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diff --git a/old/50985-0.txt b/old/50985-0.txt deleted file mode 100644 index 1c847d1..0000000 --- a/old/50985-0.txt +++ /dev/null @@ -1,1447 +0,0 @@ -Project Gutenberg's A Treatise on Acupuncturation, by James Morss Churchill - -This eBook is for the use of anyone anywhere in the United States and most -other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms of -the Project Gutenberg License included with this eBook or online at -www.gutenberg.org. If you are not located in the United States, you'll have -to check the laws of the country where you are located before using this ebook. - -Title: A Treatise on Acupuncturation - -Author: James Morss Churchill - -Release Date: January 21, 2016 [EBook #50985] - -Language: English - -Character set encoding: UTF-8 - -*** START OF THIS PROJECT GUTENBERG EBOOK A TREATISE ON ACUPUNCTURATION *** - - - - -Produced by deaurider, Turgut Dincer and the Online -Distributed Proofreading Team at http://www.pgdp.net (This -file was produced from images generously made available -by The Internet Archive) - - - - - - - - A TREATISE - - ON - - ACUPUNCTURATION, &c. - - - DEDICATED, BY PERMISSION, - - TO - - ASTLEY COOPER, ESQ. F. R. S. - - - Plummer and Brewis, Printers, Love Lane, Eastcheap. - - -[Illustration: ACUPUNCTURATION NEEDLES.] - - - - - A TREATISE - - ON - - ACUPUNCTURATION; - - - BEING - - A DESCRIPTION OF A SURGICAL OPERATION ORIGINALLY PECULIAR - TO THE JAPONESE AND CHINESE, AND BY THEM - DENOMINATED - - ZIN-KING, - - _Now introduced into European Practice_, - - WITH - - DIRECTIONS FOR ITS PERFORMANCE, - - AND - - CASES ILLUSTRATING ITS SUCCESS. - - - BY - - _JAMES MORSS CHURCHILL_, - - MEMBER OF THE ROYAL COLLEGE OF SURGEONS IN LONDON. - - - _LONDON_: - - PUBLISHED BY SIMPKIN AND MARSHALL, - - STATIONER’S COURT; - - SOLD BY E. COX AND SON, ST. THOMAS’S STREET; J. CALLOW, - PRINCE’S STREET, SOHO; MESSRS. UNDERWOOD, FLEET STREET; - BURGESS AND HILL, WINDMILL STREET; AND J. COX, BERNERS STREET, - OXFORD STREET. - - - TO - - ASTLEY COOPER, ESQ. - - - THE STEADY FRIEND AND PATRON OF HUMBLE MERIT, - - THE AUTHOR RESPECTFULLY INSCRIBES - - THIS LITTLE TREATISE; - - LESS FROM PRESUMPTION OF ITS DESERVING - - HIS APPROBATION, - - THAN - - AS A MARK OF RESPECT - - FOR SPLENDID ACQUIREMENTS, - - AND OF - - GRATITUDE, - - TOWARDS A GREAT MASTER. - - - - -TREATISE - -ON - -ACUPUNCTURATION. - - - - -_Preliminary Remarks._ - - -If the medical profession merit the reproach, of being easily deluded -into an admiration of novelty, then I need use no apology for -introducing the following pages to notice, nor will my subject stand in -need of prefatory allurements to obtain attention; but if on the other -hand, a rational theory, built on sound logical reasoning, be the only -evidence to which any value can be attached, then will my efforts have -been unavailing and fruitless. Under the impression, however, that -there exists a desire for speculation and discovery on the one hand, -regulated and qualified by a moderate and proper degree of scepticism -on the other, I shall presume a medium of the two extremes, and -proceed without apology or preface to my subject, trusting, that the -interesting facts which I have to relate, will elicit such attention -and investigation, as will kindle a desire in some men, at least, to -become acquainted with a process, which appears to rival the most -successful operations for the relief of human sufferings. - -I should not have taken the tales which are told of the wonderful cures -effected by this operation amongst the original founders of it, as -sufficient authority for recommending it, nor would I admit the fables -which are promulgated by these people, as evidence of its efficacy, had -not this efficacy been witnessed by European spectators on its native -soil, and at length experienced in our hemisphere; and even, latterly, -in our own country. - -The operation of acupuncturation has been seen by so few Europeans, -that our books have made us acquainted with little more than its -name. It is of Asiatic origin, and China and Japan peculiarly claim -it as their own. A writer in the year 1802, mentions a discovery of -its having been practised by the natives of America, and refers to -Dampier’s voyages for an account of it; but I have in vain followed -Capt. Dampier’s relation of his adventures, in crossing from the -South to the North Sea, over the Isthmus of Darien, for any account -of the operation, for he does not so much as name it. He speaks of a -work intended to be published by his surgeon, Mr. Lionel Wafer, who -accompanied the expedition, and to which he refers his readers for an -account of the manners and customs of the interior of the country. Mr. -Wafer was detained, from an accident, a considerable time amongst -the Darien Indians, and did, on his return to England, publish this -book, which I have therefore been at the trouble of perusing, but do -not learn from it, that the operation of acupuncturation was practised -in that part of America: it is true, Mr. Wafer describes a method of -blood-letting employed by the natives, which is somewhat correspondent -to acupuncturation, but both the intention and the effect are widely -different. This operation is effected in the following manner: the -patient is taken to a river, and seated upon a stone in the middle of -it. A native, dexterous in the use of the bow, now shoots a number of -small arrows into various parts of the body. These arrows are prepared -purposely for this operation, and are so constructed, that they -cannot penetrate beyond the skin, the veins of which, opened by the -puncturation, furnish numerous streams of blood, which flow down the -body of the patient. If this be the operation which has given rise to -the idea, that acupuncturation is practised by the American natives, -the conclusion is evidently erroneous, as it is simply a method of -blood-letting, and is generally resorted to for the cure of fever. -Now, acupuncturation has no reference whatever to bleeding, and it -is rare, that even a drop of blood follows either the introduction -or withdrawing of the needle; nor does it appear, that the Chinese -and Japanese, with whom it originated, intended it as a method of -abstracting blood, which is proved, not only by the consequences of -the operation, but by the manner in which it is performed, and the -nature of the diseases to which it is applied. If it could have been -established, that the natives of the American Isthmus were acquainted -with it, it would have been a curious, as well as an interesting -enquiry, to ascertain whence they derived it. - -It is a little strange, that the surprising efficacy, of which so -much has been boasted by its eastern professors, and the safety, -at least, with which acupuncturation may be performed, having been -so fully demonstrated; it is strange I repeat, that it has not met -with an earlier encouragement amongst us. It is probable, that the -hyperbole in which it has been related, has induced the sober minds -of our Northern soil, to treat these relations as the fictions