Acupuncture Revisited

At the time when acupuncture has won thousands of advocates in North America and Europe, the Chinese themselves are using the technique less frequently--and then usually in conjunction with anesthetics and analgesics borrowed from the West. That is the conclusion of Dr. Patrick D. Wall, head of the cerebral-functions unit at University College, London, after a visit to China.

Wall, an internationally recognized researcher into the anatomy and physiology of the nervous system, did not investigate the effectiveness of analgesic acupuncture for the treatment of persistent pain, but concentrated on its use as an anesthetic during surgery.

That use, Wall reports in New Scientist, "is surprisingly rare and the number of cases is decreasing." At "the most active hospital using acupuncture," the technique was employed in 845 cases in 1970 and in only 324 in 1973--a mere 6% of all the year's operations. About half of 1973's operations using acupuncture were relatively minor, involving the removal of small thyroid nodules. Even for the least radical operations, most of the patients had their acupuncture reinforced by sedation with barbiturates, followed by a morphine-type analgesic and in some cases by injections of a local anesthetic.

Wall found that patients asking for acupuncture anesthesia are admitted to a hospital days or weeks before their scheduled surgery and get test needlings to familiarize them with the sensations and to let the doctors see how they react. The surgical team emphasizes "the spiritual aspects of acupuncture" in between discussions of Marxist-Leninist dialectical materialism. At difficult stages during the operation itself, the surgical team capitalizes on the general effects of distraction: "A great deal of encouraging talk streams on almost continuously." Nevertheless, Wall saw several operations during which the patient showed "varying signs of misery." But the discomfort was "borne with a most admirable fortitude which would be rare in a Western patient." Another significant limitation is that acupuncture is not employed in operations on children under ten. Reason: they cry.

Chinese acupuncturists, Wall found, use three totally different systems for placing the needles: 1) scattered all over the body, 2) concentrated in the ear lobe and 3) concentrated in the region of the pain. All three schools claim to be using traditional methods. But those involve inserting needles at particular points along lines called "meridians" to affect the functioning of specific organs. In fact, Wall points out, it is now generally recognized in China that the classical meridians for placing the needles have no proven physiological basis.

On his trip, Wall also disabused himself of his earlier belief that acupuncture's effects are derived from hypnosis. He decided instead that the Chinese have now developed a powerful combination of three classical techniques: relief of anxiety, suggestion and distraction. When necessary, they reinforce these with modern drugs. Wall concludes that acupuncture does not work very well on many people. But because it is effective for some, he feels that it is worthy of further scientific study.

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