“Great Peter-Street, Westminster,xxxxxFebruary 27, 1821.My Dear Sir,In compliance with your request, I send you an account of the effect of Acupuncturationon our friend Mr.Scott.9I 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 thesecond lumbar Vertebra, and midway between this bone and the edge of the Latissimus Dorsi muscle of the right side, 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, theCrista 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 rightside 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 of the left side, 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 fromtwo 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.
“Great Peter-Street, Westminster,xxxxxFebruary 27, 1821.
My Dear Sir,
In compliance with your request, I send you an account of the effect of Acupuncturationon our friend Mr.Scott.9I 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 thesecond lumbar Vertebra, and midway between this bone and the edge of the Latissimus Dorsi muscle of the right side, 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, theCrista 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 rightside 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 of the left side, 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 fromtwo 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,xxxxxxxxxxYour faithful friend,xxxxxxxxxxxxxxxxxxEDWARD 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 convictionand truth, no stronger impression would be made by multiplying examples; whilst the sceptical, would “not be persuaded, though one rose from the dead.”
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 ofit 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 fittedto 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 penetratesdeeper, 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 bythe 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 thepatient; 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 theneedles 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 littledanger 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 natureoccurred 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 DesSciences 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.
1“Mémoire sur les Maladies Chroniques, les evacuationes sanguines et l’acupuncture; pur L. V. J. Berlioz, D.M. Paris, 1816.”
1“Mémoire sur les Maladies Chroniques, les evacuationes sanguines et l’acupuncture; pur L. V. J. Berlioz, D.M. Paris, 1816.”
2Dr. 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.”
2Dr. 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.”
3Notice sur l’Acupuncture et observations médicales sur ses effets thérapeuticques.
3Notice sur l’Acupuncture et observations médicales sur ses effets thérapeuticques.
4Une Aiguille d’Acier, conique, aigue, longue d’environ trois pouces, et garnie de cire d’Espagne vers son œil, pour tenir lieu de téte.
4Une 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.”
5“Ou” says Dr. Haime “la malade contracta l’habitude de l’onanisme et s’y livra sans réserve.”
6See the 66th volume of the “Journal Général de Médicine.”
6See the 66th volume of the “Journal Général de Médicine.”
7By a needle of an inch and a half in length.
7By a needle of an inch and a half in length.
8I 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.
8I 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.
9Mr. Scott first introduced the operation into England.
9Mr. Scott first introduced the operation into England.
FINIS.
Errata.
2, from the bottom, a comma after the word Epipheses, instead of a period.
Plummer and Brewis, Printers, Love Lane, Eastcheap.