QUICK, NAGAYAMA, THE NEEDLE
Most trainers and team physicians in this country either know nothing about acupuncture or are against it, or both. The great majority of American medical men and athletes alike still scoff, if they have heard of them, at the notions of Yin, Yang and Ching Lo (though they have no difficulty accepting Ping-Pong). It is not likely to happen soon that someone in a dugout will yell "Stick it in his ear!" and a sore-armed pitcher sitting beside him will say, "That reminds me, I see by The Journal of the American Medical Association that the German Society of Acupuncture reports 'amazingly rapid remissions brought about in cases of long-standing severe rheumatic pain by insertion of needles into the external ear and leaving them in situ for periods varying from 10 minutes to six hours.' "
But at least seven prominent U.S. based athletes have recently had needles inserted into various of their alleged Ching Lo points, and most of them have reported that it made them feel somewhat better. Certainly the claimed applications of acupuncture are relevant to many of the most common and frustrating ailments. The question of acupuncture in sports warrants poking into.
Eons ago, the story goes, Chinese warriors found that when they were pierced by arrows in certain parts of their anatomy they felt better (than they had before) in other places. Early Chinese medicine men kept track of these puncture points, described by 12 Ching Lo channels or meridians connecting them all, and eventually substituted needles for arrows, explaining the whole system according to the Yin-Yang theory of Taoist philosophy. Thus acupuncture, along with various herbal remedies, became the foundation of traditional Chinese medicine. Over the centuries acupuncture spread in various forms throughout Asia. Within the last 30 or 40 years it has attained some status in Russia, England, Germany and especially France, where an estimated 600 practitioners give more than a million treatments a year. Several French hospitals permit acupuncture to be prescribed and administered.
Then last year, thanks to Ping-Pong, Americans began to visit China. James Reston of The New York Times had post-appendectomy pain relieved by acupuncture, and several prominent U.S. doctors came back impressed by such anesthesiological sights as that of an acupunctured patient chatting and eating a can of fruit while his chest was cut open. The President's personal orthopedist reported seeing acupuncture used to cure the Chinese equivalent of tennis elbow.
In New York and elsewhere acupuncture research projects are being set up. Some responsible U.S. medical men are beginning to believe not only that acupuncture can work but also that the way it works may not be all that inscrutable. Pain-suffering U.S. athletes-including such notable patients as Willie McCovey and Sam McDowell of the San Francisco Giants—are beginning to add it to the list of remedies they will try.
On the other hand, the prevailing attitude in the athletic training room is one of skepticism. "I predict that acupuncture will have a growth in popularity and then fall off," says Baltimore Colt Trainer Ed Block. "It's similar to these fad diets." But Block concedes that the points at which acupuncturists insert needles might be the same as the "trigger areas, the referred areas of pain," which he has mapped out on a chart and which he treats with massage and ice.
"We do not use acupuncture, have not and do not anticipate using it," says Philadelphia Eagle Trainer G. E. (Moose) Detty. Still, in 1956 Detty saw a Taiwanese runner's pulled hamstring—an injury that is liable to keep an Eagle out for two or three weeks—cured in a few days with acupuncture, and ever since Detty has been collecting literature on the subject. He has a large acupuncture library that includes a copy of The Yellow Emperor's Classic of Internal Medicine, written over 2,000 years ago. But most of Detty's books are in French or Chinese, neither of which he can read.
Ed Lothamer, the 270-pound defensive tackle for the Kansas City Chiefs, lost his skepticism altogether. Lothamer had no idea that he would soon be decorated with gold and silver needles, silver balls, inked Xs and pink tape when he first met Dr. Kunzo Nagayama, president of the Pain Control Institute of Kyoto, Japan, who was in Kansas City visiting a chiropractor friend, Dr. Richard D. Yennie. Lothamer, who spends a good deal of time at Dr. Yennie's judo-karate school, had been suffering stiffness and recurrent pain in his lower back for some eight months—ever since he felt something snap there while he was lifting 500 pounds from a squat. And recent bouts with the flu had left him with a low energy level, commonly known as the blahs. Drs. Nagayama and Yennie suggested he try acupuncture.
"I was skeptical about it," Lothamer says, "but then I decided, why not? First Dr. Nagayama said he wanted to take my pulse. Take off your shirt,' he told me.
"It turned out he wanted to take my pulse not on my wrist but at various places on my back. He patted it all over and said I had good circulation in my upper back but that it wasn't so good down lower."
Dr. Nagayama concluded that the flow of vital energy in the Ching Lo meridian associated with the lower back had to be stimulated. The classical and possibly sexist Chinese diagnosis would be that there was too much Yin, or feminine, negative static energy down there, clogging up the spiritual works, and therefore some Yang, or masculine, positive, dynamic energy had to be stirred up to restore the balance.
