In my last article, I presented a theory stating that the concept of wu-hsing (the Five Elements) was originally inspired by ancient astronomy, especially calculations of the orbits of the five planets visible to the naked eye. I ended that article stating that I hoped to offer more information on how ancient astronomy influenced the earliest stages of Chinese medicine. I still wish to do this but thought it best to first offer my views on why exploring this subject is of particular value today.
Be Careful What You Ask For
In the last three decades, traditional Chinese medicine in general and acupuncture in particular, have made impressive inroads throughout the rest of the world. For much of that time, supporters of this healing system have fought a tremendous uphill battle, working to convince the dominant medical establishment that traditional Chinese medicine techniques constitute a viable and valuable medical resource that can compliment modern medicine. At first roundly rejected by modern medical authorities, a great increase in scientific research has convinced many authorities that acupuncture in particular seems to have legitimate clinical value. While this turnaround has been greeted by many in the Chinese medicine community as the long sought after validation they had been working for, there is real reason to wonder if this acceptance may in fact be the beginning of the end of the central role traditional theories have played in Chinese medicine for at least 2,000 years.
For reasons I will attempt to make clear in this two-part article, I believe the foundation of Chinese medicine is more threatened and unstable today than it has ever been in its long history. I also believe that our lack of clarity regarding Chinese medicine’s earliest roots seriously compounds this problem.
Acupuncture Has Arrived – Or Has It?
Chinese medicine theory has long been built on some specific concepts - the most elemental of these being Yin/Yang and the concept of qi. What we are seeing today is a new and ominous combination of acceptance mixed with doubt. Acupuncture’s clinical effectiveness is impressing medical authorities around the world but these authorities see the world through the lens of modern science - the dominant worldview of our present time. Modern medical science not only seeks proof of effectiveness but also wants to understand the “mechanisms” behind it all. When supporters of acupuncture’s traditional concepts explain its clinical effects as being the result of balancing yin and yang qi; proof of this is again demanded even though it has been practiced for 2,000 plus years.
Of course, the existence of qi has never been demonstrated in any sort of scientifically acceptable manner and perhaps never will. Without being able to scientifically validate the existence of qi, the traditional rational for acupuncture and Chinese medicine will never receive modern science’s seal of approval no matter how many clinical trails show effectiveness in treating disease. The combination of mounting evidence of acupuncture’s clinical effectiveness together with an inability to scientifically validate its traditional rational has lead to a new and rapidly growing class of acupuncture supporter; those who acknowledge acupuncture’s clinical value while disavowing its traditional rational. This new breed of supporter is beginning to do more to undermine long-held notions about Chinese medicine than all the sceptics who doubted its effectiveness combined!
As I have followed this new trend of supporters who take exception to traditional theories, I have identified three primary categories and one sub-group. I cite examples of proponents of the first three groups below, who are actively publishing and lecturing in support of their point of view:
The first group is the rapidly growing number of scientists and science-leaning researchers. This group is not at all conflicted about the concept of qi as they never took it seriously and carry-out their research assuming acupuncture works by stimulating nerve reactions or some similar scientifically acceptable physiological mechanisms. A proponent of this group is George A. Ulett, M.D., Ph. D. – Clinical Professor of Psychiatry Missouri Institute of Mental Health University of Missouri-Columbia School of Medicine and author of The Biology of Acupuncture with co-author SongPing Han. Dr. Ulett’s lab was the first in the United States to obtain a National Institute of Health grant to study acupuncture in 1972. He has written several articles on the effects of acupuncture, especially with electric stimulation as well as being the author of “Beyond Yin and Yang: How Acupuncture Really Works” published in 1992. A life-long member of the Brotherhood of Magicians with a special interest in Chinese magic. Dr. Ulett met Dr. JiSheng Han, perhaps the world’s leading acupuncture researcher, in the early 1970’s and followed his research. An example of where this authority stands on the question of traditional acupuncture concepts can be found in the following quote:
“Traditional Chinese acupuncture is an archaic procedure of inserting needles through the skin over imaginary channels in accord with rules developed from pre-scientific superstition and numerological beliefs. New research has replaced this mystical sham medical procedure with a simple evidence-based no-needle treatment that stimulates motor points and nerve junctures and induces gene-expression of neurochemicals and activates brain areas important for healing. This is a scientifically based alternative to the previous metaphysical theories and magical rituals.” - Dr. George Ulett Skeptical Inquirer article; “Acupuncture, Magic and Make-Believe” March-April , 2003.
While Dr. Ulett is perhaps more vocal than most in his distain for traditional Chinese medicine concepts, he no doubt captures the sentiment of many present-day acupuncture researchers.
2. Former traditional supporters
The second category of doubters are those who once believed in traditional Chinese medicine concepts and then later recanted their beliefs in favour of a science-based model. A proponent of this group is Dr Felix Mann. Dr. Mann is Founder and past President of the Medical Acupuncture Society (1959-1980) and was the first President of the British Medical Acupuncture Society (1980). Author of the first comprehensive English language acupuncture textbook “Acupuncture: The Ancient Chinese Art of Healing”, first published in 1962, as well as six other books on acupuncture. Following the numbering system developed by the French, Mann translated these terms into English which became the non-Chinese international system for identifying acupuncture points, i.e. “L.I.4” Dr. Mann has lectured in 15 countries and taught doctors from 45 countries. One of the West’s first proponents of traditional acupuncture, Dr. Mann’s feeling on that subject is summed up in the following quotes from his book “Reinventing Acupuncture: A New Concept of Ancient Medicine”
“The traditional acupuncture points are no more real than the black spots a drunkard sees in front of his eyes” (p. 14).
