The introduction of a needle into the body, with a view to the relief or cure of disease. It has been for centuries employed in Japan and China, and was introduced into England in 1679, by Dr. Ten Rhyne, but did not come into general use till 1810, when Dr. Berhoz,§ of Paris, wrote in its favour.

The needles generally employed are of steel, long and fine, and furnished at the blunt end with a knob of sealing-wax or ivory. They are best introduced by slight pressure, and a semi-rotatory motion between the thumb and fore-finger, and should be withdrawn with the same motion. The pain is comparatively trifling; indeed, often scarcely felt. The operation may be performed in muscular, aponeurotic, and tendinous parts, and the needle introduced from one-fourth of an inch to two inches, according to the thickness of the muscles. Dr. Elliotson,|| from whose able paper on this subject a great part of this article is extracted, advises that it should not be passed into viscera and articulations, as practised by Berlioz and other French physicians. In general, no fluid escapes when the needle is withdrawn, but occasionally a drop of blood follows. If hAemorrhage occur, as sometimes happens, it may be restrained by gentle pressure. The period during which the needle remains in the part is of great importance: the pain sometimes ceases instantly, but, as Dr. Elliotson remarks, if one needle be allowed to remain in an hour or more, the operation is more efficacious than when several are inserted and speedily withdrawn. In some cases it requires to be repeated several times, but generally twice is sufficient. The modus operandi of acupuncture is extremely obscure, neither counter-irritation, galvanism, nor mental emotion being sufficient to account for its beneficial effects.

* On Fevers, 1862, p. 266. Op. cit., p. 570.

De Arthride Mantissa Schema-tica, &c., 8vo, Lond. 1683.

§ Memoires sur les Mal. Chroniques, Paris, 1816.

|| Cyc. Pract. Med., vol. i. p. 32, et seq.

2885. Therapeutic Uses

In Neuralgia, acupuncture is often effectual. It is principally indicated in cases of a rheumatic character, which are not dependent upon inflammation or organic disease. It has been more used in French and German practice than in English. Prof. Riberi* relates five obstinate cases which completely yielded to its use; and Dr. Osborne speaks highly of its efficacy in Sciatica, which, he states, it seldom fails to relieve.

2886. In Rheumatism, It Has Proved Signally Beneficial

Of 129 rheumatic cases treated by Cloquet, 85 yielded to acupuncture; of 34 published by other practitioners, 28 were cured; of 42 cases treated by Dr. Elliotson, 30 were cured, and the remaining 12 had clearly not been adapted for the remedy. Dr. Elliotson observes, " Experience has fully confirmed the fact, that if Rheumatism be at all inflammatory, if it be accompanied by heat, or is aggravated by a high degree of heat, no relief is, in general, to be expected from acupuncture. The omission of this distinction, and the neglect of a little trouble to make it with nicety, is the chief cause of the operation proving unsuccessful in Rheumatism." Cases of Muscular Rheumatism successfully treated by acupuncture are recorded by Dr. Leared. §

2887. In Hydrocele, It Was Employed Successfully In Fifty Cases By Mr

Lewis.|| Although, in many instances, it may doubtless prove effectual, it often fails altogether to effect a radical cure, and in every respect is inferior to paracentesis and Iodine injections.

2888. In Unconsolidated Fracture of the Thigh, acupuncture was successfully employed by M. Lenoir.* It is a mode of treatment first proposed by M. Malgaigne.

* Gaz. des Hopitaux, No. xcvi Dub. Med. Journ., vol. xii. Cyc. Pract. Med., vol. i loc. cit.; and Med.-Cbir. Trans., vol. xiii.p. 467.

§ Med. Times and Gaz., Nov. 30. 1861. || Lancet, 1836-7, p. 559.

2889. In Dropsical Affections, particularly in (Edema and Anasarca, acupuncture has been successfully employed. It is not required in these diseases, that the needles should be passed in deeply; it is only necessary that the point should pierce the cutis. As soon as this is effected, and the needle is withdrawn, a small drop appears at the puncture, which augments till the fluid runs down, and the oozing will continue for a considerable period. It is extraordinary how much fluid may be let out in this way. Dr. Watson relates a case in which the fluid which oozed from a puncture in the thigh (in a case of Anasarca) was caught and measured. It was found that a fluid drachm and a half escaped in a minute, which is at the rate of 11 1/4 oz. in an hour; and this drain went on for upwards of four hours. Dr. Elliotson states that he has frequently had recourse to it, with advantage, in (Edema of the Scrotum and Penis; and that, although he has employed it in all parts of the body, he never saw any inconvenience or ill effects follow its employment. Some cases are, however, recorded in which it has been succeeded by sloughing. It can only be regarded as a palliative, doing nothing towards the removal of the cause of the disease, but the amount of temporary relief which it affords is often very great.

Affusion, Cold. See Water.