Tuesday, November 29, 2011

Acupuncture's Identity Crisis !

Editor’s note: This is a guest article by David Simpson, an acupuncturist in New York City

Growing interest in acupuncture has led to several unfortunate attempts to label it. Complementary and Alternative Medicine, Acupuncture and Oriental Medicine, Traditional Chinese Medicine… Acupuncture gets tossed willy nilly among these different rubrics.

Not only is this inconsistency confusing for patients, but all of these names present a number of difficulties in accuracy, cultural respect, and sensitivity.

The argument against CAM, biomedicine’s preferred name, has to do with its dismissive connotations. Patients often expect CAM treatments to be free—indeed, “complementary” sounds a lot like complimentary. As for “alternative,” acupuncture critics jump on this as an opportunity to accuse acupuncturists of influencing unsafe medical decisions. While some people opt for acupuncture in lieu of certain routine medications (to avoid debilitating side effects), I have never met an acupuncturist who touts his offerings as a cure for cancer.

AOM, despite the acupuncture professional community’s warm embrace of it, is inappropriate for its pejorative reference to “Oriental.” The term belittles not only the acupuncture profession but also nearly half the planet.

The Trouble with ‘TCM’

Within this tyranny of language it has been posited that acupuncturists rally around Traditional Chinese Medicine, or TCM. It’s true that acupuncture is thousands of years old, has origins in China, and is a form of medicine. However, TCM is merely a subset of acupuncture theory, making it too an inadequate moniker.

From 1940 to 1976, under Mao Zedong’s leadership, China experienced its Great Leap Forward and Cultural Revolution. China was revamped completely in order to compete with Western civilization. As part of this movement, Mao created the Ministry of Public Health, facilitating the elimination of a centuries-old lineage-based model of acupuncture. He supplanted it with a nationally standardized version—TCM.

TCM is an appropriated term and model, representing an amalgamation of theories to better interface with Western medicine. The benefit is that it gives previously disparate practitioners a common language with which to discuss patients. For example, someone with asthma might be diagnosed with Lung Qi Deficiency.

However, “Lung” under the TCM model diverges from its true acupuncture meaning, which has just as much to do with the Lung’s function as with the physical organ. TCM is heavily based on pathologies of six Yin and six Yang organs, and places great emphasis on specific point indications.

True “traditional” acupuncture favors the interdependent relationships of meridians and organs over set-in-stone points’ effects on organs. Instead of function begetting form and vice versa, as is true of pre-Mao acupuncture, form and function were differentiated with the advent of TCM.

TCM also eliminates China’s beautiful pragmatic holism. Pre-TCM acupuncture theory was not just a form of medicine. It was a way of describing and understanding the entire universe. But China’s Cultural Revolution, in an attempt to mimic Western ideals, did away with anything that incorporated intangible realities.

For example, Five Element acupuncture, a style that focuses on emotions and spirituality, is grounded in many of the precepts of pre-TCM China’s principle acupuncture texts. Despite its popularity in the West today, Five Element acupuncture is explicitly invalidated by TCM.

Given the pluralist and syncretic traditions of acupuncture, neither TCM, CAM nor AOM are appropriate labels for our medicine. However, the failure to secure a defining name for acupuncture may be a good thing.

The Dao De Jing, a principal acupuncture text, says, “The Dao that can be known is not Dao.”

Perhaps we’re searching for something that cannot be found. Perhaps the best name for acupuncture is, well, acupuncture.

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