“The meridians of acupuncture are no more real than the meridians of geography. If someone were to get a spade and tried to dig up the Greenwich meridian, he might end up in a lunatic asylum. Perhaps the same fate should await those doctors who believe in [acupuncture] meridians.” (p. 31).
The quote above regarding meridians is especially reflective of this authority’s turnabout when you consider Dr. Mann once authored a book titled “The Meridians of Acupuncture” that was once used as a text book in some acupuncture schools.
3. Supporters of tradition with a twist
The third category is a rather unique one for which I know of only one published proponent; Donald Kendall, L.Ac., OMD. Dr. Kendall received an engineering degree from University of Illinois and his OMD from California Acupuncture College in the early 1980’s (I believe). He has written several well regarded articles on the scientific basis of acupuncture, especially theories regarding propagated nerve sensations. He recently published a book titled “The Dao of Chinese Medicine; Understanding an Ancient Healing Art” In this book, Dr. Kendall utilizes his translations of Huangdi Neijing, especially the Ling Shu, to lay-out his case that current Western training in acupuncture has been based on faulty translations of original Chinese concepts. He contends that accurate translations of early Chinese medical text are very difficult to carry-out because ancient Chinese written language is extremely context-sensitive and most translators did not have the intimate knowledge of anatomy and physiology necessary for accurate understanding.
Dr. Kendall’s controversial point of view on this subject is rather complex and hinges on specifics of translating ancient Chinese text and details of physiology – subjects demanding more attention than can be given in this article. Suffice it to say his work puts a different spin on what I have been discussing thus far – essentially proclaiming the ancient Chinese got it right, but most of us in the West have misunderstood their original ideas. Some quotes from his book touch on this perspective:
“To this day many Chinese experts understand their theories involve vascular circulation and the nervous system, but use the terms qi and meridian when writing in English, or when addressing Westerners.” (p.7).
“… the Western energy-meridian explanation of Chinese medicine permeates most acupuncture training programs, and is fundamentally at odds with the physiological basis of both Chinese and Western medicine. Through a misunderstanding of the true basis of Chinese medical theories, it has been difficult to obtain consistent clinical and research results.” (p. 13).
“Despite characterizing Chinese medicine as unexplained energy flow in meridians, practitioners can still be taught its effective application.” (p.11).
While I am unaware of any other authority who has published views echoing Dr. Kendall’s, his theories have received some support, including that of a new accreditation organization in the U.S. who has incorporated Dr. Kendall’s theories into their requirements for their core-curriculum. *(1)
4. Sub-group of Historians/scholars
The fourth group consists of scholars, especially historians, who study the history of Chinese medicine. Most in this group are publicly neutral on the question of Chinese medicine’s clinical effectiveness and so constitute a sort of sub-category as compared to the three groups listed above. While I find the work of many of these scholars fascinating, important, and constructive, I also feel the emerging consensus among this group regarding the earliest origins of Chinese medicine represents perhaps the greatest challenge to our profession’s long-held notions. This group’s view has been of particular concern to me and I have spent several years working to offer alternative theories that seek to reconcile the emerging consensus of this group with that of traditional Chinese folk history. I will share my thoughts on the impact this group is having on traditional Chinese medicine concepts in Part Two of this article in the next issue of Chinese Medicine Times.
*(1) The National Oriental Medicine Accreditation Agency (NOMAA) is currently applying for recognition by the United States Department of Education. The following quote by Ted Priebe, LAc, OMD, chief executive officer of the NOMAA appears in the September, 2006 issue of Acupuncture Today’s article “USDE Report Stalls NOMAA Approval Process” and references their support for Dr. Kendall’s theories: “"NOMAA is the first accreditation body to offer programmatic criteria that is anatomically and physiologically based consistent with the historic foundations, theory, and practice of Chinese/Oriental medicine," said Priebe. "This seems to be a dramatic paradigm shift from the popular but impossible idea of Chinese medicine being based on energy and blood circulating by means of invisible meridians. Chinese/Oriental medicine represents a totally rational system that can be clearly articulated in modern physiological and biomedical terms."
Matthew D. Bauer began studying Taoist history, philosophy, and spirituality in 1978 with a 74th generation Taoist Master. He has practice Chinese medicine since 1986 and recently published "The Healing Power of Acupressure and Acupuncture: A Complete Guide to Timeless Traditions and Modern Practice" (Avery; 2005) a book that explores the roots of Chinese medicine. For further information see; www.MatthewDBauer.com
Babcock, S. (2006). Acupuncture Today USDE Report Stalls NOMAA Approval Process Huntington Beach MPAmedia
Kendall, D. (2002). The Dao of Chinese Medicine Understanding an Ancient Healing Art. New York: Oxford University Press.
Mann, F. (1993). Reinventing Acupuncture A New Concept of an Ancient Medicine. Oxford: Butterworth-Heinemann.
Ulett, G. (2003). Skeptical Inquirer article; “Acupuncture, Magic and Make-Believe”.