Trick or Treatment—The Undeniable Facts about Alternative Medicine (Electronic book text)

The first theory, known as the gate control theory of pain, was developed in the early 1960s, a decade before scientists were thinking about acupuncture. A Canadian named Ronald Melzack and an Englishman named Patrick Wall jointly suggested that certain nerve fibres, which conduct impulses from the skin to more central junctions, also have the ability to close a so-called ‘gate’. If the gate is closed, then other impulses, perhaps associated with pain, struggle to reach the brain and are less likely to be recognized as pain. Thus relatively minor stimuli might suppress major pain from other sources by shutting the gate before the troubling pain impulse can reach the brain. The gate control theory of pain has become widely accepted as an explanation of why, for example, rubbing a painful limb is soothing. Could gate control, however, explain the effects of acupuncture? Many acupuncturists in the West argued that the sensation caused by an acupuncture needle was capable of shutting gates and blocking major pain, but sceptics pointed out that there was no solid evidence to show that this was the case. The gate control theory of pain was valid in other situations, but acupuncture’s ability to exploit it was unproven.

The second theory for explaining the power of acupuncture is based on the existence of chemicals called opioids, which act as powerful, natural painkillers. The most important opioids are known as endorphins. Some studies have indeed shown that acupuncture somehow stimulates the release of these chemicals in the brain. Not surprisingly, acupuncturists have welcomed these studies, but again there have been sceptics. They question whether acupuncture can release enough opioids to create any significant pain relief, and they cite other studies that fail to confirm any connection between endorphins and acupuncture.

In short, here were two theories that could potentially explain the powers of acupuncture, but as yet they were both too tentative to convince the medical establishment. So instead of accepting either theory, scientists urged further research. Meanwhile, they also began to propose a separate explanation to account for the pain relief provided by acupuncture. In fact, if correct, this third theory could potentially explain all its supposed benefits, not just pain relief. Unfortunately for acupuncturists, this third theory attributed the impacts of acupuncture to the placebo effect, a medical phenomenon with a long and controversial history.

In one sense, any form of treatment that relies heavily on the placebo effect is fraudulent. Indeed, many bogus therapies from the nineteenth century had turned out to be nothing more than placebo-based treatments. In the next section we will explore the placebo effect in detail and see how it might relate to acupuncture. If the placebo effect can successfully explain the apparent benefits of acupuncture, then 2,000 years of Chinese medical expertise would evaporate. If not, then the medical establishment would be forced to take acupuncture seriously.

The power of placebo

The first medical patent issued under the Constitution of the United States was awarded in 1796 to a physician named Elisha Perkins, who had invented a pair of metal rods which he claimed could extract pains from patients. These tractors, as he dubbed them, were not inserted into the patient, but were merely brushed over the painful area for several minutes, during which time they would ‘draw off the noxious electrical fluid that lay at the root of suffering’. Luigi Galvani had recently shown that the nerves of living organisms responded to ‘animal electricity’, so Perkins’ tractors were part of a growing fad for healthcare based on the principles of electricity.

As well as providing electrotherapeutic cures for all sorts of pains, Perkins claimed that his tractors could also deal with rheumatism, gout, numbness and muscle weakness. He soon boasted of 5,000 satisfied patients and his reputation was buoyed by the support of several medical schools and high-profile figures such as George Washington, who had himself invested in a pair of tractors. The idea was then exported to Europe when Perkins’ son, Benjamin, emigrated to London, where he published The Influence of Metallic Tractors on the Human Body. Both father and son made fortunes from their devices — as well as charging their own patients high fees for tractor therapy sessions, they also sold tractors to other physicians for the cost of 5 guineas each. They claimed that the tractors were so expensive because they were made of an exotic metal alloy, and this alloy was supposedly crucial to their healing ability.