Pearls and Strings in Classical Acupuncture, Part One: The Acculturation of Acupuncture in the United States

Presently, the practice of acupuncture is undergoing drastic change due to the inevitable process of acculturation it is experiencing in a number of countries, including the U.S. and western European nations. We will leave the subject of acculturation in Europe for a different article, and will concentrate for now on the current situation at home in the U.S. This article discusses how acupuncturists can cope with the emerging trend of medical acupuncture, practiced with increasing frequency by medical doctors. What is an acupuncturist's strong competitive edge when MDs and DCs are starting to successfully incorporate acupuncture into their own practices?

Historically, acupuncture has undergone the process of acculturation many times during its implementation into different cultures and countries. This is why so many different types and styles of acupuncture (Chinese, Japanese, Korean, etc.) exist today. While teaching in different countries and to different audiences, I have noticed that the current acculturation of acupuncture is driven by two factors: the practitioners' backgrounds and the scientific advances in 21^st-century biomedicine.

Medical doctors are attempting to understand and practice acupuncture from within their familiar framework of biomedicine in the 21^st century. This approach is justifiable and necessary because high-tech research and clinical practice have provided enough scientific data to develop new, modern concepts of biomedical acupuncture.

At the same time, experts of traditional, classical acupuncture in China, South Korea and Japan are working together for the first time in history to re-evaluate the traditional acupoint system, by clarifying confusion in the 3,000-year-old literature to find a common ground for standardizing traditional classical acupuncture. Some of my good friends are involved in the Sisyphusian labor and have provided me with firsthand reports on this.

Thus, medical and traditional acupuncturists use different approaches to understand and practice acupuncture according to their backgrounds, although there is no reason that these two approaches cannot coexist peacefully and even enrich each other. Each group of acupuncturists is likely to set up its own training and practice standards according to its own medical and social environments. This coexistence is possible because of the everlasting presence of the immortal pearls of classical acupuncture, which make acupuncture virtually indestructible and adjustable to any acculturation without sacrificing its healing effectiveness.

One of these immortal pearls is the nonspecific nature of acupuncture. Acupuncture is by its nature nonspecific and does not target any particular pathology, but restores the yin-yang balance or homeostasis by triggering the self-healing potential of the body. From an evolutionary perspective, in order to survive, we developed the ability to spontaneously heal minor injuries by activating a neuroimmunologic reaction leading to tissue regeneration. Acupuncture, created 4,000 years ago by the genius doctors of China, is based on this built-in survival mechanism. Needling-induced lesions from acupuncture treatments stimulate longer, stronger and deeper in situ neuroimmunological modulation than any other modality can produce or duplicate.

Acupuncture needling inoculates minor lesions inside the soft tissue, including the nerve tissue, perceived by the brain as a foreign invasion. Thus, a needling-induced lesion stimulates a neuroimmune response involving the cardiovascular and endocrine systems, and other physiological reactions through the release of neurotransmitters. Acupuncture does not target any specific symptoms or diseases, but effectively normalizes physiologic processes to activate self-healing. The results of this self-healing depend on the "healability" of the symptoms (for example, the severity of the pathological conditions) and the patient's self-healing capacity (for example, how disturbed the patient's yin-yang balance/homeostasis is; how much healing energy the patient's body has left to recover).

The nonspecific nature of acupuncture therapy cannot be overstressed. Acupuncture is not a pharmaceutical therapy; acupoints do not have a pharmaceutical function; and the professional practice of acupuncture does not have side effects.

Another example of an immortal pearl that contributes to the indestructible longevity of acupuncture is that it's firmly based on an underlying biomedical mechanism that explains the interrelatedness between internal organs and the surface of the body.

Professor Long-xiang Huang, vice president of the Acupuncture Institute of the Academy of Traditional Chinese Medicine in Beijing, has proposed a "pearls and strings" concept of TCM and has been working to differentiate the pearls from the strings of acupuncture since 1983, under the guidance of his mentor, Professor Wang Xue-tai, a world-recognized scholar, acupuncture clinician and lifetime president of the World Federation of Acupuncture and Moxibustion.

For more than 20 years, working 14 hours a day, Professor Huang meticulously studied all of the ancient acupuncture literature, from archaeological relics to Qing dynasty manuscripts. The results of his research were truly revolutionary and groundbreaking. After publishing these results, Professor Huang expected a storm of repulsion and criticism of his work. Instead, to his great relief, his book was highly acclaimed by the Chinese acupuncture body, including both scholars and practitioners.

Professor Huang's research showed that over several centuries, clinical realities that did not fit into an existing theory often were suppressed to ensure continuity of the theory, in a style the Chinese call "cutting the foot to fit the shoe." Thus, today's traditional acupuncture is like a pearl necklace, with the pearls of wisdom and vast empirical/clinical experience strung together by the strings of outdated theories and inadequate explanations.

Professor Huang notes the urgent need to separate the pearls that should be treasured and preserved from the strings that should be corrected or discarded in order to ensure the continuous development of acupuncture as a live body. The strings are outdated concepts; the pearls are acupoints and the mechanism of acupuncture. In other words, while empirical facts should be studied, explanations of these facts should not simply be accepted at face value.

Acupuncture always was, is and will be a living, evolving modality. Remember the Red Queen's valuable advice in Alice's Adventures in Wonderland, by Lewis Carroll? You have to run very fast to stay in the same place. The art of acupuncture is never stagnant. It's continuously developing, buoyed by its immortal pearls and propelled by practitioners unafraid to discard outdated strings.

The biomedicalization of acupuncture will result in a deep, scientifically based understanding of the interrelatedness between different parts of the body surface, and between the body surface and viscera. It will identify the immortal pearls and connect them with new biomedical strings. Professor Huang drew the analogy that outdated strings have become the narrow neck of the bottle that traps the continued development of acupuncture in the 21^st century. Today, acupuncture is sponsored by the World Health Organization and is one of the most acceptable alternative healing arts, receiving much attention and research resources internationally. The intensive research conducted in the field of acupuncture in the past five decades has helped us to understand the mechanisms of acupuncture even better than the mechanisms of some conventional medical procedures.

This article began by asking about the competitive edge of an acupuncturist at a time when MDs and DCs are starting to successfully incorporate acupuncture into their own practices. I believe the competitive edge is this: a deep understanding of, and the ability to effectively implement in practice, the valuable immortal pearls of acupuncture, while not overemphasizing the value of outdated strings. The competitive edge also resides in acupuncturists, implementing in their daily practice not only their deep understanding of acupuncture, but also their unparalleled knowledge of all aspects of Oriental medicine, including herbal medicine, moxa, cupping, etc., which sets them apart from other medical professionals.