III. Of the cure of the COLICK by the ACUPUNCTURA or NEEDLEPRICKING, as it is used by the Japanese.
Description of this distemper
That particular sort of Colick, which Japanese call Senki, is an endemial temper of this populous Empire, and withal so common, that there is scarce one in ten grown persons, who hath not some time or other felt its attacks. Thus far do the air, which is otherwise very healthful, the climate, the way of life of the natives, their victuals and drink jointly influence the human body, and dispose it to an invasion of this distemper. Foreigners are no less subject to it, than the natives, when once they are come to taste the liquors of the Country. This we found to be too true by our own sad experience, when upon our arrival in the Country we endeavour'd, as is usual amongst seafaring people, to wash away the memory of the dangers, we had been exposed to in our tedious and difficult passage, by a plentiful use of the cold beer of this Country, call'd Sakki. This beer is brewed out of rice to the strength and consistence of Spanish wines. It is of such a nature, that it should not be drank cold, but moderately warm, and out of dishes, after the manner of the natives. The name of Senki is not given indifferently to all Bellyachs, but only to that particular sort, which besides a most acute pain in the guts, occasions at the same time convulsions in the groins. For such is the nature and violence of this distemper, that all the membranes and muscles of the abdomen are convulsed by it. As to the cause of it, and of colicks in general, the natives are of opinion, that it is not at all a morbific matter lodged in the cavity of the guts, which, they say, would occasion but a very slight pain, but that the seat of it is in the membranous substance of some other part of the abdomen, as for instance of the muscles, the peritonseum, the omentum, the mesentery, or the guts, and that by stagnating there it turns into a vapour, or rather into a very sharp sower spirit, as they express themselves, which distends, cuts and corrodes the membranes wherein it is lodged. Upon the same theory is grounded their method of cure: whenever this spirit is let out of the narrow prison it hath been confined to, and set at liberty, that very moment, they say, the pain which it hath occasioned by distending those sensible parts wherein it lay, must cease. Before I proceed farther, I must beg leave to observe, that instead of the Latin name Colica, which is sometimes wrongly given to this distemper, the gut, whence this name is derived, being frequently not so much as affected by it, the Brahmines chose rather to call it in their language, according to the opinion of the Chinese and Japanese, convulsions or spasms of the belly and guts. Some very particular symptoms of this endemial distemper of Japan are, that mimicking the hysteric affection, it often puts the pahtient under an apprehension of being suffocated, the whole region from the groins up to the false ribs, and higher, being strongly convulsed, that after it hath for a long time miserably tormented the patient, it will end in tumours, and swellings arising in several parts of the body, and attended with dangerous consequences, that particularly in men it will occasion a swelling in either of the testicles, which often suppurates and turns to an abscess, in women tubercula, or pustules in the anus and on the pudenda, commonly attended with the falling of the hair. It must be observid however, that both these tumors of the testicles, (which the Japanese call Sobi, and the patient afflicted with them Sobimotz) and the said pustules in the privities are likewise endemial distempers of this Country, and affect many, that have never lain sick of the colick.
Description of the needles.
