Chinese Medicine Demystified (Part VI): 5 ways acupuncture can help you where drugs and surgery can’t


person receiving acupunctureNote: This is the sixth article in an ongoing series. If you haven’t read the first five, I recommend doing that before continuing:

Most people in the US don’t know much about acupuncture. They might have heard it’s good for pain, that it can treat infertility, or that it can help you relax. What most people don’t realize is that acupuncture is a more complete and effective method of healthcare than western medicine.

Here’s why.

#1: Acupuncture treats your whole body

Acupuncture isn’t directed toward a particular disease or condition. It works instead by activating the body’s self-healing ability. This is why acupuncture can address everything from irritable bowel syndrome to back pain to the side effects of chemotherapy.

When you get an acupuncture treatment for elbow pain, your elbow pain will go away but it’s also likely that you’ll see improvements in other areas. The headaches you’ve had for ten years will get better, you’ll have more energy, you’ll be better able to handle stress, and you’ll sleep better.

The reason acupuncture can do this is that it focuses on treating the root cause of your health problems. The ancient Chinese knew that symptoms don’t arise out of nowhere. Symptoms are manifestations of an underlying malfunction and disease process. The progression from malfunction > disease process > symptom can take many years. If you just address the symptom without addressing the malfunction or disease process, healing doesn’t occur.

The Chinese also knew that a malfunction or disease process can give rise to many different symptoms that may seem unrelated. For example, headaches, heartburn and skin rashes may all be expressions of the same underlying problem.

Western medicine, on the other hand, often mistakes symptoms for disease. Treatment is almost always directed at the symptom, not the disease. Western medicine is based on the Cartesian paradigm that has dominated both scientific and philosophical views of the body for the past three hundred years. This philosophy created the notion that the body is a machine composed of many separate parts, and that health can be achieved by simply addressing each part in isolation. There is no consideration for how the parts are connected and related.

This is why in western medicine we have doctors for every different part of our body. We’ve got cardiologists for our hearts, gastroenterologists for our guts, podiatrists for our feet, gynecologist for female reproductive organs, neurologists for our brains, etcetera. We’ve carved our body up into various parts and put different doctors in charge of taking care of each part. In a perfect medical system these doctors would be communicating frequently and sharing ideas about their patients. While this does happen in some cases, all too often it doesn’t. I don’t believe this is the fault of the doctors themselves. They are as much victims of the deficiencies of our healthcare system as patients are.

Acupuncturists have a different perspective, because Chinese medicine is based not on Cartesian dualism but on Chinese philosophy, which is inherently holistic. Acupuncturists look at the body as one interconnected whole. From this viewpoint it is impossible to consider a specific part (like the knee, or the heart) without considering it in relation to the whole. This is of course much more consistent with what we know about how ecological and biological systems (which the body is an example of) operate. And it explains why a single therapy like acupuncture can treat your entire body at the same time.

#2: Acupuncture cures disease

What is a cure? One definition is that a cure has been achieved when the treatment is removed and the dysfunction or illness doesn’t come back.

With the exception of antibiotics, chemotherapy and selective surgery, western medicine does not cure disease. It suppresses symptoms.

How do we know this? If you take a drug for a problem you generally have to take it for the rest of your life. The problem doesn’t go away – it’s being suppressed by the drug. The drug has just replaced a certain function of your body. But as soon as you stop taking that drug, the problem will come back. And often it will be worse than before.

Blood pressure medication is the perfect example of this. It will certainly lower your blood pressure, but it doesn’t do anything to fix whatever was causing your high blood pressure in the first place. People find this out the hard way when they try to stop taking their medication, and their blood pressure skyrockets to a level higher than it was before they started taking the drug.

Why does the problem get worse after taking a drug? Because drugs don’t only suppress symptoms. Drugs also suppress functions. Though drugs provide symptom relief in the short term, over time they may worsen the underlying condition because they interfere with our body’s self-healing mechanisms.

For example, many people take ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) to cope with arthritis and inflammatory conditions. While NSAIDs are effective in reducing pain and inflammation in the short-term, they are also known to reduce blood flow to cartilage. Since blood carries all of the nutrients and immune substance necessary for tissue repair, NSAIDs can actually worsen the original problem when taken chronically.

Drugs also have side effects. Drugs may correct a specific imbalance, but in the process they cause at least one other and often several other imbalances. When this happens in western medicine, other drugs are prescribed to address the side effects caused by the first drug – and so on until the patient ends up on a cocktail of drugs treating the side effects of drugs. (See my article Problem With Your Pill? Take Another Pill! for more on this phenomenon.)

There’s nothing wrong with symptom relief. Anyone who has suffered from a debilitating health condition can tell you that. I believe that symptom suppression with medication is necessary, and even life saving, in certain cases. The problem occurs when symptom suppression with drugs takes the place of other approaches (such as nutritional and lifestyle changes) that address the root of the condition.

Acupuncture, unlike most drugs, has the potential to cure disease. Why? Because as I mentioned above, acupuncture stimulates the body’s self-healing mechanisms. And the body’s ability to heal itself far surpasses anything western medicine has to offer.

The discovery of antibiotics is certainly one of the greatest achievements of medicine (though not without problems, as the recent phenomenon of antibiotic resistance indicates). However, these medications are like children’s toys compared with the extraordinary complexity of the immune system’s ability to heal disease.

The body is capable of spontaneously healing wounds, regenerating tissue, neutralizing toxins, and keeping cancer cells at bay – all while we catch the latest episode of Lost on TV or pick up the kids from soccer practice.

