Note: This is the first article in an ongoing series. Make sure to check out the next articles when you’re finished with this one:
- Chinese Medicine Demystified (Part I): A Case of Mistaken Identity
- Chinese Medicine Demystified (Part II): Origins of the Energy Meridian Myth
- Chinese Medicine Demystified (Part III): The “Energy Meridian” Model Debunked
- Chinese Medicine Demystified (Part IV): A Closer Look At How Acupuncture Relieves Pain
- Chinese Medicine Demystified (Part V): A Closer Look At How Acupuncture Relieves Pain
- Chinese Medicine Demystified (Part VI): 5 Ways Acupuncture Can Help You Where Drugs and Surgery Can’t
I’m sure you’re at least somewhat familiar with Chinese medicine and acupuncture by now. It’s received a lot of media coverage over the last decade, and insurance companies are now covering it in many states. But even though an increasing number of people are using acupuncture to address their health problems, most still don’t understand how Chinese medicine works.
We’ve been told that Chinese medicine involves mysterious energy called “qi” circulating through invisible “meridians” in the body. When the flow of qi through our meridians becomes blocked, illness results. The purpose of acupuncture and other Chinese medical therapies (like herbal medicine and qi gong) is to promote the proper flow of qi through the meridians, thus restoring health. Sound familiar?
If you’ve ever been to an acupuncturist in the west, I’m sure you’ve received some version of this explanation. After all, this is what they teach in acupuncture school. I know this because I’m in my final semester of studying Chinese medicine, and this is the explanation in our textbooks.
Understandably, these fundamental concepts of Chinese medicine have been difficult for western patients and doctors to accept. If you sit a doctor down who has had ten years of post-graduate medical training and tell him that an unidentified energy called qi flowing through imaginary meridians is the key to health and disease, he’s going to look at you like you’re crazy. And I don’t blame him.
What if I told you that nearly everything we’ve been taught in the West about how Chinese medicine works isn’t accurate? What if I told you that Chinese medicine isn’t a woo-woo, esoteric “energy medicine” at all, but instead a functional, “flesh and bones” medicine based on the same basic physiology as western medicine? And what if I told you I could explain the mechanisms of Chinese medicine in simple, familiar terms that any eight year-old could understand and even the most skeptical, conservative doctor couldn’t argue with?
Here’s the thing. The “energy meridian” model that has become the default explanation of Chinese medicine US is not only out of sync with our modern, scientific understanding of the body – it’s also completely inconsistent with classical Chinese medical theory.
This gross mischaracterization has kept Chinese medicine on the fringes of conventional medical care since the 1930s and 1940s. Most doctors and patients have simply been unable to accept the explanation they’ve been offered for how acupuncture works. The result is that acupuncture has come to be seen as either a mystical, psychic medicine or a foofy, relaxing spa-type treatment.
And that’s a big shame. Because Chinese medicine is in fact a complete system of medicine that has successfully treated many common health conditions for more than 2,500 years. Chinese medicine was passed through the ages in an unbroken lineage of some of the best minds of China. It was used by emperors and the royal courts to help them live into their 90s and stay fertile into their 80s at a time when the average life expectancy in the west was 30 years.
The Chinese were performing detailed human dissections where they carefully measured the blood vessels and weighed the internal organs at a time when western physicians thought the body was made up of “humors”. These dissections helped Chinese physicians to discover the phenomenon of continuous blood circulation 2,000 years before it was discovered in the west. The discovery of blood circulation is still considered the single most important event in the history of medicine.
Chinese medicine has been around for a very, very long time. The first evidence of the type of medicine that led to the Chinese Medicine in use today dates back to about 6,000 BC, which was during the neolithic (new stone age) period. Stone tools from this period have been found that were specially shaped for making small incisions in the skin, which was the early form of acupuncture. That’s 8,000 years of uninterrupted use. To put this in perspective, western medicine as we’ve come to recognize it today wasn’t even invented until the 1350s (the middle ages), which makes it less than 700 years old. Ah hem.
Let me ask you this. Do you think Chinese medicine would have survived for more than 3,000 years and spread to every corner of the globe if it wasn’t a powerful, complete system of medicine?
In the next article I’m going to give you an explanation for how Chinese medicine works that is not only historically accurate, but also consistent with the principles of anatomy and physiology as we understand them today. I’m also going to tell you how this blatant mischaracterization of Chinese medicine in the west came about.