Before I proceed to shew, by what particular method Japanese proceed in the cure of this distemper, which is by the needle, it may not be amiss to take notice, that there are two principal remedies in surgery, supposed to be equally successful in the cure and prevention of diseases and which on this account are called in to assistance in these parts of the world by the healthful, as well as the sick, by regular Physicians and Quacks, by rich and poor. The Coreans, Chinese and Japanese, all great admirers of antiquity, and scrupulous to excess in keeping up the ancient customs delivered down to them from their ancestors, unanimously pretend, that they were known in remotest ages, long before the invention of physick. Their very names indeed will appear terrible and shocking to the reader, they being no less, than fire and metal. And yet it must be owned in justice to the Japanese, that they are far from admitting of all that cruel, and, one may say, barbarous apparatus of our European surgery. Red hot irons, and that variety of cutting knives and other instruments requisite for our operations, a sight so terrible to behold to the patient, and so shocking even to the assistants, if they be not altogether destitute of all sense of humanity and mercy, are things, which the Japanese are entirely ignorant of. Their fire is but moderate, it hath nothing to terrify the patient, it is such, as the very Gods of the Country are not displeased to have burnt before them, and in a word nothing else but a gently glowing tent of the Plant, which bears the name of that celebrated Queen Artemisia. So likewise the metals they make use of in their operations of surgery, are the very noblest of all, the ornament of royal palaces, the produce of sun and moon, and, as the Philosophers pretend, richly imbued with the qualities and virtues of those two celestial bodies. The reader easily apprehends, that I mean, gold and silver, of which they have needles made in a particular manner, which are finely polished, and exceedingly proper to perform the puncture in human bodies, and which are on this account held in such an esteem by the natives, that they constantly carry them along with them wherever they go, as they do whole boxes of such other of their instruments or curiosities, which they have a particular
value for, or are the most likely to want. The use and application of both these remedies is a thing of such consequence, that the very knowledge of the parts, which are the most proper either to be burnt with the Moxa, or to be prick'd with the needles, is the object of a peculiar art, the masters of which are called Tensasi, which is as much as to say, touchers or searchers of the parts, because the main business lies in the choice of the part, on which either of these operations is to be performed. Those who manage the needle, either pursuant to their own notions, or in compliance with the patients desire, have the particular name of Faritatte given them, which signifies Needle Prickers. I now make haste to give a description of these needles. It would be scarce possible to thrust a very thick needle into the body without some dangerous consequence or other: For this reason, the needles, whereby this operation is to be performed, must be exceeding small, made of either of the two metals abovementioned, so pure and fine as it is possible to get them, entirely separate from copper, and ductile. It is a particular art to temper these needles, and to bring them to a certain degree of hardness, requisite to make them fit for this operation, which art, although it be known but to very few persons, yet even those, who know it, are not allowed to make them without a particular license granted under the Imperial seal. There are two differing sorts of these needles, with regard to their structure. The first sort is made indifferently either of gold or silver; these are not unlike (as to their shape) to the bodkins, which our young boys at school spell withal, or the stylus's with which the Indians write, only they are smaller, about four inches long, thin, ending in a very sharp point, with a twisted handle, in order to its being turn'd round or twisted with more ease. Instead of a box, they are kept in a small hammer, which is fitted up so, that on each side of the handle one of these needles may be conveniently lodged. This hammer is made of wild bulls-horns, finely polished, and is somewhat longer than the needle, with a compress'd roundish head, wherein lies a piece of lead, to make it heavy. On that side, which touches the needle, in beating it into the body, it is defended by a piece of leather, commonly of a violet colour, and this to prevent, that in beating it should not leap up. The needles of the second sort are made only of silver, and are not unlike the first, as to their shape and length, but exceedingly small, with a short thick handle, which is striped or furrowed lengthways. They are kept several together in an oblong, square, wooden box, varnish'd without, with the bottom within covered with a piece of cloth, in the woolly part of which the needles are stuck. For the satisfaction of those, who are curious in names, I have thought fit to take notice, that these two sorts of needles, and in general all needles, that are made use of in surgery, are called Uutsbarri, that is, turning or twisting needles. The needles of the second sort have the particular name of Fineribarri, which signifies the very same thing; and if the operation be performed, as is done frequently, through a small brass pipe, they are then called Fudabarri, that is channel'd needles. This pipe is about
one third of an inch shorter than the needle, as big as a goose-quill and serves to guide the needle, in order to make the puncture on any part of the human body so much the surer. These needles, with their cases, the hammer, and small pipe, are represented as big as the life, in Tab. XLIII. where in Fig. 1 is the lower part of the case for the silver needles, with the needles lying in it. Fig. 2. The covering of the said case. Fig. 3. The brass pipe, which is to guide the operator in pricking. Fig. 4. The hammer, with one of the gold-needles standing out a little way, and Fig. 5 a gold-needle taken out.
