Why I don’t practise «traditional» acupuncture

Misconception

A common misconception is that acupuncture is, or should be always practised according to traditional Chinese theory. My own studies, knowledge and thirty-year experience tell me that this idea is mistaken. For the first few years of my career in acupuncture, my practice aligned with traditional Chinese theory, but then I changed my approach. I began to realise that acupuncture is overburdened by superfluous and questionable theory, but which many take to be undeniable truths written in stone.

Dogma is anti-knowledge

Just because something is taught as traditional, written in books or pronounced by sages ancient or modern, does not make it true. Acceptance without question, and robotic repetition, run counter to true knowledge. Some people have encyclopaedic knowledge of systems that are based more on fantasy than reality. Anything done differently is regarded as «wrong». Many people working in alternative medicine are afflicted with this kind of anti-knowledge.

Traditional acupuncture is not traditional

The «traditional» acupuncture taught in Chinese universities today is a standardised form established in the mid-20th century. Prior to that acupuncture practice would have varied considerably on the basis of the lineage of the practitioner. In past times masters of the art introduced their own ideas and often disagreed vehemently with one another about important points of theory. At a more grass-roots level, the healing art was passed down through families, and the spread of the ideas and practices particular to each family lineage would have been extremely limited by today’s standards due to geographic, cultural and technological factors. In reality, in addition to practical trial and error, so-called «traditional» acupuncture is derived from a mixture of contrivance, guesswork, superstition, mythology, philosophy and folklore. We do not have to swallow it whole.

There are no physical meridians

«Meridians» is one name Western texts often use for the special channels through which a form of energy, qi (pronounced chi), is supposed to flow. No such channels have ever been found as anatomical structures or demonstrated scientifically as functional entities. Now, I do not regard science as the be-all-and-end-all of truth. But still, in my view the meridians of Chinese medicine are a map (and a rough, rule-of-thumb one at that), but they are not the territory. To use an analogy, we could liken them to the contour lines on a map which represent elevation, but digging for them in the ground we will not find them.

There is no Qi

Qi is the name given to the energy that is supposed to flow through the «meridians» in a certain well-defined sequence and a certain direction, a little bit like blood flows through the blood vessels. To date science has found no such energy, and I see no reason to take its existence as a given. On the balance of probabilities, my assessment is that this hypothetical entity does not exist as such.

Traditional theories are not credible

Qi does not exist except as a concept. Meridians have not convincingly been shown to exist as discrete entities. Any subjective evidence suggesting them is most likely a composite result of the workings of the nervous system, blood and lymph circulation, and the immune system. The traditional system of correspondences and point functions is too neat to be realistic. Chinese medicine speaks in vague and ambiguous metaphors. And traditional teachings about physiology are millennia out of date.

You can squash an octopus into a pentagonal hole but it will not be happy

Traditional Chinese medicine proposes that all things can be classified as belonging to one of five basic classes, known as «elements», “movements” or «phases». This is contrived, simplistic and unrealistic. You might be able to squash an octopus into a rigid pentagonal hole, but it will not be happy about it. Moreover, for any one case the five phase model can account for everything and its opposite at the same time, and acupuncturists routinely exploit this… uhm… fluidity to justify any treatment plan.

Chinese scientific research into acupuncture is unreliable

Although it does occasionally happen, it is quite unusual to read a study of acupuncture published in China that has reported negative findings. It is just not credible that well-conducted studies could be so uniformly positive, it doesn’t happen. Or let us say, this is the only branch of science in which this happens, when the research is done in China! Moreover, a recent study found that a lot of scientific research is bogus, with the majority of this coming out of China. Unfortunately this casts a potential cloud of suspicion over all Chinese studies. It is a pity for the honest researchers there that because of this their own work simply cannot be taken at face value.

Traditional theories of illness are largely irrelevant to the actual practice of acupuncture

The ancient Chinese were supreme observers of symptoms, and their categorisation of syndromes (patterns of symptoms) is coherent and accurate in its way. Unfortunately, while fundamental for the practice of Chinese herbal medicine, in my view its relevance with regard to acupuncture is minimal and basic. Whatever specific action the acupuncturist might think they are producing, in reality the body’s response to acupuncture is a general and normalising one, not specific to any particular symptom, condition or illness. (That is, unless one is needling locally for a local condition.)

