Acupuncture

your point being?

“Did you see that program where that woman had open heart surgery and they used only acupuncture? Wasn’t it extraordinary!” Lorraine Kelly, GMTV

Acupuncture is mentioned in the oldest book on Chinese medicine, the Huang Ti Nei-Ching circa 220 BC. Before looking at the practice itself, a quick overview of the philosophy would be helpful. The traditional acupuncturist believes the cosmos and everything in it is subject to unwavering universal laws and that these laws are governed by the interplay of two opposing forces, Yin and Yang. Yin represents negative: night, cold, dark, female and the interior of the body whilst Yang represents the positive, day, hot, light, male and the exterior of the body. Across the universe, the balanced interplay between Yin and Yang express themselves harmoniously in the rising and setting of the sun, the sprouting and ripening of crops and other natural cycles. Good health is also seen as an expression of Yin and Yang working in harmony. When out of balance, Yin and Yang are said to express themselves negatively in the form of earthquakes, storms, drought, other disasters and also in sickness and dis-ease.

Imbalance between Yin and Yang leads to an interruption in the flow of chi (Qi, Ki, the fifth essence, quintessence, Hahnemann’s vital force, etc., etc..) - the invisible force permeating the universe and supposedly man’s motivating energy. In good health, chi is said to flow uninterrupted through the body via twelve invisible channels that dissect all the organs. These channels are known as the meridians. Stress, anxiety, anger, fear, grief, infections, poisons, hereditary factors, poor nutrition, trauma and the weather, are all said to affect the free flow of chi along these meridians. The acupuncturist restores the flow by inserting fine needles into the body at specific points along the meridians. These points are known as loci. Original acupuncture charts show 360 loci, corresponding to the number of days in the lunar calendar. However, more and more loci have been added over the years and some 2,000 loci points have since been assigned.

Before inserting any needles, the dis-ease must first be diagnosed. Both the acupuncturist and the TCM (traditional Chinese medicine) practitioner believe a diagnosis of the whole body can be achieved simply by studying just a small part of the body. This idea stems from the philosophical belief that ‘the whole is reflected in the part’ - that the human body is a miniature representation of the universe - ‘as in the macrocosm, so in the microcosm’. A typical acupuncture/TCM diagnosis is carried out by examining the eye or the tongue, feeling for strength and regularity in the pulse, by listening to voice tone and even by smelling the patient. All these diagnostic routes, so the acupuncturist believes, give him a clinical picture of the rest of the body. Having arrived at his diagnosis, the acupuncturist then consults his loci charts, inserts the needles at the determined points, twiddles the needles for a few minutes, unblocks the blockages and restores the flow of chi, thus restoring the body to health. If the patient fails to respond, TCM is recommended.

Although appearing profound, neither acupuncture or TCM diagnoses and treatments are based on any sensible knowledge of modern physiology, biochemistry, nutrition, anatomy, or on any of the known mechanisms of healing. Neither is there any understanding of cell chemistry, blood circulation, nerve function, hormones or other biochemical actions. Both therapies have grown out of an archaic and inaccurate understanding of the body, formulated at a time when the Chinese, for religious reasons, were forbidden to dissect cadavers. The prevailing Confucianist belief the body should return to the gods unblemished hindered the development of post mortems in modern China and they were not carried out as standard until well into the 20th century. Today in rural China, there is still a resistance to cutting the dead.¹

Early physicians simply guessed at the position of many organs and created organs where none existed. The high level of ignorance regarding layout and internal workings of the human body is revealed in the anatomical charts the early Chinese physicians devised (left). Yet, it is these same charts that remain the acupuncturist’s and TCM practitioner’s guide to the human body to this day.

The Chinese Communist Party expressed considerable antipathy toward acupuncture in the earlier 20th century, ridiculing it as superstitious, unscientific and backward.² This is not to say that science or the Chinese Communist Party have all the answers of course, but sensible observation over the years has given us a very detailed and accurate map of the human body. If you haven’t seen any of these early anatomical charts, they are pretty nightmarish, to put it mildly. You can bet if such a chart were to be displayed on the wall in a conventional UK surgery, the anxiety in the room would be palpable. But would anyone dare question the doctor? Probably not. To do so would only draw attention to ourselves. And anyway, the whole nasty business is bound to go away after a nice cup of tea. Three cheers for blind optimism and good old British reserve!

