CHAPTER 1
My Introduction to Acupuncture
"In all affairs it's a healthy thing now and then to hang a question mark on the things you have long taken for granted."
— Bertrand Russell
Acupuncture first caught my attention when I was conducting scientific research at the University of California, while on leave from a doctoral program in nutritional biochemistry at Cornell University. Finding myself with stubborn sinus congestion and a cough that medical treatment had not helped, I thought I'd give acupuncture a try.
My local acupuncturist's office was in a converted barn in the backyard of her home. Inside, I smelled the rich and earthy aromas of Chinese herbs mingling. A wall was lined with shelves that held jars of dried herbs and tablets. The space was cozy, with beds for treatment in several rooms. It felt homey and warm — not like your typical doctor's office.
I told the acupuncturist my symptoms. She felt my pulse on both wrists, looked at my tongue, and inserted some acupuncture needles in my arms and legs. I'd simply rolled up my sleeves and pant legs so she could reach these areas. After placing the fine needles – I barely felt them being inserted – she handed me some tissues and asked cryptically, "Is it worth it?" Then she left the room, leaving me with a little bell to ring if I needed her.
I immediately relaxed and felt the tension leave my body. It was a calm, comfortable feeling. Within a few minutes, I began to cry. I didn't see that coming. During the previous year, there had been a lot of changes in my life: my father had died and I'd moved across the country, away from friends and family, to a new town and job.
As my body relaxed, I felt a kind of relief and sadness mixed together. I wondered how the acupuncturist knew I would need those tissues when I hadn't even been aware of it myself. Later, I learned about Chinese pulse reading and how much it can reveal about a person's condition, including stress, pent-up sadness, and anxiety as well as purely physical problems. This must have been how she knew.
By the time she returned to the room, the sadness had passed and I was in an even deeper state of relaxation, almost like sleep but still awake. My breathing was deep and easy, and my sinuses felt clear. I told her about the tears, and she gave me a knowing smile as she rechecked my pulse. She never explained it to me, but I felt better. She sent me home with a bag of herbs to brew into a medicinal tea.
After this visit, my cough and sinuses cleared up rapidly. It had been an impressive experience; the acupuncture had healed me, but I had no idea how. Not only had my physical symptoms resolved, but it seemed as if my emotions and life situation had somehow been treated as well. This intrigued me, and I continued to return for more treatments. Over the next few years, the treatments worked again and again. Eventually, at my acupuncturist's urging, I began to consider studying acupuncture myself.
After my cough and sinusitis cleared up, you may wonder why I continued returning for acupuncture treatment. Well, I was only in my mid-20s but I'd burned myself out. As I discovered later, and as you'll see in the patient healing stories, this is typical of people in their 20s. Having blazed through college burning the candle at both ends — studying hard and living to the max (sleep? what sleep?), going to graduate school, starting a new job and then another new job, moving far from home — I was having a blast. However, my body wasn't quite as enthusiastic. My adrenals were shot and I was tired all the time. Not just tired: if I blinked at work, I ran the risk of falling asleep while standing. There were dizzy spells. I was a burn-out case. That's why I returned for acupuncture treatments over the next two years.
In addition to giving me treatments, my acupuncturist gave me dried herbs to cook into a medicinal tea. She told me to add chicken bones to the brew because, she said, I was so depleted that I needed the "yang" nourishment that plant food couldn't give me. Though I was a vegetarian, I followed her instructions. When I told her I usually had oatmeal or cereal for breakfast, she told me to add two eggs and a piece of toast! It sounded like too much food. I didn't even have much of an appetite (which, as it turned out, was another sign of my depletion). I was perplexed. I had no idea how drained I was, but little by little, as I followed her instructions and received acupuncture treatments, I came to understand it.
It took me two years to get my full strength back. During that time, if I tried to go back to my old ways of overdoing it, my energy would immediately crash. This is adrenal exhaustion. In a way, it's good that it took two years to heal, because it took that long to rehabilitate my habit of overwork and living without tending to my own body's needs.
