The Scarificator: A Bloodletting 18th-Century Device

Mallams scarificator, brass, by Arnold and Sons of London, 1866-1900 Graduated matt black perspex background.
Science Museum Group Collection
Mallams scarificator, brass, by Arnold and Sons of London, 1866-1900 Graduated matt black perspex background. Science Museum Group Collection

Intro

Bloodletting was a common medical practice in the 18th and 19th centuries for a wide variety of ailments, including fever, headaches, and even mental illness. Physicians believed that many illnesses were caused by an imbalance of bodily fluids, and bloodletting was thought to restore this balance. The scarificator was an essential tool for bloodletting, as it allowed physicians to create small incisions quickly and efficiently.

The practice of bloodletting can be traced to Ancient Egypt. Physicians mistakenly explained their ideas based on the red secretions observed in hippopotami. They erroneously assumed that the animal had scratched itself to relieve distress.

Diagram of scarificator, showing depth adjustment
Diagram of scarificator, showing depth adjustment

In Greece, the practice of bloodletting was modelled on the process of menstruation. It was widely believed that the menstrual cycle functioned as a way to “purge women of bad humours.”

By the early 18th century, a new device was invented as a substitute for the use of leeches in bloodletting. This surgical instrument was called the scarificator and it was viewed as a more humane and efficient bloodletting instrument than lancets and fleams. The scarificator was principally used in conjunction with cupping, although there is evidence they were also sometimes used by physicians for other purposes.

Some scarificator examples from Duke University Libraries
Some scarificator examples from Duke University Libraries

History

The scarificator is a medical instrument that was commonly used in bloodletting procedures throughout history. It was designed to make small incisions on the skin, allowing for blood to flow out of the body.

The scarificator was a spring-loaded mechanism with gears that had multiple blades that shot out with the press of a lever, creating an instantaneous series of parallel cuts in the skin of the patient.

Bloodletting machine showing internal components
Bloodletting machine showing internal components

The scarificator became an increasingly popular device by the early years of the 18th century and was used until the 19th century. It was invented, allegedly, by the father of modern dentistry, Pierre Fauchard. However, this claim is highly disputed given the number of patents, inventions and designs circulating at the time. However, the instrument was quickly adopted by physicians for bloodletting purposes.

Use of the Scarificator in Bloodletting

The first scarificators were designed to make a single incision in the skin, but later versions had multiple blades that could create several incisions at once. The instrument was operated by turning a key that would release the blades and create the incisions. The blades were held under tension by a spring mechanism, ensuring that they would retract back into the instrument after use.

To perform bloodletting, a physician would first select a suitable vein and then use the scarificator to create several incisions on the skin above the vein. The physician would then use a cup or other device to collect the blood that flowed out of the incisions. The amount of blood taken would vary depending on the patient’s condition and the physician’s judgment.

Chilling, Odd, and Mysterious Artifacts_ The Scarificator –
Chester Inn Museum & State Historic Site

Impact on Medicine

The scarificator was an important tool in the history of medicine, as it allowed physicians to perform bloodletting procedures quickly and efficiently. However, the practice of bloodletting was eventually recognized as ineffective and even harmful, and the use of the scarificator declined as a result.

Brass scarificator, with 12 lancets, in case, 19th century, with three sets of blades. Three quarter view. White background.
Brass scarificator, with 12 lancets, in case, 19th century, with three sets of blades. Three-quarter view. White background.Science Museum Group Collection

Today, the scarificator is largely obsolete, and bloodletting is no longer used as a medical treatment. However, the scarificator remains an important artifact of medical history, providing a glimpse into the medical practices of the past and the tools that were used to treat illness.

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2 thoughts on “The Scarificator: A Bloodletting 18th-Century Device

  1. This is very interesting! In some African communities, blood letting is still practiced but the belief behind it is that it lets out evil spirits which are the ones suspected to bring disease.

  2. When I was a a living history docent at a Rev War site, we traveled to different schools conducting educational outreach on medicine in the 18th century. We had a huge repro medical chest. The pelican key made the kids wince and the saws.