Read the next post in the series: Chinese Medicine Demystified (Part II): Origins of the “Energy Meridian” Myth
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I feel bad coming here and criticizing your blog without an invitation but there’s just so much misleading and wrong information here. You wrote:
“And that’s a big shame. Because Chinese medicine is in fact a complete system of medicine that has successfully treated many common health conditions for more than 2,500 years. Chinese medicine was passed through the ages in an unbroken lineage of some of the best minds of China. It was used by emperors and the royal courts to help them live into their 90s and stay fertile into their 80s at a time when the average life expectancy in the west was 30 years.”
You ought to know there was no “system” of Chinese medicine that long ago. There were umpteen various schools who held and taught dozens of conflicting theories. Most of what we can read from that time is pure superstition, unless you really believe that the corporeal soul is in the Liver, which stores the blood from our body in the evening, and the heart which “makes” blood. The brain is an empty organ which holds “essence” and plays no role at all in TCM. Amazingly, they discovered that needling the fingertips would cure all mental illnesses! Gosh, if we would just do that, our mental wards would be cleared out.
You might want to research when the life expectancy of Chinese rose. I’ll give you a hint: it wasn’t way back then. It was after the introduction of the evil western medicine. The fact that some chinese lived a long time means nothing, as countless examples from European history show that many lived into old age, even Christian monks who ate much of nothing and had no doctors at all, which is probably why they lived longer, given the state of medicine at the time.
There are some serious issues with your series.
— Old doesn’t mean true or efficacious. Otherwise animal sacrifice to appease imagined deities and astrology could be counted superior to TCM.
— Your comparisons with “western” medicine, whatever that is, doesn’t support or help your argument one bit. I could list dozens of examples from classic TCM texts which would make TCM appear ridiculous. (I withdrew from a TCM program due to nonsense propounded as truth)
— Comparing western medicine (no such entity) with TCM is unhelpful, misleading, and fallacious, because there is no monolithic entity of either.
— You wrote: “The reason Chinese medicine isn’t more popular in the west is that it’s completely misunderstood even by the people who practice it.” Nice that you know the truth while the professors who come from top universities in China don’t know (the real truth).
There are countless other reasons why it’s not popular: Not efficacious for many diseases, costs an arm and a leg, people are scared of the unknown.
— You wrote: “I’m also going to tell you how this blatant mischaracterization of Chinese medicine in the west came about.” And it’s still perpetuated by my former Chinese professors who’ve been practicing for an average of 15 – 20 years and graduated from Chengdu University. Even the Chinese themselves don’t know this great truth!
wow that study is fascinating Kumar.
Is there an online version of that study to read?
Chris,
I was an engineer for 18 years prior to coming to school for TCM (in my 2nd year) and I really struggled with the TCM concepts for a while, constantly trying to translate them to a western paradigm.
The article might be useful to give people to help them view TCM from a biomedical theory, especially if they are skeptical.
Are you familiar with the Technitium-99 study done by French researchers (Nuclear Medicine Investigation of Trasmission of Acupuncture Information – by: J-C Darras, P Albarede, P de Vernejoul — published in: Acupuncture in Medicine May 1993 Vol 11, No 1)? They injected T-99 into known acupuncture points and compared them with non-acupuncture points, adjacent blood vessels, lymphatics). The tracer traveled along a pathway specific to the location of the primary channels. If it was injected in a point on a meridian, it would migrate along what appeared to be the meridian. If the dye was injected into a non-acupuncture point, it would diffuse in a circular pattern. If another tracer were injected into a blood-vessel (adjacent to the acupuncture-point), it would travel in a separate path (the blood-vessel) and disappear very quickly (assumed to be carried away by the relatively rapid blood flow.)
I can forward you a copy of the article if you’re interested. How can one explain this result in terms of the blood-vessel paradigm? One theory I’ve heard is that the channels are myofascial tissue planes along the body. But there is more than one thing going on with regards to this study than simply myofascial planes — (eg: the relatively slow movement of the tracer along “meridians”, and the ultra fast response of the paired meridian on the opposite side of the body to contralateral stimulation).
I am on point with a lot of what you say in this series. But let me clarify one thing are you saying that the nomenclature by which we define meridians is wrong, or that the whole concept of meridians is erroneous? If it is the later, you are making a bold statment indeed!
That’s exactly what I’m saying. But it’s not just me saying it: it’s the classic texts. The notion of a meridian system outside of the vasculature was a creation of Soulie de Morant.