But to come now to the operation itself, the same is performed after the following manner. The surgeon takes the needle near its point in his left hand, between the tip of the middle finger, and the nail of the forefinger, supported by the thumb, and so holds it toward the part which is to be pricked, and which must be first carefully examined, whether it be not perhaps a nerve, then with the hammer in his right hand, he gives it a knock, or two, just to thrust it through the hardish resistent outward skin. This done, he lays the hammer aside, and taking the handle of the needle between the extremities of the fore-finger and thumb, he twists it till the point runs into the body to that depth, which the rules of art require, being commonly half an inch, sometimes, but seldom, an inch or upwards, in short, till it runs into the place, where the cause of the pain and distemper is supposed to be hid, where he holds it, till the patient hath breathed once or twice, and then drawing it out, compresses the part with the finger, by this means, as it were, to squeeze out the vapour and spirit. The needles of the second sort are not knocked, but only twisted in, the operator holding them between the extremities of the thumb and middle finger: Those who are very dextrous at it, give it a knock with the forefinger, laid upon the middle finger just to thrust it through the skin, and then they compleat the business by twisting; others make use for this purpose of a pipe, such as above described, which is somewhat shorter than the needle, and will by this means stop it from running in too deep. The precepts and rules of this pricking art are very different, with regard chiefly to the hidden vapours, as the supposed cause of the distemper. Hence, when the operation is to be performed, a careful and circumspect Physician must determine with all his attention and judgment, where and how deep they lie. The acupunctura is esteem'd a very good remedy for those distempers which are cured by burning with the Moxa, and the needle is to be applied nearly on the same places, and with the same cautions, as that Caustick; but of this more in my account of it. Even the common people will venture to apply the needle, meerly upon their own experience and without the advice of an expert Tensasi, taking care only not to prick any nerves, tendons or considerable blood vessels. Having premised thus much concerning the Acupunctura in general, it now remains to add a few words relating to its use in the cure of the colick in particular.
In order to cure the colick the Japanese perform this operation in the belly, in the region of the liver, making nine holes in three rows, disposed after the manner of a Parallelogram, at about half an inches distance from each other in grown persons, (vid. Tab. XLIII. Fig. 6.) Each of these rows hath its peculiar name, as they are also made according to different rules. The first row is called Sioquan, and is made just beneath the ribs; the second row is called Tsiuquan, and claims the middle place between the navel and the cartilago mucronata, or ensiformal cartilage; the third is called Gecquan, and is made about half an inch above the navel. I have been myself several times an eye-witness, that upon these three rows of holes, made according to the rules of art, and to a reasonable depth, the colick Senki pains, as they call them, ceased almost in an instant, as if they had been charmed away.
Some endeavours have been made to cure this colick, by burning the patient with the Moxa, but upon trial this method hath not been found altogether so successful, as that of the Acupunctura. However it may not be amiss to take notice, that in this case the caustick must be applied to the belly, on both sides of the navel, about two inches from it. Both these places are called Tensu; they are famous for having numbers of causticks applied to them, and are known even to those, who do not practise this art. But of this more in another place. To compleat this account, I must not forget to mention another remedy of pretended great efficacy, and frequently used by the common people in the colick, of which hitherto, as also in the cholera morbus, which is a very frequent and fatal distemper in this Country, in that bellyach, which they call Saku, and which is likewise an endemial distemper, not very different from the Senki, and from the common colick, in other pains of the lower belly, where the cause of the distemper lies in the guts, out of reach both of the needle and Moxa; and in several other diseases, which I here forbear mentioning. It is a powder, to be taken inwardly, and called by the common people, Dsiosei, and in the language of the learned, Wadsusan. It is sold in the village Menoki, in the province Oomi, sealed up by the inventor, who, by a religious fraud, obtained a privilege for the sole disposal of it. For he gave out, that the ingredients of it, being vegetables, were shewn him by the God Jakusi in a dream growing upon a neighbouring mountain, which is other wise famous for many fabulous stories, said to have happened on it, and in the neighbourhood. The good effect people found upon taking it, soon brought it into repute, and the great consumption there is of it, enrich'd that whole family, which was formerly very poor, but became afterwards able to build three temples, as publick and lasting monuments of their gratitude to the God, who communicated the secret to them. These temples stand opposite to three shops, where this powder is now made and sold.
I bought a quantity of it with me out of Japan, but found upon trial, that it would not at all agree with my Countrymen. It is bitterer than gall. The preparation of it is kept a secret in the family. However, upon seeing some of the ingredients in a shop, where I bought mine, I took notice, that the bitter sort of Costus, which is called Putsjuk, and is imported into Japan by the Dutch, who bring it from Suratte, was one of the chief; the virtues of this Costus are said to be very considerable, and there is a much greater demand for it in Japan, than for any other exotick drug, excepting only the root of the Sisarum montanum Coraeense, or Ninsin of Dr. Cleyer.