Felix MannBMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6322 (Published 27 October 2014) Cite this as: BMJ 2014;349:g6322
- Alexander MacDonald
Felix Mann was an inspiration to doctors who wanted to find out more about acupuncture. He himself had gone from Malvern College to Christ’s College, Cambridge; to Westminster Hospital; and on to Ottawa; to return to Europe via Strasbourg, there to become medical assistant to Jean Scoch, whose anthroposophical thinking encouraged doctors to continue to observe phenomena faithfully, even when no explanation or even the ghost of an underlying theory is on offer. Felix once showed me his library, which contained part of his inspiration—the complete works of Goethe. This way of thinking was praised by Aldous Huxley in a preface to one of Felix’s books, “From telepathy to acupuncture, unusual facts get ignored by the very people whose business it is to investigate them—get ignored because they fail to fit into any of the academic pigeonholes and do not suffer themselves to be explained in terms of accredited theories.”
Given permission to proceed in this way allowed Felix to cope with the apparently bizarre practice of acupuncture, where, for example, recurring headaches can be relieved by a few sessions, where only one needle may be placed in the foot. This was the subject he studied in Munich, Vienna, and Montpellier, and finally in China, where he learnt to read Chinese.
With a flair for timing, Heinemann published some of his beautifully written books in time for US President Richard Nixon’s visit to Chairman Mao Zedong in 1972. Before ordering American universities to investigate acupuncture, President Nixon said, “There is no place on this small planet for a billion of its potentially most able people to live in angry isolation.” Suddenly Felix, who by this time was ensconced in Devonshire Place, London, received worldwide attention, as his books had become the latest and almost only intelligible source of information on the subject—at his behest, one of these, Scientific Aspects of Acupuncture, is still freely available on the internet. Meanwhile he was calm and thoughtful enough to invite doctors, many of whom were distinguished names in their own countries, to sit in his consulting room and learn what on earth this “new” story was about.
I met him one day in 1974. Here I found myself speaking to a doctor who had found out the Chinese acupuncture method worked in a trice for back pain—this caught my attention as it happened to be a condition I presented with. Indeed as I watched him treating a patient for difficulty in flexing her little finger while playing the violin, an instrument she needed to play as she was travelling the world in various orchestras. He employed one needle with no syringe attached and inserted it into her forearm—within a few minutes she could bend it much further. I thought this was interesting but not necessarily remarkable. But when he asked her what he had treated her for more than 10 years ago, she could not remember. When she left, I asked him what brought her to him a decade before—he said she had such severe angina she could not leave her house. So I thought, here might be an extraordinary story of a medical approach, discovered by observation, that can on occasion be deployed for a life threatening condition but can also relieve common or garden complaints that afflict us all. I now felt ready to plunge a needle into my own back and treat myself—to my amazement and delight, relief occurred. We all need permission. Such was Felix’s skill in promoting the interest of the thousand and more doctors who came to see him—he generously provided a meeting in his own house twice a year, where we could all foregather and speak quite freely about the commonplace and sometimes unusual conditions we had treated by applying his version of the Chinese method, a method apparently completely alien to anything taught at our medical schools. But Felix’s interpretation of works that he had taken the trouble to read—both Chinese and Western—gave us a framework to which we could hang on, particularly when we saw its effects in our patients. Felix freely admitted that he did not understand most of the important mechanisms of acupuncture that were indeed quite inexplicable at that time. Yet nearly all of these mechanisms can be explained now—particularly since the discovery that the nervous system produces its own pain relieving substances, such as opioids and indeed cannabinoids, as a result of the noxious stimulation of an acupuncture needle: these substances facilitate a newly discovered self perpetuating system that reduces pain everywhere in the body.
It was his modesty, honesty, and directness in the face of scepticism that attracted so many followers to his standard. He did not seem to mind what most of the rest of the medical profession thought of his apparent unorthodoxy. He learnt from his patients. He brought to us the idea that treatments should be separated by a fortnight. He pioneered the development of treating the periosteum to produce a radiating sensation that relieved distant pain. He commented on the interactions of physiological dysfunction with psychological factors that can affect large regions of the body and the fact that some patients require very little in the way of acupuncture stimulation and produce curious reactions to it. He introduced us to the meaninglessness of some of the so called traditional concepts of meridians and acupuncture points and championed a modern neurophysiological approach that is bearing so much fruit today.
His example formed a much needed shelter for us lesser mortals. Indeed, during the 12 months I met him, two opposing articles appeared in the medical journals. The first was an editorial in the BMJ of 1973, “Acupuncture is said to have been devised . . . to re-establish in the patient a correct equilibrium between the yang, or the male element, and the yin or female element. While this worthy motive appears never to have been challenged, the variety of explanations for its modus operandi, the complexity of the techniques, its exploitation by charlatans . . . seem to have weighed heavily against its chances of thorough trial by medical scientists faced with competing claims of seemingly greater priority.” These scathing words were counterbalanced by a study from 1974, when the research group of acupuncture anaesthesia of Peking Medical College injected cerebrospinal fluid taken from an acupunctured subject into an untreated subject and found an elevation in pain threshold in both—the very beginnings of the realisation that acupuncture encouraged the nervous system to produce its own opioids, a realisation that vindicated Felix’s opinion that a modernised version of acupuncture is a proper topic for medical study and practice—something he defended very ably despite the hostility and dismissal by so many in the profession, a doughty feat that in 1995, to his great pleasure, the German Society for Pain Management recognised and paid full tribute to when it presented him its special award, the German Pain Prize [Deutscher Schmerzpreis].
He will be sorely missed by those whom he met and helped; his patients and pupils; and his dear wife, Ruth.
Cite this as: BMJ 2014;349:g6322
Doctor and acupuncturist (b 1931; q 1955), d 2 October 2014.