"He started by sticking one needle into my hand," reports Lothamer. "I hardly felt it. Then he began probing my back with his hands and every time he'd find a spot where I reacted because of soreness he'd mark an X on it with a pen. He marked about 25 places and then he picked out 20 of them and began inserting needles. They looked like they were made of gold and silver and were about the size of the filament in a light bulb. I hardly felt them going in. He left them in for from three to five minutes, occasionally vibrating them.
"Next he put two larger needles in my back and drew about two centimeters of blood. He withdrew these needles and where they had gone in he placed two small silver balls, taping them in place with small squares of pink tape. He told me to leave the balls in place for three days but didn't explain why. Next he put needles in each of my calves and one in each ankle. Then he put one in the middle of my stomach and when he took that one out later he taped one of the silver balls where the needle had made a small hole. After that he put three needles in each of my arms. While he was inserting one of them in the outer side of my right forearm I suddenly felt my whole right hand go dead. This sort of upset me but he said this effect was perfectly normal."
Also normal, according to advocates of acupuncture, were the effects that Lothamer says he began to feel shortly after the removal of the needles. His energy returned, and it has remained. He now feels "more circulation in my back than I've had for years. My back has taken quite a beating in four years of college and eight years of pro ball and for a long time that area hadn't felt very much alive." Lothamer finds that he no longer feels stiff in the morning if he lies the wrong way at night, and whereas he used to tighten up after jogging half a mile, he can go nearly two miles now with no trouble. Lothamer thinks that pro teams should try acupuncture.
Chi Cheng, the world's fastest woman except for pain, cannot give acupuncture such high marks. For several months she had suffered unbearably in her thighs when she tried to sprint. The condition had been diagnosed as acute tendinitis or bursitis, but Western medicine failed to improve it. In March Chi Cheng returned to her native Taiwan for treatment by traditional Chinese medicine.
She did not expect this to include acupuncture, which she had already undergone fruitlessly eight times in California with a woman doctor named Wu. But after two sessions a day for two weeks with a Chinese specialist in massage and osteopathic manipulation failed to help her, she was referred to Dr. Chin Pao-Te, who stuck a dozen needles, some several inches long, into her hands, legs and lower back.
When the doctor inserted the needles, and when he twirled them occasionally before removing them half an hour later, Chi Cheng found the pain "excruciating." She reacted similarly to a murky-looking herbal liquid that he gave her to drink. This potion smelled so bad that she could swallow only half of it, while holding her nose, and then she vomited. Shades of Rosemary's Baby. A second acupuncture was scheduled, but by the next day Chi Cheng had decided to forgo it. "They say it shouldn't hurt," she said, "but I call it my Chinese torture."
Dr. Chin was not easily put off. He argued that the distress she had complained of was not really pain but "suan tung"—an aching or feeling of electricity caused by stimulating the nerves, which he said is a necessary part of the cure. Chi Cheng said she did not know about suan tung but her pain was severe. When the doctor insisted that part of the problem—aside from the wasted potion—was her inability to distinguish between pain and suan tung, Chi Cheng told her American husband, Vince Reel, in English, "These people really know how to talk. They should be politicians." At length she decided to have a muscle removed from her thigh.
Acupuncturists in Taiwan claim good results in treating athletes' ankle sprains, but Reel believes that the Chinese doctors failed to appreciate Chi Cheng's problem because they are unfamiliar with the tremendous strain placed on the body by world-class athletic training and performance. At any rate, Chi Cheng's experience would indicate that acupuncture is not likely to send Willis Reed and Joe Namath scampering like boys onto the basketball courts or playing fields again.
What little literature exists about acupuncture in English is enough to establish that there is no real consensus about what it will cure—or even about how many acupuncture points there are; figures range from 365, one for each day of the year, to over 1,000. But few of its proponents claim that it can quickly repair serious anatomical damage, such as broken bones or ravaged cartilage. It is supposed to be effective against tendinitis, bursitis, arthritis and other complaints that afflict athletic joints, but then so, to some extent, is cortisone. Cortisone helped Sandy Koufax, but he still had to retire—not because arthritis cramped his style but because doctors told him that if he kept on pitching his arm could be permanently crippled.
If the pain in a pitcher's elbow or a sprinter's thigh is straightforwardly telling him or her that the tissues can't take the strain much longer, there is no reason to believe acupuncture can make it well. What it might do is reduce the pain and swelling, allowing the injured part to resume its normal function—and perhaps hasten a cure if the athlete takes it easy. But, like cortisone or novocaine, acupuncture might also get him through a game, a series or a season by overriding the body's warning signal—pain—which could increase the damage if he goes all out.