As evolutionary biologist Paul Ewald puts it:

Put bluntly, medicine’s success at vaccination and antibiotic treatment are trivial accomplishments relative to natural selection’s success at generating the immune system… We will probably obtain much better disease control by figuring out how to further tweak the immune system and capitalize on its vastly superior abilities than by relying on some human invention such as new antimicrobials (antibiotics, antivirals or antiprotozoal agents).1

Acupuncture does just that: it “tweaks” the immune system and capitalizes on the body’s vastly superior ability to heal itself. That is the strength of acupuncture. However, this strength can also be a limitation. Since acupuncture works by stimulating the body’s built-in healing capacity, if that capacity is impaired or damaged (by poor nutrition, excessive stress, etc.) then the healing power of acupuncture will be limited.

#3: Acupuncture prevents disease

The superior physician makes it his prerogative to treat disease when it has not yet structurally manifested, and prevents being in the position of having to treat disorders that have already progressed to the realm of the physical. The low level physician finds himself salvaging what has already manifested in physical form, and treating what is already ruined. 2

Amazingly enough, this quote comes from a medical text in China written 2,500 years ago! The idea of “preventative medicine” has received a lot of attention in the west during the past decade. But as the quote above indicates, the Chinese have been aware of the importance of preventative medicine for thousands of years.

Acupuncture and the other branches of Chinese medicine (nutrition, herbal medicine, tai qi, qi gong) restore homeostasis and keep the body functioning at an optimal level. When the body is functioning at an optimal level, we’re far less likely to get sick, and far more likely to recover quickly when we do get sick.

Another way to put it: acupuncture is an effective method of healthcare.

Healthcare, which may be defined as a method of promoting and maintaining health, is not the focus of our current medical system. A more accurate term for the focus of Western medicine would be disease management.

Disease management is important and we certainly need it in the modern world. Yet it’s a mistake to confuse disease management with healthcare. They aren’t the same thing at all.

Western medicine is focused on the treatment of serious disease. Many of the tests, for example, performed in western medicine will not be triggered as abnormal unless the person being tested is already very sick. If a person goes to see a doctor complaining of headaches, digestive problems, fatigue and insomnia, the doctor will run some tests. If the tests come back “normal”, the patient is told that there’s nothing wrong with them! But of course the patient knows that’s not true. They know it’s not normal to have all those problems, and they know that something is wrong.

In fact, until recently doctors thought serious health conditions such as irritable bowel syndrome and fibromyalgia, and physiological changes related to normal life stages like menopause, were “all in the patient’s head”.

Why is western medicine so oriented towards serious disease? Part of the reason is that there is no concept of health in western medicine. If you look in the index of any western medical textbook, you’re not going to find a definition of health. Doctors don’t study health, and what it takes to be healthy, in medical school. They study diseases and the drugs that are used to treat those diseases. This puts western medicine at a serious disadvantage when it comes to promoting health.

I want to emphasize that I am making generalizations here. There are surely many doctors (and I have seen quite a few of them myself) that are deeply committed to the health and well-being of their patients, recognize the interconnectedness of the body and mind, emphasize the importance of preventative care, and prescribe nutritional and lifestyle changes to their patients. In particular I see this with many younger doctors who have graduated from medical school in the past ten to fifteen years. They tend to be much more open-minded to alternatives to drugs and surgery, and more inclined to recommend these alternatives when appropriate. This is an encouraging trend in medicine.

#4: Acupuncture makes your life better

The goal of Chinese medicine is to improve your quality of life and keep you healthy right up until the end. This means you’re rock climbing, snowboarding, playing with your grandchildren, or doing whatever else you enjoy until you pass away in your sleep at a ripe old age.

Western medicine, on the other hand, is focused on the treatment of serious, life-threatening conditions. It is an unsurpassed intervention for trauma and acute emergencies. Doctors can achieve almost miraculous feats to keep people alive, including reattaching severed limbs and literally bringing people back from the dead. It’s also true that antibiotics have nearly eliminated the risk of dying from the infections that were the primary cause of death all the way up until the mid-20th century, and that medications like insulin for Type 1 Diabetes have made a normal life possible for people who otherwise would have died at an early age. These interventions have extended our average lifespan considerably, and their contributions to our quality of life shouldn’t be underestimated.

So I’m certainly not “against” Western medicine. Believe me, if I get in a car accident or someday have a heart attack, I’ll go straight to the hospital. However, if I were to develop type 2 diabetes, I would begin by changing my diet because in many cases type 2 diabetes can be completely controlled with diet alone. (Of course it’s very unlikely that I will ever get diabetes, because my diet and lifestyle make it virtually impossible for that kind of blood sugar dysregulation to occur.) These examples explain my guiding principle in making decisions about my health care: for any given condition, I will choose the treatment that does the most good and causes the least harm. In my experience, acupuncture and Chinese medicine fits this guiding principle far more often than drugs and surgery.

#5: Acupuncture won’t kill you or make you sick

Primum non nocere, or “first, do no harm” is one of the principal precepts of medical ethics that students are taught in medical school. Another way to state this principle is, “given an existing problem, it may be better to do nothing than to do something that risks causing more harm than good.”

Somewhere along the line this important precept got swept under the rug. While western medicine has made tremendous contributions to disease management, it has also proven to be dangerous to our health.

We may have the most advanced disease management system in the world, but the US is far behind most other industrialized countries when it comes to health. The U.S. ranks just 34th in the world in life expectancy and 29th for infant mortality. Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from bottom) for 16 available health indicators. 3

Even worse, a recent study (PDF) by Dr. Barbara Starfield published in 2000 in the prestigious Journal of the American Medical Association demonstrated that medical care is the 3rd leading cause of death in this country, causing more than 250,000 deaths per year. Only heart disease and cancer kill more people. Although this study was published in one of the most reputable medical journals in the world, it received little media attention and my guess is that few doctors have heard of it.

Dr. Starfield estimates that, each year, medical errors and adverse effects of the health care system are responsible for:

  • 116 million extra physician visits
  • 77 million extra prescriptions
  • 17 million emergency department visits
  • 8 million hospitalizations
  • 3 million long-term admissions
  • 199,000 additional deaths
  • $77 billion in extra costs

As grim as they are, these statistics are likely to be seriously underestimated as only about 5 to 20% of medical-care related incidents are even recorded. Analyses which have taken these oversights into consideration estimate that medical care is in fact the leading cause of death in the U.S. each year. 4

I ask you this: can a medical system that potentially kills more people each year than any other cause of death else be considered “healthcare”?