of -Eastern imagination, and to reject them without examination, as -fables calculated only for amusement. There have not, however, been -wanting sensible minds, and men of talent and reputation, to recommend -this operation; and the names of Ten-Rhyne, Bidloo, Kœmpfer, and -Vicq-d’Azyr, stand conspicuous on the list of those who speak in its -favour; but still, neither of them had undertaken to put its merits -to the test, by actual experiment. Several practitioners in France, -however, have now taken up this neglected operation, and their -report verifies the praises which have been bestowed by others upon -it. My attention was lately directed to it by my friend Mr. Scott, -of Westminster, who, as far as my knowledge goes, was the first who -performed it in England, and some successful cases which I witnessed in -his practice, assured me of its efficacy, and led me to its adoption. -The success of my own subsequent practice, warrants a recommendation of -it, in almost any terms I could give it; but I shall content myself in -laying before my readers, the opinion and experience of some physicians -of eminence, accompanied by a relation of some cases of my own, where -the benefit of the operation has been decidedly successful; upon a -better foundation than which it cannot at present rest for public -examination; it remains for the medical profession to ascertain its -claims to attention by the test of experience, and having undergone -the ordeal of experimental enquiry, it will, I have no doubt, so -fully develope its merit, as to obtain a conspicuous rank in medical -estimation, as a valuable curative measure. - - - - -ACUPUNCTURATION. - - -The method of performing the operation of acupuncturation is simple -and easy, requiring neither practice to give dexterity, nor adroitness -that it may be done with propriety. Anatomical knowledge of the human -body is, however, necessary; as an imprudent application of it, by an -operator ignorant of the structure of the part into which he introduces -his needle, might be productive of bad consequences. To a surgeon, -however, properly qualified, (and no other ought to perform this or -any operation) no danger can arise; as the cautions are but few, and no -risk is incurred, if they are attended to. It is only necessary that -the operator, in introducing the needle, should avoid the course of -large vessels, of nervous trunks, and of the tendons of muscles. It is -not, however, proved, that the latter sustain injury from the puncture -of the needle; but it is as well to avoid the possibility of mischief, -by such a cautious mode of introducing the instrument, as shall be -divested of risk. I cannot better familiarize my subject to the reader, -than by a sketch of it in its native state; and as an excellent -description of the operation, as performed by the Japonese natives, is -given in the ninth volume of the “Modern part of an Universal History, -from the Earliest Account of Time,” I shall extract it, as containing -all that is known of its original practice. - -“The place made choice of for the puncture, is commonly at a middle -distance between the navel and the pit of the stomach, but often as -much nearer to, or farther from either as the operator, after a due -scrutiny, thinks most proper; and in this, and the judging rightly -how deep the needle must be thrust below the skin, so as to reach the -seat of the morbific matter, and giving it a proper vent, consists the -main skill of the artist, and the success of the operation is said to -depend. Each row hath its particular name, which carries with it a -kind of direction, with regard to the depth of each puncture, and the -distance of the holes from each other, which last, seldom exceeds half -an inch in grown persons, in the perpendicular rows, though something -more in those which are made across the body, thus, - - - . . . - . . . - . . . - - -The needles which perform the operation are made, as was hinted at -first, either of the finest gold, or silver, and without the least -dross or alloy. They must be exquisitely slender, finely polished, and -carry a curious point, and with some degree of hardness, which is -given by the maker by tempering, and not by any mixture, in order to -facilitate their entrance, and penetrating the skin. But, though the -country abounds with expert artists, able to make them in the highest -perfection, yet none are allowed, but such as are licensed by the -emperor. - -“These needles are of two sorts with respect to their structure, as -well as materials; the one, either of gold or silver indifferently, -and about four inches long, very slender, and ending in a sharp point, -and have at the other end a small twisted handle, which serves to turn -them round with the extremity of the middle finger and thumb, in order -to sink them into the flesh with greater ease and safety; the other -is chiefly of silver, and much like the first in length and shape, -but exceedingly small towards the point, with a short thick handle, -channelled for the same end of turning them about, and to prevent their -going in too deep; and for the same reason, some of them are cased in a -kind of copper tube, of the bigness of a goose quill, which serves as a -sort of guage, and lets the point in, just so far as the operator hath -determined it. The best sort of needles are carefully kept in a case -made of bull’s horn, lined with some soft downy stuff. This case is -shaped somewhat like a hammer, having on the striking side a piece of -lead, to give it a sufficient weight, and on the outside a compressed -round piece of leather to prevent a recoil, and with this they strike -the needle through the thickness of the skin; after which they keep -turning the handle about with the hand, till it is sunk to the depth -they design it, that is, till it is thought to have reached the seat of -the morbific virus, which in grown persons is seldom less than half, or -more than a whole inch: this done, he draws it out, and compresses the -part, in order to force the morbific vapour or spirit out. - -“The directions and nice rules for the performing of this curious -operation are many, and require great skill and attention in the -operator; and when duly performed, may be of excellent use, not -only against the excruciating distemper, called Senki, but against -many other topical ones, which are most commonly cured by the Indian -Moxa, and other caustics. On the other hand, these last are often -tried against the distemper above mentioned, by applying the caustic -to the belly, on each side of the navel, and about two inches from -it, but mostly without any success, it being very unlikely that such -an application should reach the seat of the distemper; whereas, the -benefit which has accrued from the _acupuncture_, in that one disease, -hath encouraged others to apply it indifferently to other parts of the -body, where the moxa is used, and by a due care and precaution not to -prick any nerves, tendons, or other considerable blood vessels, have -cured their patients by it, without putting them to the excruciating -torture which