ABSTRACT
J An eschar was a sore or ulcer artificially produced by severe cau terisation with an instrument of red-hot iron. This was analogous to the moxibustion of China, but since the glowing moxa was by no means always allowed to burn the skin, and since acupuncture was often relatively painless, it must be allowed that traditional Chinese practice \\·as rather more civilised than that of ancient, medieval, and even eighteenth-century Europe. Indeed in + 1712 Engelbert Kaempfer said precisely this. 'Nam primus ignem fundit, cedit alter metalii aciem; aciem vero, non ferocis chalybis sanguinantis, nec ignem quosque candentis ferri; quo utroque trux supra humanitatem chirurg-ia Occidentis in mortalium saevire
back to Paul of Aegina in the +7th century. Often dismissed as folk-medicine, all these have been extremely widely used, and successfully, for the relief of pain by what may be termed hyper-stimulation analgesia.a A recent study by Elliott (I) has considered the more sophisticated modern descendants of these techniques-rubefacient creams, methyl nicotinate, capsicum,b nonylic acid vanillylamide, etc. - interpreting their action in terms of erythema (increased capillary blood supply) spreading the bradykinin produced by the sweat glands to stimulate strongly the local afferent nerve-endings. Counter-irritation is quite real. Even brief successive applications of cold or heat produce significant decreases in some kinds of pain.c And of course the Chinese parallel is the entire moxibustion story, together with its derivatives in the West in and after the +17th century, which we describe more fully elsewhere.d As expressed in contemporary China, the brain' confronts an antithesis '(or contradiction, mao tun l ), and in the competition of stimuli there are 'two sensations contending' (hsiang tou cheng2 ).e
Many modern techniques have relations with these phenomena. For example, strong saline solutions injected into the stump of an amputated extremity will give transitory sharp pain but will relieve severe phantom limb pain for long periods of time.f Acupuncture here will also give relief.g Painful low temperatures applied to the skin can raise the pain threshold elsewhere by 30%.h Stimulation of peripheral nerves by low-intensity electric shocks can abolish neuralgic pain for a long while afterwards, and the effect can be enhanced by pharmacological analgesics. i Electrodes
membra jubet, opera detestabili iis, quorum humana mollities et mansuetudo praecordia occupat; sed ignem gratiosum, et ncn verendum magis, quam quo sibi litari hoc caelo Dii ipsi amant, nimirum remisse gliscentem tururdam, "olutam ex herba Regii nominis Artemisia' (Amoenitates Exoticae, pp. 584-5). Fransiszyn (I) did "ell to notice this. A translation might read: C (Of the two sources of surgery of the Koreans, Chinese and Japanese) the first was heat, the second the sharpness of metal, sharpness, I say, but not those ferocious blocdy cauteries of iron, nor yet the flaming of red-hot brands, with which our Western surgery commands the r.trocious ravaging of the limbs of mortals, beyond the dictates of humanity, in works detestable to all those who have any kindness and gentleness left in their hearts; and as for the heat, it is a grateful 'warmth no more to be feared than that ,,'hich the gods themselves enjoy as it rises from their sacrifices, a warmth from glowing cakes which have been rolled from a dried plant with a royal name, Artemis,·a.' Similar translations, one from Kaempfer's inaugural dissertation of + 1694, are given by Bowers & Carrubba (I, 2).