In contrast to western medicine, acupuncture is extremely safe and well-tolerated. A recent cumulative review published in the British Medical Journal examined the incidence of adverse effects with acupuncture in more than one million treatments.

According to the evidence from these studies, the risk of a serious adverse event with acupuncture is estimated to be 0.0005% per 10,000 treatments, and 0.0055% per 10,000 individual patients.

The authors conclude:

The risk of serious events occurring in association with acupuncture is very low, below that of many common medical treatments. The range of adverse events reported is wide and some events, specifically trauma and some episodes of infection, are likely to be avoidable.

The incidence of milder side effects during acupuncture is also relatively low. In a study of 230,000 patients who received an average of 10 treatments each, 8.6% reported experiencing at least one adverse effect and 2.2% reported one which required treatment. Common adverse effects were bleedings or hematoma (6.1% of patients, 58% of all adverse effects), pain (1.7%) and drowsiness (0.7%).

To put that in perspective, a review of more than a hundred phase I double-blind, placebo-controlled trials reported that 19% of those receiving placebo experienced side effects, with higher rates following repeated dosing and in the elderly. 5

This suggests that placebos (sugar pills) may cause more side effects than acupuncture.

I hope this article has helped you to understand the power of acupuncture and Chinese medicine and its relevance as a genuine system of healthcare. And I hope this series of articles has made clear that acupuncture is not a “woo-woo” energy therapy, but a complete system of medicine based on known anatomical and physiological principles.

I would love to hear your feedback on how these articles have affected your perception and understanding of acupuncture. Please leave a comment!

If you’d like to refer people to this series of posts in the future, I’ve created a special “acupuncture” page on the blog with an index of all of the articles in the series. It’s listed on the right hand side of the page, in the sidebar, under “Health Reports”.

  1. Ewald, P. Plague Time. p.64
  2. See chapter 2 of the Suwen, in Nanjing Zhongyi Xueyuan, ed., Huangdi neijing suwen yishi (An Annotated Text With Translation of the Yellow Emperor’s Classic of Medicine: Plain Questions) (Shanghai: Shanghai Kexue Jishu Chubanshe, 1991), p. 16;
  3. Starfield B. Primary Care: Balancing Health Needs, Services, and Technology. New York, NY: Oxford University Press; 1998.
  4. General Accounting Office study sheds light on nursing home abuse. July 17, 2003 . Available at: http://www.injuryboard.com/view.cfm/Article=3005. Accessed December 17, 2003
  5. Rosenzweig P, Brohier S, Zipfel A. The placebo effect in healthy volunteers: influence of experimental conditions on the adverse events profile during phase I studies. Clin Pharmacol Ther 1993;54:578-83.

Related posts:

  1. Chinese Medicine Demystified (Part IV): How Acupuncture Works Modern research demonstrates that acupuncture can relieve pain, reduce inflammation and restore homeostasis. In this...
  2. Chinese Medicine Demystified (Part I): A Case of Mistaken Identity Most of what we've been told in the west about how Chinese medicine works isn't...
  3. Chinese Medicine Demystified (Part V): A Closer Look At How Acupuncture Relieves Pain Research continues to shed light on how acupuncture relieves chronic pain and inflammation without significant...
  4. Chinese Medicine Demystified (Part II): Origins of the “Energy Meridian” Myth The idea that Chinese medicine is a psychic, metaphysical medicine is based on gross mistranslations...
  5. Chinese Medicine Demystified (Part III): The “Energy Meridian” Model Debunked Historical evidence and modern research indicate that the Chinese medicine has nothing to do with...

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  1. Josh’s avatar

    Chris,
     
    I’ve really enjoyed this series of articles, though I had some questions that I feel weren’t directly answered.
     
    Firstly, how can you define Qi? If it is not “energy”, then what is it? You’ve mentioned before about it being (or being related to) breath, and I understand how proper breathing is important with internal practice, but how does this coincide the feeling of qi one experiences when practicing internal arts (I know when I adopt a stance from Ba Gua Zhang, I feel it immediately in my palms) or occasionally during acupuncture treatment? I have waited with baited breath to see if this would be explained in detail in your series of articles :D .
     
     
    Further, I am curious if there is any reason why sometimes this feeling is stronger and sometimes lighter? I know there was one spot I’ve experienced under the knee (the aim was to treat an inflamed hamstring tendon that was giving me discomfort proximal to the isheal tuberosity when I sat down) that was very intense, like a river of qi! Lastly, I’ve noticed that lots of times an area that needs needling (at least based on my experience as a patient) always seemed to be very sore. My acupuncturist would palpate and it was always the sorest of spots that would be needled; most of the time this was to treat various pain issues. Why is there this connection between these points, the aching pain, and needle location?
     
     
    Another question for you. You’ve said that acupuncture can help loosen the muscles, so perhaps this answers my question. In the past I was treated by an acupuncturist for my scoliosis. My acupuncturist found that in addition to spinal deviation, my left scapula was raised slightly as well.
     
     
    She would palpate along my spine and back and would insert a needle next to one of the vertibrae that were out of alignment and would also insert a needle into sore spots on my back (most commonly in the area south of the scapula and proximal to the spine). Sometimes she would also use a (what she said was) Japanese method of acupuncture on my head (the scalp). My spine did seem to straighten and my scapula lowered (the feeling was very strange and I couldn’t place it at first what the cause was. It felt like there was a trigger point under my scapula almost. Later I rememebered that she said she was lowering my scapula and then it made sense why I had a trigger point feeling in an area that doesn’t form trigger points). Did this process occur only due to the muscles loosening and thus allowing the bones to shit into their proper location?