The chief boast of acupuncture is in the area of pain management. But how much of a part do the needles really play? Several theories suggest the insertion of the needles induces a hypnotic-like state in the patient, leading to a temporary alleviation of symptoms. There is also the ‘gate theory’, which holds that stimulation of certain fibres in the sensory nerves by the acupuncturist’s needle closes a ‘gate’ in the spinal cord, thus blocking pain. Other theories suggest the needles stimulate the body into producing narcotic-like substances called endorphins, equivalent to the runner’s high.

Although many of today’s acupuncturists claim endorphinism [sic] is the science that at last legitimises acupuncture, the mechanism of endorphin release and even its very existence is still in dispute. Those unconvinced of the theory argue that many people experience the same feelings of euphoria from meditation and yoga. Neither of these exercises physically stress the body enough to produce an endorphin release. These arguments aside though, most telling of all in these acupuncture books is the marked lack of information on how pain relief can be achieved by many other types of sensory stimulation, not just needles. The analgesic effects of electricity, heat, cold and human touch applied almost anywhere across the body is well-documented. “The effectiveness of all of these forms of stimulation indicates that acupuncture is not a magical procedure but only one of many ways to produce analgesia via intense sensory input.” ³ Putting it bluntly, no pun intended, you don’t need acupuncture needles inserted into the body to bring about pain reduction.

Acupuncture is also easily mimicked. In the same way that Dr John Haygarth used painted wooden sticks to disprove the healing powers of Elisha Perkins’ tractor rods (see homoeopathy story), researchers investigating acupuncture under controlled conditions have achieved the same results in patients receiving ‘sham’ acupuncture, revealing the fallacy of those ancient and mysterious loci points. Skeptics.org explains:

“There are two basic methods by which sham acupuncture can be performed so that it can be compared to real acupuncture:

1. Placing needles in non-acupuncture points. This method tests the validity of using specific acupuncture points. If acupuncture is given but the needles are placed in non-acupuncture points (unknown to the patient) and the results are the same as when acupuncture points are used then this shows that specific, important acupuncture points do not exist. Many trials have been done using this method and the conclusion is that acupuncture gets the same results in patients no matter where the needles are placed.

2. Using sham needles to mimic the effect of acupuncture. Retractable acupuncture needles have been developed which look like the real thing; the only difference is that the point retracts rather than penetrating the skin. To people who have never had acupuncture before, they feel genuine. Using retractable needles tests whether needling itself, rather than acupuncture per se, has any effect. Again, it is found that people respond in the same way whether genuine needles or sham needles are being used. These two methods show that the theory of acupuncture involving Qi, meridians and acupuncture points, is not valid and that results can be obtained whether needling occurs or not. It’s the belief that acupuncture is being performed that seems to make the difference.” ⁴

The idea that some form of a priori belief in acupuncture can help in the overall success of the treatment was understood by the earliest physicians. A text from the Huang Ti Nei Ching again:

“When dealing with a person who believes in ghosts and spirits, it is not much use to tell him about the effectiveness of [rational] medicine. When consulted by someone who cannot bear the thought of acupuncture, it will not help to expound on the successes and skills of those techniques. When a patient refuses a particular way of treatment, his illness will never be cured by it and in the end no success will be achieved.” ⁵

Harvard researcher Ted Kaptchuk has conducted detailed research into acupuncture and the placebo effect. His findings, which are easily located in any Google search, suggest the whole ritual of acupuncture affects how the patient feels. Says Kaptchuk:

“Performing acupuncture is more elaborate than prescribing medicine. Other rituals that may make patients feel better include white coats, and stethoscopes that you don’t necessarily use, pictures on the wall, the way you reassure a patient, and the secretaries that sign you in.” ⁶