attends that of the Moxa, or other caustics.” - -From the little we have learned of the practice of this operation -amongst the Asiatics, it would seem, that it was chiefly diseases of -the abdominal cavity and viscera, which afforded opportunities for its -performance, such as Colic, Tympany, &c. It is not in such diseases, -however, that I have any experience of its use, but it is questionable, -whether it might not be beneficial, particularly in the latter, and I -would beg to recommend it as a matter of interesting experiment, to be -tried in this malady; such an opportunity, should it fall in my own -practice, I shall take advantage of. - -The Indians, however, do not confine their practice of Acupuncturation -(or Zin-king, as they call it) to diseases of this kind. They puncture -the head in all cases of Cephalalgia, in Comatose affections, -Ophthalmia, &c. They puncture the chest, back, and abdomen, not only -to relieve pain of those parts, but as a cure for Dysentery, Anorexia, -Hysteria, Cholera Morbus, Iliac Passion, &c. Local diseases of the -muscular and fibrous structures of the body, also often afford them -occasions for its performance; and it is for diseases of this class -only, that I have hitherto practised it, and for which I would -expressly recommend it. - -Neither sufficient time has elapsed, nor a proper selection of cases -been made since this operation has been known to me, to have afforded -me, either a large number of experiments, or a great variety of -diseases on which to try the effects of it: it is true I have employed -it on some few, and I have it in contemplation to encrease the list, -by giving my experiments a wider range, but at present I should not -be doing justice to my subject, to form conclusions on such imperfect -evidence; I shall therefore confine myself, merely to the description -of the good effects, which I have witnessed in diseases of a rheumatic -character, and in those injuries of the fibrous structures of the body, -which are often observed to arise, (particularly in labouring persons) -from violent exertion. This circumstance must be ever in view, and if -it be not fully impressed on the mind, I doubt not but many who may -be induced to try the effect of the operation, may be disappointed in -it; viz. that acupuncturation does no good, nor does it produce even -a temporary alleviation, when the disease for which it is used, is of -an inflammatory character. This distinction seems to have regulated -the practice of those, who have experimented on the subject, and to -have decided them in their selection of cases for the operation. Mr. -Berlioz, of Paris, has practised it extensively, and has recently -published an account of the success which it has had in his hands.[1] -He says, - -“The eulogia given to acupuncturation by Kœmpfer and Ten-Rhyne, are -just and merited. We have reason to feel surprized, that although an -age or more has elapsed, since this curative measure has been known in -Europe, no physician has made trial of its efficacy. The practice of -the operation is attended with but little pain, and the success of it -is so prompt, that the disease is alleviated or entirely ceases, as -soon as the needle has been introduced the depth of a few lines; most -frequently, however, the pain is not removed by the first introduction -of the instrument, and it is not until after the use of it for a -second, third, or fourth time, that the cure is completed. Simple -nervous affections, especially demonstrate how much acupuncturation -merits the attention of physicians, for there are but few remedies -possessed of such prompt activity, and which produce such wonderful -effects. - -“_But acupuncturation does not appertain in any respect to sanguineous -evacuations_,[2] it can only contribute sometimes to establish the -indications for them. This operation is _not indeed followed by any -success_, when the disease _depends upon sanguineous turgescence and -inflammation_. - -“In contrary circumstances, Acupuncturation, by dissipating the -symptoms, demonstrates, that disorder of the nervous system only had -given rise to them.” - -The only cases of Rheumatism in which I have been successful with -the operation, have been of the Rheumatalgic form, or that which is -divested of external inflammation; characterised by pain upon motion, -stiffness and coldness of the part; the disease having a disposition to -change its place; is aggravated by atmospheric changes, and relieved -often by stimulant Diaphoretics, Narcotics and external warmth: but I -have yet met with success in some cases where the intensity of the pain -would have led me to believe, that considerable inflammatory action -must have given rise to such exquisite nervous sensibility. - -Mr. Berlioz in speaking of the diseases to which this remedy is -applicable, says, “vague and wandering Rheumatism sometimes attacks the -external muscles subservient to respiration; the patient is obliged to -remain motionless; every motion of the trunk compels him to cry out; a -deep inspiration is very difficult, and coughing occasions such cruel -pains, that expectoration is impossible. Acupuncturation dissipates -instantly this state of distress, and renders to the muscles their full -liberty of action. In the space of one or two minutes, a patient whose -sufferings drew from him tears, exclaims he is quite cured.” - -These observations of Mr. Berlioz are fully substantiated by the -experience of Dr. Haime of Tours, who has devoted much time and -attention to the operation of Acupuncturation, and has lately published -a most interesting paper upon the subject in the 13th volume of the -“Journal Universel des Sciences Medicales,” at Paris.[3] - -The doctor declares that his own practice bears evidence of the -fidelity of the preceding remarks of Mr. Berlioz. He accuses the -Japonese and Chinese, (to whom this operation he says is peculiar,) -practising it too extensively, which has been partly the cause of its -being disregarded by Europeans, and acknowledges that it was to Mr. -Berlioz’s cases, which he has related in his “estimable work,” that he -owed the fortunate application which he has made of this measure. - -The following cases are given by Dr. Haime, which he says support the -Theory of Mr. Berlioz. - -“Antoinette Boulard, 38 years of age, had experienced in April 1818, a -severe attack of Rheumatism, which fixed on the inferior part of the -left side of the chest; it gave way in 48 hours to the use of some -sedatives, the tepid bath, and the application of a blister to the part -in pain. - -“Six weeks afterwards I was called to see this woman, who had fallen -again into the same state. I found her with the trunk in a state of -inability of action, the motion of the respiratory muscles extremely -difficult, and the plaintive tone of voice indicated the violence of -the pain, which drew from her cries on the least motion. The pulse was -small and concentrated, but without sensible acceleration; the body was -covered with cold sweats; and the unhappy patient, altogether, was in -a state of inexpressible anguish. I