In 1971, James Reston, a reporter
for the New York Times with Nixon's Chinese trip, developed
appendicitis while in China. The Chinese proposed surgery for
his appendectomy using acupuncture anesthesia. His postoperative
pain after appendectomy treatment was relieved by acupuncture
at the Anti-Imperialist Hospital in Beijing. Below is James
Reston's 1971 article in the New York Times describing his experiences.
Nixon's personal physician, Dr. Walter
Tkach, was so impressed with the treatments he saw there that
National Institutes of Health set up the Ad Hoc Committee on
Acupuncture. An acupuncture research conference was held the
following year.
by James Reston
New York Times, Monday July 26, 1971
PEKING,
July 25--There is something a little absurd about a man publishing
an obituary notice on his own appendix, but for the last 10
days this correspondent has had a chance to a learn little about
the professional and political direction of a major Chinese
hospital from the inside, and this is a report on how I got
there and what I found.
In brief
summary, the facts are that with the assistance of 11 of the
leading medial specialists in Peking, who were asked by Premier
Chou En-lai to cooperate on the case, Prof. Wu Wei-jan of the
Anti-Imperialist Hospital's surgical staff removed my appendix
on July 17 after a normal injection of Xylocain and Bensocain,
which anesthetized the middle of my body.
There
were no complications, nausea or vomiting. I was conscious throughout,
followed the instructions of Professor Wu as translated to me
by Ma Yu-chen of the Chinese Foreign Ministry during the operation,
and was back in my bedroom in the hospital in two and a half
hours.
However,
I was in considerable discomfort if not pain during the second
night after the operation, and Li Chang-yuan, doctor of acupuncture
at the hospital, with my approval, inserted three long thin
needles into the outer part of my right elbow and below my knees
and manipulated them in order to stimulate the intestine and
relieve the pressure and distension of the stomach.
That
sent ripples of pain racing through my limbs and, at least,
had the effect of diverting my attention from the distress in
my stomach. Meanwhile, Doctor Li lit two pieces of an herb called
ai, which looked like the burning stumps of a broken cheap cigar,
and held them close to my abdomen while occasionally twirling
the needles into action.
All
this took about 20 minutes, during which I remember thinking
that it was a rather complicated way to get rid of gas in the
stomach, but there was noticeable relaxation of the pressure
and distension within an hour and no recurrence of the problem
thereafter.
I will
return to the theory and controversy over this needle and herbal
medicine later. Meanwhile, a couple of disclaimers.
Judging
from the cables reaching me here, recent reports and claims
of remarkable cures of blindness, paralysis and mental disorders
by acupuncture have apparently led to considerable speculation
in America about great new medical breakthroughs in the field
of traditional Chinese needle and herbal medicine. I do not
know whether this speculation in justified, and am not qualified
to judge.
Hardly
a Journalistic Trick
On the other side, it
has been suggested that maybe this whole accidental experiment
of mine, or at least the acupuncture part of it, was a journalistic
trick to learn something about needle anesthesia. This is not
only untrue, but greatly overrates my gifts of imagination,
courage and self-sacrifice. There are many things I will do
for a good story, but getting slit open in the night or offering
myself as an experimental porcupine is not among them.
Without a single shred
of supporting medical evidence, I trace my attack of acute appendicitis
to Henry A. Kissinger of the White House staff. He arrived in
China on July 9. My wife and I arrived in South China the day
before, just in time.
But when we reached Canton
we were told by our official guide that there had been a change
in our plans. We were to remain in the Canton area for two days
and proceed by rail to Peking on the evening of the 10th arriving
in the capital on the 12th. We debated and asked to fly to Peking
at once, but we were told it was out of the question.
Three days later, at precisely
10:30 AM, while I was describing to several Foreign Ministry
officials at the Peking International Club the unquestionable
advantages of my interviewing Chairman Mao Tse-tung, Premier
Chou and every other prominent official I could think of, Chen
Chu, the head of the ministry's information service interrupted
to say that he had "a little news item."
"Mr. Kissinger had
been in Peking from July 9 to July 11." He said, and it
was now being announced here and in the United States that President
Nixon would visit Peking before May.