  2. Josh’s avatar

    ischial* tuberosity
     
    I need to proof read better :D

  3. Rhonda’s avatar

    How does one tell if an acupuncturist is “good”, qualified?
    Also, how does one find such a person?  (I live in San Francisco; we have lots of acupuncturists in the Bay Area, but I do not know the difference between a “quack” and the real thing.)
     
    Thanking you in advance for your reply.

  4. admin’s avatar

    Josh,

    As I wrote in Part II, if we’re talking about the qi that moves around the body in vessels (erroneously called meridians), then the most accurate translation is probably oxygen. But qi can also refer to the function of something, so there are several different types of qi described in Chinese medicine (i.e. Zhong Qi, Zheng Qi, etc.)

    Second, as a Ba Gua and internal arts practitioner myself, I’m familiar with the experiences you describe. But I don’t think we need the concept of “energy” and meridians to describe what happens when we train.

    For me it’s just a question of reframing what i’m experiencing. It doesn’t change the actual experience. My Ba Gua teacher is adamant that there’s no magic or mystery involved in the kind of “soft power” one can cultivate. I’ve seen him send huge guys across the room without much effort. We have a tendency in the west to assume this is somehow non-physical (probably because of movies like crouching tiger), but my teacher will be the first to say that it’s 100% a matter of body awareness and organization.

    I don’t know all of the mechanisms involved, but certainly increasing the amount of oxygen available to tissues, increasing heart rate, increasing blood flow (through movement and different standing postures), contracting and extending muscles, etc. will have a profound effect on physiology.

    The tenderness in various points you describe is probably a reflection of something called “referred organ pain”. This is a fundamental aspect of Chinese medicine, but wasn’t discovered in the west until the 1800s. When there is a disharmony in the internal organs, that can manifest as a tender spot on the skin. Tender spots can also be trigger points, which are small contraction knots in the skeletal muscle.

    The propagated sensation you describe as the needles are inserted is the subjective feeling of nerve activation that travels along nodal pathways of the body. Muscle action potentials can be measured along the course of the propagated sensation (PS), and PS can be blocked by mechanical pressure on the node or lowered temperature, indicating involvement of static load muscle spindle fibers.

    I think you answered your last question.

    Thanks for your comments, Josh.

  5. admin’s avatar

    I would ask where they did their training, how long they’ve been in practice for, what additional training or specializations they have, and what their success rates are with the condition you’re seeking treatment for.

    You can also use Yelp to search for an acupuncturist in your neighborhood and read reviews from other patients.

  6. Deedee’s avatar

    Hiya. Thank you for this detailed explaination! I have always been curious about Chinese medicine and acupunture. I had a friend who did acupressure and taught me some – I always wondered what the difference was. I have shied away from acupressure, and most Chinese medicines because in this country (England) at least, they seem to be very linked with Chinese religion and I’m a pastor’s wife! Not something we want to mix. I appreciate your explainations that this is medical, not spiritual. Alot the think about and go read more about…………..

  7. admin’s avatar

    Hi Deedee,
    I’m glad you enjoyed the series. There’s nothing religious about acupuncture. As you now know it works by stimulating the body’s natural healing mechanisms. Give it a try!

  8. Jesse’s avatar

    If I understand correctly, you’re saying acupuncture is comparable to the entirety of western medicine? That acupuncture is better for most conditions, though western medicine is better for some?

  9. admin’s avatar

    Jesse,

    That’s not exactly what I’m saying.

    What I’m saying is that Chinese medicine is a better method of healthcare than western medicine.  I understand healthcare to be simply defined as “promoting health”.  I see little in western medicine that promotes health.

    On the other hand, as I explained in the article, western medicine is superior to Chinese medicine in dealing with trauma and emergency situations.  This includes the management of some serious diseases that require pharmaceutical or surgical intervention for the survival of the patient.

    Chinese and western medicine are complementary.  I use them both myself.  For example, if I get in an accident and break a leg I’ll definitely be going to the hospital.  But then I’ll use acupuncture and herbs to recover much more quickly from the injury.

    Using Chinese medicine to stay healthy and address common issues such as digestive problems, headaches, musculoskeletal pain, immune deficiencies, insomnia, anxiety, etc., and using western medicine for trauma and emergency care is the best approach.

    Perhaps I need to re-write this article to clarify.

  10. Jesse’s avatar

    So western medicine has been better at treating acute life-threatening situations, while Chinese medicine is better for curing chronic conditions and making life more enjoyable?
    I don’t know that the article was unclear; perhaps I didn’t read carefully enough.

  11. admin’s avatar

    I would say that’s true for the most part, although it depends on the nature of the chronic condition.

    Chinese medicine = improves quality of life and reduces morbidity

    Western medicine = serious disease management and emergency care

  12. Jesse’s avatar

    I understand.
     
    You also said, “Western medicine, on the other hand, confuses symptoms with disease. Treatment is almost always directed at the symptom, not the disease.”
     
    Would you say that, for the most part, only symptoms are treated because it is so difficult to discover the root causes, so most of them haven’t been figured out yet, or is it something more fundamental about western medicine?

  13. Dave’s avatar

    Hi Chris,
    Any thoughts regarding electro-acupuncture?
     
    Thanks.

  14. Chrid’s avatar

    An interesting series. I was already provisionally pro-acupuncture from the success it showed in medical studies, but I always knew the “energy” explanation was a load of crap. Thanks for providing the real information!
    But I do have a question. In this last article you talk about Western medicine being mostly emergency and reaction based rather than preventative. Aren’t general practitioners and nutritionists exceptions to this rule though? While many times primary care physicians will prescribe drugs for things like cholesterol or high blood pressure, they will often also prescribe better diet or exercise. Chinese medicine obviously has some interesting uses (acupuncture being the best example not duplicated by Western medicine), but isn’t it a little unfair to say Western medicine ignores root causes, holistic views of health, and only focuses on reacting to symptoms?