thought it right to have recourse -to the same remedies which had been successful on former occasions; -but my hopes were deceived. Three days were passed in this state, and -Antoinette obtained no relief: I determined therefore to practice -acupunctuation. I introduced a needle[4] at the inferior margin of the -cartilages of the false ribs. The instrument had hardly passed to -the depth of a few lines, when the patient said the pain had changed -its seat, and was descended into the abdomen, at the same time that -it had lost much of its violence. I continued the introduction to the -depth of an inch; by this means the pain was driven from the abdomen, -and permitted the patient to breathe freely: however I maintained the -needle in its place for five minutes, and then made a second puncture, -and successively a third, in the place where the disease had taken -refuge. This third puncture made the pain totally disappear, and the -patient cried out that I had restored her to life. Sleep of eight hours -duration and a state of perfect calmness succeeded this operation. - -“However Antoinette sent for me on the following day, saying her -sufferings had returned, but with less violence, and entreated me with -much earnestness that I would repeat the operation “seeing” she said, -“that it was only the sound,” (for so she named the needle) “which gave -her relief.” The operation was this time still more successful. The -treatment was now continued for four days, and the last puncture so -entirely relieved the pain, that it has not since returned.” - -In addition to the above successful case the doctor adds another not -less so. - -“A woman had suffered for several days with wandering Rheumatic pains, -which continued daily to encrease in violence; there were however at -all times fixed pains in the shoulder and in the right arm, which -acquired such a degree of intensity by intervals, that the patient -could not refrain from crying out. She was in this state when she came -to consult me: finding, however, neither alteration in the pulse, nor -encrease of heat, nor redness of the skin, nor tension, nor swelling -in the part affected, I considered the case to be simple Rheumatalgia, -and passed the needle to the middle of the arm, between the fibres of -the Triceps Brachialis muscle; the place designated by the patient as -the seat of the pain. The pain was driven into the fore arm, and the -second puncture caused it to descend into the hand, and a third being -made in this part, caused it totally to disappear, and the patient said -with delight and astonishment, she was cured; and was so satisfied with -this treatment, that she spoke of it to every body. I have not since -seen her, although I requested her (and she promised) to return in the -event of a relapse.” But the most remarkable case which has occurred -to exemplify the triumphant effects of acupuncturation, was that of a -girl of 24 years of age. She was naturally healthy and robust, and had -enjoyed good health till she was 15 years old, at which time the signs -of puberty were manifested. At this period the system became much -disturbed, menstruation was established with difficulty, and continued -with irregularity; she lost her cheerfulness, and symptoms of the -nervous temperament became predominant.--Various nervous symptoms now -evinced themselves, and amongst others an obstinate vomiting occurred, -which subsided only during very short intervals. She continued in this -state for two years[5]. From this time she gradually got worse, and -in addition to the habitual vomiting which she had endured from the -age of 16, she suffered extremely from violent general convulsions. -Some medicines were now given which relieved the sickness, and the -use of the cold bath suspended the convulsions. After the treatment -had been continued two months, she was visited by Dr. Haime, (to -whose description of this interesting case, I am indebted for these -particulars,) who found her labouring under partial convulsions, with -a disposition to vomit occasionally. The means which had been before -employed were still continued, but the symptoms became more aggravated, -but were a little subdued by blood-letting from the saphena vein. -The convulsions were almost wholly removed, at least had become only -partial; the spasmodic efforts being concentrated on the diaphragm and -stomach; but a nervous hiccup supervened which acquired such a degree -of intensity, that the unhappy patient experienced no intervals of -ease. All the known anti-spasmodic remedies were now tried during the -space of six months without any benefit. Blisters to the pit of the -stomach afforded no sort of relief, and the cold bath gave but a short -and temporary alleviation. Scarifications followed by the application -of a cupping glass were made on the side of the Dorsal Vertebræ, and -the situations corresponding to the pillars of the Diaphragm, which -suspended the symptoms but for a few days: relief was only partially -obtained by the cautery, and the hiccup returned with its original -force accompanied with such a convulsive affection of the stomach, -that this organ appeared to act like a pair of bellows, alternately -receiving and expelling large quantities of air. At length when the -hiccup ceased, it was replaced by partial convulsions or some other -symptoms, and vice versa. - -Seeing the want of success of all attempts to cure this obstinate -disease, and reduced to the necessity of remaining a mere spectator of -its dreadful effects, Dr. Haime consulted every book which he conceived -might give him some information by which some other curative measure -might be suggested; but his researches were totally unsatisfactory, -until he met with Dr. Berlioz’s observations upon Acupuncturation, -when, not less struck with the curious facts which Dr. Berlioz -relates, than with the efficacy which it was reported to possess in -nervous diseases, he resolved to try it as a sort of forlorn hope, -upon his present patient: he accordingly proposed it to her, and -readily obtained her consent to its performance. He communicated his -intention to Doctor Bretonneau, Physician to the general hospital, who -had seen the case with him, and had often spoken of it; and in his -presence he performed the operation for the first time. A needle was -introduced perpendicularly at the centre of the Epigastrium, and the -two physicians soon became convinced of the astonishing promptitude of -the remedy; for the instrument had hardly passed to the depth of a -few lines, when the symptoms vanished as it were by enchantment. The -operation not appearing to be painful to the patient, the introduction -of the needle was continued to half its length, in depth from twelve to -fifteen lines, where it was suffered to remain for five minutes. The -result was a perfect calmness, and a total suspension of the hiccup -for three days, when the same symptoms returning, the needle again was -had recourse to, and with the same efficacious effect as at first; -and the operation was performed again and again, at longer or shorter -intervals, according