The First Stab of Pain
At that precise moment,
or so it now seems, the first stab of pain when through my groin.
By evening I had a temperature of 103 degrees and in my delirium
I could see Mr. Kissinger floating across my bedroom ceiling
grinning at me out of the corner of a hooded rickshaw.
The next day I checked
into the Anti-Imperialist Hospital, a cluster of gray brick
buildings with green-tiled roofs behind high walls of the middle
of Peking.
The hospital had been
established by the Rockefeller Foundation of New York in 1916
and supported by it, first as the Union Medical College of Peking
and later as the Peking Union Medical College.
By coincidence I had had
a letter before leaving New York from Dr. Oliver McCoy, president
of the China Medical Board of New York explaining that his organization
had been responsible for building and running the hospital with
Rockefeller money until it was nationalized by the Communist
Government in January, 1951. Dr. McCoy said that if we should
happened to notice "a large group of buildings with green-tiled
roofs not far from the southeast corner of the Forbidden City,
it might be interesting to inquire what those were." It
was interesting indeed.
My wife and I were taken
to Building No. 5, which is the wing used to serve the Western
diplomatic corps and their families. On the right of the entrance
was a large sign quoting Chairman Mao (it was removed during
our stay). "The time will not be far off" It said,
"when all the aggressors and their running dogs of the
world will be buried. There is certainly no escape for them."
We were taken at once
by elevator to the third floor and installed in a suite of plain
but comfortable rooms with large light-blue-bordered scrolls
of Chairman Mao's poems on the walls and tall windows overlooking
a garden filled with cedars. It was a blazing hot and humid
evening, with the temperature at 95 degrees, but a revolving
fan at least stirred the air. I stripped and went to bed.
Tests and a Checkup
A few minutes later the
two doctors who had originally called on me at the Hsin Chiao
Hotel came in and said they had arranged some tests. They were
Prof. Li Pang-chi, a calm and kindly man who was the "responsible
person" for the case, and Chu Yu, a visiting surgeon and
lecturer at the Anti-Imperialist Hospital.
Professor Li, who understood
and spoke a little English, explained that other doctors would
examine me later and that there would be consultations about
what was to be done.
A parade of nurses and
technicians then slipped quietly into the room. They bathed
me with warm towels. They checked everything I had that moved
or ticked. The took blood out of the lobe of my ear. They took
my temperature constantly, measure pulse and blood pressure
and worried over a cardiogram showing a slightly irregular heartbeat.
They were meticulous, calm and unfailingly gentle and cheerful.
An hour later the consultants
summoned by Premier Chou arrived; surgeons, heart specialists,
anesthetists, members of the hospital's revolutionary committee,
or governing body. Each in turn listened to the offending heartbeat.
I felt like a beached
white whale at a medical convention and was relieved when they
finally retired for consultation and returned with the verdict;
"Acute appendicitis. Should be operated on as soon as possible."
They
sought my decision. It did not seem the time to ask for a raincheck.
Accordingly, at a little
after 8:30 in the evening they rolled me through the dim, hot
corridors to an air-conditioned operating theater and Dr. Wu
Wei-jan, a remarkably bright and lively man with a quick intelligence
and a compelling smile, took over. He bound me tightly but comfortably
on the operating table, put a small iron stand with a towel
over my head so that I could look backward to the interpreter
but not forward, and then pumped the area anesthetic by needle
into my back.
Everything Was Roses
Everything was roses after
that. I was back in my room talking with my wife by 11. The
doctors came by to reassure me that all had gone well and show
me the nasty little garbage bag they had removed. They asked
my interpreter, Chine Kuei-hua, to remain at the hospital, gave
me an injection to relieve the pain and lit a little spiral
of incense to perfume the room for the night.
Since then I have lived
with the rhythm of what must be the quietest city hospital in
the world, constantly regaining strength and acquiring an intense
curiosity about the politics and medical philosophy of the doctors
in attendance.
They insist that the two
cannot be separated and they are quite frank in saying that
the sole purpose of their profession since the Cultural Revolution
of 1966 - 1969 is to serve all the people of China, 80 percent
of whom live on the land.