And yet acupuncture did Lothamer good. Last spring it helped Sam McDowell, then of Cleveland. "The muscles of my left shoulder have a tendency to tighten up because of inactivity during the winter," McDowell says. "It takes two to three weeks of hard work to break the adhesions and loosen up the arm. Last spring because I was so late going to camp I didn't have time to follow my normal routine." So when Tokyo's Lotte Orions came to play an exhibition against the Indians, McDowell asked their trainer for some needlework. "The next day, believe me, the arm was as loose as it ever had been. Amazing, really."
Many skeptics react to such reports as McDowell's in the manner of Dr. Robert Kerlan, the orthopedic surgeon who has treated Koufax, Reed and nearly every other big-name athlete with severe joint problems. "I'd hate to call Sam hysterical," Kerlan said, "but his [recurrent arm] problem seems to be complicated by a definite psychological overlay. A highly suggestible individual will respond to any concept at least for a while. I don't think Reed or even Koufax falls into that category."
A similar reaction is that of Dr. Theodore Fox, another orthopedic surgeon who is team physician of the Chicago Bears: "Acupuncture, I believe, has no scientific validity, but is a form of hypnosis...like a posthypnotic suggestion when a person is awakened and told that his headache is gone. Take the case of a chronic worrier, who develops peptic ulcers because of increasing his peptic juices and acidity. His mind, not his body, is causing the problem. If you tell such a man, athlete or not, that you'll slick a needle in his arm and that another part of his body will cease to hurt...he could believe it."
Well, the San Francisco Giants, because they have trained the last two springs with Japan's Lotte Orions, have been exposed to acupuncture more than any other U.S. team. Chris Speier thinks acupuncture helped his back spasms. Juan Marichal thinks it helped his arm. Jerry Johnson thinks it helped his elbow. Willie McCovey won't talk about his leg problems anymore, and his recent broken arm has temporarily mooted the issue, but he submitted to acupuncture this spring for pains in his hip. McCovey does not seem the suggestible type. As a matter of fact, acupuncture is less popular in Japan now than before World War II. American medical experts on the staff of General Douglas MacArthur were so horrified upon encountering the practice during the occupation that they had to be talked out of outlawing it, and Western medicine has become more fashionable than Eastern in Japan in recent years. Yoshisada Komori, the chief trainer of the Tokyo Giants, is flatly opposed to acupuncture, although lie is qualified to perform it and his father was among the best acupuncturists in the country. "I insist on going the American way in Heating our boys," he says. "I feel I must. After all, baseball was born in America, you know."
But the practice retains considerable stature in Japan. During the 1964 Olympics, Japan's great gymnast, Yukio Endo, began suddenly to suffer acute shoulder-muscle pains. A top acupuncturist treated Endo in the locker room and he recovered to win a gold medal. And most Japanese baseball trainers get out their needles fairly often, at players' requests, to relieve sore forearms, elbows, shoulders and waists. Pitchers most often ask for acupuncture. One day in 1963 pitching ace Noboru Akiyama of the Taiyo Whales failed to finish a single inning because of fierce elbow pains. The next day, after the Whales' trainer applied acupuncture, Akiyama went nine innings and won. Japanese pitching arms, by the way, are noted for their endurance and resilience in comparison to American. When Alvin Dark was manager of the Giants, his own bursitis was so improved by two acupuncture treatments that he wanted to hire a Japanese specialist for the team, but he was talked out of it by American doctors.
Maybe all these sporting figures, East and West, felt better after acupuncture just because they thought they did. But the Chinese are using acupuncture to anesthetize animals. There are no recorded instances of hunting dogs or racehorses being prepared for their sport by acupuncture, but Dr. Jacques Milin, a leading French acupuncteur, claims to have cured paralysis in dachshunds and chronic pulmonary emphysema in the horses of France's national police.
Maybe these were highly suggestible dachshunds and police horses, but the distinction drawn by Drs. Kerlan and Fox between mind-induced and body-induced pain is one that means less and less to current pain researchers. The mind is always involved in pain in a number of ailments that contemporary flesh—athletic or sedentary—is increasingly heir to. One French acupuncturist says that his practice is "the medicine of the future, because it deals so effectively with the ills of civilization." These ills include insomnia, constipation, sexual impotence, minor neuroses, asthma, sinusitis, arthritis, migraine and sciatica. And no doubt a great many post-Iron-man-McGinnity sore arms.
All these complaints entail mental stress, but that doesn't mean they are imaginary. Nor does it necessarily mean that any effect acupuncture might have on them is the same effect that any placebo advertised as a panacea might have.