as the symptoms re-appeared, and always with the -same advantages. Dr. Bretonneau became convinced of its efficacy by -himself performing it several times. The treatment of the case was -thus continued, selecting the part for the introduction of the needle, -according to the situation of the symptoms which each operation was -intended to alleviate; and Dr. Haime asserts, it never once failed -of success; for the convulsive motions of the head, the instrument -was passed into the muscles of the neck; into the masseter muscle, to -relieve constant gaping; and into the fore arm when these muscles were -affected; and thus, by pursuing the disease as it were, the convulsive -disposition was entirely removed, and the patient restored to health. - -For the fidelity with which I have reported this case, I refer the -reader to Dr. Haime’s own record in the 13th volume of the “Journal -Universel des Sciences Medicales,” and should further evidence of the -efficacy of this remedy be necessary from other authority, I have but -to mention the experience of Dr. Demours of Paris, who has recently -confirmed[6] the report of Messrs. Berlioz and Haime. He dwells with -particular force upon its good effects in Ophthalmia, for which he -directs five or six needles to be passed between the fibres of the -supraspinatus muscle. His method of performing the operation I shall -presently notice when describing this part of my subject. The following -cases which have occurred in my own practice, I shall now lay before -my readers, and I doubt not but I shall make it appear that the -beneficial effects of the remedy employed, are sufficiently flattering -to deserve the esteem I hold it in, and to justify me in bringing the -subject into general notice. - - -CASE I. - -GEORGE MC’LAUGHLAN, about 30 years of age, a Bricklayer by employment, -came to my house in November last, supporting himself by a stick in one -hand, and resting the other against the wall, as he proceeded. The body -was bent at nearly right angles with the thighs, and his countenance -indicated acute suffering. He had been attacked, he said, three days -before, with darting excruciating pains in the loins and hips; every -motion of the body produced an acute spasmodic pain, resembling -an electric shock; and the attempt to raise the body to an upright -position was attended by such insupportable agony, as obliged him to -continue in this state of flexion rather than encounter it by altering -his position. There was no more constitutional disturbance than was -to be expected from three days and nights of constant pain; the pulse -was a little quickened, and the tongue white, but I attributed this -derangement to the irritation set up by the pain and loss of rest. I -directed him to place himself across a chair for support during the -operation, and I immediately introduced a needle of an inch and a half -in length into the lumbar mass on the right side of the spine; in two -minutes time I observed that he seemed to rest the weight of his body -more on his limbs, and in the next instant, without any enquiry being -made, he observed, that he felt his limbs stronger from the “pain -having left his hips.” He next plainly indicated that the disease was -lessened, by raising his body; from which he only desisted, by being -desired to remain at rest, through fear of the needle being broken. -The instrument having remained in its place about six minutes, the -patient declared he felt no pain, and could, if he were permitted, -raise himself upright; it was then withdrawn; the man arose, adjusted -his dress, expressed his astonishment and delight at the sudden removal -of his disease, and having made the most grateful acknowledgements, -left the house with a facility as though he had never been afflicted. -The relief was no doubt permanent, as he did not return, which he would -most probably have done, had he suffered a relapse. - - -CASE II. - -WILLIAM MORGAN, a young man in the employment of a timber merchant, -felt a violent pain suddenly attack the loins whilst in the act of -lifting a very heavy piece of mahogany. The weight fell from his hands, -and he found he was incapable of raising himself. He was immediately -cupped and blistered on the part; but two days had passed and he -was still labouring under considerable pain, augmented violently -by every motion of the body. On the third day the operation of -Acupuncturation[7] was performed upon the part of the loins pointed out -as the seat of the injury, which, as in the former case, dissipated the -pains in five or six minutes, and restored the motions of the back. He -returned, however, the next day, with the same symptoms as at first, -but in a mitigated degree. A needle was now passed to the depth of an -inch on each side of the spine, which, as I expected, terminated the -disease in a few minutes, and it was with pleasure that I understood -the next morning, that the man had gone to his usual employment. - -This case illustrates the observations of the French physicians -before cited, as to the efficacy of the remedy in injuries of this -description: it is true that in my own practice it is a solitary -example; but so decisive was the benefit derived from it, that the -case proves a powerful corroboration of both Mr. Berlioz’s theory and -practice. - - -CASE III. - -ELIZABETH JACKS, a married woman, aged 44 years, was admitted into -one of the public hospitals of London, in the year 1817, for an -enlarged Bursa situated under the Rectus Femoris muscle. Soon after -her admission she was attacked with violent pains in the limbs, which -continued to affect her with greater or less violence, till the month -of October, 1820, when a severe rheumatic state of the back of the -head and of the loins supervened; the one preventing flexion of the -neck, the other of the back. Her digestion continued unimpaired, the -pulse about its natural standard, without hardness or acceleration. -Her nights were passed without sleep, and every motion of the body was -performed with pain and reluctance. In this state she applied to me, -and I gave her antimonials combined with opium, keeping the bowels -open with gentle aperients. Under this treatment, she was in some -degree relieved, but as she laboured under the impression that nothing -could be done to eradicate the disease, she discontinued it after a -short time, but in a few days afterwards (Nov. 4th,) Mr. Carpue was -requested to see her; he prescribed ten grains of Dover’s powder, to -be taken every night at bed time: this dose she took twice without -any benefit. The pains had now entirely left the parts they at first -occupied, and had fixed on the intercostal muscles above and below the -seventh and eighth ribs on each side of the chest; whence, to avoid -the insupportable anguish occasioned by the action of these muscles in -the process of respiration, this function was (or at least appeared -to be) wholly supported by the Diaphragm, the abdominal muscles, and -the large external muscles of the neck, chest and back. No other -force but that of pressure upon the situation corresponding with