For this purpose medical
education and medical procedures have been transformed. The
doctors at the Anti-Imperialist Hospital make an average of
about 150 yuan, or $65 a month and take their turn for six months
of more, training barefoot doctors in rural farm and industrial
communes. The is to prepare a medical army of young men and
women for public-health service all over the People's Republic
as fast as possible. Their training begins with political indoctrination
in the thoughts of Chairman Mao.
The Anti-Imperialist Hospital
is run by a four-man revolutionary committee--Tung Teo, chairman
and his deputies, Huang Chung-li, Shen Pao-hung and Tsui Ching-yi--two
of whom are qualified physicians and two of whom are not.
Discussion and Criticism
They meet with the professional
staff of the hospital constantly for discussion of the philosophy
of Chairman Mao and for common criticism of each other and their
work, and they discuss the procedures with the zeal of religious
fanatics, constantly repeating, as in a litany, the need to
improve their work and their moral purpose in the service of
the state.
To understand the urgency
of China's medical problem and its emphasis on the quantity
rather than the quality of medical training, it is necessary
to understand the problem's scope. Edgar Snow quotes Dr. William
Chen, a senior surgeon of the United States Public Health Service
as saying that before the Communists took over this country
in 1949, four million people died every year from infectious
and parasitic diseases and that 84 per cent of the population
in the rural areas were incapable of paying for private medical
care even when it was available from the 12,000 scientifically
trained doctors.
That helps explain the
current emphasis on rapid expansion of the medical corps and
the determination of the Government to increase the use of herbal
medicine and acupuncture.
Dr. Li Chang-yuan, who
used needle and herbal medicine on me, did not go to medical
college. He is 36 years old and learned his craft as an apprentice
to a veteran acupuncturist here at the hospital. Like most young
apprentices in this field, thousands of whom are being trained,
he practiced for years with the needles on his own body. "It
is better to wound yourself a thousand times than to do a single
harm to another person." He said solemnly.
Effects Were Observed
The other doctors
watched him manipulate the needles in my body and then circle
his burning herbs over my abdomen with obvious respect. Prof.
Li Pang-chi said later that he had not been a believer in the
use of acupuncture techniques "but a fact is a fact there
are many things they can do."
Prof. Chen Hsien-jiu of
the surgery department of the hospital said that he had studied
the effects of acupuncture in overcoming post-operative constipation
by putting barium in a patient's stomach and observing on a
fluoroscope how needle manipulation in the limbs produced movement
and relief in the intestines.
Even the advocates of
Western medicine believe that necessity has forced innovation
and effective development of traditional techniques.
Mr. Show quotes Dr. Hsu
Hung-tu, a former deputy director of the hospital as saying:
"Diseases have inner and outer causes. The higher nervous
system of the brain affects the general physiology."
Professor Li said that
despite his reservations he had come to believe in the theory
that the body is an organic unity, that illness can be caused
by imbalances between organs and that stimulation from acupuncture
can help restore balance by removing the causes or congestion
or antagonism.
Dramatic Cures Reported
The controlled Chinese
press is reporting on cases that go well beyond the relief of
pain in the gastrointestinal tract and illnesses of the nervous
system or those of neurological origin. It is reporting not
only successes in treating paralysis and arthritis but spectacular
results in curing blindness and deafness.
While I have no way of
knowing the validity of the reports, the faith even of the professionally
qualified doctors at the Anti Imperialist Hospital is impressive.
Maoism itself has obviously become an infectious disease, even
among many of the well-educated urban citizens who had a hard
time during the Cultural Revolution.
"We are just at the
beginning of all this." Professor Li said as he prepared
to unstitch me and set me free. "We have gone through great
changes in this hospital. We are now treating between 2,500
and 3,000 patients here every day--over a hundred of them by
acupuncture for everything from severe headaches to arthritis--and
we are learning more about the possibilities all the time."
I leave with a sense of
gratitude and regret. Despite its name and all the bitter political
slogans on the walls, the hospital is an intensely human and
vibrant institution. It is not exactly what the Rockefeller
Foundation had in mind when it created the Peking Union Medical
College, but like everything else in China these days, it is
on its way toward some different combination of the very old
and the very new.
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