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Chinese Medicine Demystified (Part VI): 5 Ways Acupuncture Can Help You Where Drugs and Surgery Can’t


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Note: 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, gynecologists 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.

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#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.

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  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.


Join the conversation

  1. While the design of acupuncture studies has been improving, it is still not sufficient in isolating the ‘placebo effect’ and other variables responsible for the inconsistent positive effects that have been seen in past studies. There is still quite a few biases that are not included in any of these studies. It is evident that there’s still a need for a better designed ‘double blind tests’ between receiving acupuncture and not receiving acupuncture at all.

    Here is a suggestion by Dr. Steven Novella.” We need to develop an experimental acupuncture needle that is housed in an opaque rigid sheath. This has been done with glass sheaths in some studies because when pressing the sheath against the skin the subject cannot tell if a needle is inserted or not (because of limitations in what we call two-point discrimination – the nerves cannot separate the stimuli). This is a good idea to blind the subject, but now we must take it a step further to blind the acupuncturist. Modify this setup so that a plunger is depressed that either will or will not insert a needle into the subject, in a way so that the subject and the acupuncturist cannot know if a needle was inserted. What this will accomplish is to truly isolate the variable of needle insertion.”

    So far what we have seen in the acupuncture literature amounts to “noise”. After reading all 6 parts, I would say it is more than obvious that we don’t yet fully understand how placebo works.

  2. This series was very informative to me! It was great to hear a more balanced, scientific perspective of TCM. Now I am left wondering: is there a big difference in outcome between acupuncture and acupressure? Is the latter as effective? Aren’t the mechanisms similar?

  3. Hi, Thankyou so much for this article I’m fresh out of school and very much bewildered. If there are no meridians how do I determine point functions? (we used peter deadman at school), In addition to your answer it would be super if you could refer me to some articles/books on this topic

  4. Chris,

    I enjoyed this article very much. I’ve had great results with acupuncture but frustration around understanding what the mechanisms are and getting thrown with whackadoodle/woo woo talk. Do you know much or have an understanding of chiropractic philosophy & methodology? Specifically the Gonstead technique? You may notice that many wellness, paleo physicians network members are chiropractors. I find that a combination of chiropractic, acupuncture, nutrition, exercise and stress management solves most aliments. Even one that completely puzzled the medical community. I’d love to know your thoughts on chiropractic. I believe it is in some cases as misunderstood as acupuncture, and that the paleo community, especially crossfitters would benefit from it greatly.

    Thanks for everything you’re doing here!


  5. CHRIS, really enjoyed this series and I am convinced that I should seek some acupuncture treatments for a some digestive disorders that I suspect are linked to the PNS. Is there a source that is available that can be used to locate practitioners who have a similar east meets west philosophy to yours?

  6. Hi Chris, a very late comment but I wanted to thank you for your articles, which, as a teacher of acupuncture and research, and a practising acupuncturist, I find most useful in many ways. I wish you would publish a book!

    Just a quick further thought on the meaning of ‘qi’ (Birch and Felt, in ‘Understanding Acupuncture’ by the way have an excellent section on this. One suggestion – from memory – is that it could be called ‘the signals that stop, start or moderate a process’):

    My thoughts (and I am not a sinologist) about the character for qi: it consists of two parts: one part is the sign for steam, and inside this is the sign for rice: boiling rice, the basic nutrition for all of East Asia. The body can only digest rice if it is boiled, and then it is the main source of nutrition in East Asia.
    When qi is written without the sign for rice, then it simply means air. So the complete pictogram describes the transformation of vital essences (food, air) to support life.
    Transformation takes place on a spectrum from energy to matter or vice versa. As we know from basic physics, the addition of heat to solid water (ice) causes increased movement of molecules and a change to the liquid state. Further addition of heat, and the liquid changes to steam (gas). The only difference between states of matter is the amount of energy (or heat) in each state. So this ‘potential’ to transform states is maybe what is meant by qi.
    In a study of Qi in classical texts, Rochat de la Vallee (2006) explains:
    When we speak of qi in general or of qi being everything, we cannot perceive it because it is just a kind of potential. But when some of that potential is realised then there is form, and we can see what kind of qi is acting by the transformation enacted through the form. That is the basis of medical theory. By observing qi through the forms it takes, by knowing what kind of qi is at work, whether all the necessary transformations are proceeding well at each level of the physiology and even the psychology, and by reading signs shown by the form or body, we can know what kind of qi is disturbed.
    Acupuncture treatment according to traditional principles is about regulating transformative processes – or ‘tuning’ qi, as you might with a piano, to make it more harmonious.

    How eternally interesting Chinese medicine is!

    Best wishes to you Chris, and all contributors.


  7. As a Bowen therapist, I am very interested in all forms of holistic healthcare and I found your series of articles very interesting and informative. I am glad to now understand what chi and meridians really refer to. No talk of the fascia though. My understanding of acupunture was that it worked by stimulating the superficial fascia in a similar way to the Bowen technique which I practice. Do you know anything of that?

  8. Really loved this series Chris! I never truly understood Chinese medicine or acupuncture or the mechanisms behind it. Now I have to say that I might give it a try for some “chronic pain” in my lower back! I’ll let you know how it goes once I get the chance.

  9. Thanks Chris for the articles. I have been considering going back to school to learn acupuncture/TCM but after buying an introductory book, I was somewhat put off and discouraged by the esotericism and lack of scientific frame of reference. I now think I will go for it (and read the sources you provided before I jump!)


  10. 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.

  11. 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.

  12. 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?

  13. 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?

    • 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.

  14. 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.

  15. 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?

  16. 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!

    • 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.

  17. 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.

  18. 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.

    • 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.

  19. 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?

    • 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.

  20. 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.

    • 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.