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:
It is obvious, from her appearance, that the patient has already received sedative drugs and I am informed that these comprised midazolam, droperidol and fentanyl. The doses used were small, but these types of drugs ‘amplify’ the effect of each other so that the effect becomes greater. Fentanyl is not actually a sedative drug in the strict sense, but it is a pain‑killing drug that is considerably more powerful than morphine. The third component of the anaesthetic is seen on the tape as well, and that is the infiltration of quite large volumes of local anaesthetic into the tissues on the front of the chest where the surgical incision is made.
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.’
Acupuncture’s reputation in the West had risen and fallen in less than a decade. It had been praised unreservedly following President Nixon’s visit to China, only later to be treated with suspicion by the medical establishment. This did not mean, however, that Western physicians were necessarily close‑minded to the whole notion of acupuncture. The more extraordinary claims might have been unjustified, but perhaps many of the other supposed benefits were genuine. The only way to find out would be for acupuncture to pass through the same protocols that would be required of any new treatment. The situation was best summarized by the American Society of Anesthesiologists, who issued a statement in 1973 that highlighted the need for caution, while also offering a way forward:
The safety of American medicine has been built on the scientific evaluation of each technique before it becomes a widely accepted concept in medical practice. The premature use of acupuncture in the United States at this time departs from this traditional approach. A potentially valuable technique which has been developed over thousands of years in China is being hastily applied with little thought to safeguards or hazards. Among the potential hazards is the application to the patient who has not been properly evaluated psychologically. If acupuncture is applied indiscriminately, severe mental trauma could result in certain patients. Another hazard is the possible misuse by quacks in attempting to treat a variety of illnesses, including cancer and arthritis, thus diverting the patient from obtaining established medical therapy. Exploitation may delude the public into believing that acupuncture is good for whatever ails you. Acupuncture may indeed have considerable merit and may eventually find an important role in American medicine. That role can only be determined by objective evaluation over a period of years.
The American Society of Anesthesiologists, therefore, was neither accepting nor rejecting the use of acupuncture, but instead it was simply arguing for rigorous testing. These level‑headed experts were not interested in anecdotes, but rather they wanted ‘objective evaluation’ with large numbers of patients. In other words, they wanted to see acupuncture submitted to the sort of clinical trials discussed in Chapter 1, which had decided the effectiveness of treatments such as bloodletting and lemon juice for scurvy. Perhaps acupuncture would turn out to be as useless as bloodletting, or perhaps it would be as effective as lemons. There was only one way to find out: do proper research.