proved Scarificator also
featured blades that could easily be removed for cleaning and repair. In
place of two rows of six blades, one could insert a single row of four
blades to adopt the scarificator for cupping on small areas such as the
temple.[118] The feature of inserting a pinion with clean and sharp blades
permitted the cupper to own only two scarificators. For cleansing the
blades the manufacturer supplied a thin piece of wood covered with wash
leather or the pith of the elder tree.[119]

Scarificators in which the blade rods turned in opposite directions
(called "reversible" scarificators in trade catalogs) were more
complicated to manufacture and therefore somewhat more expensive than
unidirectional scarificators. The cocking lever meshed directly with only
the first blade rod. To make the second blade rod turn in the opposite
direction, an extra geared plate (or idler lever) was necessary to act as
an intermediary between the cocking lever and the second blade pinion. The
cocking lever turned the idler lever, which then turned the second pinion.
Two support rods and two cantilever springs were needed in place of the
one in unidirectional scarificators.

The brass, octagonal scarificator with 8, 10, and particularly 12 blades
became the standard scarificator sold in England and America.[120] Both
unidirectional ("plain") and reversible scarificators were offered through
trade catalogs. Smaller octagonal scarificators with four to six blades
were sold for cupping parts of the body with limited surface area.

_Cupping Procedure_

The art of cupping, it was generally agreed, required a high degree of
dexterity that could be maintained only by constant practice. Professional
cuppers were concerned with avoiding any appearance of clumsiness, else
the patient might come to fear an operation essential to his health. In
the hands of an inexperienced physician or surgeon, cupping could be
highly painful to the patient, and yet fail to produce the requisite
amount of blood. While expert cuppers were usually available in cities,
the rural doctor was not trained in the operation. It was to these rural
practitioners that the treatises of the professional cuppers were
addressed. One cupper, George Frederick Knox, offered in addition personal
instruction in cupping procedures. His charge was a guinea for medical
students and three guineas for non-medical students for a three month
course.[121]

Physicians and surgeon