  15. admin’s avatar

    Chris,

    I don’t think it’s unfair to suggest that western medicine ignores root causes in general.  As I explained, the only drugs that cure disease rather than simply suppressing symptoms are antibiotics and chemotherapy.  Some would argue that antibiotics and chemo don’t cure disease, because they ignore the “terrain” that allowed the infection or cancer to prosper in the first place.

    Certainly there are individual doctors who have a “holistic” view.  I’ve seen quite a few myself over the years.  But they do not acquire this view in medical school, nor is it encouraged within their professional organizations or within the scientific literature.  Nutritional training in medical school is woefully inadequate, as any doctor will tell you.

    Part of the problem is that western medicine is based on a Cartesian, dualistic view of the body which assumes that the parts are not connected to each other or the whole.  If someone goes to a general practitioner with a thyroid issue, constipation, depression, and fibroids, they could very well end up being treated by four different specialists (endocrinologist, gastroenterologist, psychiatrist and OB/GYN specialist) and taking four or more medications for each of those conditions.

    What distinguishes Chinese medicine and other holistic approaches is that they recognize the interconnectedness of the systems of the body, and diagnose and treat accordingly.  So, with the example above, rather than four separate doctors and treatments the patient may see a single practitioner and do a single treatment that improves all of her symptoms at once.

    The recent trend of “functional medicine” that has been embraced by some doctors will hopefully change the way medicine is practiced in the future.  For now, though, I think it’s not at all inaccurate to say western medicine in general is overwhelmingly focused on disease/symptom management.

  16. Forty2’s avatar

    Whoa, thanks for this series. I’d always associated acupuncture with the one time I tried it where this guy thwapped a buncha needles into my legs and ass for back pain, then dimmed the lights and put on some Enya for 30 minutes while mumbling some new-agey nonsense and leaving me to stew in my reactive juices or something. That experience put me off all Chinese medicine until reading your series.
    Look, naturopaths; explain this to me in non-woo-woo terms and we’ll be OK. I’ve known for years that allopaths are for the most part only interested in treating symptoms, not causes, but I’ve run into too many naturopaths who follow the woo-woo train which is a complete turn-off to rationalists.

  17. Chris Kresser’s avatar

    Ha.  That’s hilarious.  The super new-age mumbo jumbo puts me off too – and I’m studying to be an acupuncturist!  I’m glad this series helped open your mind to acupuncture again, because it’s a remarkable therapeutic modality.

  18. Bryan - oz4caster’s avatar

    Chris, thanks for the interesting and insightful series on TCM, or perhaps it should be better called TCHC, traditional Chinese health care :)

  19. Chris Kresser’s avatar

    Great idea, Bryan! I’m glad you enjoyed the series.

  20. Darren Austin Hall’s avatar

    Chris,
    This is truly a great work on your part to bridge the gap between Chinese and Western Medicine. Indeed, many Chinese Medical practitioners take the “woo hoo” root you broach as the attraction of mystifying knowledge is a due vulnerable of a spiritual egoist. However, I would like to posit that there is another perspective of Chinese Medicine also steeped in the classical texts that makes Chinese Medicine even more remarkable. This is what has been coined “the inner tradition” by Chinese Medical luminary, Lonny Jarrett, and harkened by Heiner Fruehauf, Founding Professor of the School of Classical Chinese Medicine, who attributes to Chinese Medicine the notion of it being “virtue therapy”. These perspectives draw much on the Five Element Tradition put forth by J.R. Worseley and focus on Chinese understandings of Shen (with a capital S) as the spirit housed in the Heart as amalgamation of the 5 shen of the Yin Organs. In the inner tradition, this spirit is the focus of all treatment, guided by the development of the virtues of each particular organ’s or official’s shen, which is radiated when the organ/official is functioning harmoniously with the “sheng” or generating cycle of the elements. Although I came out of a more basic TCM approach to the medicine, it is this inner tradition that I am now studying and find deeply captivating in potent. Indeed, your work is a gift unto the world as it is a great step forward in the work of integrating Western and Eastern medical perspectives but there is a wealth of other wisdom also to be looked into in Chinese Medicine and, ultimately, bringing the Chinese concept of spirit into the health-care may be the final frontier of truly bridging the gap. As you I’m sure are familiar the West is still mightily fortified in materialist views of reality, making there science a study of quantity, while Chinese science is much more interested in the quality of things, which can be just as gross as material things, but also can be far more subtler. It’s telling that the ancient Chinese character for nerves is “shen jing” literally “wires that conduct spirit”.
    Great work, Chris! To the revolution-evolution of integrated health-care. I shall share your work with many and hope more do the same. This will definitely aid in many conversations between medical traditions. You have done a great service!

  21. Chris Kresser’s avatar

    Darren,

    Thanks so much for your feedback and support. I’m familiar with Jarrett and Fruehauf’s work and enjoy them both. We might both agree that acupuncture, as powerful as it is, is the “physical therapy” of Chinese medicine, which taken as a while is a complete system that integrates spiritual, psychological, emotional and physiological health. Nevertheless, acupuncture is the doorway to Chinese medicine for most people, so I feel that it’s important to find a way to talk about it that most folks can understand and relate to. Once they walk through that doorway, a whole new universe awaits!

  22. Markus’s avatar

    Some years ago, I saw a documentary about Chinese medicine. There was a man, not sure if he was a western doctor, who studied Chinese medicine in China. When he broke his leg, he decided to employ Chinese medicine for treatment. His leg was oiled and massaged for about 48 hours if I remember correctly. Shortly afterwards, maybe about two weeks, he went hiking. He emphasized that if he had used western medicine, he would have been plastered for maybe six weeks and afterwards had to work a long time to regain his muscles.
    His “explanation” was that Chinese medicine had been used to treat martial arts injuries for hundreds or thousands of years and that it would be silly to think they had not found ways to quickly cure broken arms or legs.
    Fact or fiction?
    Thanks for this refreshing series about acupuncture!
    Markus

  23. Chris Kresser’s avatar

    Markus,

    It’s true that “hit medicine”, as it’s referred to in the martial arts community, can produce results that sometimes seem miraculous.  I’ve experienced that first hand, as a martial artist who has had my share of injuries.  I don’t think much research has been done on using plasters, liniments and poultices of Chinese herbs for these purposes in the West, but there is certainly a long tradition of using them successfully in China.

