We went one morning to observe a brain operation using acupuncture anesthesia, at the Worker-Peasant Soldier Hospital attached to the Shanghai No. 2 Medical College. When we entered the operating-room in sterile gowns, caps and masks, the patient, a 38-year-old worker named Liu Wen-chang, was lying calmly on the operating table, draped with a white sheet. He was to have an operation for brain tumor on the left side. The tumor was growing, and if not removed would cause general paralysis and eventually the patient's death. A growth in the right of the head usually causes paralysis of the left hand and foot, and vice versa. But Liu Wen-chang's case was quite different. Six months before he had a convulsion and since then progressive loss of muscle tone of the left arm and leg, until his left hand and foot were almost totally paralyzed. But the operating team was confident. "We're sure the operation will be successful and the patient safe," said the surgeon.

Anaesthetization began at 9:15. The anesthetist, instead of using the complicated anesthesia apparatus in a corner of the room, applied several needles to the patient's left ear. The patient counted, "One, two . . ." and at the fourth, said, "There's one more." We wondered how the patient knew how many needles had to be inserted until we learned that before the operation the medical workers had explained the whole process of the operation to the patient, and told him the problems that might arise, so that he could co-operate consciously with the team. When all five needles were in position, they were connected with fine wires to a transistor which vibrated them rhythmically (several hundred times per minute), instead of twisting them by hand. After some minutes the anesthetist said, "Now we'll step up the stimulation to produce a feeling of combined soreness, swelling, heaviness and numbness." When the patient feels these in the part to be operated, the anesthesia has taken effect.

It was 9:50. The chief surgeon went to the operating table while the anesthetist increased the stimulation to the needles for most effective anesthesia.

The surgeon swiftly made an incision 96 sq. cm. in area on the patient's scalp. As the scalp is most sensitive, cutting it would ordinarily be excruciatingly painful, and this was a major test of the analgesic effects of acupuncture anesthesia. The patient remained calm and obviously felt no pain. We asked him how he felt.

"All right," he smiled. "Only a little sore in my scalp and stomach. I'm sleepy."

A nurse brought him a cup of iced water. He took a few sips and lay back quietly on the operating table. At 10:05, with the incision in the scalp completed, the surgeon called for a hand-drill and said, "Old Liu, we're going to drill into your skull. Don't be afraid."

"I'm not afraid. Go ahead."

After drilling the first hole in the patient's skull the surgeon asked him if he felt uncomfortable.

"I'm all right. Can I move my legs a little?"

"You can," said the surgeon.

In ten minutes five holes were drilled in the patient's skull. Then with a saw that looked like a silver thread he opened the skull, exposing the cerebral membrane criss-crossed with blood vessels and nerves.

At 10:30 the battle to locate the tumor in the cerebral tissues began. The surgeon carefully separated the cerebral membrane and quickly found the tumor among the other tissues. The patient remained calm while this was being done. At this stage of the operation the requirement for analgesia was less, so the frequency of needle vibration was reduced. The task now was for the surgeon to work carefully and ensure safety.

The atmosphere was tense, as each member of the operating team concentrated on doing his job conscientiously. The team member in charge of blood transfusion saw that blood dripped steadily into the patient's body, and another kept close tab on his blood pressure and pulse. The chief surgeon and his two assistants began removing the tumor bit by bit with forceps.

At 10:40, when the operation was well under way, the patient was suddenly dazed and seized with convulsions so violent that the operating table shook. Emergency acupuncture and sedatives were administered and the convulsions and coma ceased. It was 10:50. The patient said he felt cold, and the nurse spread a coverlet over him.

The surgeon told us that such convulsions, which sometimes occur in brain surgery, were not caused by the needling but by pulling on the cerebral cortex in the motor area in the course of removing the tumor.

As the seconds ticked by, the surgeon extracted the tumor bit by bit from deep inside the skull. When light from the shadowless lamp failed to penetrate to such depth, a stand lamp was used.

"The tumor has spread to the right," the chief surgeon stood up and said.

At 12:50 the entire tumor had been removed. The surgeon asked the patient first to move his right leg and then the left. He did this satisfactorily. Then the surgeon stretched out one finger and the patient said he could see it clearly.

"He's all right," the surgeon said. "None of his organic functions is affected and there's no bleeding. We can suture the wound now."

The anesthetist increased the stimulation to the needles. "Sewing up the scalp is more painful than cutting into it. We've had patients who couldn't stand it," he explained. "Nerves have the property of inertia, and continuous strong stimulation may result in diminished analgesia at the latter stage of an operation. We reduced stimulation mid-way of the operation so that we could use a strong stimulation now and induce better analgesia." There was a lot of dialectics in this.

After checking instruments and cotton sponges, the wound was closed, first the cerebral membrane, then the skull bone and finally the scalp.

The patient was in fine spirits at 13:40. The operation was over. It had been done with the patient conscious. He felt no pain though his five senses were functioning. It seemed wonderful that a few slender needles had produced the anesthesia! The operation was highly successful. As soon as the surgeon finished dressing the wound, the smiling patient sat up on the operating table and, facing a portrait of chairman Mao, cheered: "Long live Chairman Mao! A long, long life to Chairman Mao!"

In the past, when brain surgery was done with general anesthetics, the patient was left unconscious at the end of the operation. Some regained consciousness only several days later. Whether an accident had occurred in anesthesia or in the operation was often not known to the surgeons themselves. Infections of the respiratory tract, pneumonia and other complications often followed inhalation anaesthetization. Acupuncture anesthesia prevents these complications which often resulted in the brain surgery patient's death.

The surgeon's ability with acupuncture anesthesia to continue the operation safely when the patient Liu Wen-chang had a sudden attack of convulsions reminded us of the struggle that took place when this method of anaesthetization was first introduced in neurosurgery. In a vain attempt to nip it in the bud, the exponents of Liu Shao-chi's counter-revolutionary revisionist line in health work raved that acupuncture was a "step backward in anesthesiology", that it might be used in minor operations but not in major ones. When facts proved otherwise they challenged, "Can you cut the head open with it?" They didn't believe it was possible to apply acupuncture anesthesia in brain surgery, itself a new branch of China's medical science. This patient's skull had been opened and an extensive tumor removed. Moreover, with acupuncture anesthesia brain surgeons have performed operations of the third ventricle with success. With acupuncture anesthesia they have also undertaken with success a thalamencephalic operation, said to be a forbidden zone by Western medical scientists. Bourgeois "specialists" maintained that convulsions interdicted the use of acupuncture anesthesia, and that the death rate of patients so seized during the operation was bound to be high. These medical workers, however, armed with Mao Tsetung Thought and with indomitable revolutionary spirit, have opened another "forbidden zone" in brain surgery. After such an operation, Liu Wen-chang has regained his health and returned to work in his factory.