Acupuncture has been around for millennia.  Because of this long history, the language and thought processes that the ancients used to understand the effects of this medical practice can seem like so much “mumbo-jumbo.”  Admittedly, I do not have a clear understanding of how some patients respond to acupuncture in the same way. As an anesthesiologist, I understand how  they respond to opioids.  As a scientist, I always prefer to have a molecular level of understanding about how a drug or therapy works. As a physician, I am experienced enough not to be paralyzed when that understanding simply is not available.

In my own practice, I routinely use volatile anesthetic (inhalational) agents, confident that I can consistently anesthetize patients with these gases for surgery.  I also am aware that the full mechanism of action for the volatile anesthetics remains a mystery, and yes, patients are occasionally harmed or even killed using these drugs.  I doubt Dr. Hall would suggest my use of volatile agents for anesthesia is “quackery.”  Certainly the effect of the volatile anesthetics, despite our incomplete understanding, is a great deal easier to objectively measure than the effects of acupuncture.  From my perspective, the difficulties in objectively evaluating acupuncture are less an indictment of the practice as of medical science’s inability to explicate its effects on the human body.  So many conventional paradigms of medicine, accepted as truth by the so-called non-quack medical establishment, have ended up in the dustbin of history, while acupuncture marches on.  Blood-letting for evil humors, craniology, electromagnetic coils, radioactive water, no hand-washing. Need I continue? 

If medical history tells us anything, it is that the medicine we practice today as the “standard,” will not be the standard tomorrow.  The medical peers of our not-too-distant future will likely look back upon us with a wry smile and shake of the head as they try to fathom our lack of comprehension.  I do not understand how acupuncture works for some patients, but it works for many — and has for thousands of years — while so many other “standards” of care have been banished.  I, for one, applaud the military for demonstrating the leadership and courage to try something other than traditional opioids to improve upon the available tools for pain management of our patients.  For now, that is enough, until medicine matures sufficiently to understand how volatile anesthetics and acupuncture work.

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