  24. Hap’s avatar

    A fascinating series and discussion. Now that you’ve begun to bring TCM back into the realm of Western understanding, I wonder if you’ll tackle a related subject.
    The Israeli genius Moshe Feldenkrais (founder of the body-mind discipline of the same name) seemed to think that “chi” was a mystifying, unnecessarily confusing concept. He believed (as has been stated here) that a martial artist’s power came from very fine skeletal organization, not from muscular strength or some woo-woo force. (Some claim he did mellow on the notion of “energy” late in his life.)
    Now, do you have a take on stuff like the “microcosmic orbit,” i.e. the small and large circulations? It seems to me that those of us trying to “find” such things may be looking for something that isn’t there; or if it is are tying ourselves in knots in the looking.
    Or are they nothing more than some kind of kinematic sequencing of skeletal movement? That is, something that really can be felt, if one senses in the right way, or one holds a particular intention which happens to be functional at a given point?
    I enjoy practicing tai chi, but so far haven’t a clue about any “circulations.”
    Will be interested in any comments on this subject from other readers here.
     

  25. Chris Kresser’s avatar

    Hap,

    My wife is a Feldenkrais practitioner, so I’m very much aware of his work. I don’t have much to say about the microcosmic orbit concept. I’ve been involved in various internal martial arts (bagua, taiji, qi gong) for fifteen years, but I do not utilize those concepts in my practice. I suppose you could say I take a more “Feldenkrais” approach. Incidentally, so does my teacher, who is one of the most highly regarded bagua teachers in the world. I believe that internal power and strength come from proper skeletal organization and breath. There’s nothing magic about that in theory, but in practice it is quite difficult to attain so the results can feel and look that way.

  26. Hap’s avatar

    Chris -

    Thanks for writing. Interesting that your wife is a Feldenkrais teacher. I graduated from the ‘Somathematics’ Feldenkrais teacher training (taught by Dennis Leri and Elizabeth Beringer) back in 1991, but I’ve not made it into a career. Still, I’m grateful that Moshe’s way of thinking is a part of my life.

    While I was living in Boston years ago I learned a Yang-style tai chi form from Master Yang in Jamaica Plain. I still practice that on my own here in Berkeley. What I especially enjoy is incorporating some sense — even if minimal — of the martial applications of the tai chi movements. (Thanks to Master Yang’s DVD for that.) Once a movement is “informed” with a specific purpose in relation to an imagined enemy, the feeling is quite different — just as the experience of a person’s touch varies with the intent of the one touching. Any “movement” of body/mind (martial and touch in this example) are informed by Moshe’s notion of “function,” an orientation to intent which distinguishes his approach from many others. (One masseuse friend told me they were taught to imagine they are touching a membrane full of water. That’s useful, and very different from a Feldenkrais teacher’s inclusion of skin, muscle, and especially, bone in their intent.) Anyhow, interesting stuff.

    I also especially appreciate Feldenkrais’ conversational model (as opposed to subject-object) which can inform any kind of relationship (with oneself or others) where the function is learning. Thus, for example, the power of the blog.

    They say older guys become more conservative with age. Maybe so. I just came across this: “[A neoconservative] is a liberal who has been mugged by reality.” – Irving Kristol. So, here’s to more “nuts-and-bolts” explanations!

    P.S. It would make for easier-on-the-eyes comment reading if carriage returns got displayed as paragraph breaks, not just line breaks. I’ve done double-ones here, hoping to create a blank line between paragraphs. I hope it hasn’t made a mess.

  27. Hap’s avatar

    The TCM doc I see once told me that if a person is skeptical about Chinese Medicine, then it won’t work for them. Ironic, then, that the “healthy skepticism” here may actually help to improve the results of TCM patients (or prospective patients) who read the series. (I don’t suppose it would hurt practitioners either!) I recently referred a friend to this series and she came back very interested. Seems the Western mind’s gotta get some respect. (Thank you, Rodney D.)
     
    In two visits to my doc since I read this series myself, I feel more comfortable and confident with TCM. Does this amount to a placebo? Does it improve one’s outcomes? I don’t know. But I do believe in the value of fictions, especially the practical ones.
     
    I’m passing along this info to a woman who runs a TCM/massage studio in Petaluma, CA. I’ve suggested to her that for Westerners this kind of explanation might make a very effective educational/marketing tool.

  28. Chris Kresser’s avatar

    These days I prefer the terms “meaning response” or “contextual healing” to placebo, because they capture the essence of its significance much more accurately. Placebo is nothing short of self-healing, the body’s ability to repair itself and restore homeostasis. We know that 30-80% (or more) of the therapeutic benefit of any treatment is due to this meaning response, which is highly dependent upon the context in which the treatment is offered. Thus sugar pills can stimulate real physiological changes, but only when they are prescribed and taken in a setting that reflects all of the patient’s expectations about the medical encounter and its results.

    Placebo research suggests there are two components necessary to obtain the effect: a belief in the efficacy of the treatment, and hope that it will work (positive attitude). Explaining Chinese medicine and acupuncture in terms the patient can understand contributes to both of these components. If she grasps that the principles guiding her treatment are the same as those agreed upon by the authorities in her culture, whom she has been conditioned to respect and believe in (whether she consciously does or not), her respect for Chinese medicine will deepen and her faith that it will help her will grow.

    I think only good can come of this.

