G.A. Ulett and S.P. Han (2002) The Biology of Acupuncture Warren H Green Inc., St. Louis, USA 160 pages, £20.50
(Reviewed by Dr Gordon Gadsby, EJOM Vol. 3 No. 2)
The authors describe their book as ‘a scientifically supported explanation of the basic biological mechanisms and processes underlying the practice of traditional Chinese acupuncture’. They argue that whilst acupuncture is still mainly performed as a mystical ritual, explained in pre-scientific terms of hypothesized meridians, acupuncture points, qi, yin/yang, pulse diagnosis etc, there is now a wealth of scientific knowledge available to support a simpler more effective approach to acupuncture treatment called ‘neuro-electric acupuncture’ (NEAP) or ‘needleless electro-acupuncture’. The authors review more than thirty years of stringent research from Han’s team at Beijing Medical University and elsewhere that support this approach to acupuncture and reveal the real meaning and neuro-biological equivalents behind traditional acupuncture practice.
The first chapter contains a brief introduction to the background of the book, the author’s own research and the development of needleless electroacupuncture, together with observations on Professor Jisheng Han’s work at Beijing Medical University. The authors claim that there is no need to study ancient Chinese philosophical beliefs or needling techniques at all, for scientific acupuncture is a simple technique that uses electrical stimulation via electrically conducting pad electrodes applied to acupuncture points. Such stimulation induces gene expression of neuropeptides in the central nervous system, thus assisting the body’s homoeostatic healing mechanisms.
The second chapter provides an interesting and detailed examination of historical developments in traditional Chinese acupuncture over the past 3,500 years, with observations on the Shang dynasty, the Yellow Emperor, Confucianism, Taoism, Buddhism and other mystical beliefs, many of which eventually formed the so-called ‘folk religion’ of China. These ancient philosophical concepts all played a role in the formation of the traditional Chinese theories of health and healing, many of which have survived to the present day. The chapter ends with a review of the development of electro-acupuncture to neuro-electric acupuncture, from 1764 to the present day approach, with its scientific basis.
The third chapter examines the role of the placebo effect in health care interventions, but with an emphasis on the strength of the placebo action in traditional acupuncture as compared with scientifically based neuro-electric acupuncture. Ulett’s own studies are also described, which show that electroacupuncture is equally as effective as morphine and twice as effective as traditional needling for pain relief.
The fourth chapter examines pain pathways and neurophysiology in relation to nociception, and is a useful revision text. Acupuncture and electro-acupuncture stimulation of acupoints, especially he gu (LI 4), is also examined, together with the related electro-neurophysiology, forming a basis for patient treatment.
The fifth chapter examines the neurochemistry of electro-acupuncture and is perhaps the most important chapter in this book, worthy of careful reading. A selection of important studies by Ji-Sheng Han and his team over the past thirty years is examined in some detail, together with the relevant work of others. The studies reviewed here have led to a scientific understanding of the neurochemical mechanisms of neuro-electric acupuncture. They include work on acupuncture and pain thresholds, acupuncture tolerance, transferring the analgesic effect from one animal to another, opioid receptor antagonists, electroacupuncture and neurochemical release, frequency specific effects, advantages of ‘dense-disperse’ treatment modes, comparison of frequency-determined analgesic effects, heroin detoxification, and a guide to the selection of optimum treatment parameters.
The sixth chapter describes the clinical uses and evidence base of neuro-electro acupuncture in the treatment of many conditions, including pain management in general, headache, back pain, nausea and vomiting, stroke, addiction, gastrointestinal disorders, psychosomatic conditions, depression, conditioned healing and so on. It slowly becomes clear from the evidence that not only is neuro-electric acupuncture essential for the best possible acupuncture treatment responses, but that specific frequencies of stimulation may well be useful for treating different clinical problems. Furthermore, it is not the needles nor the meridians and manipulation of qi that are the salient factors in treatment, but rather the selection of appropriate electrical parameters together with strategic electrode placement, and that the archaic rituals of traditional Chinese acupuncture are no longer necessary.
The seventh chapter describes methods of electro-acupuncture treatment, with an examination of appropriate acupuncture points, motor and trigger points, cutaneo-visceral and viscero-cutaneous reflex points, ear points and neurotomes, and also guidance for appropriate point selection for specific treatments. Sections follow this on treatment positions, electrode placements, the selection of electrical parameters, intensity of stimulation, frequency of treatment, side effects and some general rules of administration as suggested by the authors.
The final three chapters contain an atlas with descriptions and locations of useful acupuncture and motor points, some useful hints on neuro-electric acupuncture treatment parameters and management, twelve case studies and finally a pictorial review of ancient metaphysical acupuncture.
So what does this book tell twenty-first century acupuncture practitioners and physicians about the use of needleless neuro-electric acupuncture, and why should they consider using it in preference to the traditional Chinese needling methods based on so-called ‘obsolescent metaphysics’? The detailed evidence base for neuro-electric acupuncture, in comparison with traditional acupuncture, is clearly set out for the reader to examine, together with guidance on the clinical applications of needleless techniques in practice. This book is therefore an excellent introduction to the ‘biology of acupuncture’ and the basic principles and practice of scientific neuro-electric acupuncture. Evidence is also presented which confirms the needleless approach to be just as effective as electro-acupuncture through needles and twice as effective as needling alone – surely worthy of careful reflection. This book should appeal to all acupuncture practitioners, traditional or modern, as well as physicians and others interested in learning and using a scientific evidence-based approach to acupuncture treatment. Whilst we may not readily agree with everything Ulett and Han have to say in their book, we cannot ignore their stimulating presentation of an important evidence based contribution to the knowledge and practice of acupuncture. However, there may be some difficulty for those among us who have spent a considerable amount of time, and thousands of dollars/pounds, learning traditional pre-scientific concepts and needling techniques, to abandon them for a comparatively simple and evidence-based approach to effective acupuncture treatment. Nonetheless, this book will enable us to consider the scientific evidence, to reflect on the issues of acupuncture practice development, and the potential benefits of this approach for both practitioners and patients. The book can be ordered from the UK publishers Gazelle Book Services Ltd at
It is well worth reading - who knows - you might even decide to try this approach for yourself and implement it in your own practice?
Dr Gordon Gadsby Dr Gordon Gadsby has been in private practice in England for more than twenty years as a clinical nurse specialist in neuro-electric acupuncture and hypnosis. He has a PhD in the historical and contemporary developments in electroanalgesia from De Montfort University, Leicester, UK.