Careful manipulation of such rituals could make all types of treatment more effective, Kaptchuk suggests. An article in the American Sunday Tribune describes the doctor-patient relationship as:

“One of the most unique and privileged relationships. The only relationship, to my mind, which stands above this, is the mother-child bond. Another relationship which might come near it is that between a teacher and disciple. A patient to a doctor is at once a dependent child, an eager student, a friend and a person needing advice, help, sympathy, understanding and hope.” ⁷

Imagine a first time acupuncture patient, we’ll call him Eddie, laying there on the treatment table, surrounded by the acupuncturist’s healing paraphernalia. The charts have been consulted, Eddie’s been told his lower back pain is treatable, even curable! One by one, the teacher insert his needles into his disciple, in all sorts of places but strangely, nowhere near the source of his back pain. At first, Eddie is a bit tense. He’s heard those needles are quite sharp! But the needles don’t hurt at all. All Eddie can feel is a slight tingling sensation. Eddie begins to relax and as the acupuncturist goes about his business, he reassuringly tells Eddie exactly what to expect when the needles are inserted. The acupuncturist quotes almost verbatim from acupuncture author Peter Mole who suggests the following as evidence for the existence of chi and those invisible meridians:

“When the needle reaches the required depth and touches the flow of chi, a remarkable thing happens - a distinct sensation is felt, often described as a dull ache or tingling sensation and can sometimes be felt along the pathway of the meridian. This sensation, is known as De Qi and indicates to the practitioner and patient that the point has been accurately located.” ⁸

But what other sensation other than a dull ache or tingling sensation is Eddie going to feel when a fine needle is inserted into his skin? Lying there though, in the midst of this elaborate ceremony, Eddie’s ability to maintain any form of critical judgment is considerably diminished. To Eddie, the unmistakable tingling sensation he felt just then was his first brush with the mysterious chi. The session over and having felt this life-force for himself, Eddie’s next move is to go down to the local library and borrow a few books on the subject. It’s a fair bet he’ll find a copy of ‘Acupuncture; cure for many diseases’ by Felix Mann - one of the most widely read books on acupuncture in the western world. With editions in seven languages, Mann’s book is bursting to the gills with mumbo-jumbo, magical thinking. In this book, Mann tells his readers that depression is a disease of the liver, excessive joy is a disease of the heart, obsession is a disease of the spleen, anguish is a disease of the lungs and fear a disease of the kidneys.⁹ Last week, this might all have been a bit strange to Eddie. But now that he’s ‘experienced’ the amazing chi for himself, a whole new world is opening up for him.

Other books in Eddie’s pile tell him that acupuncture is a ‘proven treatment’ for allergies, asthma, arthritis, bladder problems, bronchitis, colds, constipation, depression, diarrhoea, dizziness, fatigue, flu, gynaecological disorders, headaches, high blood pressure, kidney problems, migraines, paralysis, PMS, sciatica, sexual dysfunction, smoking, stress, stroke, tendonitis and vision problems. It isn’t really a cure for any of these conditions of course, but just like Jenny, whose thinking was transformed by her single ‘experience’ of homoeopathy, Eddie’s world view is undergoing the same softly-softly magical transformation process. Anything positive in the press about acupuncture will now instantly be believed by Eddie. Any critical comments are merely the snipings of ‘dark, conventional forces’ intent on undermining this ‘proven, natural cure’.

And so it goes on. Acupuncture has built its entire reputation on ‘evidence’ such as this. Those defending acupuncture must first of all demonstrate to us that those ancient anatomy charts really are accurate and that depression really is a disease of the liver. Any healing success boasted by the acupuncturist, if success is what it can be called, dwindles to zero after taking into account self-limiting illness and the placebo response. Furthermore, any relief from longer-term pain is almost always short-lived and patients are usually urged to make follow up appointments for more fee-paying treatment.

Unfortunately for Eddie, his back pain, which stemmed from a rugby tackle several months earlier, doesn’t appear to be a self-limiting condition and only a day after his first session, the twinges have started to return. Mind you, the acupuncturist did say that it would probably take between five and six sessions before he noticed any improvement. Eddie dutifully books himself in for five more sessions at a reduced rate of £45.00 a session.

