China Daily 02/15/2006 page13

http://www.chinadaily.com.cn/english/doc/2006-02/15/content_520228.htm

Of pins, needles and pain relief

Chen Zhiyong
2006-02-15 07:21

It is commonly believed that acupuncture went mainstream in the United States after President Richard Nixon's visit to China in 1972.

However, after years of research, Dr Li Yongming, president of the Traditional Chinese Medicine Association in the United States, has overturned this general consensus and announced recently that the "acupuncture fever" in the United States got started a bit earlier.

The man who started it was journalist James Reston, with his 1971 New York Times story, said Dr Li, who is organizing a series of events to mark the 35th anniversary of this incident.

Unique experience

In June 1971, Reston, a columnist and editor of The New York Times and winner of two Pulitzer Prizes, received an invitation from the Chinese Government to visit China. He arrived in Guangzhou on July 8. However, his trip was delayed and he did not set foot in Beijing until July 12.

On July 15, Reston suddenly felt a stab of pain in his groin. The next day, he checked into the Peking Union Medical College Hospital, which was then named Anti-Imperialist Hospital.

In his story entitled "Now, Let Me Tell You About My Appendectomy in Peking," Reston blamed Henry Kissinger for his pain.

As Nixon's National Security Adviser at that time, Kissinger arrived in Beijing on July 9 to secretly negotiate with the Chinese Government the date of President Nixon's visit to China, and left on July 11.

As an experienced journalist, Reston felt great regret and anger at having missed a golden chance to cover such breaking news.

Reston was diagnosed as suffering from acute appendicitis and had to undergo an appendectomy.

Though the operation went off well, Reston was in considerable discomfort during the second night after the surgery. Li Zhanyuan, a doctor of acupuncture at the hospital, with Reston's approval, inserted three long thin needles into his right elbow and below his knees.

The needles sent twinges of pain through Reston's limbs and diverted his attention from the distress in his stomach.

Meanwhile, Dr Li lit two pieces of a herb called ai (Chinese mugwort), which looked like the burning stumps of a broken cigar, and held them close to his abdomen, while occasionally twirling the needles into action. Reston later learned that this was the procedure called moxibustion.

"All this took about 20 minutes, during which I remember thinking that it was a rather complicated way to get rid of gas in the stomach, but there was noticeable relaxation of the pressure and distension within an hour and no recurrence of the problem thereafter," he wrote in his article.

Reston's story appeared on the front page of The New York Times along with the Apollo 15 lift-off, on July 26, 1971.

Dr Li Yongming calls the acupuncture treatment that Reston underwent "an oriental Apollo."

Though acupuncture had been practised in North America ever since the first immigrants came to the continent from China, it never entered the mainstream before the early 1970s, according to Li.

Reston's article was the first genuine American experience in acupuncture to appear in the mainstream Western media.

"Several years later, after Reston's death, I got in contact with his three sons, who remembered that their father received a lot of letters from readers to inquire about acupuncture," said Li. He graduated from the Liaoning Traditional Chinese Medicine Institute in 1982 and has been researching both Chinese and Western medicine as attending physician at the Warren Hospital in New Jersey.

Dr Li began tracking down the persons involved in Reston's operation, and it took him more than five years to finally locate Dr Li Zhanyuan, who retired from the Peking Union Medical College Hospital in 1995. The delay was caused by Reston who used the old Western way to spell the Chinese names.

Li Zhanyuan, who is in his 70s, retains his love for acupuncture, training young practitioners in a vocational skills education centre in Beijing.

Interestingly, even while telling his students the story of acupuncture's spread to the United States, he ignored the Reston story.

"I never expected Reston's experience with the silver needles to evoke such a strong response in America," he said.

Thousands of young acupuncturists like Dr Li Zhanyuan were trained after the founding of the People's Republic of China to provide inexpensive medical care for the vast rural population. Owing to the strong support of the government, acupuncture enjoyed its strongest development in those years in China.

Viable alternative

"Research on acupuncture anaesthesia has played an important role in the spread of acupuncture in the US. It has attracted people's attention to its pain-relieving effects," said Dr Li Yongming.

Although the acupuncture fever cooled after the initial burst of enthusiasm, the treatment retained its influence in the United States. In the 1990s, there was a resurgence of interest, as more Americans began paying greater attention to alternative medicine.

