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.