Acupuncture is also said to be an excellent preventative. The Aberdeen Acupuncture Clinic advises:

“Acupuncture can make an important contribution to increasing your energy, vitality, and zest for life. Acupuncturists are trained to recognise disease often long before you are aware of any problem. Treatment at this early stage can prevent a more serious condition developing. ¹⁰

Less well known is the fact that many of the so-called ‘illnesses’ diagnosed by the acupuncturist are unique to acupuncture and do not correspond to any sensibly categorised disease. Worrisome conditions the acupuncturist may diagnose include ‘too much heat in the heart’, ‘too much cold in the spleen’, ‘retention of damp in the lower abdomen’, ‘kidney Yang deficiency’, ‘wind in the liver’, ‘exogenous pathogenic wind invasion’, ‘excessive joy’, ‘lung imbalance’ etc., etc., - all these conditions and more alleviated only by those celestial needles.

The belief the whole is reflected in the part has become the basis for another form of acupuncture known as auriculotherapy. The loose resemblance between the human ear and a curled up baby has resulted in the ear becoming a sort of map of the body (left). According to the charts, the earlobe represents the head of the baby and has loci points for the eye, teeth, lips, tongue, nose and cheek. Travelling up the outer edge of the ear, we find loci points for the shoulder joint, spine and upper arm etc., etc.. Any condition affecting these areas is treated simply by inserting needles at the relevant loci points. Speakers at the annual conference of the Society of Auricular Therapists held in Dec 2007 told their audience of all manner of ear acupuncture healing successes including healing of eye disorders, infertility and hormonal imbalance, eating disorders and how auriculotherapy was being used successfully in outreach work for the homeless and drug users.

A web page going by the rather creepy name of DrFeely.com recommends auriculotherapy for degenerative conditions such as osteoarthritis, rheumatoid arthritis, spinal stenosis, multiple sclerosis, cardiovascular problems as well as gastrointestinal and genitourinary dysfunction. None of this ear-pricking has any basis in fact, but just like acupuncture and TCM, because this auricular ‘wisdom’ is some two or three thousand years old, we assume that antiquity must somehow carry with it validity. It does not. In his critically acclaimed book Scientism in Chinese Thought, Professor of Chinese history Daniel Kwok describes what the term ‘Chinese doctor’ means to him:

“Our men of learning do not understand science; thus they make use of yin-yang signs and beliefs in the five elements to confuse the world. Our doctors do not understand science: they not only know nothing of human anatomy, but also know nothing of the analysis of medicines. As for bacterial poisoning and infections they have not even heard of them. We will never comprehend chi even if we were to search everywhere in the universe. All of these fanciful notions and irrational beliefs can be corrected at their roots by science.” ¹¹

I don’t think Daniel Kwok is saying that science is the final plumbline - the be all and end all. Science, or rather what happens to it when it falls into the hands of fallible man is often far from exacting. And it was Max Plank who famously said, “Science progresses funeral by funeral.” And also, for all his cold and calculating methodologies, Professor Richard Dawkins can’t scientifically explain a rainbow or the spine-tingling awe we feel when we stand at the rim of the Grand Canyon or how a certain piece of music can stir the emotions. No, I think that what Daniel Kwok is coming nearer to saying is that if we apply unfashionable, unsexy logic to acupuncture, we can easily explain yet another otherwise ‘ancient and mysterious Eastern healing art’.

A BBC2 three part series on alternative healing was screened in February 2006. The first program focused on acupuncture and featured a fully-conscious open heart surgery patient apparently being given only acupuncture for pain relief. A few days after the program was aired, GMTV presenter Lorraine Kelly was chatting to her guest plus a few million viewers about the program and it was obvious she had been deeply affected by what she had seen. “Did you see that program the other night, where that woman had open heart surgery and they used only acupuncture? Wasn’t it extraordinary!”

