The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 1).
- Date:
- 1849-59
Licence: Public Domain Mark
Credit: The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 1). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![make them penetrate. If steel needles be selected, .hey should be heated to redness and allowed to cool slowly, in order that they may be less brittle. At the blunt extremity of the needle a head of lead or sealing-wax is attached to prevent it from being forced entirely into the body. This is the simplest method of acupuncture, and it is as effectual as any other. If a needle-holder, or porte-aiguille, be used, that recommended by Professor F. Bache is as good as any that has been invented. The needle with its porte-aiguille consists of a handle, with a steel socket, to receive the end of the needle, which may be fixed securely after having been inserted by the pressure of a small lateral screw. By this contrivance the operator can at pleasure fix in the handle a needle of the length he may desire, and, after inserting it, he is enabled to detach the handle by releasing the screw. After all, however, needles prepared in the simple man- ner mentioned above are adequate to every useful purpose.] They are best introduced by a slight pressure, and a semi-rotatory motion, between the thumb and fore-finger; and withdrawn with the same motion. The pain is next to nothing, and often absolutely nothing. The operation may be performed in muscular, aponeurotic, and tendinous regions ; and the needle introduced to the depth of from i of an inch to 2 inches, according to the thickness of the muscles. We should not advise it to be passed into viscera, articulations, or blood-vessels. In general no fluid escapes when the needle is removed ; but now and then a small drop of blood follows; and once when the needle had been introduced into the pectoral muscle, I knew blood to spirt forth, but it was immediately restrained by gentle pressure,— an occurrence in every respect similar to what once happened in the practice of M. Bretonneau.* The period during which the needle remains in the part is a matter of great importance. The pain may indeed cease instantaneously : but more frequently does not till the needle has remained some time : and my own experience accords with that of others,— that one needle, remaining an * M. Bretonneau says, that lie had passed needles into the cerebrum, cerebellum, heart, liiiurs, and stomach, of sucking puppies, through and through, and in all direc- tions, with no sign of pain nor particular ill effect; un- less when too large a needle was thrust into the heart, and in one instance of this, a little extravasation took place into the pericardium. So far from fearing to acu- puncture the heart. Dr. C'arraco would have us do so in the worst cases of asphyxia. He declares that, in the presence of several persons, he kept several kittens under cold water till they were apparently dead,—stiff, motion- less, frothing at ihe mouth, without pulsation of the heart,— and regularly sunk to the bottom every time ihey were thrown into the water again ; that he passed a needle into the heart; that soon the needle began to be gently agitated, then rapidly so, and one voluntary mo- tion after another gradually recommenced, till life was fully re-established; and that the animals did as well afterwards as if nothing had happened. Death, however, by acupuncture of the brain or spinal marrow, as a secret mode of infanticide, is notorious in works on State-Medicine. Guy Patin relates that a midwife was executed at Paris who hud murdered seve- ral infants, at the moment their head presented at the os uteri, by passing a long and very fine needle into the brain through the temples, the foiuanelle, or the nape of the neck, or into the heart and its large vessels. Albert! and Brendel quote similar examples. In the Causes Celebres we read the horrible story of a woman who, towards the middle ofthe last century, made it her busi- ness to murder all tho new-born infants that fell into her hands by acupuncture, practised at the beginning of the vertebral column, or in the brain, with the sole intention, ihe told the judges, of peopling heaven more and more.'' voderc, 'I'raitt de .Ve'dceme Legale, t. iv. p. 492. sq. hour or more, is far more efficacious than several speedily withdrawn. I usually allow them to remain one or two hours j and have known them reman, twenty-four hours, without any ill eliect. I have usually found the operation requisite a second time, and in one case, lumbago did not yield till the ninth repetition. The modus operandi of acupuncture is un- known. It is neither fear nor confidence ; since those who care nothing about being acupunctured, and those who laugh at their medical attendant for proposing such a remedy, derive the same benefit, if their case is suitable, as those who are alarmed and those who submit to it with faith. Neither is it counter-irritation ; since the same benefit is experienced when not the least pain is occasioned, as when pain is felt. Galvanism, likewise, fails to explain it; because, although the needle frequently becomes oxidated and affords galvanic phenomena while in the body, these phenomena bear no proportion to the benefit, equally take place when acupuncture is practised upon a healthy person, and do not take place when needles of gold or silver are employed, which, however, are equally efficacious with a needle of steel. [We can scarcely conceive the effects to be anything more than a new nervous impression produced by the needle in the parts which it penetrates.] Acupuncture has been successfully employed to remove the fluid of oedema and anasarca. In these cases, the needle does not require to be passed deeply; its point has merely to go through the cutis. As soon as this is done and the needle withdrawn, a small bead of water appears at the puncture, which augments till the fluid runs down ; and the oozing will continue for a longer or a shorter time,— generally for some hours, occasionally for a few days, and even after death, should that event take place. Any number of punctures may be made. Although the puncture is so minute, it is, in such cases, not devoid of danger, any more than scarification, if practised below the knee. The writer has frequently had recourse to it with great advantage in oedema of the scrotum and penis, frequently along the trunk, and the whole length of the superior extremity, and on the posterior part of the thigh, and never saw or heard of the least inconvenience. But several cases have been related to him, in which sloughing, and in some of which fatal sloughing, resulted from its performance below the knee, even though the needle had been passed merely through the cutis. Before these cases came to his knowledge, he had acupunctured the leg, and even the foot, in dropsy, and never but once saw any inconvenience, and that was merely a suppuration at each puncture. It should evidently, however, never be performed below the knee except when absolutely necessary, a circumstance that hardly can happen, except in oedema not extending higher than the knee : and when we reflect that acupuncture removes an effect only, leaving the cause of the effusion untouched, and that a lar^e number of effusions are the result of an inflamma- tory state, or of sanguineous congestion, and that, while lessening or removing these by bleedin^ general or local, or purging, we are employing means which have also a direct tendency to ex- cite absorption; and when we reflect upon th«](https://iiif.wellcomecollection.org/image/b21116805_0054.jp2/full/800%2C/0/default.jpg)