"People started to get sick of the side-effects of Western medicine and turned to effective and safe non-medicinal therapies," said Dr Li.

In 1997, the US National Institute of Health (NIH) concluded that acupuncture provided effective therapy for certain medical conditions, especially post-operative nausea and pain as well as vomiting. It said acupuncture was remarkably safe, with less side effects than many well-established therapies.

Cao Xiaoding, director of the Research Department of Acupuncture under the WHO Collaborating Centre for Traditional Medicine, has been studying acupuncture analgesia since 1964.

She was one of the three Chinese acupuncture experts invited to take part in the 1997 hearing on acupuncture conducted by the US NIH.

She said acupuncture was being applied widely in Western countries to alleviate pain. As acupuncture also helps regulate body functions, it can help conditions such as high blood pressure, arthritis, myasthenia and paralysis.

According to Dr Li Yongming, allocations of research funds for acupuncture from the USNIH have been increasing every year. It now accounts for nearly half of TCM research funds, which in turn account for a quarter of the total funds earmarked for Complimentary and Alternative Medicine.

Currently, the US has about 20,000 acupuncturists and 5,000 physician acupuncturists. More than 30 states have laws dealing with acupuncture.

"One can find acupuncture advertisements in the yellow pages in any hotel in the United States," said Dr Li.

Reston himself might have never imagined that one day acupuncture would find such wide acceptance in his country while penning his article from a hospital bed 35 years ago.

China Daily 02/15/2006 page13

China Daily 02/15/2006 page13

http://www.chinadaily.com.cn/english/doc/2006-02/15/content_520232.htm

No substitute for anaesthesia, say experts

Zhi Yong
2006-02-15 07:21

Chinese-media reporting on acupuncture went well beyond its effectiveness in pain relief as experienced by James Reston, during the "cultural revolution" (1966-76).

There were extensive reports on the spectacular results of using acupuncture for anaesthetic reasons in 1971, astounding both the layman and medical professionals around the world.

"Acupuncture was said to be able to replace the conventional drug anaesthesia in each operation," said Dr Wu Weiran. The honorary president of the Beijing Hospital, now in his 80s, conducted the appendectomy on Reston.

However, the effects of acupuncture anaesthesia were quite exaggerated, Dr Wu said.

After the normalization of Sino-US relations, he led a group of Chinese doctors to participate in a cultural exchange organized for medical practitioners in the United States.

His American counterparts asked him to perform acupuncture anaesthesia.

"I told them that clinically I seldom applied acupuncture anaesthesia," he recalled.

Acupuncture does have an effect in relieving pain, "but I said that I was not clear whether acupuncture could realize ideal anaesthesia effects for an operation. It deserved further research," said Wu.

In fact, Reston was anaesthetized with an injection of Xylocain and Bensocain, although there were reports saying that acupuncture was administered, Wu said.

"There are quite a few problems with acupuncture anaesthesia, and we still have not been able to solve them," said Cao Xiaoding, director of the Research Department of Acupuncture under the WHO Collaborating Centre for Traditional Medicine, who has been studying acupuncture analgesia since 1964.

First, the analgesic effect of acupuncture is not complete, which means a patient undergoing surgery will continue to experience at least a little pain.

Second, when surgeons touch the internal organs, the patient will feel sick.

Third, the analgesic effects of acupuncture on different patients vary greatly.

Last, the relatively brief period of efficacy of acupuncture anaesthesia can be troublesome for surgeons.

Owing to these limitations as well as a rapid development of drug anaesthesia, acupuncture anaesthesia, once thriving in the 1960s, is rather uncommon now.

It is rarely practised clinically unless the patients are allergic to anaesthetics.

However, Cao believes that acupuncture anaesthesia is by no means dead.

Experiments conducted by professor Cao and her colleagues show that anaesthetics such as morphine immobilize the intestines and thus lead to post-surgery decreased immunity and fever.

"Acupuncture anaesthesia can effectively relieve these adverse effects and produce movement and relief in the intestines. So combining the two methods can draw on each other's strong points to offset their individual weaknesses," said Cao.

According to her, administering acupuncture during an operation can reduce the usage of anaesthetic drugs by as much as 40 per cent.

(China Daily 02/15/2006 page13)