Thursday, March 23, 2017



the blog about the medicine and surgery of yesteryear

Keith Souter aka Clay More


Bleed, blister, vomit and purge! Those were basically the components of Heroic medicine, the name given to the aggressive medical practice used right up to the mid-19th century. They were therapeutic techniques that had their origins back in the days of Hippocrates, the father of medicine in the fifth century BC. 

In England in the 18th century Dr John Lettsom (1744-1815), founded of the London Medical Society, which is the oldest medical society in the UK. He was a Quaker and an abolitionist, who became one of the most eminent physicians of his day. He was a staunch advocate of Heroic medicine and wrote humorously about himself:

When people's ill they come to I
I, blisters, bleeds and sweats 'em.
Sometimes they live, sometimes they die.
What's that to I?
I let's 'em.

Sadly, that may not have been far from the truth.

On the other side of the Pond, Heroic medicine,'s greatest advocate was Dr Benjamin Rush (1746-1813). He was a signatory of there Declaration of Independence and was a physician, politician and social reformer.

He was famous for providing the Lewis and Clark expedition with "Dr Rush's Bilious Pills," essentially calomel, a drug containing mercurous chloride, which they used liberally throughout their two year journey.

Doctors used blistering, the deliberate production of blisters on the skin to produce a powerful confer-irritation. Effectively, the pain of the blister would over-ride the painful condition being treated.  They were used in pneumonia, rheumatic conditions, sciatica and neuralgia. They also were advocated in heart disease, diabetes and liver disease.

Mustard plasters were used for mildly painful conditions. Mustard paste would be applied to the body and bandaged on. Sprains and chills were treated with these.

More extreme conditions were treated with 'blistering fluids' called vesicants. Capsicum, made from chilli peppers was commonly used. Capsicum could be applied as a tincture, liniment or ointment. It would produce redness and a raised area, but not quite a blister. This could be used over arthritic joints.

The most powerful vesicant was the famous Spanish Fly. This was actually a pulverised beetle, one of the so-called 'blistering beetles.' Doctors had supplies of it labelled Cantharis vesicatorium.

When an area was to be blistered it would be surrounded by vaseline to limit the area.. Then it would be painted with the blistering fluid. As soon as the blister arose, the area would be cleaned and a dry dressing applied.

Cups were extensively used by 19th century doctors, both as an adjunct to  bleeding or as a method on its own. 

In fact, cupping is a technique that was used by the ancient Egyptians and the ancient Chinese. The Greek traveller and historian describes cupping used by Egyptian physicians. 

A frieze from the temple of Sobek at Kom Ombo depicts a case of surgical instruments, with  cups used for cupping in the bottom left corner. 

Doctors used both wet and dry cupping. Wet cupping was used for the treatment of local areas of inflammation. Wet cupping meant that it was used together with scarification to draw off blood. A scarificator consisted of a brass box containing a series of spring loaded blades that could be triggered to cut through skin.



After the scarification site was selected, usually an area of localised inflammation, the cups were warmed in water. With a small lit torch or spill in one hand and the cup in the other, an edge of the cup would be placed against the skin. The lighted torch would then be placed inside the cup for two seconds, then withdrawn and the cup placed immediately down. The vacuum produced would suck the skin up to a third of the volume of the cup. It would be left on for one minute and then removed and the scarification applied to produce a series of cuts. The cup would again be applied with the same method. About four ounces of blood would be produce per cup applied. 

Dry cupping was called vesication, for it is another method to produce a blister. This would be used for pneumonia and other chest infections, rheumatic conditions, liver disease and other internal organs. The theory as that the cupping would draw blood to the surface, as a bruise, but also other disease causing humours or fluids. 

Dry cupping is still used in sports medicine and in Traditional Chinese Medicine and acupuncture. Indeed, in my own practice I have used acupuncture and cupping for over 35 years in pain management. 

THE DOCTOR'S BAG - MEDICINE AND SURGERY OF YESTERYEAR has been published by Sundown Press, available in ebook or paperback.

Clay More's novel about Dr George Goodfellow is published in the West of the Big River series by Western Fictioneers. 

Available at


  1. As always, fascinating! I love these explanations of yours as to these medical practices. Thanks for another excellent post, with explanations even us "non-medical" readers can understand.

  2. Sounds like the treatments were more dangerous than the disease. Ouch.

    1. Sometimes they were, Jim. Yet sometimes they worked. The resin they worked may have had ore to do with human resilience than he treatment prescribed. If the patient recovered, it was, of course ascribed to the skill of the physician, rather than nature.

  3. Keith, I saw a video the other day of a woman with a series of drinking glasses. She took each one and stuck a flame inside and then firmly plunked it down on a relative's back. I saw blisters form. I was told it was an Old World cure/treatment for sinus problems. Every hear of this "treatment"? Ouch!

  4. Keith, everything you write should be required reading for all of us!

    1. Coming from a double Spur winner, I am grateful for that comment, Troy!

  5. I agree with Troy,Keith. Your explanation of remedies gives me some insight to the past. When a child, I once heard my Uncle instruct my Aunt to place a heated bottle over a boil on his backside. I didn't stick around to see the results. I always wondered about what was going on.

    1. You should have, Jerry. I bet he benefitted from it!

  6. I've often wondered at how people survived 'Heroic' medicine. Still, there must have been something to some of it, since we still use capsain and cupping today. Thank you again for another much needed piece of history. Doris

    1. Many thanks, Doris. I am sure that people would have benefitted, through imbibing in the drug 'docazepam.' It is a complex process, but the psycho-neuoro-immunological effect of the doctor's prescription and treatment would have had an effect.

  7. Thanks, Cheryl. I have been at a medical conference, trying to explain to doctors why we need to use normal English, not Medical Jargonese!