This is my story, but it's probably your story too. Almost everyone I meet, and everyone I treat with acupuncture, lives in a state of overdoing it, without giving enough healing care and restoration to their own body. It's our culture. And it's very much at the root of our disease. I know how hard it is to change that pattern, but you must. Most people wait until they hit the wall to make a change. Finally, your body "makes you an offer you can't refuse." You reach down to pick up a piece of paper and your back goes out. You get the flu and can't get out of bed for a month. You start waking up with panic attacks. These are all your body's way of saying, "Enough, I can't go on like this." Try to take steps to heal before you reach that point. Acupuncture is a potent healing method to restore your worn-out body, mind and spirit, and thereby heal what ails you.
How does acupuncture work? What is its scientific basis? As a biochemist turned acupuncturist, I should be able to answer these questions easily. But, I don't actually know the answers. No one does. Scientists, physicians, and clinical acupuncturists are researching the elusive mechanisms of acupuncture. We have a lot of intriguing data and proof of its effects, but no comprehensive explanation for how the placement of needles in different parts of the body helps with the healing process.
When I began studying acupuncture, it was hard to get my head around a foreign technique that had absolutely no basis in modern science. But over the years I've been repeatedly impressed by how effective it is. Not only does acupuncture relieve pain, but it also treats a range of internal diseases such as asthma, acid reflux, high blood pressure, irritable bowel syndrome, insomnia, anxiety, and vertigo. And on top of that, it provides an indescribable feeling of well-being that takes the edge off the stress of life — and who couldn't use some of that these days?
There are those who doubt that acupuncture works at all, and believe it's nothing more than snake oil medicine with a big dose of the placebo effect — that patients feel better solely because they believe the treatment will help them. This is unlikely, however, because although we don't yet know precisely how acupuncture works, studies that control for this effect have shown distinct physical results. Using blood tests to measure neurotransmitters, hormones, and natural painkillers as well as brain imaging, scientists have shown that acupuncture causes measurable changes in the body's physiology.1 This is even true in animals, where the expectation of acupuncture "working" plays no part at all.
Others don't believe that sticking a needle in specific locations in the body can provoke therapeutic changes, as acupuncture contends. However, evidence suggests that different replicable effects can be measured depending on where and how the needle is placed, indicating that point specificity matters.2 Other studies, using groups of people suffering from the same condition, such as low back pain or high blood pressure, validate acupuncture's therapeutic effects.
Because science hasn't yet provided a full explanation, acupuncture's supporters and critics alike can make similarly compelling arguments to bolster their cases. Until we have solid scientific evidence, we're still navigating by long tradition, opinion, and anecdotal evidence. Firsthand accounts from people whom acupuncture has helped seem at least partly responsible for the practice's growing popularity. When you hear that your colleague's migraines were relieved using acupuncture, or your cousin's back pain went away, you begin to wonder if it can help you with your neck pain, anxiety, or allergies. And you're more likely to try it yourself.
Interestingly, Western medical treatments also are often difficult to explain. We call them scientific because they involve technology, seem objective and precise, and are backed by scientific research. That's often the case. However, medications are frequently given for conditions simply because they've been observed to work, not because we understand their mechanisms of action. Many off-label uses of drugs fall into this category. By the same token, doctors may test an unproven procedure on a patient, and if it works, then that procedure may become more widely used and eventually made the focus of a study. So even the medicine that we consider to be scientific isn't entirely so. I point this out not to discredit Western medicine, but simply to show that in any medical system, the science — and its proofs — often comes after the treatment has been shown to work.
Understanding Acupuncture
By investigating the science behind the time-tested technique of acupuncture, we're attempting to build a major new bridge between two dissimilar worlds. Acupuncture was developed in ancient China more than two thousand years ago in a culture, a period, and through a language completely foreign to contemporary Western sensibilities.
We tend to assume that today we're more knowledgeable and advanced, and that a Chinese physician from ancient times would have been too primitive and uninformed to understand health and medicine. We disdain him before we even meet him; we discount all that came before as part of an ignorant past. We may soon learn that this doctor from ancient times understood a lot more than we could have imagined.
As a patient, I overcame my own skepticism because acupuncture made me feel better, and I knew from experience that it was working. It seemed to generate health from the inside out. But as a scientist, I wanted to know how it worked and was loathe to admit to my colleagues that I took it seriously — to the point of studying it.
