Traditional versus modern Acupuncture

INTRODUCTION

The Guide to Professional Behaviour (page 22), issued by the Veterinary Council of Ireland in April 1988, states:

"19. Meeting an unqualified person in consultation. By this is meant the meeting for the purpose of consultation, with an unqualified person such as an acupuncturist, osteopath, bone setter, chiro-practitioner etc. Such a consultation is unethical and would be construed as conduct disgraceful in a professional respect...".

On being found guilty of that charge, the penalty may be removal of the veterinarian's name from the Veterinary Register of Ireland. He or she would be unable to practice veterinary medicine legally in Ireland or in any other country which recognises the Irish veterinary qualification.

Before and since the advent of western medicine, TCM and TAP have stood the test of time. They serve more of the world's population than our medicine and it will not go away because some westerners scoff at it. Among professionals and the public in the west, there is also growing awareness that holistic medicine must involve the study of many modalities, including western and eastern. Today, a small but slowly growing number of medical, dental, physiotherapy and veterinary graduates in almost every country in the developed world use acupuncture (AP) routinely. However, AP is practised at levels of proficiency ranging from grossly incompetent (by professionally qualified people who may have attended an expensive but worthless weekend AP crash-course) to highly skilled (by people fully trained in Classical AP but deemed to be professionally "unqualified").

Orthodox colleagues of "professionally qualified" acupuncturists have mixed reaction to their use of AP, ranging from encouragement, to disinterest (due to complacency with the status quo or intellectual laziness), to honest scepticism (based on genuine criticism of the poor standard of science/statistics behind many of the published claims for AP, or based on ignorance of the body of solid research and clinical results from well conducted AP trials), to antagonism (based on prejudice, if not malign intent in the face of knowledge that AP has a useful role in medicine).

Three main factors limit the more widespread use of AP and allied methods in "western medicine":

• a. Scepticism and/or vested interest;
• b. Refusal of orthodox practitioners to re-train and
• c. The difficulties of organising AP training.

a. Scepticism and/or vested interest among the more influential members of the professions inhibit active promotion of training, clinical trials and basic research in AP by the professional associations and academic authorities. If they were to admit openly that AP methods are effective, even in some human and animal diseases, the implications for the establishment would be enormous.

For example:The public image of professorial/scientific authority would be weakened. Competent AP teachers and clinicians would have to be found, selected and graded. Who would be competent to select/grade them? Who would pay their salaries and how much?Academic undergraduate curricula (already over-stretched) would have to be re-scheduled to incorporate considerable time for AP at the expense of other course-work.

Research teams would have to recruit expert AP specialists and fund AP research in the face of a multi-national, multi-million dollar drug industry which has a powerful influence on funding of orthodox research, sponsorship of drug-related professional seminars/conferences and junkets for cooperative practitioners.

The National Health, med/dental/vet hospitals, physiotherapy clinics and the general professions would have to establish AP services.

How would the establishment treat AP practitioners unqualified to practice in the orthodox professions and how would the latter react to attempts to control or ban "unqualified" practice?

b. Refusal of orthodox practitioners to re-train: If post-graduate basic- to master- class training were to be made available (even a voluntary basis, at the State's expense) many professionals would probably opt out.

c. The difficulties of organising AP training: Most western countries have no cohesive national approach to AP training, the minimum standard needed, whether classical or simplified AP should be taught. There are many differences of opinion on these questions within and between AP factions within the professions, and between the "professionally qualified" and "unqualified" acupuncturists. Even if these differences can be resolved, there is a chronic shortage of competent AP teachers.

This paper compares and contrasts aspects of the two main schools of AP: the Classical and the Cookbook. It concludes that both systems have strengths and weaknesses and that the minimum requirement is a working knowledge of the basic principles of AP theory and a good knowledge of the main AP points. Neither the Traditional nor the Cookbook system (alone or combined) is effective as a therapy for all types of disease. Therefore a complete approach to professional therapy requires more than proficiency in AP.

The ideal for western societies is an orthodox professional training, combined with a mixture of classical and modern AP, to say nothing of integration of other complementary therapies (homoeopathy, manipulative therapy, etc). Ideals are difficult to attain. A good compromise solution would:

a. allow graduates from bona fide AP Schools to continue to practice and
b. encourage Universities to provide highly practical, elective AP courses (including the Cookbook method and short, basic instruction in Classical AP) at undergraduate and postgraduate level.

Without such a compromise, acupuncturists (even those with recognised qualifications within the medical and paramedical professions) are likely to remain "out in the cold" for the foreseeable future in most western countries.