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What puzzles scientists is that these points and meridians don't correspond to any biological system in the body. How, then, can sticking a needle into the ear, for example, affect a distant organ like the gallbladder? One possible explanation, for which the panel found "considerable evidence," is that acupuncture works at least in part by releasing opioids, natural morphine-like substances, into the central nervous system.
However it happens, scientists know that acupuncture produces measurable changes in the brain. Some of the most compelling evidence presented last week was a series of brain scans taken by Dr. Abass Alavi, chief of nuclear medicine at the University of Pennsylvania Hospital in Philadelphia. Alavi's images showed dramatic changes in regions of the central nervous system that coordinate the perception of pain. "Acupuncture definitely changed the landscape of pain we see in the brain," Alavi told the panel.
Not everyone was persuaded. Dr. Wallace Sampson, a member of the National Council Against Health Fraud, complained that the panel had not invited the naysayers. And although the studies presented were mostly conducted in Western countries using accepted scientific methods, several critics pointed out that the best-designed experiments showed the poorest results.
The future of acupuncture in the U.S., however, will probably not rest on the quality of these experiments. If it's cheaper and less painful than going to the hospital, and if it gets results, Americans will use it. A Boston University researcher told the panel that the saving from just faster stroke rehabilitation and effective carpal-tunnel-syndrome treatment could cut the nation's annual medical bill by $11 billion. Such a saving is sure to catch the eye of HMOs and private health insurers. As Daniel Cherkin, a senior scientific investigator for a large HMO in Seattle, puts it, "Why something works is not of interest to those individuals and organizations providing care." What matters these days is that it works for less.