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 of it 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.

"Dr. Haime, and, I believe, the French surgeons who practise 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 fitted to 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 congestion occasioned by the suction of the pump, that the instrument passes without producing the least pain, whilst at the same time it penetrates deeper 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 operator's 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 tumour 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 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

No. 73.]

Acupuncturation.

9

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 Haemorrhage, 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 favour, 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 Japonese have long employed this operation with success, in cases of colic and tympany; and in some parts of India it is a popular remedy, not only for these diseases, but also head-ache, lethargy, and inflammation of the eyes. The operator often punctures the chest, back, and abdomen, to relieve pain of those parts, and as a cure for dysentery, hysteric fits, cholera morbus, iliac passion, &c. It is also successfully employed by them in cases of local diseases of the muscular and fibrous structure of the body; and it is for diseases of this class only, such as rheumatism, &c., for which Mr. Churchill particularly recommends the practice.

To illustrate the success of this Asiatic remedy, Mr. Churchill has given a few cases, in which he has employed it; and the testimony of Mr. Jukes, a respectable surgeon of Westminster, and of some eminent practitioners of France, who have given it a fair trial. From the cases we select the following:

"George McLaughlan, about thirty years of age, a bricklayer by employment, came to my house in November last, supporting himself by a stick in one hand, and resting the other against the wall, as he proceeded. The body was bent at nearly right angles with the thighs, and his countenance indicated acute suffering. He had been

attacked, he said, three days before, with darting excruciating pains in the loins and hips; every motion of the body produced an acute spasmodic pain, resembling an electric shock; and the attempt to raise the body to an upright position was attended by such insupportable agony, as obliged him to continue in this state of flexion rather than encounter it by altering his position. There was no more constitutional disturbance than was to be expected from three days and nights of constant pain; the pulse was a little quickened, and the tongue white, but I attributed this derangement to the irritation set up by the pain and loss of rest. I directed him to place himself across a chair for support during the operation, and I immediately introduced a needle of an inch and a half in length into the lumbar mass on the right side of the spine; in two minutes time I observed that he seemed to rest the weight of his body more on his limbs, and in the next instant, without any enquiry being made, he observed, that he felt his limbs stronger from the pain having left his hips.' He next plainly indicated that the disease was lessened, by raising his body; from which he only desisted, by being desired to remain at rest, through fear of the needle being broken. The instrument having remained in its place about six minutes, the patient declared he felt no pain, and could, if he were permitted, raise himself upright; it was then withdrawn; the man arose, adjusted his dress, expressed his astonishment and delight at the sudden removal of his disease, and having made the most grateful acknowledgments, left the house with a facility as though he had never been afflicted. The relief was no doubt permanent, as he did not return, which he would most probably have done, had he suffered a relapse."

It is worthy of notice, that in the natives of the East and West Indies, operations on the bowels, and accidents which would prove fatal to an European, go on well without any constitutional sympathy or fever. We have seen a most formidable compound dislocation of the elbow-joint of a negro, terminate more favourably than a simple one, in a native of this country. The wound, after reduction, healed as kindly as an incised one, and the patient had the free use of the joint. Had not a surgeon been present who had witnessed the favourable termination of similar accidents in negroes, the limb would have been amputated. Mr. Churchill has given a drawing of the Zin-King needle, as improved by Mr. Jukes. It is scarcely necessary to observe, that an instrument which is to penetrate muscles, should be employed only by a practitioner well acquainted with anatomy. The thanks of the profession are due to Messrs. Churchill, Scott, and Jukes, for having given publicity to a remedy, which, in many cases of deeply-seated pain, may, no doubt, be employed with great advantage.

INDIGESTION, &c.-We have received a copy of a pamphlet lately published by Messrs. Sherwood and Co., under the title of Friendly Letters to an English Countess, on the causes, prevention, and treatment of Indigestion and Bilious Complaints, and their consequences on the general health, which, it is said, was written by a late royal physician. The lady to whom the letters were

No. 73.]

Indigestion, &c.

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addressed, states in the preface, that "having found the instructions they convey, highly beneficial to herself, and a large circle of friends, she has thought proper to authorize their publication for the benefit of those who suffer from indigestion; a disorder, (says she), which, by disturbing the general health, will, sooner or later, produce in some part of the constitution, the most formidable disease to which human nature is liable. The work contains four long letters. In the first, the Doctor takes a moral view of medicine, which he thinks, by diverting the mind of an invalid from a future state, and misleading him with the hope of recovery where there is no prospect of it, is injurious to society.

