Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1

Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world. As a system of medical treatment, acupuncture's prevalence and robustness are continuously demonstrated by strong public demand, growing scientific evidence, and vast institutional support. Over the last thirty-odd years, students, scholars, researchers and practitioners of acupuncture and Chinese medicine in the United States have witnessed a swift rise in popular acceptance of acupuncture therapy, hand-in-hand with the profession's steady advancement.

Although the increasing momentum of acupuncture acceptance and awareness in the West is based on a solid foundation of daily work and practice by tens of thousands of practitioners around the world, the acupuncture profession has also been shaped by a succession of historical landmark events.

1958: Acupuncture Anesthesia

In acupuncture medicine, 1958 was bench-marked by an extraordinary development: the discovery of acupuncture anesthesia, one of the most spectacular modern applications of acupuncture and Chinese medicine.

In acupuncture anesthesia, the insertion and manipulation of acupuncture needles replaces anesthetic drugs. Patients are awake and even talking to their surgeons while undergoing major surgical procedures. The first successful instance of acupuncture anesthesia occurred in 1958, in Shanghai No. 1 People's Hospital. Dr. Yin Huizhu performed a tonsillectomy without the use of conventional anesthesia by applying acupuncture to Hegu (LI 4) acupoints. The case was immediately reported in Shanghai's Liberation Daily.¹

This extraordinary discovery was immediately followed by an observational study with 74 patients participating. A fairly high success rate was reported and published in the Shanghai Chinese Medicine Journal.² Subsequently, hospitals all over China rapidly assimilated this breakthrough procedure. Between 1958 and 1986, more than two million procedures using acupuncture anesthesia were performed in Chinese hospitals, including operations on the brain, face, neck, chest, abdomen and limbs, either without drug-induced anesthesia or with only a small dose of conventional anesthesia. More than one hundred different surgical procedures have been conducted using only acupuncture anesthesia, including significant surgeries such as thyroidectomy, hysterectomy, heart surgery, and subtotal gastrectomy.³ The enthusiastic popularization of acupuncture anesthesia in the 1960's led to widespread total replacement of conventional anesthesia by acupuncture anesthesia in a variety of surgical operations. China officially announced acupuncture anesthesia to the world in China's People's Daily in 1971⁴. During the 1970's, the more rational practice of combining acupuncture with conventional anesthesia to reduce the overall dosage of anesthetics became the norm. A quiescent period followed in 1980's, but acupuncture anesthesia never disappeared from Chinese medical practice. From the 1990's on there has been a resurgence of interest in acupuncture anesthesia in both research and practice.

How does acupuncture anesthesia actually work? Although acupuncture is involved in many aspects of the anesthesia process, the central theme of the mechanism of acupuncture anesthesia is acupuncture analgesia (AA). The analgesic effect is accomplished through the production and regulation of neurotransmitters in the central nervous system. When acupuncture needles are inserted into specific acupuncture points on or under the skin, nerve fibers in the underlying tissues are stimulated. This stimulation sends impulses to the spinal cord, activating the spinal cord, midbrain and hypothalamus-pituitary complex to release neurotransmitters. Incoming pain messages are blocked by the release of neurotransmitters such as enkephalin and dynorphin. The midbrain uses enkephalin to activate the raphe descending system which inhibits spinal cord pain transmission. In the hypothalamus-pituitary center, the pituitary gland releases endorphin into the blood and cerebrospinal fluid to produce an analgesic effect. Nerve cell extensions from the hypothalamus to the midbrain stimulate the midbrain's production of endorphin, which activates the descending analgesia system⁵.

The discovery and development of acupuncture anesthesia is a remarkable chapter in the ongoing story of Chinese medicine. Scientific research into the effects and applications of acupuncture are now being conducted in countries around the world. Although acupuncture is an ancient treatment modality, it continues to provide a seemingly inexhaustible supply of avenues for exploration.

1971: Acupuncture in America

Acupuncture has been practiced in Chinatowns in San Francisco, Los Angeles, and New York since the beginning days of Chinese immigration, but it was a 1971 article in the New York Times which is generally credited with first bringing acupuncture to the notice of the American public. In July 1971, Secretary of State Henry Kissinger made a secret visit to China to clear the way for President Richard Nixon's groundbreaking visit to China. This was also the month that journalist James Reston (1909 – 1995), a two-time Pulitzer Prize winner, was visiting China by special permission and invitation. While in China, Reston suffered an appendicitis attack. After Reston's appendix was removed using conventional surgery at the Anti-Imperialist Hospital (now Peking Union Medical College) in Beijing, Dr. Li Chang-Yuan treated his post-operative pain with acupuncture. Reston recounted this experience in a front-page article in the on July 26, 1971, "Now, About My Operation in Peking."⁶ For the vast majority of Americans, this was the first time they had ever heard of acupuncture and the practice of Traditional Chinese Medicine. "Acupuncture" officially became a word in American dictionaries.

