The Martlet

I first remember hearing about acupuncture back when I was in elementary school. My mom was seeing an acupuncturist for some reason, and I remember her talking about the profound emotional and psychological impact the experience was having on her.

But it wasn’t until recently that it really piqued my curiosity, as I began to notice how mainstream this rather mysterious practice has become. Very many of my peers have great faith in acupuncture, and some are even aspiring acupuncturists. Here in B.C., acupuncturists are designated health professionals, acupuncture treatments are covered by our provincial medical services plan, and acupuncture clinics are ubiquitous — there are about 15 within five blocks of my downtown apartment. Here at UVic, our tuition fees subsidize acupuncture thanks to our student health plan, and there is a temporary acupuncture clinic on campus.

But as I started to look into it, I began to suspect that many people haven’t thought very deeply about acupuncture, and that it might not be so popular if they did. I even began to wonder how deeply acupuncturists themselves have thought about what they do.

To find out, I paid a visit to seven local clinics, collected their brochures, and asked a few very basic questions about acupuncture. I was shocked by some of the answers I received. Acupuncture seemed . . . inaccurate.

WHAT IS ACUPUNCTURE?

The brochures I collected offer understandably broad definitions of “acupuncture”:

“Acupuncture is based on the recognition of a system of energetic pathways in the body called meridians. Meridians connect the body’s surface to the internal organs and contain energy called Qi . . . by inserting special needles at specific points on the meridians, acupuncture can correct energetic imbalances or blockages, which may be the cause of distress.”

“Acupuncture is the insertion of fine sterile needles into the body at specific points shown to be effective in the treatment of specific health problems.”

“An acupuncturist will place fine, sterile needles at specific acupoints on the body. This activates the body’s Qi and promotes natural healing”.

But, as their authors might agree, “acupuncture” can vary. Sometimes needles are manipulated after insertion and other times they are not. Sometimes they are heated, or charged with electricity. Some acupuncturists use lasers. Many acupuncturists augment their treatments with prescriptions of various herbs or creams, with “moxibustion” (the burning of mugwort over acupoints), massage and acupressure. And very diverse systems such as traditional Chinese acupuncture, Korean hand acupuncture, and French auricular acupuncture are all huddled together beneath this linguistic umbrella.

To its credit, one of the brochures explicitly acknowledged this, advising patients that

“in different countries, different styles [of acupuncture] have developed based on differing opinions as to theory and technique . . . learn as much as possible about the treatment being proposed.”

Nonetheless, this flexibility of the word “acupuncture” turned out to be very relevant to some of the answers my next question provoked.

WHAT IS ACUPUNCTURE FOR?

The World Health Organization (WHO) has issued a list of health conditions for which “acupuncture” has been proven effective. This is a truly extensive list, and includes afflictions as diverse as: anxiety, arthritis, colds and flu, dysentery, hiccups, pain of all kinds, pneumonia, smoking addiction and urinary tract infections.

Two of the clinics I visited were prominently advertising this fact, and understandably so: that the prestigious WHO has endorsed acupuncture as a treatment for so many diverse afflictions is a very impressive indication of its overall effectiveness.

But to my amazement, upon locating the WHO list on-line, I discovered that it is prefaced by the following statement:

“in this publication the term ‘acupuncture’ is used in its broad sense to include traditional body needling, moxibustion, electric acupuncture, laser acupuncture, microsystem acupuncture such as ear (auricular), face, hand and scalp acupuncture and acupressure.”

In other words: the WHO’s endorsement of acupuncture is based on a motley collection of studies that actually examined very dissimilar procedures — some of which did not even involve needles. And this, in turn, means that local acupuncture clinics are promoting their services using studies that did not necessarily involve the specific treatments they are offering.

As just one example of the kind of ethical concern this raises: “electric acupuncture” is effectively identical to a conventional medical procedure (known as TENS) which is used to treat some of the WHO-endorsed conditions (osteoarthritis, various kinds of pain), and yet neither of these two clinics appeared to be offering electric acupuncture.

Unfortunately, it turns out that these two clinics deserve to be commended for their relative modesty, as I collected brochures from other clinics, which claim that acupuncture can treat:

AIDS, anemia, attention deficit, cancer, carpal tunnel, “computer syndromes,” Crohn’s disease, deafness, diabetes, ear ringing, epilepsy, emotional problems, eye problems, heart disease, hepatitis, herpes, “insufficient milk,” kidney disorders, liver disorders, lupus, menopause, mental retardation, menstrual disorders, “neuroasthenia,” pinworm infection, parkinsens [sic], reproductive problems, shingles, stroke, tuberculosis, thyroiditis, and yeast infections.

. . . among other things. Until recently, a spa in my neighbourhood was soliciting acupuncture for “body-shaping” purposes. And just in case you happen to be perfectly happy, healthy and fit, one of my brochures even states that “acupuncture can help you in maintaining your health, and possibly prevent future imbalances.”

HOW DOES ACUPUNCTURE WORK?

To this I invariably received answers that prominently featured the words Qi (a.k.a. Chi), meridians and “acupoints” (sometimes confused with “pressure points”), although one acupuncturist also mentioned “chakras.”