At the time, there was no science to explain acupuncture. To make matters worse, the language used to explain it sounded absolutely primitive. A common cold was described as an attack of "evil wind," a urinary tract infection was described as "damp heat in the lower burner," while nausea and vomiting were described as "counterflow qi."
When I took the leap into studying acupuncture, I struggled with this for a long time. And yet, I knew I'd encountered a healing system that could both prevent and cure many kinds of illness effectively. In addition to acupuncture, the system of Chinese medicine includes herbal medicine as well as dietary and lifestyle remedies.
If I waited for science to explain how acupuncture worked, I reasoned, I'd probably wait a lifetime. I prize scientific research but what drew me to science in the first place was health and healing. If I stayed in the lab, I might spend decades understanding the function of a single enzyme or a section of DNA. As interesting and important as such research is, I chose instead to work with a system that helped people get better and improve their quality of life in real time.
Can Valid Treatment Come from Invalid Concepts?
I now understand that Chinese disease patterns describe something real and treatable, even though they may seem inconsistent with our scientific understanding of the body. At some point, we may be able to translate these patterns into the language of Western anatomy and physiology, and understand precisely what they are describing. To a certain extent this is taking place already, as acupuncturists compare their observations to Western medical diagnoses.4 This conversation is taking place more in the acupuncture community than in the scientific community, where the focus is more on testing the effects of acupuncture itself.
Historical documentation suggests that demonology played an extensive role in the concept of health and illness in ancient China. This grew out of earlier shamanic traditions that understood illness as an affliction sent by demons or displeased ancestors. The "treatment" included spells and rituals to appease the ancestors or cast out the demons.
If the fundamental concepts of ancient Chinese medicine were originally associated with demonology and magic, can they be valid in medical treatment? Could there be some thread that connects the magic with the science? This is what acupuncture research is trying to discover. Perhaps the thread will turn out to be the observation of natural phenomena, described in the past as demons and more recently as germs, for example. Although the explanations change, the underlying observations might be rooted in something more permanent and true. Even today, science exists for us alongside non-scientific beliefs that arise from a human yearning to understand the subtle forces at work in our lives that we cannot yet explain.
In some respects, ancient Chinese acupuncturists may have better understood the workings of the human body in health and illness than we do today. They grasped its nuances and the interrelationships among systems, and how to treat them effectively. Ancient Chinese doctors looked at the body through a different lens than we do, using metaphors from nature and society to describe its functions. It's not that they weren't aware of specific organs; the ancient Chinese had opened the body in surgery — contrary to legend that it was taboo and therefore to be avoided — and they knew a great deal about the shape, size, placement and functions of each of the organs.5 However, they combined this knowledge with other observations and — using the tools they had at hand — emphasized the body's physiological workings in their medicine.
We can now identify specific organ functions and measure body chemistry in ways unknown to ancient Chinese physicians. Yet, despite its strengths, our scientific approach tends to be reductionist — breaking things down to their smallest parts and seeing them in isolation from one another. We are not good at understanding the body's integrity — how all of its parts work together as one whole to support health and healing.
The use of metaphor to describe the body's functions, along with the ability to see things from several different perspectives at once, is inherent in acupuncture healing. In my early acupuncture studies, I apprenticed with an accomplished acupuncturist who had been practicing for many years. I watched as he diagnosed and treated patient after patient. Just when I thought I understood what he was doing and could anticipate how he would treat the next patient, he would do something completely different, and that approach worked as well. How did I assess that it "worked"? A patient with neck pain dramatically increased her range of motion immediately after the selected points were needled. I felt the release of muscle tension with my own hands and heard the patient report that the pain in the affected area had decreased. In addition, palpation of the Chinese pulses on the wrists revealed significant changes, corresponding to changes inside the body.
In acupuncture, there are many ways to achieve healing, and no two acupuncturists may treat in exactly the same way. In this respect, acupuncture is an art as well as a science. As you will see, this is one of the reasons why it can be so challenging to design well-controlled scientific studies to validate its effects.
