Despite all the efforts to find a suitable substitute, the use of natural leeches persisted until the practice of local bloodletting gradually disappeared in America. By the 1920s leeches were difficult to find except in pharmacies in immigrant sections of large cities like New York or Boston. One of the last ailments to be regularly treated by leeches was the common black eye. Leeches commanded rather high prices in the 1920s, if they could be found at all. One Brooklyn pharmacist, who deliberately kept an old-fashioned drugstore with the motto "No Cigars, No Candy, No Ice Cream, No Soda Water, But I Do Sell Pure Medicines," wrote in 1923: Here in this atmosphere free from the lunch room odor my armamentarium consists of drugs and preparations from the vegetable, mineral and animal kingdoms. Among the latter are leeches, prominently displayed in a number of glass jars in different parts of the store, including one in the show window. Anything moving, anything odd, arouses the curiosity of the public, and my reputation as a "leecher" has spread far beyond the "City of Churches." Besides, this leech business is also profitable, as they are retailed at $1.00 per head without any trouble; in fact patients are only too glad to be able to obtain them.[194] Veterinary Bloodletting The same theories and practices that prevailed for human medicine were applied to the treatment of animals. Not only were horses routinely bled, they were also cupped and leeched.[195] Manuals of veterinary medicine gave instructions for the bleeding of horses, cows, sheep, pigs, dogs, and cats.[196] There was one major difference between bleeding a man and bleeding a horse or cow, and that was the amount of strength required to open a vein. The considerable force needed to pierce the skin and the tunic of the blood vessel made the operation much more difficult to perform than human phlebotomy.[197] As in the case of cupping, the simplest instruments, those most often recommended by experts, were not easy to use by those without experience. Although a larger version of the thumb lancet was sometimes employed, most veterinarians opened the vein of a horse with a fleam, that is, an instrument in which the blade (commonly double beveled) was set at right angles to the blade stem. These are enlarged versions of the fleam employed in human bloodletting. The fleams sold in the eighteenth and nineteenth centuries consisted of one or more blades that folded out of a fitted brass shield. In the late nineteenth century fleams with horn shields were also sold. The largest blades were to be used to open the deeper veins and the smaller blades to open the more superficial veins.