In addition to venesection, scarification and cupping remained an important means of bloodletting. More sophisticated and ornate scarificators were developed which contained adjustable, spring-loaded and pointed blades. Cupping procedures and devices also experienced changes (See accompanying figures). W. A. Gillespin in 1834, writing in the Boston Medical and Surgical Journal recommended the use of cow horns to replace the use of glass cupper devices which were subject to breakage during use.
Images courtesy of Wikimedia CommonsCupping equipment using syringe for vacuum