ACUPUNCTURE. 



197 



posed. Acupuncture has been employed to a con- 

 siderable extent, and with a good share of success, 

 in the Meath Hospital, Dublin, under the direction 

 of Drs Graves and Stokes. We shall quote a case 

 of sciatica treated on this plan, by the direction of 

 the former of these physicians. 



" One of the most commonly employed agents," 

 says Dr Graves, " in the treatment of chronic scia- 

 tica, is acupuncture, and of this it is necessary to 

 say something, as there are many and decided proofs 

 of its efficacy, in giving not only temporary, but 

 also permanent relief. Persons who have received 

 benefit from acupuncture, have been always noticed 

 to labour under the affection in the chronic stage ; 

 few, if any, having derived any advantage from it 

 when their symptoms were acute, and when there 

 was severe pain and tenderness along the course of 

 the nerves. You are not, however, (o be deterred 

 from employing it in chronic cases by the existence 

 of tenderness along the course of the nerves ; and 

 you should impress on your minds that it is in all 

 cases deserving of trial, where the disease has been 

 of considerable d uration. A common sewing needle, 

 heated red-hot, and allowed to cool gradually, with 

 a head of sealing wax, will answer the purpose 

 much better than the needles which are sold, and 

 called acupuncture needles." " The reason of heat- 

 ing the needle," says Dr Stokes, "is to take the 

 temper out of the needles, by holding them in a can- 

 dle, and then letting them cool gradually. The next 

 thing is to place a head, which will remain firm on 

 the needle, and for this purpose you place a small 

 portion of thread through the eye, and then cover 

 it with a bit of melted sealing wax. Having thus 

 formed the head, you sharpen its point and polish 

 it by the emery pincushion, and the sharper it is the 

 better." 



" I remember a case of chronic sciatica," observes 

 Dr Graves, " which came under my notice several 

 years ago; the patient was very much reduced; he 

 was quite lame and greatly weakened ; he had been 

 through France, and remained at Barege for a con- 

 siderable time, without any benefit ; his sufferings 

 were very great, and broke down his constitution 

 considerably. On his return to this country, he 

 consulted me, and I advised the application of the 

 needles. After the third application the pain was 

 removed, the lameness also rapidly diminished, and 

 in the space of a fortnight he was quite well, and 

 what is very remarkable, continues so ever since." 

 So happy a result as this is, however, seldom met 

 with. Chronic cases of sciatica, in general, give a 

 great deal of trouble, and frequently disappoint the 

 best directed efforts of medical skill. 



Respecting the use of the electro or galvanic 

 puncturation in a case of paralysis, " it has lately 

 been proposed," says.Dr S. "to employ the stimu- 

 lus of electricity and galvanism in a different way, 

 by transmitting it directly to the muscles of the 

 affected limbs, by means of needles, which are to be 

 inserted into different parts of paralysed extremi- 

 ties, and which are intended to act as conductors 

 for transmitting the galvanic influence. This has 

 been termed the electro or galvanic puncturation, 

 and forms an excellent mode of applying the sti- 

 mulus of galvanism. The mode of preparing the 

 needles has been already described, and there is 

 nothing more simple than to introduce them. 



"Placing the point of the needle perpendicularly 

 on the part, you press it downwards in a slanting 

 direction, using, at the same time, a rotatory motion, 

 and thus easily pass it in. When you have pierced 



the skin and fascia there is no difficulty in introduc- 

 ing it into the muscular fibres. The distance be- 

 tween the needles must be regulated according to 

 circumstances. You then proceed to send the gal- 

 vinic fluid to the part, and for this purpose the best 

 mode is to employ a small galvanic battery, with a 

 limited number of plates. If you have plates of 

 from one to two or three square inches, you will 

 find that from fifteen to twenty of these in a state 

 of ordinary action, will be quite sufficient, particu- 

 larly in the commencement of the treatment. It 

 is a curious fact that the intensity of the shock is 

 increased to an extraordinary degree, by means of 

 the needles. A battery which, in the usual man- 

 ner, would not communicate any shock, will, when 

 used with the needles, give a violent one, and com- 

 municate such a stimulus to the nerves as will throw 

 the whole limb into violent spasms, and cause a 

 copious perspiration to break out over the body. I 

 have seen (continues Dr Stokes), very good effects 

 from a feeble battery in this way, and it would ap- 

 pear, that this is the result of the direct transmis- 

 sion of the galvanic influence to the muscular fibres. 

 In most cases a perspiration is brought on, the limb 

 convulsed, and sometimes the whole body is thrown 

 into spasms." 



Dr Elliston of the London University, who has 

 devoted a considerable share of attention to this 

 branch of therapeutics, prefers the following mode 

 of performing the operation. " The spot being se- 

 lected, usually the seat of the pain, or when any 

 circumstances forbid this, the adjacent parts, the 

 operator having stretched the skin with the fore 

 and middle fingers of the left hand, pierces it per- 

 pendicularly with a gentle pressure, and the body 

 of the needle is advanced by means of a semi-rota- 

 tory motion, in opposite directions, till it has pene- 

 trated to the required depth, and this is repeated 

 till the desired number is introduced. Their with- 

 drawal is sometimes effected by means of a forceps, 

 but it will be better to withdraw them by the same 

 motion with which they were introduced, as the 

 skin is painfully elevated by their direct and forci- 

 ble retraction : possibly also, by the latter mode, 

 the point of the needle might be broken off if it 

 were not well tempered. The withdrawal of the 

 needles is not followed by haemorrhage ; but some- 

 times a single drop of blood oozes from the punc- 

 ture. In penetrating, the needle often meets with 

 variable degrees of resistance, according to the na- 

 ture of the parts through which it passes. The 

 Japanese and Chinese allow the needles to remain 

 only while the patient makes thirty respirations. 

 M. Cloquet states, that he derived the most marked 

 benefit in cases where he caused them to be kept 

 in several days, and this accords with our own ex- 

 perience. It is true, the pain may cease instantan- 

 eously on^the introduction of the first needle, but 

 we observe this by far more frequently after the 

 needles have been in some time : indeed, so satis- 

 fied are we on this point, that we prefer a single 

 needle remaining for some time in the part to several 

 introduced and withdrawn speedily. But there is 

 yet no general rule as to the time which the needles 

 ought to be allowed to remain." 



Chronic rheumatism is one of those complaints in 

 which acupuncture is perhaps most frequently suc- 

 cessful, and it appears that, in proportion to the 

 length of time the rheumatic affection has existed, 

 should be the length of time in which the needles 

 remain in the part. 



There is another class of cases in which the ops- 