As a gathering tide of knowledge and tradition concerning acupuncture and Chinese medicine poured into the United States, acupuncture pioneers in this country began their quest to learn and understand the principles of energetic anatomy upon which acupuncture is based, and to apply their understanding to the practice of acupuncture. In an effort to disseminate information about Chinese medicine, two journals were launched in 1973: the American Journal of Acupuncture, published in California; and New York's American Journal of Chinese Medicine. The following year, with the help of Americans Arnie Freiman and Steven Breeker, the late master acupuncturist James Tin Yau So founded the first acupuncture school in the United States, the New England School of Acupuncture (NESA). Dr. So then supported Dr. Gene Bruno and Dr. Steven Rosenblatt as they founded a second school in the United States, the California Acupuncture College, located in West Los Angeles. Dr. So studied and practiced acupuncture for decades in China before bringing acupuncture medicine to the United States. He developed two of the earliest English textbooks in the field of acupuncture: The Book of Acupuncture Points and The Treatment of Disease with Acupuncture. Dr. So is considered by many to be the "father of American acupuncture."

While acupuncture and Chinese Medicine were being introduced to the United States, students from all over the world were invited to study in China. This endeavor was initiated in 1975, when the World Health Organization (WHO), with the cooperation of the Chinese State Council, Ministry of Health, Ministry of Foreign Affairs, and Ministry of Foreign Economics and Trade, authorized China to initiate three acupuncture programs for international students. These programs were affiliated with three leading acupuncture and Chinese medicine institutes: the China Academy of Traditional Chinese Medicine in Beijing, Shanghai College of Traditional Chinese Medicine in Shanghai and Nanjing College of Traditional Chinese Medicine in Nanjing. In 1983, these three international acupuncture training centers/colleges were officially designated as the Beijing, Shanghai, and Nanjing International Acupuncture Training Centers and have trained students from more than 140 countries and regions since they were opened.

1987: WFAS

Worldwide interest sparked the emergence of an international organization, the World Federation of Acupuncture-Moxibustion Societies (WFAS). The idea of establishing WFAS was initiated by eight countries in 1984, an important time for the development of acupuncture in China. A preparatory committee was formed in Beijing that year, and by 1987 the WFAS was founded, holding its first inaugural conference that year. WFAS was headquartered in Beijing; it was approved by the Chinese State Council and coordinated by China's Ministry of Health, Ministry of Foreign Affairs, Commission of Science and Technology, and National Commission of Science. Further development of WFAS was facilitated by the China Acupuncture Association and China Academy of Chinese Medicine. WFAS started with 57 members representing 37,000 acupuncture practitioners, scholars and medical doctors. To qualify for membership in WFAS, an organization was required to be a registered acupuncture organization with at least three years' history in a country/region, and must include a minimum of fifty individual members, three-fourths of whom had to be medical doctors and/or acupuncture practitioners.

In 1991, the World Journal of Acupuncture and Moxibustion was launched by WFAS. In 1998, WFAS and WHO established an official non-governmental partnership. This relationship allowed WFAS members to attend WHO's World Health Assembly as well as meetings of the WHO Standing Committee. Under the auspices of WHO, WFAS held international conferences for institutional members and professional members. At international conferences hosted by WFAS, many significant topics of acupuncture theory and practice have been addressed. WFAS has been instrumental in developing the acupuncture standards promulgated by WHO.

As a non-governmental international union of acupuncture associations and organizations, having official relations with the World Health Organization (WHO) since 1998, WFAS functions to promote understanding and cooperation among acupuncture groups throughout the world, to strengthen international academic exchanges, to advance acupuncture medicine, and to enhance the status of acupuncture in health care systems. More specifically, WFAS was established to organize international conferences, symposiums and seminars on acupuncture; promote cooperation among acupuncture groups throughout the world; encourage academic exchanges on acupuncture; meet responsibilities required by the official relations between WFAS and WHO; cooperate with WHO to implement WHO's strategy regarding traditional medicine; publicize and promote acupuncture medicine; strive to attain legal status for acupuncture in all countries; develop education and training methods for acupuncture and improve its professional quality; promote acupuncture treatment and research; publish periodicals and provide information on acupuncture; and formulate and promote organizational standards and international standards of acupuncture.

References:

1. Editorial. Shanghai No. 1 People's Hospital Successfully Performed Tonsillectomy, Liberation Daily, September 5, 1958.
2. Li JX, et al. Acupuncture Expands Options for Clinical Anesthesia. Shanghai Chinese Medicine Journal, January 1959.
3. Zhang XT, Ji ZP and Huang JS. Acupuncture Anesthesia Research, Science Press,1986.
4. Editorial. Chinese Medical Workers and Scientists Develop Acupuncture Anesthesia, People's Daily, July 18, 1971.
5. Stux G, Berman B, Pomeranz B, Kofen P. and Sahm KA. Basics of Acupuncture, 5th Edition, Springer. 2003
6. Reston J. Now, About My Operation in Peking, New York Times, July 26, 1971.