the -interstices of the ribs gave any uneasiness, but on these parts, the -slightest pressure produced intolerable pain: this plainly proved -that the disease affected the intercostal muscles alone. Peritonœal -inflammation ensued, and the suffering which this occasioned, banished -for the time, all attention to the original disease; but no sooner was -this removed, (which was effected by the most active means) than the -patient found that she was still the victim of an unrelenting malady, -which had now pursued her upwards of three years. Acupuncturation now -recurred to me as a probable mean of relieving her from her sufferings. -I accordingly introduced a needle between the sixth and seventh ribs, -and another between the seventh and eighth of the right side; in two -minutes the patient became sensible of relief, and in two or three -minutes more, that side of the chest was emancipated from the disease. - -The same operation was now performed on the other side, though the -good effect was not equally extensive on this as on the right; yet -the patient respired now with so much comparative freedom and ease, -that she exclaimed, she should “soon be quite well.”--The following -day but one, there was a little augmentation of the pain on both sides -of the chest, but a single needle introduced into each part, entirely -removed it. No return of pain after this time visited the right side, -but the left, still continued to be attacked; until at length the -third introduction of the needle, dissipated it permanently, and the -patient has since remained free from the disorder. The needles in every -instance were suffered to remain in the part about five or six minutes. - - -CASE IV. - -HANNAH HOWARD (a female servant in my house) aged 25 years, became in -September last the subject of Rheumatalgia. The shoulders, arms, back -and hips, were the parts selected by the disease for its wandering -peregrinations. Antimonials, Opium, Guaiacum, Hyosciamus, &c. relieved -her occasionally, but at the end of three months, metastasis to the -heart suddenly took place. I was called hastily to her at this time; -she had fainted, and when recovered from the syncope, complained of -violent pain about the region of the heart, which she informed me had -troubled her more or less for several hours. Her pulse was hard, and -beat somewhat about 106 in a minute; but from its extreme irregularity, -it could not be measured with exactness; nor if it might, would it -have been found, I believe, to have preserved an uniformity within -any two given periods; as both its intermissions and its actions of -rapid velocity were produced at uncertain and variable intervals. -Copious bleeding, blistering, cupping, with the use of digitalis and -colchicum, at length removed the disease; and in three weeks she was -able to leave London, to try the effect of country air in restoring -her health and strength. She returned to town after a short time, -perfectly recovered; and continued so, until an exposure to wet brought -on another attack of rheumatalgia; which, after variously shifting its -seat for several days, now fixed itself on the left side. The remedies -which had formerly been of service, were now taken without relief; and -the colchicum[8] (which in most cases of rheumatism will be found, -after bleeding, more valuable than any other article of the materia -medica) was totally inert. The pain had now acquired such a degree of -violence, that the slightest motion of the body gave the most exquisite -agony; and so intense was this state of suffering, that the patient -could not be urged to speak in a tone loud enough to be conveniently -heard, through the fear of exciting an exacerbation of pain, which even -such slight motions occasioned. I now had recourse to acupuncturation; -having introduced a needle through the integuments covering the -interstice of the 8th and 9th ribs, at the part corresponding to the -junction, with their cartilaginous epiphises. I continued to press it -gently forward, by rolling it freely between my fingers. When it had -penetrated to about two thirds, its whole depth (an inch) I enquired -if she experienced either pain from the puncture, or relief from the -disease; she replied, “she scarcely felt the instrument, but that her -rheumatism had suddenly abated of its violence;” and to my surprise, -this reply was expressed in her natural tone of voice. She added, -“that she could now speak and breathe freely,” so that I now found her -former taciturnity, which I had attributed to moroseness, was banished. -I continued the introduction of the needle, and in a few minutes the -disease was dislodged, and fled to the back of the chest, near the -angle of the ribs. The motions of the shoulder were now restored to -their utmost freedom, and I withdrew the needle, and inserted it into -the part which had become the seat of the pain, about two inches from -the spinal column. The disease soon began to dissipate itself totally; -the patient said she was free from uneasiness, and could make a deep -inspiration without pain. The instrument having been retained in its -place five or six minutes, was withdrawn; the chest had regained its -full liberty of action, and the utmost variety of flexion of the body -could be used, not the slightest inconvenience ensuing. The next -day, however, the pain again visited the anterior part of the chest, -and I again had recourse to the needle. The operation was completely -successful; for excepting a slight darting pain, which occasionally -troubled her for a few days afterwards, no symptoms of the disorder -remained, and she continues at this time to attend to the duties of her -station in my family. - -Whilst occupied with the preceding pages, I received the following -communication from my friend, Mr. Jukes; which I subjoin as the -strongest corroborative evidence of the efficacy of the practice under -our consideration. - - “Great Peter-Street, Westminster, - February 27, 1821. - - - MY DEAR SIR, - - In compliance with your request, I send you an account of - the effect of Acupuncturation on our friend Mr.Scott.