A Treatise on Acupuncturation

by James Morss Churchill

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to ask if the patient be relieved; and the needle should always be allowed to remain five or six minutes before it is withdrawn.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.