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The Humoral Management of Blood: Cupping, Bloodletting and Staunching- PART 3

The ‘Governor’ - The King of Cups

Drawing of M. Hills Senior.

In 1853 within the Lancet* St Thomas’ trained surgeon Thomas Wakley (1795-1862) wrote a substantial obituary of Monson Hills Senior (1792-1853) the long serving Cupper to Guy’s Hospital (a drawn portait is seen to the left): “In March, 1823, he was appointed surgery-man in Guy's Hospital, and after six months, having in this interval qualified himself by assiduity and dexterity, he was advanced to the situation of cupper. In 1832 he published a work on cupping … and recommended, in order to avoid the needless alarm experienced by Patients, a small pocket-case, containing the necessary, but his improved, instruments …The hospital authorities have perhaps hardly known how much of the general order of the establishment has been due to him.” Wakley continued that “Mr. Hills was there … with an ear open to listen to all the wants of the pupil, and ever ready to caution and advise … they respected him, they revered him, they loved him … to patients to whom he was remarkably kind and indulgent; and so far (as is sometimes seen) from growing callous, from a constant presence amongst disease, the suffering of others only increased his sympathy”. 

Wakely naming ‘Mr.’ Hills in this regard could be making reference to his surgical skill and was at least high appraisal of a valued leader of the Hospital’s accident and emergency admission management  …“In such a moment, perhaps in the dead hour of the night, when a bleeding, insensible body is brought in from the streets, and the dresser at his wits end whether it is a case for the stomach-pump or the trephine, or whether or not it be a stroke of apoplexy, at such a time could the presence of the “Governor” alone restore calm and decision to the troubled mind of the student. I speak of the “Governor,” for by this name was he best known at Guy's; and those who have experienced his fatherly care and regard will bow well his actions responded to this honourable title.” Wakley details ‘Cupper’ Hills work that he “attended diligently to the practical part of surgery, especially to the diagnosis of fractures and dislocations, and soon acquired such a proficiency, that Sir Astley Cooper advised him to qualify himself for the College of Surgeons”** Hills did not further his official surgical qualification but wrote the book A Short Treatise on the Operation of Cupping published in 1832 in which he reports that within Guy’s Hospital “…above six thousand Patients [both on the ward and outpatients] undergo the operation yearly” and of his methods that “… I have, since that period, given this plan a full and fair trial on the persons, of at least eight thousand patients, during the last two years; and in many instances, on the same patient, I have used the eight and fifteen lancets at the same time, and then compared the product…” For protection of the cuppee he advised that “It is of importance to keep patients, while under the operation of cupping, as warm as is convenient, and not heedlessly expose them to the cold air, as they are thereby rendered uncomfortable case” and warning “There is one observation particularly applicable to cupping on the neck and head, namely, that the burner, after quitting the glass, should be drawn away from the head downwards; if it be drawn to one side, probably the appearance of the cap or patient's head on fire will remind the operator of the necessity of this precaution.” Most important perhaps for any student of cupping he recommended “If, after cupping, the bleeding be troublesome, and it cannot be stopped by lint and strapping, a bandage applied round the head is the best method, and will always be found quite sufficient a means, to stop the bleeding.”

Photo of M. Hills Junior with instruments: scarificator, cuppers, bowl, bloodletting knives.

Hills’ thirty years service no doubt made him a great teacher and on his death it was his eldest son (of six children) Monson Hills Junior who took the vacant Hospital position of Cupper to Guy’s, his second son qualified to become a surgeon. The bloodletting equipment shown also presents a photograph of Hills Junior in his Guy’s Cupper role. The equipment shown with his image was likely to have been used by him at the old Guy’s Hospital and is presented within the museum displays.

Mysterious early Blood Staunching Cure Trialed at St Thomas’ Hospital 

Generally a Hospital patient was in danger of life threatening blood loss due to accident, surgical operations, or due to the engagement of war. French surgeon Ambroise Pare (1510-90)*** had already directed surgeons to simply dress and suture soldiers’ wounds over the earlier more damaging tradition of cauterisation of wounds. In the following century in 1673 Henry Oldenburg (c. 1619–1677) Secretary to the  newly founded Royal Society, London reported within their Philosophical Transactions that a new blood staunching liquid was been trialed for surgical use: (In Volume VIII, 1673-4, p6078-9) “The King [Charles II] having in his presence caused some considerable Experiments to be made with the new Blood-stopping liquor upon Brutes and there remaining yet some persons here doubting, whether it would as well succeed upon Men.” He caused a trial to be undertaken at St Thomas’ Hospital by the surgeons:

Fungus Chirurgorum.

“The first Experiment was made July 3. the King having sent some of his Physicians and Chirurgeons to the said Hospital to be present at the operation and faithfully to report to his Majesty what should pass there. The leg therefore of the poor woman being cut off, immediately the Arteries were dressed with some linen pedlgets dipt in the [mysterious] Astringent liquor with a compress on it, and a bandage keeping all close against the arteries. The success was, that the blood was staunch without any other dressing; and instead of complaining, as those are wont to do who have a limb cut off, and the mouths of whose arteries are burnt with a hot Iron or a caustique to stop the blood, this Patient look’d very cheerful, and was free from pain, and slept two hours after, and also the night following; and from that time hath found herself still better and better without any return of bleeding, or any ill accident.” The mystery cure was likely imported for use (a sample of the styptic “Fungus Chirurgorum” or Fomes fomentarius was known as the Surgeon’s Agaric and was reputed to staunch blood flow is presented with the Museum exhibition see to right). Today the action of the herbs yarrow, golden seal, turmeric, flour, spiders webs, or even tea bags are known to staunch low level bleeding but the excellent modern micro suturing skills and use of diathermy along with the provision of blood and plasma transfusion are more likely the patients’ best insurance against blood loss.


* Social reformer and surgeon Thomas Wakley founded the Lancet medical newspaper in 1823. Wakely’s obituary The Late Mr. Monson Hills was published in 1853, Vol I, pages 166-167.

** Wakely reports that Hills had been advised to qualify surgically by Sir Astley Cooper (1768- 1841) who was one of the greatest surgeons of Guy’s Hospital, a.k.a. the ‘Father of Arterial  Surgery’, he had successfully operated on George IV.

***Over the traditional standard method of cauterisation of gunshot wounds by hot oil, French military surgeon Ambroise Pare radically introduced ligatures to close blood vessels during his 1536-37 experience in Turin. He as reports the method within his book: Method of Treating Woundspublished in 1545


References

Apothecary and Surgery Bills for St Thomas’ Hospital 1791-1845. London Metropolitan Archives.

Cox, E. 1832. A Short Treatise on the Operation of Cupping. Monson Hills Publishers.

Oldenburg, Henry. 1673-4. Philosophical Transactions of the Royal Society. Volume VIII: 6078-9) 

Wakely, Thomas. 1853. The Late Mr. Monson Hills. Vol I: 166-7. 


To cite this post : Karen Howell, “The Humoral Management of Blood: Cupping, Bloodletting and Staunching- PART 

3”, Museum Highlights (blog on oldoperatingtheatre.com), September 21st, 2017. [On line]http://www.oldoperatingtheatre...



Karen Howell was trained at Chelsea College of Art as a video and installation artist and undertook postgraduate work at Central St Martins School of Art, London. Throughout her training she has always had the history of medicine as a core interest. It was only after joining the museum that she undertook her museum studies training at Leicester University becoming then the Curator of the Old Operating Theatre Museum and Herb Garret. 

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