[9] I - received an urgent message on the morning of the 18th inst. - from that gentleman, requesting I would visit him instantly. - I found him in bed; and, with a countenance expressive of - much anguish, he informed me, that for three days he had - been suffering severely from pain in the loins, which he - attributed to leaving a warm room during one of the late - foggy nights. Within the last 12 hours it had acquired such a - degree of violence that even respiration was insupportable, - except the body were fixed in such positions as permitted - the least possible motion. An attempt to resume the erect - posture, produced violent spasmodic action of the muscles of - the back, which appeared to be communicated by sympathy to - those of the abdomen and chest, impeding respiration with a - convulsive effort; nor could any motion of the body be made - without producing this distressing effect. Neither fever - nor general derangement was present; the secreting organs - of the body properly performing their function, proved the - external locality of the disease. In this state of things, - Acupuncturation presented itself to us as likely to afford - relief, and it was therefore immediately resorted to. - - “I applied an exhausted cupping glass upon the integuments, - opposite to the second lumbar Vertebra, and midway between - this bone and the edge of the Latissimus Dorsi muscle, which - was the part referred to as the most concentrated spot of the - disease. As soon as a needle had penetrated to the depth of - an inch, a sensation arose, apparently from the point of the - instrument, which the patient described as resembling that - which is produced by the passage of the electric aura, when - elicited to a metallic point, diffusing itself at first to - some distance around the part, and then extending itself up - the side to the Axilla. This sensation continued to be felt - for the space of a minute, when a violent pain struck into the - right iliac region, immediately above, and corresponding with - the line of, the Crista of the Ilium. No pain was now felt in - the back, except a dull aching of about two inches in breadth - on the right side of the spine, extending from the lower part - of the neck to the Sacrum; corresponding with the situation - and course of the Longissimus Dorsi Muscle. The pain above the - hip now began to subside and in the space of three minutes - from its commencement, had ceased altogether. - - - “The uneasiness along the course of the spine still remaining, - a needle was introduced about an inch from one of the upper - Dorsal Vertebræ, and another in a corresponding situation - to one of the lower Lumbar Vertebræ. The pain in the right - side was in a few minutes entirely dissipated, and the - patient arose, declaring, that, excepting a slight degree of - uneasiness on the posterior part of the chest, near the angles - of the inferior ribs, he was completely relieved from the - disease. He, however, requested I would pass a needle in this - last situation; on effecting which the pain soon left its last - refuge, and the patient dressed himself, and left his house - in the most perfect health. 1 have this day seen him, and - he assures me that he has not experienced any return of the - affection. - - “I should have stated that the sensation, described as - resembling somewhat an electrical effect, was experienced from - two of the needles only; the first and the last of those - which were introduced. - - “I send you the history of this case without any comment upon - the mysterious nature of this extraordinary operation; yet - I am convinced there is something more in it than has been - hitherto explained. I have, it is true, some notions (not - however fixed) as to its nature; but I would not at present - venture to detail them, lest the embers of animal magnetism - might be rekindled in the discussion, and the operation - from being associated with an exploded theory, sink into - undeserved and premature oblivion, from preconceived prejudice. - - I am, dear Sir, - - Your faithful friend, - - EDWARD JUKES.” - - -Conceiving that the foregoing cases will be as satisfactory as a larger -number would, I shall not trouble my readers with a more minute detail. - -I could certainly add many others to the list; but to minds open -to conviction and truth, no stronger impression would be made by -multiplying examples; whilst the sceptical, would “not be persuaded, -though one rose from the dead.” - - -The OPERATION of ACUPUNCTURATION DESCRIBED. - -The first step necessary to the performance of this operation, is the -selection of a proper apparatus. It is not requisite, however, that -our needles be either of gold or silver, as those of the Japonese are; -although it is true that the flexibility of these metals prevents -the risque of their breaking; but I have not heard of, or seen, any -instance of such an accident with the steel needle, which is the -material employed in European practice. It may however be left to the -discretion of the surgeon, whether he uses the former or not; it is -only of consequence, that the extremity should be finely pointed, and -preserved so. - -Mr. Berlioz uses a steel needle, three inches in length, which has a -head given to it of melted sealing wax. This needle is introduced to -such a depth as the operator thinks proper, depending on the part in -which it is used, as well as the nature of the disease which it is -intended to remedy. If it be intended to puncture any of the viscera, -such a needle will indeed be wanted; but it will be seen by the -practice of the French physicians, that though they have sometimes -thought it right to penetrate the visceral cavities to the whole depth -of this needle, yet it is but seldom that more than one inch of it has -been sunk into the part. I have not, in my own practice, ventured to -use needles of greater length than one inch, and one inch and a half; -and the instrument which I use is an ingenious adaptation of a common -sewing needle to an ivory handle, constructed by Mr. Edward Jukes, -Surgeon Accoucheur to the Westminster Medical Institution (see plate, -fig. 1 and 2.) - -Dr. Haime, and I believe the French surgeons who practice -acupuncturation, use this long needle (three inches) and Mr. Demours, -who appears to be a man of considerable mechanical genius, has lately -invented a new apparatus for this purpose. An exhausting syringe is -fitted to the side of a cupping glass, which can be unscrewed and -removed after the exhaustion has been effected by a few strokes of the -piston, leaving the glass affixed to the part. From the top of the -glass proceeds a hollow staff, in which slides (the tube being air -tight) a handle, armed with a three inch needle, which is inserted to -any depth the operator chuses. - -The theory which Mr. Demours gives in defence of this instrument -is, that the sensibility of the part is so much lessened by the -conjestion occasioned by the suction of the pump, that the instrument -passes without producing the least pain, whilst at the same time -it penetrates deeper, and more readily, through the tumefaction -occasioned by the turgescence of the sanguineous capillaries and -lymphatics. These advantages, he says, being only obtained by the -operators ability of passing the needle whilst the surface of the body -remains in the state of tumefaction, he contends they cannot possibly -be derived from the simple process of affixing a common glass by the -flame of a taper, as the tumor subsides the instant the glass is -removed. - -I do not think it, however, a matter of any moment, whether a cupping -glass be applied or not; it may, certainly, lessen the sensibility -of the part, and consequently diminish the pain occasioned by the -needle; but this is in general so trifling, that no preparatory steps -are required to mitigate it; in fact, it deserves so little the name -of pain, that the patient is often unconscious of the needle having -penetrated. - -The Japonese and Chinese drive in the needle by the stroke of a mallet. -This instrument, in use amongst the former, is made of