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BOOK REVIEWS Acupuncture Therapy: Current Chinese Practice. By Leong T. Tan, Margaret Y.-C. Tan, and Ilza Veith. Philadelphia: Temple University Press, 1973. Pp. 159. $15.00. Just as Swedish folk medicine can be described as "troll medicine," Chinese folk medicine can be characterized variously as "massage," "love philters," "divination," "youth drugs," "herb remedies," "moxibustion," and "acupuncture ." The latter technique is lavishly illustrated in this attractive publication. What emerges from its study is awareness that the Chinese still seem to prefer dreaming to experimentation and that such a speculative philosophy of the health sciences apparentlyjustified the authors to uncritically defend a treatment which has no scientific basis. It should be remembered that acupuncture has not been effective in Taiwan and that on Mainland China many Western observers have noted the concomitant use of neuroleptic (promethazine) and analgesic drugs (usually meperidine), which could account for all the observed effects. During 1968, the Cultural Revolution in the People's Republic of China led to the suspension of publication of the professional medical journals until quite recently. The authors, therefore, had to depend on lay sources for their final chapter on "acupuncture anesthesia," which was only conceived of during this last decade. The sparse bibliography suffers from the same weakness. It seems that the current vogue of acupuncture therapy is largely the result of political exploitation of folk medicine in the People's Republic of China. There is, one should recall, an appalling shortage of doctors in the rural areas of China, where most of the medical services are provided by barefooted auxiliaries possessing few or none of the medical skills taught in the West. In contrast to the more comprehensive book Acupuncture: The Ancient Chinese Art of Healing, by Felix Mann (2d ed. [London: Heinemann, 1972]), the monograph by Tan, Tan, and Veith contains many naïve statements which exemplify an irrational awe of acupuncture. Both books provide ample evidence of the pseudoscientific nature of acupuncture. Tan et al. claim that acupuncture "as an analgesic and as therapy stems from the neolithic age and that it is therefore at least seven thousand years old." Proof for this statement is the "existence of acupuncture needles made of flint used long before the discovery of metal." The authors go on to cite spurious explanations such as the story of ancient Chinese warriors who, after having been injured by arrows, noticed the disappearance of pains of long standing. In the West this is quite well understood, because pain is known to be a "multidimensional" experience which not only includes the capacity to identify the onset, duration, location, intensity, and physical nature of the stimulus, but also involves the motivational, affective, and cognitive components that determine and condition behavior, degree of unpleasantness, and, 286 I Book Reviews generally, interpretation of the stimulus in the light of present and past experience . Unlike many other modalities of perception, pain cannot be directly observed or measured. During surgical operations, the major clinical methods of measuring pain depend indirectly on circulatory, neuromuscular, respiratory, and central nervous system responses; much depends on the patient's background and personal response to pain. What one might call chronic pain another might regard as an ache or distress, a sense of pressure, or an indescribable agony. During open heart surgery, patients not infrequently become aware of their surroundings when extracorporeal circulation is employed. Neuroleptic drugs are used to insure against panic and other undesirable responses in this nightmare situation, but it is probable that postoperative repression of memory is incomplete and often contributes to the psychosis quite commonly encountered in this population ofsurgical patients. The point is that chemical anesthesia is sometimes used today in insufficient or no amount during successful surgery, even without attempts at hypnosis or acupuncture. It can be done. It was, in fact, accepted as an inevitable necessity prior to 1846, and many doctors at that time were loath to accept the oblivion of general anesthesia, which many regarded as immoral interference with the natural order. Pain is also an integral part of daily living. The soldier goes "over the top" not so much because of bravery but because he believes that it is his comrade who will be killed...

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