"It has often," says he, "been a matter of doubt to me, whether medicine has been of more benefit or injury to society. Man, like the rest of creation, has a limited existence, and disease is the means by which these limits are terminated. But man differs from the rest of the creation in having his prospects extended beyond the limits which at present encircle his corporeal frame. He consists of two parts, intimately blended together, but at the same time capable of existing in a separate state. That immaterial part, peculiar to himself, forms the guide, the director, and guardian of the whole. Considering, then, disease, in this view, as the means ordered by Providence for terminating his corporeal existence, and giving a new era to his being in another shape, how far are we warranted in interposing with the will of that Power who has sent it for this purpose, and intends thus, by each attack, to sever us from our attachment to the present state of things, and to render the change easier to us at last? If this be really the intention of Providence, the interference of medicine is both ridiculous on the one hand, and injurious on the other. It is ridiculous, because, if sent by the wise Director of all things, with such an intention, no such efforts on our part can have any influence, it is clear, in counteracting the mandates of his will. It is injurious, by giving a confidence to the unhappy sufferer in a power too weak to render him any service, and withdrawing his hopes from the Bestower of all good, to secondary objects, which can only mislead. Such is my opinion of medicine, in a religious and moral view. This, you will say, is going too far; but in pursuing the subject, I consider it also as equally injurious on the very principle of counteracting disease in the animal frame, without regard to an immaterial principle, or its future prospects. That man is born to trouble, as the sparks fly upward,' is a truth universally felt; and this proceeds equally from the complex nature of his frame and the mode of life he is destined to pursue. But, still, though thus formed and thus situated, his constitution possesses within itself the powers of renovation. The attack of disease is counteracted by the efforts of the system to overcome it; and the interference of medicine is apt, too often, to interrupt the salutary efforts in their course, or prevent them altogether taking place. This is particularly remarked in acute diseases; and it is only in those of a chronic nature that perhaps it is proper that the aid of medicine should at all be had recourse to."

Medicine has been termed God's second cause of health; and he who considers the surprising effects different articles of the three kingdoms of nature manifest on the vital powers, will not doubt for a moment that they were given us by the Creator, to combat the diseases to which, for some wise purpose, he has made us liable. Most of the ailments, we agree with the author, are the consequences of imprudence, particularly indulgence in excessive meals, and vinous or spirituous liquors. He, knowing the fraility of our nature, has kindly given us remedies for the cure or alleviation of disease, although the consequences of indiscretion. Diseases are no doubt intended for our good. By many we learn what to avoid, and are reminded of our mortal condition. To the wise they are indeed instructive lessons.

"The stomach," the Doctor observes, " from its office, and its powers of sympathy, which it possesses with other parts, is more exposed to disease than any other portion of the body; and this disease may consist either in a simple loss of tone of its muscular fibres, an irritability of its nerves, a vitiated state of the digestive fluid, or a fault in its organic structure. All these causes produce each a separate affection; which though the symptoms may be somewhat similar, demand an opposite and peculiar treatment. Of the sympathies of the stomach, the most important is that with the head. Hence affections of the stomach often produce a diseased state of the nervous system; and that lowness and depression which attend stomach complaints can only be referred to this source. The primary state of what are termed nervous disorders, may, therefore, always be ascribed to this organ; and the affection of the nervous system is but a secondary link in the chain. There is no species of disease, local or general, which entails on the unhappy sufferer such misery, and which gives to the mind all the dread of death, without much danger of its taking place. Even religion is here found at times to want its consolation, and the unfortunate victim of his deranged feelings is hurried to extremes which reason cannot command. He flies either to the Circean cup, whose deceitful draught, giving a momentary relief from its exhilarating effect, renders him soon a complete drunkard; or, misled by the false promises of the empiric, he repairs to the patent warehouse, and ruins his constitution by a wanton and excessive abuse of medicine, ill directed for his complaints. His mind wants relief; and, if he avoids Scylla, in attempting this, he is sure to be ensnared by Charybdis.'

The doctor then proceeds to notice the progress and consequences of stomach complaints. In the second letter, after enumerating their causes, he gives copious instructions for their cure and prevention, by diet, exercise, &c. His remarks on these subjects, (to invalids, and particularly to those who are subject to indigestion, highly important) are very judicious. On drink, of which invalids are often at a great loss to make a proper choice, the doctor observes, "If restriction be then necessary with respect to solid food, it is still more so in respect to drink; and a total abstinence from fermented liquors should be laid down as an indispensable