Loved your series, especially your explanation of Qi. I usually describe the character for Qi as being made up of two radicals: one is for things that are in the air, the other is grain. Air and Grain make Qi….
This is one hell of an article. I have a close friend who came from China to practice medicine in America. He has a western MD degree and a degree in Traditional Chinese Medicine from Shanghai, earned in 1963. I couldn’t agree more with the lack of understanding for this system. The arrogance of modern western medicine refuses to entertain that there could be knowledge that is unknown and misunderstood by them even as they look through their microscope hunting for answers to complex diseases. Arrogance ends in failure. Traditional Chinese Medicine employs herbs, massage, pulse and tongue diagnoses, stress reduction, Chi Gung, , cupping, laughter and needles.
What impresses me most about my Chinese colleague is that he cares about his art and science and he actually works on your body for an hour or two when you come to see him. I know of no medical doctor who does the same thing. Instead, they see you for two minutes, write you a prescription and don’t care to listen to a word you have to say.
I am going into my fourth week of acupuncture to treat cervical dystonia. I decided to try this alternative to the botox injections…the only thing prescribed by the numerous neurologists I’ve seen. I just wasn’t comfortable injecting a toxin into my body. The doctors did not want to discuss alternatives or take the time to listen. Quite the opposite with my acupuncture dr who is 4th generation…he takes the time to listen, is empathetic and truly cares about me. After only 6 sessions, I can now turn my head (I could not turn to the right at all), the head tremors are significantly less and I can keep my head still in the center without it trying to pull to the left. I’m also finding myself much calmer and sleeping better. I don’t know if I’m the exception….nor do I care how it works…I’m just grateful it is helping me and I have finally found a dr who cares.
@ Gordie. Good point: I will answer with a question: can it be considered placebo effect when an infant with spastic paralysis due to cerebral palsy can have his limbs relaxed, even temporarily, by an intervention such as putting acupuncture needles into select points?
Also, you are right in mentioning multifactorials. I myself am a father of a five year old and my main method for treating her would depend on the disease. In one case of bronchitis I referred to her pediatrician for appropriate antibiotics. In some cases of common cold I relied on massage. I recall only two instances of using acupuncture needles on her and both were to quickly lyse a fever (both due to viral infections.) Diet and massage are actually the most important tcm modalities for children. Again this reinforces what Chris is saying about having many tools at one’s disposal.
Chris: yes, for some reason sticking needles to yourself doesn’t quite have the same effect.
General comment: one tragic error among many western MDs who study acupuncture (like myself) is that they end up only using acupuncture much to the detriment of patients who could benefit more from another modality like tui na or herbal medicine. I myself learned that the hard way.
Chris, I believe you’re correct about acupuncture outperforming placebo for some conditions – even sceptics grudgingly admit that. I still wonder if that is to do with selection bias (i.e. only positive trials being published) but this is as much, or more, of a problem with mainstream medicine, as we all know. I wish acupuncture worked, I hope it does. I did end up here after searching for “chemical imbalance myth” and have had my own dreadful experiences with psychiatrists.
Ah, I see. I can see how that would be the case. Thanks.
One would think. But as any acupuncturist can tell you, giving yourself a treatment doesn’t seem to have quite the same effect. I’m not sure how to explain this, but it’s true in my experience as well.
And, as I mentioned, although studies don’t show that points selection matters many acupuncturists would disagree. (Of course they would, you say.) Many patients disagree as well. It’s not uncommon for a patient to see one acupuncturist, not get a good result, and then see another and have their problem cured. Now we can’t say that point selection made the difference, but we can’t rule it out either.
Finally, many acupuncturists are also trained in Chinese herbalism, nutritional medicine, and other therapeutic and preventative modalities. Acupuncture is just one aspect of Chinese medicine. Kind of like the “physical therapy” of western medicine, only far more powerful. But don’t ignore the other parts of Chinese medicine. In some cases they can be even more helpful.
Chris,
Non-specificity does seem like it could be an advantage. It strikes me though, that if the positioning of the needles doesn’t seem to make a significant difference, couldn’t I get some sterile needles and stick myself in random places, rather than paying someone to do it for me?
Gordie,
I agree with your points about placebo and how it can confound research. However, as I mentioned above acupuncture has consistently outperformed placebo in clinical trials.