ivory, with -holes, sunk on its surface in the same manner as a lady’s thimble, -which prevent the hammer from sliding off when the stroke is given. -Such a method is however objectionable, as well from the danger there -would be of breaking a needle not possessing flexibility, as from its -being more painful to the patient. - -The method to be employed is the following: - -The handle of the needle being held between the thumb and fore finger, -and its point brought into contact with the skin, it is pressed gently, -whilst a rotatory motion is given it by the finger and thumb, which -gradually insinuates it into the part, and by continuing this rolling, -the needle penetrates to any depth with facility and ease. The operator -should now and then stop to ask if the patient be relieved; and the -needle should always be allowed to remain five or six minutes before -it is withdrawn. This mode of introducing the needle, neither produces -pain (or at least very little) to the patient; nor is productive of -Hœmorrhiage, which Dr. Haime says arises from the fibres being -separated, rather than divided by the passing of the needle; the former -of which (the absence of pain) is a point in its favor, which few -surgical operations possess. - -It is but rare that I introduce more than one needle at the same time, -as a greater number does not appear to be more efficacious than a -single one. I, however, depart from this rule (as will be seen from -some of the cases) when the pain becomes fugitive from the effects -of the instrument; which is a most encouraging symptom. In such -circumstances, following the disease by introducing the needles where -the pain has removed to, has always proved ultimately successful. - -Where also the disease is seated in such several parts, which from -their anatomical situation, are known to receive their nerves from -distinct or opposite departments of nervous origin; or if the disease -pervades more organs or muscles than one, which are but little -connected as to their nervous relations; then I regulate the number of -needles, accordingly as I suppose the several parts may be more or less -connected with each other. - -The perforation made by a sharp smooth instrument like a needle, is -of such a simple nature, that there is little danger of doing any -mischief with one of this kind. Dr. Bretonneau, Physician to the -“_Hospital Général_” of Paris, has made a number of experiments on -puppies, the result of which is, that the Cerebrum, the Cerebellum, -the Heart, the Lungs, the Stomach, &c. may be penetrated without -occasioning the least pain or inconvenience. - -In one case, where the heart had been punctured, he afterwards -discovered an extravasation of blood into the Pericardium; and Dr. -Haime asserts, that his experiments prove the doctrine of Mons. -Beclard, respecting the elasticity of the arterial tunics, which may -be punctured with impunity. One case of this nature occurred to Dr. -Bretonneau, where a jet of blood followed the puncture of an artery. -The hœmorrhage was immediately stopped, simply by pressure upon -the opening. Dr. Haime says, that he has often, when performing this -operation upon the human subject, thrust the needle to such a depth -into the Epigastrium, that the stomach must have been pierced; but that -it was productive of no more inconvenience than the same operation upon -the more simple parts of the body. I should, however, contrary to such -high testimony, hesitate much to puncture an artery, as an aneurism -has been known to result from a small puncture made by an awl, which -required the division of the vessel for the cure. - -I shall here close my subject, not without exciting, perhaps, in the -minds of some of my readers, surprise that I have not attempted an -hypothesis of the operation. I have by no means made up my mind as to -the nature of its action, and rather than venture into speculative -reasoning, which may be received as doubtful by some, and visionary -by others, I prefer preserving a profound silence. The authors whom -I have before referred to, have attempted such an explanation; and -should opinions of this kind be considered as deserving attention, the -enquirers may find them in the paper upon acupuncturation, in the 13th -volume of the “Journal Universel Des Sciences Medicales,” published at -Paris in 1819. - - - The needles may be obtained at Mr. Blackwell’s Bedford-Court, - and Mr. Laundy’s, St. Thomas’s Street, Borough. - - - - -FOOTNOTES: - -[1] “Mémoire sur les Maladies Chroniques, les evacuationes -sanguines et l’acupuncture; pur L. V. J. Berlioz, D.M. -Paris, 1816.” - -[2] Dr. Haime, whose practice will be presently noticed, -observes, - -“Lorsque l’aiguille a été introduite avec les précautions -requises, il n’y a pas émission de la plus petite -gouttelette de sang. A ce sujet, le docteur Fréteau est du -mème avis que M. Berlioz, puis qu’il dit, dans son Traité -des emissions sanguines, que l’acupuncture doit être rayée -de la liste des agens propres à provoquer ces evacuations.” - -[3] Notice sur l’Acupuncture et observations médicales sur -ses effets thérapeuticques. - -[4] Une Aiguille d’Acier, conique, aigue, longue d’environ -trois pouces, et garnie de cire d’Espagne vers son œil, -pour tenir lieu de téte. - -[5] “Ou” says Dr. Haime “la malade contracta l’habitude de -l’onanisme et s’y livra sans réserve.” - -[6] See the 66th volume of the “Journal Général de -Médicine.” - -[7] By a needle of an inch and a half in length. - -[8] I have every reason to believe, the wine impregnated -with this plant, is of the most medicinal value, when the -infusion has been made with the seeds, rather than the -roots, as lately recommended by Dr. Williams, of Ipswich. -It is the preparation which I have found most beneficial, -and upon which 1 could place the greatest reliance. - -[9] Mr. Scott first introduced the operation into England. - - -FINIS. - - - - -Errata. - - - Page 30, line 8, after the word _peculiar_, add, of _practising_. - 44, 2, for _univerel_ read _universal_. - 62, 2, from the bottom, a comma after the word - Epipheses, instead of a period. - 68, 3, after the word _muscle_, add, _of the right side_. - 70, 5, after the word _ribs_, add, _of the left side_. - - - Plummer and Brewis, Printers, Love Lane, Eastcheap. - - - - - -End of the Project Gutenberg EBook of A Treatise on Acupuncturation, by -James Morss Churchill - -*** END OF THIS PROJECT GUTENBERG EBOOK A TREATISE ON ACUPUNCTURATION *** - -***** This file should be named 50985-0.txt or 50985-0.zip ***** -This and all associated files of various formats will be found in: - http://www.gutenberg.org/5/0/9/8/50985/ - -Produced by deaurider, Turgut Dincer and the Online -Distributed Proofreading Team at http://www.pgdp.net (This -file was produced from images generously made available -by The Internet Archive) - -Updated editions will replace the previous one--the old editions will -be renamed. - -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the United -States without permission and without paying copyright -royalties. 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