In America, Benjamin Rush (1746-1813) promoted vomits, purges, salivation, and especially bleeding. Rush, a signer of the Declaration of Independence, is notorious in medical history for his resorting to massive bleedings during the epidemics of yellow fever at the end of the eighteenth century. Rush told a crowd of people in 1793: "I treat my patients successfully by bloodletting, and copious purging with calomel and jalop and I advise you, my good friends, to use the same remedies." "What?" called a voice from the crowd, "Bleed and purge everyone?" "Yes," said the doctor, "bleed and purge all Kensington."[61] The alternatives to bleeding in this period included administering mercury (calomel) to promote salivation and tartar emetic to induce vomiting. These substitutes could be as hazardous as bleeding and offered little choice to the patient who had to bear the unpleasant effects. Thus, the late eighteenth and early nineteenth century has been referred to by historians as the era of heroic medicine because of the large amounts of strong medications given and excessive bloodletting.[62] One of the most notable victims of heroic medicine during this period was George Washington (1732-1799), who was bled four times in two days after having contracted a severe inflammation of the throat. Washington's physician, Dr. Craik, admitted that the removal of too much blood might have been the cause of his death. Additional bleeding was prevented only by Washington's request to be allowed to die without further medical intervention, since he believed that his illness was incurable.[63] Bloodletting was especially resorted to in times of crisis. One woman, Hannah Green, had been anesthetized in 1848 by chloroform before undergoing a minor operation on her toe. The physician bled her in a futile attempt to revive her, but she died, becoming the first known victim of inhalation anesthesia.[64] _Spring Lancets_ The great vogue in phlebotomy inspired the invention of ingenious instruments. From Vienna came the automatic or spring lancet, originally called a _Schnepper_ or _Schnepperlein_, which permitted the operator to inject the blade into a vein without exerting manual pressure.[65] It was widely adopted if the variety of models now extant is a proper indication. In the spring lancet, the blade was fixed into a small metal case with a screw and arranged to respond to a spring that could be released by a button or lever on the outside of the case. The blade was positioned at right angles to the spring and case, thus adopting the basic shape of the fleam. The case of the spring lancet was usually made of copper, silver, brass, or an alloy. It was often decorated with engraved furbelows or embossed with political or other symbols depending on the preference of the owner and the fashion of the period. The mechanism of this handsome implement has been described by a modern collector (Figures 6, 7):