In fact, point specificity is illusory

The supposed specific actions of acupuncture points (that is, apart from their action on their immediate surroundings) is an illusion. There are some points which are used with a frequency greatly outweighing the others. These have a very wide range of traditionally described indications. All of these points are on the limbs below or at the elbows/knees. The areas below the elbows/knees are generally more sensitive than those on the trunk or those on the limbs above the elbows/knees. These are likely to be the most effective points for any treatable (non-local) condition or symptom. Inserting a needle through the skin and into the body’s tissues causes a tiny area of damage. The brain registers this and sends resources to the area to initiate healing. But the effect of this is not only around the needle. Although the strongest effect is around the part needled, there is also an effect in the entire body, and especially in the quarter of the body needled. For example, if a needle is inserted into the right foot, it will trigger a healing response in the right foot, the right leg, the right abdomen, and the whole body, in that order of strength. The system of attributing specific functions to points is not credible. It is too perfect. For example, no, there are really no «Wood», «Fire», «Earth», «Metal» and «Water» points with specific effects according to their elemental correspondences. It is all too neat and tidy to be realistic. And in fact, the assignment of these labels to points was not the original acupuncture. The original acupuncture was what we call «empirical», that is, «this point seems in practice to work well for such and such a condition».

Gathering and focusing the healing attention

Inserting an acupuncture needle through the skin and into the body’s tissues, as well as the needle manipulation that usually follows this, constitutes a minor assault, which gathers and focuses the healing attention of the brain. The brain provides resources for healing. This is all there is to acupuncture.

The word is information, not energy

According to traditional Chinese medicine, acupuncture influences the flow of qi energy along the «meridians». As I mentioned above, I do not believe that qi or «meridians» exist as a discrete entities. Personally, instead of energy flow, I like to think of information flow and the provision of resources. Instead of energy channels («meridians»), I think of the nervous system, the circulation and the planes of connective tissue that run throughout the body. All of these can transmit information. A needle inserted into the tissues is a signal to the brain to mobilise resources for healing to take place. These resources include blood flow, biological chemicals, the immune system, and yes, also the physical energy (not qi) required for their mobilisation and use.

The response to acupuncture is a stress response

This observation, hiding here in the midst of all the others, is the main thing! Around which all the rest is arranged. Acupuncture provides a small, controlled source of acute stress and as a consequence a mini alarm response from the organism. There is, in Hans Selye’s* terms, a local adaptation of physiology, and in many cases hopefully a general adaptation. These are temporary adaptations whose function is to reset the body’s homeostasis nearer to normal.

[* Hans Selye: the «father of stress research».]

We cannot micromanage physiology

The body cannot be micromanaged. What we have to do with acupuncture is to work out how to influence its homeostasis at a very general level by means of stimulating the peripheral nervous system. This observation follows from the previous two observations, and I am speaking of the longer term. In a patient with energy and resources that are not extremely depleted, any kind of needle stimulation within a normal therapeutic intensity range will result in normalisation. If stimulation is strong, it may provoke a short-term increase in expenditure of physiological resources and a local dispersion of energy (kinetic energy from blood flow, heat energy from the opening of the peripheral circulation), and this may be a useful thing in some acute cases. But after anything from a few hours to a few days local and systemic physiological parameters will tend to a normal equilibrium, often at a better homeostatic setting than before. You may think you have «tonified» but if the body really needed to put the brake on, that is what it will do. And vice versa. Thus «tonification» and «dispersal» modes of needle manipulation are relevant only to acute conditions.

Pulse taking is divining / dowsing

Chinese medicine has a special way of taking the pulse, wherein the qi of the different internal organ systems is supposed to be palpated at slightly different positions on the wrist. However different eastern traditions and different historical eras have varied in the positions used and the way the pulse should be taken. Yet everybody has claimed that pulse-taking has materially and successfully aided their diagnoses. Let us perhaps naively take this all as being true. If that were the case, we would be obliged to concede that pulse taking is both reliable and subjective, which seems paradoxical. The only conclusion could be that it were akin to divining, like dowsing for water. Strange as this may seem to the reader given what I have written so far, I believe in divining. I believe in it more than I believe that e.g. the deep middle radial pulse position on the left objectively reflects the health or functioning of our liver energy, for example.

Image: Needle placed in the hand, by Chinese Medicine Podcast, from Pexels.com.