There may be a point to ancient treatment
It is no surprise that Angelina Jolie attributed her Bell’s palsy recovery to acupuncture
The introduction to the West of the traditional Chinese treatment of acupuncture is attributed to an article in the New York Times in 1971 by veteran journalist John Reston, describing his emergency appendectomy in Beijing’s Anti-imperialist Hospital when covering president Nixon’s visit to China. The operation itself was performed under local anaesthetic, but when he subsequently developed cramping abdominal pain, the hospital’s acupuncturist inserted three long needles into his right elbow and below his knees. “All this took about 20 minutes, during which I remember thinking it was rather a complicated way to get rid of gas in the stomach,” he wrote. “But there was a noticeable relaxation of the pressure and distension within an hour and no recurrence thereafter.”
Since then acupuncture has become much the most popular, if perplexing, form of complementary medicine and it is no surprise to learn, as reported in this newspaper last week, that the legendary Angelina Jolie attributed her recovery from Bell’s palsy last year – after splitting with husband Brad Pitt – to a course of the needling treatment. This is scarcely evidence as to its efficacy for, as most will know, Bell’s palsy usually resolves spontaneously within six weeks.
The difficulty of establishing the value of acupuncture in a way that meets current standards for rigour and avoidance of bias has been solved by comparing it to a “sham” procedure – with the use of toothpicks that do not penetrate the skin. And here two recent clinical trials are of considerable interest.
The first was a comparison with the standard fertility drug Clomiphene in women who had polycystic ovarian syndrome and who were having difficulty conceiving. Predictably, significantly more taking the Clomiphene became pregnant. There was, however, no benefit for those who underwent either real or sham acupuncture. This is clearly important for those with fertility problems who may be tempted to resort to acupuncture. The second refers back to John Reston’s experience. The director of surgery at the Anti-imperialist Hospital informed him that barium studies had shown that the acupuncture treatment he received improved gut motility following abdominal operations. Last year, doctors of the Academy of Chinese Medical Sciences in Beijing indeed confirmed “real”, but not sham, acupuncture, to be a highly effective treatment in patients with chronic severe functional constipation. Fascinating.
Itchy ears
The conundrum of the gentleman with the painful red itchiness at the top outer edge of his ears has prompted a diverse medley of possible explanations. Several readers have suggested it is likely to be the impressive-sounding chondrodermatitis nodularis helicis (literally a nodular inflammation of the skin and cartilage of the helical pinna of the ear), attributed to the pressure between the head and pillow in those who sleep predominately on one side. For obvious reasons this tends to be unilateral, which would be against the diagnosis in this instance.
“The culprit was finally identified when I stopped using a well-known shampoo and conditioner,” writes one lady, while, from personal experience, retired ophthalmologist Graham Kirkby attributed it to allergy to pollen as the rash always coincided with his severe hay fever. Finally, there is juvenile spring eruption – itchy red lumps that evolve into blisters and crusts – that curiously only affect males (boys and young men) and tend to occur in mini-epidemics in March and April. This is attributed to a sensitivity to light.
Recurring nightmare
This week’s medical query comes courtesy of Mrs AV from Halifax, whose sleep virtually every night is disturbed by vivid nightmares recreating terrible events that have occurred in her past, “evoking the same emotional and physical upsets that accompanied them”. Might anyone, she wonders, with the same harrowing experience, have discovered some method of avoiding them?