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- As shown in the bibliography acupuncture has been practiced by highly experienced practitioners for decades without resorting to traditional ideas and with no loss of efficacy. This mode of post-traditional practice is consistent with current neurophysiological theories and so is testable and can be further explored and developed by current scientific methods.
Economically at least, most of Chinese medicine in the West rides on the back of acupuncture. Without acupuncture CM would not be as viable financially or as popular as it currently is. To take this further most of CM in the West depends on a very specific use of acupuncture, namely the treatment of pain.
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- These facts suggest the current practice of Traditional Chinese Medicine (in its current non-scientific form) may not have the future that many practitioners envision for it and may well now be entering a period of decline.
As far as I’m aware pulse diagnosis has never been shown to be consistent across a group of qualified practitioners, at least in the West (I am aware of a small study that showed no correlation between practitioners and another even smaller still that showed minimal correlation detecting one or two pulse qualities). In actuality in clinical practice pulse and tongue diagnosis are used more to back up what is already assumed from taking a medical history and rarely used as a stand alone diagnostic tool even by traditional acupuncturists.
As a diagnostic tool it is highly subjective and prone to “idea motor action” distortion i.e. unconsciously “finding” the pattern that is sort. Verbal description of pulse qualities and the actual feel of the pulse are simply not clearly connected for different practitioners. This lack of objectivity was expounded by many Western physicians as far back as the 18th century who struggled with a Galenic pulse taking as equally complex as that of CM (see Kuriyama 2002)
Added to this the “organ” names given to traditional patterns of imbalance have been hopelessly confused with modern anatomical organs to such an extent that patients, acupuncturists and authors of numerous books on CM and alternative medicine all think that the condition of the anatomical organs can be felt on the pulse and treated with specific acupoints. It is a common experience in acupuncture to have a patient come into the office complaining of weak kidneys or a deficient spleen thinking they have impaired anatomical organ function as another acupuncturist told them this through traditional diagnosis.
Acupuncturists continue to assiduously run through the ritual of pulse taking and tongue diagnosis diagnosing organ, yin, yang and Qi, heat and damp imbalances, even though as suggested through modern research (both scientific and historical) it’s unlikely that specific acupoints can treat any of these as acupuncture for the most part is non-specific. Choosing K3 for kidney yin, Lv2 for liver fire, Ht6 for heart fire and so on as a way of rationalizing traditional acupuncture treatment in a quasi-scientific manner with no clear basis at all in neurophysiology. The stepwise logic of traditional dogma is served but except for minor health complaints efficacy can only really be determined through modern medical tests etc. Because this neurophysiologic effect may occur with almost any acupoint anywhere on the body confirmation of whatever specific treatment protocol cannot occur. If over-all functioning improves this seems to justify traditional theory, but acupuncture by its very nature stimulates widespread healing responses in the body either temporarily or for sustained periods of time.
Consequently once the dogmatic nature of the traditional system is seen – how choice of acupoints has been organized and forced into an artificial symmetry and a pharmaceutical model has been imposed upon what is essentially a neurological effect it becomes almost impossible to accept that for example acupoint St44 is effective for “stomach fire” or heat in the face or that K3 treats afternoon fevers due to lack of Yin cooling and so on.
Ultimately then the practice of traditional acupuncture cannot in the end respond to the challenge of burden of proof and will not survive a clear scientific gaze.
The post-modernist view often used by traditional acupuncturists and others that the ancients developed a “science“ with access to hidden factors not accessible to modern science is a highly questionable stance to take given that key concepts and theories are forced and formed to fit the limited understanding of Nature at the time. In addition concepts are largely untranslatable and material that is available in modern texts is ridden with what historians call Presentism – the tendency to interpret the past based upon current knowledge and understanding.
Adding the prevalence of redaction of various Western ideas recycled back to the West via Eastern authors and experts to the mix further compounds the confusion.
This is not to acquiesce to a hard-nosed skeptical position about as yet unknown subtle factors. It is however a call for a rigorous approach to these mysteries as well as questioning whether this has any place at all in the clinically practical medical modality of acupuncture.
To date it has been very easy for traditional acupuncturists to make untestable claims and elaborate all sorts of theories with the grand warrant of ancient wisdom and special knowledge which purports to be beyond science. Given on the one hand the late 20th century interest in traditional knowledge and on the other rejection of alternative medicine by mainstream medicine there was in the past decades among acupuncturists the luxury of much enthusiasm without rigorous questioning and rational analysis. Today as medical science investigates acupuncture and with its increasing acceptance as a mainstream modality the cultural space that enabled such a flourish of dogma and imagination is rapidly closing..
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