The question that is harder to answer is whether point selection has any bearing on the outcome of a treatment. The research suggests not, but my personal experience and that of many other practitioners and patients suggests otherwise. I wouldn’t make an argument here because my observations are just anecdote, but mention it for whatever it’s worth.
philip: because the placebo effect encompasses more than just “feeling a bit better because the doctor was nice to us”. It also includes regression to the mean (i.e. getting better naturally) and observer bias (i.e. having faith in some treatment and as a result imagining that your baby’s condition has improved when it hasn’t). Presumably if your baby is sick you wouldn’t rely solely on acupuncture etc. You would feed him differently, you would keep him warm or make sure he slept more. Who’s to say this isn’t what helped him? It is even possible that, because you have so much faith in a treatment, your child feels better as a result of recognising your own confidence. All of these are well established problems with relying on anecdote, not just in alt med but in mainstream medicine too.
Jesse,
I’m aware of that study, and others like it. Here’s what I think (and I’m not alone – several very well-respected luminaries of Chinese medicine in China have said the same thing): acupuncture by nature is mostly non-specific and doesn’t target any particular pathology, but instead restores homeostasis by stimulating the body’s innate healing mechanisms. From this perspective it makes sense that inserting a needle just about anywhere would create a treatment response.
Acupuncture is a far more elegant approach than using drugs or surgery to suppress symptoms, which is what western medicine does. The immune system is the most complex and sophisticated ecology we’re aware of. We have the ability to spontaneously heal injuries, fight infection and regenerate tissue without any conscious awareness or participation on our part. Drugs and surgery are like children’s toys when compared to the regulatory mechanisms of the immune system. And although we’ve made great strides in understanding how it works, we have only barely scratched the surface.
So I don’t see the nonspecificity of acupuncture as a problem. I see it as an advantage. Acupuncture stimulates the body’s self-healing ability. When you go in to get an acupuncture treatment for elbow pain, not only will your elbow pain go away, you’re digestive problem will improve, you’ll start sleeping better, and your chronic sinus issue will clear up. Nothing in western medicine can do this. Drugs can’t do this. Surgery can’t do this. And acupuncture does it at a minimal cost, with virtually no side effects and risks.
It’s true that lack of evidence for one method over another doesn’t mean there isn’t a better method.
Are you aware of this more recent paper by Moffet? It concludes, from my reading of the abstract, that acupuncture points that were specifically selected as either the wrong points or not points at all (as opposed to just points selected with a different method) give as much effect as true acupuncture points. What do you think?
@jesse and Chris
Yes, I believe that different traditions also depend on the practitioner. I know someone who just loves scalp acupuncture for some reason. I prefer five transporting points and combining Yuan Source and Luo Connecting Points as needed. Our choice of “style” reflects practitioner preference.
Jesse,
What the study showed was that there may not be a statistically significant difference between one style of choosing points and another. This is also supported by the fact that there are many different methods of acupuncture (80 in China alone), and they all seem to be effective.
Elsewhere in the paper Moffet does point out that traditional acupuncture points do have a higher concentration of neurovascular structures than non-points, so the treatment effect could be expected to be higher when points rather than non-points are selected.
However, the research done so far doesn’t support the idea that one method of acupuncture point selection is better than another. Keep in mind that this doesn’t mean that there isn’t a better method. It just means the research doesn’t currently support this idea.
Hm, that Moffet paper is interesting. There were many things I hadn’t heard of before. Do lasers, capsicum bandaids, and electro-stimulation really count as acupuncture?
The paper also concluded: “In short, acupuncture can affect outcomes but might not depend on specific points, locations, or techniques.” Weren’t you saying that the traditional acupuncture points were supposed to work because they had the largest concentrations of nerves or something?
That’s a good point about drugs though. I hadn’t considered that I could investigate the efficacy of drugs I might be prescribed.
Gordie,
There’s abundant evidence that acupuncture outperforms placebo. In the recent Moffet paper published in the Journal of Clinical Epidemiology, he states:
“Clinical trials demonstrate that acupuncture can affect outcomes and is distinguishable from a placebo.”
I wonder if your skepticism extends to western pharmaceuticals. Did you know that antidepressants are no more effective than placebo in most cases? And did you know that researchers believe that placebo accounts for between 30 – 80% of the treatment effect of most drugs? Many drugs are only 4-7% better than a sugar pill (not to mention often carrying considerable side effects and risks).
As you know, I’m a skeptic myself, so I’m not discouraging a skeptical approach. On the contrary! But most people who claim they are “skeptics” are only skeptical of the non-dominant paradigm. That’s not skepticism, it’s narrow-mindedness.