  29. Jonah’s avatar

    Chris,
    Awesome articles.  As a student of Chinese Medicine myself, I’m always looking for explanations that patients can understand.  You did a great job with these articles.  Thanks for doing the work for me!  I wonder how you would explain microsystems (such as Master Tung, or auricular), or balance method therapeutics in Acupunture?

  30. Chris Kresser’s avatar

    Hi Jonah,

    I’ve thought about your question quite a bit, because I use Balance Method and Tung’s style exclusively. (In fact, I started the Balance Method Acupuncture Forum with a friend. Check it out if you’re not already aware of it.)

    There are a few modern neurological concepts that can at least partly explain Tan and Tung’s style. The first is reciprocal innervation, which is associated with the notion of paired muscular activity. Skeletal muscles exist as pairs, which work “against” one another in order to reach optimum efficiency. Reciprocal innervation occurs so that the contraction of a muscle results in the simultaneous relaxation of the corresponding other. This explains System 3, where balancing the paired meridian stimulates changes in the effected meridian. For example, the Lung channel runs along the biceps (flexor) muscle, and the Large Intestine runs along the triceps (extensor) muscle.

    Second, crossed extensor responses dictate that the axons of associated neurons within a particular limb also cross the midline of the spinal cord to stimulate motor neurons of the opposing extremity. This explains how contralateral needling, which is basic to both Tan and Tung systems, is effective.

    For more on reciprocal innervation and crossed extensor reflexes, check out this article.

    Finally, the peripheral nerve response I described in this article explains why distal needling has such a potent effect.

    Beyond that, it’s still a bit of a mystery.

  31. Jonah’s avatar

    Chris,
    Thanks for your explanation.  And I appreciate your acknowledgment that some of these things remain a mystery.  The nervous system is highly complex and there is still oodles to be understood by “modern” science.  My own sense is that microsystems, and 6 channel theory in acupuncture illustrate the holographic nature of the body (and everything for that matter).  I believe that quantum mechanics touches on this idea.  Where it really becomes interesting is in mirroring and then reverse mirroring!  How can the body know that the hand can be the head or the foot?  I’m wondering what your take is on that.

  32. Chris Kresser’s avatar

    I really have no idea, Jonah.

    As you say, the nervous system is vastly complex. There are obviously sophisticated links between every part of our body. Without them, proprioception would be impossible. My completely rough and inadequate guess is that mirroring has something to do with that proprioceptive network.

  33. luke’s avatar

    Great article! It is nearly impossible to unwind peoples perceptions of TCM when you use terms like QI and meridians, I usually just say “go find out if it works for you” and step back from explaining it.
    I’ve gone from skeptical (having never tried it but still judging it)  to using it as my primary healthcare.
    With TCM you leave feeling good. No drugs, no side effects. try it.

  34. Joseph Davis’s avatar

    Hi Chris,
    Late comment, but I’ve really enjoyed reading this 5-part analysis of how acupuncture works.  It’s put a lot of research that I’ve encountered in one place, in a very systematic presentation.  De-mystifying is key to the acceptance of our medicine by people that are alienated by things outside of the western/objective approach to healthcare, and your efforts are really commendable.
    While I agree that translating the word “qi” as “energy” is not really adequate, I respectfully disagree that thinking of it as oxygen or neural activation is much better, except in the context of communicating to people in a strictly conventional medical paradigm.  As a fellow practitioner of Nei Jia Quan (in fact, I believe we share some of the same teachers), there is something about the subjective nature of qi sensations that is unique, and worth keeping in our description of this phenomenon.
    In my qi gong classes, I’ve come around to the clumsy description of qi as “feeling-awareness.”  It is that feeling of blood-flow, the tingling in your hands after a palm-change, the invisible, almost magnetic feeling in the whole body after a good session of Tai Ji or Qi Gong.  It is something that we can consciously experience, doing any activity that makes us feel more alive, and the Chinese just happen to realize that there were places in our bodies (the dan tians and channels) where this aliveness is more likely to aggregate.  I forgive the woo-woo people for calling this “energy,” because that is what it feels like sometimes.  I also understand that the scientifically minded people will hate this, because there is no room in science for this messy, unmeasurable subjective feeling stuff, and they like to think of  energy is something we can store, convert, and measure.
    This, in the end, is where Chinese Medicine and nei gong practices actually will lose something if we define them exclusively in terms of the western-rational paradigm:  these arts (and they are arts, as well as sciences) engage the person on the subjective level, and that just doesn’t boil down into objective models.  To say that “channels are X” and “qi is Y” will miss this part of the equation:  that we can experience these things directly ourselves, and they lose something when we try and pluck them out of this context.  The Tao that can be spoken etc etc.
    Great work in any case!  I look forward to further posts!

  35. Chris Kresser’s avatar

    Thanks for your comment, Joseph.

    I think we’re mostly in agreement, but here’s where we might differ. I’ve experienced the sensations you describe, but I don’t believe we need non-western terminology or concepts to describe them. The fact that organizing my body, breathing and moving in a certain way can produce the experience I have when doing internal martial arts is no less magical when I understand it in terms of neurovascular mechanisms than it is if I explain it in terms of energy.

    There are many other movement oriented practices that are western in origin and produce similar sensations. For example, my wife is a Feldenkrais practitioner. She experiences something very similar to what you describe in her practice of Feldenkrais. Yet she is able to explain it without any concept of meridians or energy.

    I understand your concern that explaining this phenomenon in western scientific terms is reductionistic. But that’s only true if we take a reductionist view of western science. Unfortunately, many docs and researchers are stuck in that reductionist paradigm. But there is another, emerging paradigm within the western scientific community that acknowledges the wholeness and interconnectedness of all life (via quantum physics) and the influence of non-material phenomena on physiological processes (via psychoneuroimmunology, with placebo effect being a prime example).

    This is the paradigm I’m speaking from and identifying with. It’s what makes sense to me, it’s verifiable using contemporary scientific methods, and it’s no less wondrous than anything I’ve read about in Western translations of Chinese texts.

