Trick or Treatment (7 page)

The first detailed description of acupuncture appears in the
Huangdi Neijing
(known as the
The Yellow Emperor’s Classic of Internal Medicine
), a collection of writings dating from the second century
BC
. It presents the complex philosophy and practice of acupuncture in terms that would be largely familiar to any modern practitioner. Most importantly of all,
Huangdi Neijing
describes how
Ch’i
, a vital energy or life force, flows though our body via channels known as
meridians
. Illnesses are due to imbalances or blockages in the flow of Ch’i, and the goal of acupuncture is to tap into the meridians at key points to rebalance or unblock the Ch’i.

Although Ch’i is a core principle in acupuncture, different schools have evolved over the centuries and developed their own interpretations of how Ch’i flows through the body. For instance, some acupuncturists work on the basis of fourteen main meridians carrying Ch’i, while the majority support the notion that the body contains only twelve main meridians. Similarly, different schools of acupuncture have included additional concepts, such as yin and yang, and interpreted them in different ways. While some schools divided yin and yang into three subcategories, others divided them into four. Because there are so many schools of acupuncture, it is impractical to give a detailed description of each of them, but these are the core principles:

• Each meridian is associated with and connects to one of the major organs.
  
• Each meridian has an internal and an external pathway. Although the internal pathways are buried deep within the body, the external ones are relatively near the surface and are accessible to needling.
  
• There are hundreds of possible acupuncture points along the meridians.
  
• Depending on the school and the condition being treated, the acupuncturist will insert needles at particular points on particular meridians.
  
• The penetration depth varies from 1 centimetre to over 10 centimetres, and often the therapy involves rotating the needles in situ.
  
• Needles can be left in place for a few seconds or a few hours.
  

Before deciding on the acupuncture points, as well as the duration, depth and mode of needling, the acupuncturist must first diagnose the patient. This relies on five techniques, namely
inspection
,
auscultation
,
olfaction
,
palpation
and
inquiring
. Inspection means examining the body and face, including the colour and coating of the tongue. Auscultation and olfaction entail listening to and smelling the body, checking for symptoms such as wheezing and unusual odours. Palpation involves checking the patient’s pulse: importantly, acupuncturists claim to be able to discern far more information from this process than any conventional doctor. Inquiring, as the name suggests, means simply interviewing the patient.

Claims by the Chinese that acupuncture could successfully diagnose and miraculously cure a whole range of diseases inevitably aroused interest from the rest of the world. The first detailed description by a European physician was by Wilhelm ten Rhyne of the Dutch East India Company in 1683, who invented the word acupuncture in his Latin treatise
De Acupunctura
. A few years later, a German traveller and doctor named Engelbert Kaempfer brought back reports of acupuncture from Japan, where it was not restricted to specialist practitioners: ‘Even the common people will venture to apply the needle merely upon their own experience…taking care only not to prick any nerves, tendons, or con siderable blood vessels.’

In time, some European doctors began to practise acupuncture, but they tended to reinterpret the underlying principles to fit in with the latest scientific discoveries. For example, in the early nineteenth century Louis Berlioz, father of the famous composer, found acupuncture to be beneficial for relieving muscular pain and nervous conditions. He speculated that the healing mechanism might be linked to the findings of Luigi Galvani, who had dis covered that electrical impulses could cause a dissected frog’s leg to twitch. Berlioz suggested that acupuncture needles might be interrupting or enabling the flow of electricity within the body, thereby replacing the abstract notions of Ch’i and meridians with the more tangible concepts of electricity and nerves. This led to Berlioz’s proposal that the effects of acupuncture might be enhanced by connecting the needles to a battery.

At the same time, acupuncture was also growing in popularity in America, which prompted some physicians to conduct tests into its efficacy. For example, in 1826 there was an attempt in Philadelphia to resuscitate drowned kittens by inserting needles into their hearts, an experiment based on the claims of European acupuncturists. Unfortunately the American doctors had no success and ‘gave up in disgust’.

Meanwhile, European acupuncturists continued to publish articles reporting positive results, such as one that appeared in the
Lancet
in 1836 describing how acupuncture had been used to cure a swelling of the scrotum. At the same time, the therapy became particularly popular in high society thanks to its promotion by figures such as George O’Brien, 3rd Earl of Egremont, who was cured of sciatica. He was so impressed that he renamed his favourite racehorse Acupuncture as an act of gratitude towards the wondrous therapy.

Then, from around 1840, just when it seemed that acupuncture was going to establish itself within mainstream Western medicine, the wealthy elite adopted new medical fads and the number of acupuncturists dwindled. European rejection of the practice was mainly linked to disputes such as the First and Second Opium Wars between Britain and China, which led to a contempt for China and its traditions – acupuncture was no longer perceived as a potent therapy from the mysterious East, but instead it was considered a sinister ritual from the evil Orient. Meanwhile, acupuncture was also in decline back in China. The Daoguang Emperor (1782–1850) felt it was a barrier to medical progress and removed it from the curriculum of the Imperial Medical Institute.

By the start of the twentieth century, acupuncture was extinct in the West and dormant in the East. It might have fallen out of favour permanently, but it suddenly experienced a revival in 1949 as a direct result of the communist revolution and the establishment of the People’s Republic of China. Chairman Mao Tse-tung engineered a resurgence in traditional Chinese medicine, which included not just acupuncture, but also Chinese herbal medicine and other therapies. His motivation was partly ideological, inasmuch as he wanted to reinforce a sense of national pride in Chinese medicine. However, he was also driven by necessity. He had promised to deliver affordable healthcare in both urban and rural regions, which was only achievable via the network of traditional healers, the so-called ‘barefoot doctors’. Mao did not care whether traditional Chinese medicine worked, as long as he could keep the masses contented. In fact, his personal physician, Zhisui Li, wrote a memoir entitled
The Private Life of Chairman Mao
, in which he quoted Mao as saying, ‘Even though I believe we should promote Chinese medicine, I personally do not believe in it. I don’t take Chinese medicine.’