In fact, many of the claims acupuncturists make hinge entirely on the validity of these concepts. For example, they form the basis of the amazing versatility they credit themselves with, by implying that many dissimilar health issues have a common “root cause” and can therefore be treated in a similar way. And the presumed existence of Qi and meridians allows acupuncturists to advertise, not mere relief, but a potentially profound and lasting cure:

“Not only can acupuncture treat signs and symptoms of pain and discomfort, it can also get to the root cause of the problem.”

“Your [acupuncturist] will . . . perform a physical exam to determine how and why your body’s vital energy, or Qi, is out of balance, and what the root causes are contributing to the overall problem.”

“All activities, both physical and mental, are manifestations of Qi. The body is woven together and interconnected by a network of meridians through which the Qi and blood flow . . . By inserting special needles at specific points on the meridians, acupuncture can correct energetic imbalances or blockages, which may be the cause of distress.”

And yet my brochures also inform me that Qi and meridians are “unfamiliar to the West” and that “modern Western medicine cannot explain how acupuncture works.”

This might have seemed like a plausible claim in the 1970s, when Western pop culture discovered acupuncture in the wake of U.S. President Nixon’s famous trip to communist China. But here in 2011, now that acupuncture has been a designated health profession in B.C. for the past 15 years, this suggestion that it is still mysterious and arcane is remarkable to say the least.

For one thing, acupuncture has now been very extensively studied here in the West — although this has failed to produce any evidence of meridians or Qi — and many “Western” scientists actually have proposed a plausible mechanism by which acupuncture might be “explained”: it’s called the placebo effect.

It is now obvious that the concept of Qi and meridians is eluding the modern East as well. According to the government-authorized news outlet china.org.cn, Chinese scientists recently used a subatomic particle accelerator to try and find something — anything — special about acupoints. But in the end they could only report “a gathering of micro-vessels” certainly a remarkable manifestation of the “body’s vital energy.” Perhaps these scientists would be interested in my “Western” brochures, since one claims that “electromagnetic research has confirmed [acupoint] locations,” and another offers a “computerized meridian analysis and diagnosis.”

Finally, it should be noted that the precepts of acupuncture conflict not just with Western medicine but also with basic science: for example, germ theory and the theory of evolution. Make no mistake: the central unifying concept of modern biology would face a serious reassessment in light of a fundamental “life force.”

HOW OLD IS ACUPUNCTURE?

To be honest, I did not actually pose this question to any of the acupuncturists I spoke with. But neither did I have to: almost without fail one of the first things I was told about acupuncture was that it is “ancient.” This did not appear to be out of great respect for the history of their discipline however, because I was told that acupuncture is 2 000, 3 000 and 5 000 years old.

It could have something to do with the fact that this claim of ancientness has obvious value to any acupuncturist seeking to attract patients and students, since it portrays a thoroughly time-tested Chinese folk remedy that has been gradually perfected by the trial and error of untold generations. And this implies a credibility that no scientific study could ever hope to match — or to undo.

Strangely however, and as previously noted, this allegedly ancient procedure often incorporates technologies that are clearly endemic to the industrial era, such as electricity and lasers. In fact, it turns out that even the acupuncturist’s most common tool, the stainless steel needle, is only about 100 years old. Considering this, it is almost comical that one of my brochures states:

“Acupuncture is an ancient Chinese medical procedure that involves the insertions and manipulation of sterilized stainless-steel needles in the body.”

Stainless steel can be fashioned into extremely fine, strong and flexible needles, and any acupuncture that occurred prior to its invention probably bore precious little resemblance to its contemporary counterpart. And it is very unlikely ancient Chinese peasants were eagerly lining up to have their dizziness, fatigue, emotional problems or hiccups addressed with bone, bronze, iron or gold needles.

It is also unlikely that ancient acupuncturists were addressing obesity, cigarette addictions, or street-drug highs as they do in Victoria today.

It may be true that these techniques are based on concepts that are thousands of years old, but this is a very different claim. After all, surgeons do not suggest that experimental procedures are “ancient” simply because a recognition of flesh and bone extends into antiquity.

In truth, acupuncture appears to be a fairly modern offshoot of what is known today as “traditional Chinese medicine,” and the claim that acupuncture is a thousands-year-old discipline appears to jar with the fact that the Traditional Chinese Medicine Association of British Columbia actually opposed the 1996 designation of acupuncture as an official health profession on the grounds that it is “only one part of the more broadly based practice of traditional Chinese medicine.”

To be clear: everyone I spoke to on my “acu-tour” willingly answered my questions, and they all appeared to be compassionate, intelligent and entirely sincere.

But I can’t help but wonder: what are they thinking? Based on what I witnessed, it appears that local acupuncturists are a) using dubious and scientifically unsubstantiated claims to advertise their services; b) obfuscating the fact that their services and teachings are based on a parallel version of biology and c) propagating historical inaccuracies which might be construed as self-serving. And by so doing they could encourage people suffering from health problems to misdirect their resources, or to take unnecessary risks (after all, acupuncture is not risk-free); by so doing they could impoverish our culture, much like the teaching of “intelligent design” or doctored versions of history.

Of course, it is always possible that these concerns are misplaced, and that acupuncturists are helping to lead us all into a better, healthier and more enlightened tomorrow. But it seems clear that the road there is paved with their own good intentions.

Nathan is a biology and journalism student at UVic and author of the blog memescreen.com.