  36. Jennifer’s avatar

    Hello all,
    At the age of 23 I all of a sudden started having grand mal seizures out of nowhere, with no history of epilepsy in my family. I have been on Lamictal for nearly 5 years, and since I’ve been on it, I have had no problems. But I did go off briefly for 3 days and the seizures came back. Does acupuncture heal seizures? is there any record of it healing epilepsy?

  37. Fredo’s avatar

    The Chinese description of chi is very analogous to electromagnetism.

    The importance of electromagnetic energy and the human body was brilliantly shown by Dr. Robert Becker who using energy (electricity) was among other things able to regrow animal limbs. Documented in his book- The Body Electric: Electromagnetism and the Foundation of Life

    His research in the electro-conductivity of collagen in bone marrow give evidence of how advanced chi-kungs such as bone marrow washing work as well as I-Chuan, Yogic stretching, and importance of correct posture to keep bones and tendon in both electrical and structural connection.  This also begins to explain what internal martial arts describe as tendon and bone power (tendon is made from collagen) and why minimal muscle is used.

    Dr. Mae Won Ho further connects the electromagnetic nature of the human body to acupuncture in her paper, “The Acupuncture System and The Liquid Crystalline Collagen Fibres of the Connective Tissues”, in which she states, “Bound water layers on the collagen fibres provide proton conduction pathways for rapid intercommunication throughout the body, enabling the organism to function as a coherent whole.” In another paper she states, “Aligned collagen fibres in connective tissues provide oriented channels for electrical intercommunication, and are strongly reminiscent of acupuncture meridians in traditional Chinese medicine.”  (note an acupuncture needle is a conductive material)

    Collagen, Collagen, Collagen, a triple helix, a beautiful spiral encompassing water, a liquid crystal, sensitive to light, pressure, vibration, and electromagnetism. Is it a coincidence that its spiraling extension is like the movement of Chinese internal martial arts.

    Lastly I am electrical engineer and have also practiced internal martial arts / qi-gong for many years. With the research of the above and others, good teachers, and discipline (almost daily practice) have all helped me to actually experience stronger chi. Among other experiences, it feels as though the electromagnetic field of my body has increased and unified my body. Its hard to describe. This in turn has transformed my tai-chi and bagua movements, making my entire body float effortlessly. Its quite beautiful.

    I have also taken medical chi-kung for several years which uses the same meridian system as acupuncture yet there is no touch necessary to help heal someones body. One uses ones own field (which has been strengthened through chi-kung) and intent to get energy moving through a patients meridians.

    The science described above has only just begun to explain some of how chinese medicine works in terms of western concepts.  The science done by Dr. Robert Becker is relatively new and no doubt much is still unknown about the energetic nature of the human body.

  38. Mark’s avatar

    Chris, Thanks a lot for these articles. A friend of mine put me in contact with your blog. I have a decision to make. I’m 60 yrs old and was recently diagnosed with a number of heart related ailments (atrial fibrillation, high blood pressure and a malfunctioning contraction of the heart – I forgot the medical term). My cardiologist told me a pacemaker is a certainty and the usual drug treatment will follow. I’m considering trying accupuncture first – depending on cost. My questions are: (1) Is there an accupuncture treatment that can correct a heart that’s malfunctioning in so many ways? (2) Is there a point at which a malfunctioning heart becomes too serious for accupuncture treatment?

  39. Chris Kresser’s avatar

    Mark: acupuncture can help with high blood pressure and overall cardiovascular health by improving blood flow, reducing inflammation and reducing stress. However, I’m not aware of any particular effect acupuncture would have on reversing atrial fibrillation or a malfunction in the contraction of the heart. I think in your case acupuncture would be best used as a complementary therapy alongside what your doctor recommends.

  40. Clark’s avatar

    Chris,
    I’m a first year acupuncture student, and have found your six part series on chinese medicine very interesting and informative.  I appreciate you sharing your thoughts and insights.
    Reading your material has generated a few questions:
    - People can have a fair amount of anatomical variation, including the precise location of veins, arteries, nerves etc.  Have you found that acupuncture points and meridians vary significantly person to person as well?  Are there methods you use to locate points other than tranditional surface anatomy landmarks and cun measurements?
    - Some studies have shown that practitioner to patient interaction, expectations, and confidence are key, but that the point locations chosen may not be as critical.  Do you have thoughts on the criticality or importance of point selection?  What do your insights on meridians suggest about point selection?

  41. Dave’s avatar

    Hi Chris, I once heard a quote by a Chinese TCM professor. He told the Western Students that most of them are more likely to be more precise than him in terms of locating the points according the anatomy landmarks. However, he is more likely to be successful in resulting the desirable effects, even if he is missing the point locations by a few mm according the standard texts. The main points I am trying to share is that a skilled practitioners can feel the points by scanning the skin surface, while the talented ones can effect the desirable results even though the needle is off by a few mm. The best analogy is to watch the star war episode IV, instead of relying on computer to guide the missiles, Luke is advised to trust the “Force”. So, close your eyes and train the point localization.  Therefore you are right to state that the physical variation can slightly modify the point locations. I just happened to find this blog and I would like to congratulate Chris for putting up this nice sharing platform.

  42. Dave’s avatar

    Hi Clark, I once heard a quote by a Chinese TCM professor. He told the Western Students that most of them are more likely to be more precise than him in terms of locating the points according the anatomy landmarks. However, he is more likely to be successful in resulting the desirable effects, even if he is missing the point locations by a few mm according the standard texts. The main points I am trying to share is that a skilled practitioners can feel the points by scanning the skin surface, while the talented ones can effect the desirable results even though the needle is off by a few mm. The best analogy is to watch the star war episode IV, instead of relying on computer to guide the missiles, Luke is advised to trust the “Force”. So, close your eyes and train the point localization.  Therefore you are right to state that the physical variation can slightly modify the point locations. I just happened to find this blog and I would like to congratulate Chris for putting up this nice sharing platform.

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