Because of China’s isolation, its renewed interest in acupuncture went largely unnoticed in the West – a situation which changed only when plans were being made for President Nixon’s historic trip to China in 1972. This was the first time that an American President had visited the People’s Republic of China, so it was preceded by a preparatory visit by Henry Kissinger in July 1971. Even Kissinger’s visit was a major event, so he was accompanied by a cohort of journalists, which included a reporter called James Reston. Unfortunately for Reston, soon after arriving in China he was struck by a stabbing pain in his groin. He later recalled how his condition deteriorated during the day: ‘By evening I had a temperature of 103 degrees and in my delirium I could see Mr. Kissinger floating across my bedroom ceiling grinning at me out of the corner of a hooded rickshaw.’

It soon became obvious that he had appendicitis, so Reston was urgently admitted to the Anti-Imperialist Hospital for a standard surgical procedure. The operation went smoothly, but two nights later Reston began to suffer severe abdominal pains which were treated with acupuncture. He was cared for by Dr Li Chang-yuan, who had not been to medical college, but who instead had served an apprenticeship with a veteran acupuncturist. He told Reston that he had learned much of his craft by practising on himself: ‘It is better to wound yourself a thousand times than to do a single harm to another person.’

James Reston found the treatment to be both shocking and effective in equal measure, and he wrote up his experience in an article published in the
New York Times
on 26 July 1971. Under the headline ‘
NOW ABOUT MY OPERATION IN PEKING
’, Reston described how the acupuncturist had inserted needles into his right elbow and just below both knees. Americans must have been amazed to read how the needles were then ‘manipulated in order to stimulate the intestine and relieve the pressure and distension of the stomach’. Reston praised the way that this traditional technique had eased his pain, which resulted in the article generating enormous interest among medical experts. Indeed, it was not long before White House physicians and other American doctors were visiting China to see the power of acupuncture with their own eyes.

During the early 1970s, these observers witnessed truly staggering examples of Chinese acupuncture. Perhaps the most impressive demonstration was the use of acupuncture during major surgery. A certain Dr Isadore Rosenfeld, for instance, visited the hospital at the University of Shanghai and reported on the case of a twenty-eight-year-old female patient who underwent open-heart surgery to repair her mitral valve. Astonishingly, the surgeons used acupuncture to her left earlobe in place of the usual anaesthetics. The surgeon cut through the breastbone with an electric buzzsaw and opened her chest to reveal her heart. Dr Rosenfeld described how she remained awake and alert throughout: ‘She never flinched. There was no mask on her face, no intravenous needle in her arm…I took a color photograph of that memorable scene: the open chest, the smiling patient, and the surgeon’s hands holding her heart. I show it to anyone who scoffs at acupuncture.’

Such extraordinary cases, documented by reputable doctors, had an immediate effect back in America. Physicians were clamouring to attend the three-day crash courses in acupuncture that were running in both America and China, and increasing numbers of acupuncture needles were being imported into America. At the same time, American legislators were deciding what to make of this newfound medical marvel, because there had been no formal assessment of whether or not acupuncture really worked. Similarly there had been no investigation into the safety of acupuncture implements, which was why the Food and Drug Administration (FDA) attempted to prevent shipments of needles from entering the United States. Eventually the FDA softened its position and accepted the importation of acupuncture needles under the label of experimental devices. The Governor of California, Ronald Reagan, took a similar line, and in August 1972 he signed into law a bill that permitted acupuncture, but only in approved medical schools and only so that scientists might test its safety and efficacy.

In hindsight, we can see that those who argued for caution were probably correct. It now seems highly likely that many of the Chinese demonstrations involving surgery had been faked, inasmuch as the acupuncture was being supplemented by local anaesthetics, sedatives or other means of pain control. Indeed, it is a deception that has occurred as recently as 2006, when the BBC TV series
Alternative Medicine
generated national interest after showing an operation that was almost identical to the one observed by Dr Rosenfeld three decades earlier. Again, acupuncture was being used on a female patient in her twenties, also undergoing open-heart surgery, and also in Shanghai.

The BBC’s presenter explained that: ‘She’s still conscious, because instead of a general anaesthetic this twenty-first-century surgical team are using a two-thousand-year-old method of controlling pain – acupuncture.’ British journalists and the general public were amazed by the extraordinary images, but a report by the Royal College of Anaesthetists cast the operation in a different light:

In short, the patient had received sufficiently large doses of conventional drugs to mean that the acupuncture needles were a red herring, probably playing nothing more than a cosmetic or psychological role.

The American physicians who visited China in the early 1970s were not accustomed to deception or political manipulation, so it took a couple of years before their naïve zeal for acupuncture turned to doubt. Eventually, by the mid-1970s, it had become clear to many of them that the use of acupuncture as a surgical anaesthetic in China had to be treated with scepticism. Films of impressive medical procedures made by the Shanghai Film Studio, which had once been shown in American medical schools, were reinterpreted as propaganda. Meanwhile, the Chinese authorities continued to make outrageous claims for acupuncture, publishing brochures that contained assertions such as: ‘Deep needling of the
yamen
point enables deaf-mutes to hear and speak…And when the devil was cast out, the dumb spake: and the multitudes marvelled.’