Like many viewers though, Lorraine had not picked up on the frequently conflicting information running through the program or on the fact that acupuncture was not the only pain-relieving treatment that had been given to the patient, despite what presenter Professor Kathy Sykes had led her audience to believe.

As the screen fed us dramatic images of the woman lying on the operating table, eyes wide open, bloody chest wall exposed and acupuncture needles sticking out at various points, it would have been easy amidst all the razzamatazz to miss the quiet, one line admission from Ms Sykes that the patient had also been given a sedative and that the area surrounding her heart had been numbed with anaesthetic.

At no point later during the program did Ms Sykes ask viewers to bear in mind the effects the sedatives and anaesthetic would have had upon the patient during the surgery. Instead, the narrative gushed with praise for ‘this ancient art’. But considering the doped up patient probably didn’t feel a thing, just how astounding was acupuncture’s contribution in this instance? An article a few days later in the Daily Telegraph noted the following:

“In fact, in addition to acupuncture, the patient had a combination of three very powerful sedatives (midazolam, droperidol and fentanyl) and large volumes of local anaesthetic injected into the chest. With such a cocktail of chemicals, the needles were merely cosmetic. In short, this memorable bit of television was emotionally powerful, but scientifically meaningless in building a case for acupuncture.” ¹²

The skeptics.org.uk website stated:

“This entire section of the program was extremely poor and Kathy Sykes has done her reputation no good whatsoever (other than in the eyes of the credulous) by presenting such a load of pap. A bit of truth would have helped with this section: the acupuncture was entirely superfluous in this woman’s operation.” ¹³

Professor Edzard Ernst from the University of Exeter had been hired as a scientific advisor and qualified counter-balance to the series. In a telephone conversation with me shortly after the series was aired, he expressed his disgust at the predetermined manner in which the BBC had approached the whole subject, saying he had found himself constantly having to do battle with an editor and presenter who did not want trifling matters such as facts getting in the way of the romantic story they wanted to present to their viewers, later estimated at approximately 4 million. Ernst’s advice was largely ignored. He has since had people writing to him, believing acupuncture could be a realistic pain relief therapy during their own surgery.¹²

More than 25 years before Sykes’ travesty of a programme on acupuncture was aired, two Chinese medical professors published an article in the Shanghai newspaper Wenhuibao, casting doubt on the demonstrations of acupuncture laid on for visiting westerners. The article described the enormous courage of victims who were forced to undergo various operations using only acupuncture but dared not cry out, despite the excruciating pain, for fear of what might happen to them. The authors also admitted that many such operations were performed on patients who were also under the influence of stupefying chemical agents. Far from ancient wisdom, the true history of Chinese medicine is probably one of the most ignorant across the continents but anyone suggesting otherwise is soon rounded upon and accused of having little respect for the ‘ancient traditions’.

In my experience though, discussing these issues to any degree with TCM/acupuncture practitioners is futile. The one thing the all-embracing CAM movement seems loathe to embrace in any form is criticism. But that’s probably true for all of us, I suppose. Staying with the eastern influence, the next chapter looks at what is possibly the most fanciful fairytale in the whole of the CAM healing catalogue - feng shui.

Chapters

about the author

1. The Ultimate Temptress FREE
2. No Stone Unturned FREE
3. Homoeopathy: The Formative Years FREE
4. Death by Doctoring
5. Hahnemann’s ‘Secret’ Powders
6. Like Cures Like?
7. Just My Imagination Running Away With Me
8. Less is More?
9. The Memory of Water And other Fancies
10. Our Wonderful Immune System
11. A Certain Charm
12. Veterinary Homoeopathy
13. The Dance Of Homoeopathy
14. Gimme The Moonlight!
15. Hahnemann’s Latter Years
16. Homoeopathy Today
17. Bach Flower Remedies
18. Acupuncture FREE
19. Naturopathy
20. The Feng Shui Horrorscope
21. Reflexology, Iridology and other Intolerances
22. The Medicine Business
23. Ooooh! Heaven is a Place on Earth!
24. My Kingdom for Consistency!
25. Nothing New Under the Sun
26. References