Numerous scientific studies have confirmed this judgment, and it’s now widely accepted in medical circles that acupuncture is an effective treatment for most types of pain. But Lei may be mistaken in one respect: the distinction between Western medicine and acupuncture is getting blurrier all the time. In countries around the world, acupuncture is becoming a bona fide treatment for pain–another tool, along with painkillers and anesthetics, in the doctor’s medical kit. Increasingly, acupuncturists are white-coated physicians who receive payment from state-run health systems or even private medical insurance. Even in China, scientists are working to put this ancient art on a firm scientific footing.
Scientists have failed, though, to come up with a good theory as to why acupuncture seems to work. Traditional Chinese medicine believes that acupuncture helps to smooth the flow of the life force, or qi, through the body along 14 major pathways, or “meridians.” According to this theory, pain is the result of blocked qi in one or more meridians. Dr. Han Jisheng, director of the Neuroscience Research Institute at Beijing University, would like to believe it, not least because it’s a fundamental tenet of his culture. However, he says, “I have no evidence.”
Han got involved with acupuncture in 1965 when he witnessed a surgical procedure performed without anesthetics–only acupuncture to relieve the pain. Since then he’s tried to explain scientifically how it works. Although the “acupoints” highlighted by the meridian map of the body don’t correspond to any part of the anatomy, they seem to be the most effective places to apply needles or electrical currents. He also found that acupuncture triggers the release of endorphins and other pain-blocking chemicals. Han has even gotten different results by applying different frequencies of alternating current to the needles: 100 hertz worked better for muscle spasms as a result of spinal injuries, while 2Hz was more suitable for chronic lower-back pain. But despite his efforts, Han hasn’t been able to come up with a good scientific explanation for why this is so.
Scientists in the United States who’ve applied brain scans to acupuncture patients have been able to observe that the needles stimulate those parts of the brain involved in pain perception. Zang-Hee Cho, a professor of radiological sciences at the University of California, Irvine, got interested in the subject 10 years ago when he injured his back in a hiking accident. Since his doctor’s office was closed, his wife suggested acupuncture. “I was almost mad at her,” he recalls. But it worked. Since then Cho has been studying patients with –fMRI and PET scans, but he’s still at a loss to explain why acupuncture works. “I think it’s funny,” he says, “that with all this modern science, we cannot explain this thing. Nobody knows the mechanism.”
Medicine, of course, is a pragmatic profession. Physicians and patients don’t care so much about the why, as long as it works and has no side effects. Four years ago Marie Rochette, a 36-year-old Parisian, had a particularly painful bout of sciatica, which two weeks on painkillers couldn’t resolve. After four or five sessions with an acupuncturist, she felt enormous relief. “I went from being in bed in pain to being fully functioning, even exercising again,” she says. She’s been a needle junkie ever since.
She’s in good company. Acupuncture is all the rage in Europe. Cherie Blair, wife of the British prime minister, has been seen sporting a tin needle in her ear. More than 2,000 acupuncturists are licensed in France–medical doctors whose services are reimbursed by the state health system. In Germany, 50,000 physicians practice acu-puncture, and the numbers are rising. Most hospitals and pain-treatment clinics include acupuncture as a standard regimen. And the government is currently funding clinical trials on 150,000 patients suffering from chronic back pain, migraines and arthritis, as a prelude to making acupuncture a part of the country’s health service later this year. Even some private health insurers in the United States now offer at least partial reimbursement for acupuncture treatments.
Perhaps the clearest sign that acupuncture has made it big in Western medicine is that it’s being used to cut health-care costs. Even though acupuncture treatments extend over many weeks, they’re often cheaper than drug regimens. Hospitals are catching on. This week Dr. Peter Tassani, an anesthesiologist at the Cardiac Clinic at Munich Technical University, will begin using acupuncture on patients undergoing heart-bypass surgery. Rather than knocking them out with powerful anesthetic drugs, he inserts 3cm needles into their ears and arms 30 minutes before surgery starts, and amplifies the effect with a 90-volt electric current. He still administers drugs, of course, but has cut dosages by 75 percent. The payoff comes after surgery. Patients don’t lie unconscious for the rest of the day, taking up a valuable bed in intensive care–instead they’re trundled out shortly after their chests are sewn up. The clinic expects to save a bundle on the more than 2,000 heart operations it performs each year. “Acupuncture doesn’t fit with anything I learned at university,” says Tassani. “All I know is, it works.” For the art of medicine, that’s as good as it gets.