There are scientific grounds for believing that acupuncture is more than mumbo jumbo. Some experiments have shown, for instance, that electrical resistance is lower at acupuncture points than at other points on the skin. And researchers hypothesize that stimulation of the Ching Lo is actually stimulation of the nervous system, or of those nerve fibers that transmit sensations other than pain. According to one recent medical article, Professor Kim Bonghan of Korea even claims to have discovered "groups of egg-shaped cells at acupuncture points that are united to one another by bundles of hollow tubular cells corresponding to the meridians. These tubular cells also connect the acupuncture points to the internal organs. If the bundles of tubular cells are divided, stimulation of the acupuncture points has no effect." Professor Bonghan calls this a fourth system of communication—the others being nervous, vascular (blood) and lymphatic.
No one, even in China, has come up—with an accepted scientific explanation for acupunctured methodology, but it might not be too outlandish to consider the Yin-Yang explanation as partly valid: that needle-twirling restores a balanced state of tension in the body's energies. Modern theorists suggest that "the ills of civilization" are caused by, in one specialist's phrase, "maladaptation of the body to stress," a kind of psychic overkill. If bodily distress is caused or characterized by ill-organized (perhaps bunched-up) tension within the tissues, and if tension is transmitted by the nervous system or some other bodily conduit, then it seems conceivable that acupuncture can have at least some therapeutic and anesthetic value.
No one has ever done chest surgery with any sort of rubdown as anesthesia, but massage has long been an integral part of medicine in China. When Marilyn Monroe came down with severe stomach cramps during her Tokyo honeymoon with Joe DiMaggio, DiMaggio called onetime acupuncture patient Lefty O'Doul. O'Doul sent over a Japanese doctor who gave Miss Monroe's abdomen almost immediate ease by pressing with his thumbs at the right spot between her shoulder blades. The doctor himself left somewhat agitated, having been "profoundly moved by her loveliness." Science cannot explain how massage works.
Nor—points out Dr. Frank Z. Warren of New York's Postgraduate Center for Mental Health—can science explain how aspirin works. All that American doctors know is that aspirin does relieve such things as headache and peripheral pains of arthritis, so they prescribe it. And it sometimes has harmful side effects. "Acupuncture is Chinese aspirin," says Dr. Warren. "Of the two, I would choose acupuncture."
Dr. Warren, a former anesthesiologist now in psychiatric practice, is chairman of a committee appointed by New York Health Commissioner Joseph Cimino to study acupuncture. One purpose of the committee is to end the type of acupuncture practice that flourishes in New York's Chinatown—often in the hands of people who do not sterilize their needles and who turn out to have been laundresses or investment bankers back in Hong Kong. When one acupuncturist is asked about another, Dr. Warren says, he is likely to reply, "Oh, he fine man, but he no acupuncturist."
No one, says Dr. Warren, should go around sticking needles in people without long training in the art, and he can advise no one to submit to acupuncture without first trying everything orthodox medicine has to offer and then consulting a doctor. But new research seems to indicate that acupuncture will prove more than a fad, Warren says, and he has himself had an old knee injury relieved by a Chinatown needle man. A piece of cartilage popped out of place when he was playing high school foot-ball, and from time to time it pops back out, causing considerable pain, swelling and immobility. Always before, he had to go easy on the knee for two weeks, as the swelling first enabled the cartilage to slip back into place and then slowly went back down. With acupuncture the same natural healing process took only a couple of days.
"When the body is injured," Dr. Warren explains, "histamines are discharged, starting a chain reaction that makes the pain worse." In other words, the body—even without the aid of hypochondria—overreacts or maladapts to stress. It has been found that acupuncture somehow interrupts the reflex-are of the pain, dispels the histamines and keeps the inflammation to a minimum. Cortisone has a similar effect. But cortisone also has side effects—last year when Tony Conigliaro was having "emotional problems" as a California Angel, it was observed that he had just undergone cortisone treatment, which sometimes produces emotional confusion.
"This country is too drug-oriented," says Dr. Warren. "Any procedure that will reduce the introduction of toxic foreign agents into the body is to the good. Acupuncture could knock out 90% of the inappropriate drug usage in the Western world. I'm for that."
A good deal of what is believed in the East about acupuncture. Dr. Warren feels, "has its roots in mythology." But he has seen the effects of acupuncture on his knee—and on people who could not be helped with Western methods. "What will develop here," he says, "is American acupuncture. It won't be limited by notions about gold and silver needles. It will use sanitary, disposable needles. The acupuncture developed here will be as Chinese as chop suey. Which is not Chinese, but it works."
So acupuncture might eventually make its way into the mainstream of U.S. sports medicine without trainers having to translate the Yellow Emperor's book or fool around with little silver balls or get into embarrassing conversations with an athlete about his Yin and Yang. They might want to remember that term the acupuncturist pulled on Chi Cheng, though: "Your arm don't hurt, that's just a little suan tung."
PHOTO
DR. NAGAYAMA EQUALIZES YIN AND YANG IN TACKLE ED LOTHAMER'S FOREARM