Gianfranco Miotto

Quite how young Gianfranco Miotto learned his acupuncture will never be known. He was an orphan and had been brought up in an institute. His schooling did not go beyond what was then compulsory (we are in Italy in the 1940s), but he was intelligent and an avid reader. He was also an engaging and charismatic young man, traits which took him a long way in many senses.

I was told that he began practising as a young man, treating the country people in the vicinity of his home, on their beds or kitchen tables. He evidently helped a lot of people, as he soon established a large practice, taking proper premises in the city of Treviso, north-eastern Italy. There he practised until, hounded by the medical establishment, he took his young family off to South America to begin a new life. In Paraguay he rose to the heights of society, with a busy practice in Asunción and counting the then President among his clients. Life in Paraguay treated him kindly until turns of events led to one of those episodes that occur from time to time, when a beleaguered dictator finds scapegoats for his country’s troubles in the foreign population, and summarily expels them. Although he had been a favourite, Dr Miotto was not immune from this, as intrigues within the presidential entourage had worked to sour his relations with those who mattered most. In the exodus he lost most of his wealth and belongings, and so, back in Italy once more, he had to start again almost from scratch.

I first met him, and was for a few years taught and mentored by him, several years after his return to Italy. I was, of course, also a patient, and he cured me rapidly and definitively of the hay fever that had badly tortured me every spring and early summer.

Dr Miotto’s acupuncture was unorthodox. He had long discarded many of the traditional methods that he had studiously applied in his youth, learned from the few translations of acupuncture texts, both traditional and contemporary, that he could lay his hands on in those years. “Western people are different,” he told me, “Trying to treat people adhering strictly to the traditional theories leads only to disappointment”. He had worked with Korean émigrés in Asunción, and had picked up many ideas and methods from them. He was also an inventive man, devising many new techniques and constructing the devices necessary to carry them out. He believed in efficiency, effectiveness and ease of practice, rather than slavish adherence to tradition.

Dr. Miotto valued pulse diagnosis highly, but his interpretation of the radial pulses was not highly detailed in the sense that he was not interested in subtle nuances. His point of view was that there was nothing very precise to be usefully palpated, but basic perceptions such as of a strong or weak pulse, a hard or soft one, a deep or superficial one, were important indicators to him of how best to treat his patient.

Dr Miotto had three favourite points. One of them because it is an effective point for any kind of pain anywhere in the body, and, as with most practitioners, many of his patients came with pain. The other two because he considered them psychosomatic points par excellence. I use the term psychosomatic as I believe he did, not to mean, necessarily, “somatic symptoms of psychological origin”, but in the holistic sense of “disorders pertaining to the body-mind complex”. Dr Miotto rarely if ever saw a patient with any kind of condition for which he did not consider the psychological element to be an integral part. (Because of this interest he gained a doctoral degree in psychology from Padua University at the age of 45.) The first treatment of a patient would invariably employ these three points, to which he would add points on the ears.

During subsequent treatments he would vary his choice of points. Along with one or two of his favourite three points, he would use one or two of a small range of others, selected according to pulse diagnosis. Every two or three treatments he would revert to the three-point scheme of the first treatment. On the first and every second session thereafter he would also use a special technique, which here I do not divulge, which he saw treatment as somehow priming the whole system to amplify the effect of his needles. He had invented and produced an electrically operated contraption to make the task easier and more effective.

Then there were his symptomatic techniques. Additional, local points were employed on top of the general protocol outlined above. For localised pain and trigger points he used a contactless mesotherapy pistol (now out of production due to safety concerns) to fire small quantities of irritant (sterile saline) at high speed, sufficient to break the skin and form a small blister. If he saw a need, he created an instrument to fulfill it. He invented a small probe to insert into the nostrils and deliver a small electric shock to specific points in the nasal mucosa. This was used for nasal hypersensitivity conditions like allergic rhinitis. Tendon inflammations would occasionally be made to bleed by pricking the overlying skin with a hypodermic needle followed by the application of a suction cup (typically, for ease, those with a manual pump rather than the traditional heated glass cups).

Dr Miotto was a highly original, successful and respected practitioner. He never wrote anything (he was dyslexic) or taught formally. Although he was asked, he felt unable to teach “standard” traditional acupuncture, which he neither believed in nor practised. Yet I am inclined to believe that his acupuncture was the most traditional kind of all: one produced by a distillation of ancient concepts, his own empirical observations and reflections, tricks of the trade learned from various masters while “on the road”, and his own ingenuity. Above all he understood people, and used that understanding in his clinical practice. That surely, is a more natural, real, and effective approach than sterile adherence to what has become today a stiff body of dogma.

Dr. Miotto was my mentor. The acupuncture that I use today derives from the observation that he got good results in a wide range of conditions by using variations on a very simple scheme. This reflects the fact that the body harnesses its self-healing potential according to a fundamentally simple scheme: the stress response. And from these two observations it is but a short step to the realisation that the basic mechanism of action of acupuncture is that of stimulating and/or supporting a stress response.