Until 1972, when President Nixon visited China and doctors with him witnessed surgical operations apparently being conducted with acupuncture as the anaesthetic (or analgesic), acupuncture was little known in the West. One of the few doctors practising and teaching the subject in Britain at that time was Felix Mann; I myself attended one of his courses in 1977. As he explains in a foreword to this book, he originally studied the traditional system under various teachers, including some who were Vietnamese or Chinese; he also studied Chinese to allow him to read the traditional texts. However, he later came to disbelieve much of the traditional lore. This changed opinion resulted from his own observations of patients and also from experiment: he found that putting needles in the 'wrong' places was as effective as 'correct' treatment.
His early books on acupuncture were based on the traditional ideas, being written before he revised his opinions. This one reflects his present position and is therefore non-traditional, not to say iconoclastic. Acupuncture points in the traditional sense, he says, do not exist, and nor do 'meridians' (channels). Also, Mann has introduced some ideas that do not form part of the traditional system, such as the use of periosteal needling and the concept of 'strong reactors' -- people who are particularly sensitive to the effects of acupuncture. As he acknowledges, many acupuncturists disagree with his ideas, but he is unrepentant. Generally, he insists, effective needling sites are not 'points' but rather areas varying in size. In certain patients it makes little difference where the needle is placed, so that anywhere in the body will do; in others anywhere in a particular limb works, or else segmental treatment will be the answer (dermatome, myotome, sclerotome). Some modern acupuncturists regard acupuncture points as identical with trigger points. Mann does use trigger points but he does not regard them as the whole basis of acupuncture. He points out that some areas, such as his favourite Liver 3 in the foot, are seldom tender (which trigger points are, by definition), yet they are extremely effective.
Mann attaches great importance to the idea of 'dosification' in acupuncture. In recent years he has increasingly tended to favour the use of what he terms 'micro-acupuncture'. The needle (usually only one is used) is inserted on one side of the body, to a depth of about 3 mm, and withdrawn without stimulation after a few seconds. He now uses this technique in about 70 per cent of his patients.
The book describes Mann's approach in detail and then goes on to apply it to different body areas. The techniques used are described clearly and are illustrated with good line drawings. Mann's wish to avoid classic acupuncture terminology has led him to devise his own nomenclature for needling sites, so that his favourite Liver 3, for instance, becomes dorsalis pedis/dorsal interosseus area (abbreviated to DPDI). One can understand his motive for constructing this terminology but I have to say I find it cumbersome in practice, and I doubt if it will become widely used.
This is a very readable book, written in a colloquial style. It presents an idiosyncratic view of acupuncture but one that I myself am in sympathy with. I find that what Mann says makes sense to me and corresponds well with what I see in clinical practice. On one or two topics my experience is different. Mann says that he has seen some 30 patients with chronic fatigue syndrome (myalgic encephalomyelitis, ME), all of whom responded as strong reactors. I think his experience has been unusual here; most people, myself included, have found that acupuncture seldom works in this disorder. He is also more impressed by the importance of diet ('rich food') than I am. But these are minor points. I should say that this is one of the best books on acupuncture to have appeared in English.