Brooklyn pharmacist, who deliberately
kept an old-fashioned drugstore with the motto "No Cigars, No Candy, No
Ice Cream, No Soda Water, But I Do Sell Pure Medicines,"