Is There a Place for Integrated Medicine in the Western World?
Kwee Swan Hoo EJOM Vol. 3 No. 3
For Western MDs, Traditional Chinese medicine (TCM) is quite an alien paradigm. Acceptance is subjected to strict scientific rule. For this western scientific rule the 'context of justification' of western medicine is totally commensurable with the 'context of discovery' of western science, but it is not commensurable with the 'context of discovery' of Chinese science, for example with acupuncture (qi-paradigm), acupuncture anaesthesia, the compass and architecture. The 'context of discovery' and the 'context of justification' are the two main contexts in scientific enterprise. Incommensurability in philosophy of science means: two bodies of discourse - whether theories, worldviews, paradigms or what have you - are incommensurable, if the assertions made in one body are unintelligible to those utilising the other. The incommensurability of the two medicines is especially at the conceptual level and not within the empirical level. So Chinese medicine should also undergo testing in the same way as evidence based medicine and try to develop its own scientific base, which will facilitate the integration of Chinese and western medicines. Consideration must be given to any gains or losses resulting from this process. The incommensurability diagnosis and the suggested integration method are discussed.
In modern day China it is apparent that there is one unifying and distinctive style of acupuncture, familiar to us all in the West as TCM. Japanese acupuncture is more pluralistic, and embraces many different styles and schools. In this article the authors give an overview of a number of Japanese acupuncture systems. The four systems reviewed are: Dr. Manaka’s Yin Yang Channel Balancing Therapy; Keiraku Chiryo Meridian therapy; Toyohari Meridan Therapy; and Kiiko Matsumoto’s Integrated Approach. The authors convey the characteristics of each system and contrast them within the wide spectrum of Japanese acupuncture styles. Becoming open to these contrasting systems, which have demonstrably powerful effects, can challenge our conceptions and add new meaning to the concept of 'maximum benefit from minimum intervention.'
Complementary Medicine Research: An Alternative to the Reductionist Approach
Roisin Golding interviews Dr David St. George EJOM Vol. 3 No. 2
During this interview David St George develops a variety of theories and ideas that transcend the limitations of the currently accepted scientific view, which is based on 'atomic materialism' and which sees the building blocks of existence but not the creative forces, including consciousness, which may line them up like a 3-dimensional holographic structure and determine their functioning. The following is a paraphrased quote:An expanding force, originating in the big bang, is pulsating out of the sun, which is counteracted by gravity.Similarly, out of the earth, out of plants, out of every atom and molecule, out of every living being, come these expanding and contracting forces, which are orchestrated by what is called life force, biorhythms, qi or prana.David St George questions a scientific paradigm which is unwilling to discuss evidence that does not fit into the current belief system, reminiscent of the church elders refusing to look through Galileo’s telescope.
The Qi Jing Ba Mai (8 Extraordinary Vessels) as Representatives of the 7/8 year Life Cycles
Avi Magidoff EJOM Vol. 3 No. 1
Although the use of the qi jing ba mai is very widespread, not many people pay deep attention to the philosophical statements that they might represent. This article is an attempt to look at the qi jing ba mai as the basic scheme of human life. The ideas presented here are based on the work of Daoist priest Jeffrey Yuen and the author's own understanding and experience.
Medicine as Signification: Moving Towards Healing Power in the Chinese Medical Tradition
Volker Scheid and Dan Bensky EJOM Vol. 2 No. 6
A question to which we pretend we know the answer (for it is crucial to everything we do), yet which to the best of the authors' knowledge has never been addressed in a satisfactory manner by any proponent of Chinese medicine in the West is the question of what Chinese medicine actually is. In this article the authors provide an idiosyncratic response which, While neither complete nor based on the kind of comprehensive investigation which would indeed be necessary, reflects their current thinking. They believe that this response can act as a stimulus for future research, reflection and debate.
Arnold Desser, Dr Kevin Baker, Nadia Ellis, Roger Newman Turner, and Dr Adrian White EJOM Vol. 2 No. 6
Five practitioners from different backgrounds, including Western medical doctors, an osteopath, a physiotherapist and a university lecturer, express their personal views on this subject. The contributions range from the philosophical to the practical and include views on the effectiveness of acupuncture and its role in health care, and notes on the foibles and idiosyncracies observed in members of the acupuncturist 'species'. Transcribed from the presentations given at the 1998 BAcC Conference.
Using a case history, the author shows how the patient's psyche can be helped with TCM; that even though the patient's psyche may be in a complicated state, it is in the understanding of yin, yang, qi, xue, jinye, i.e. 'substance', that TCM operates most effectively. Read the whole article
What is the Meridian System Encoding? (Part 3)
Phillip Beach EJOM Vol. 2 No. 5
Continuing on from his previous two articles, Phillip Beach analyses the Heart, Small Intestine, Bladder, Kidney, Pericardium, Sanjiao, Gall Bladder and Liver channels. He looks at how needling patterns affect the shape of disease, and at how acupuncture works on internal organs.
Give Me That Old Time Religion, It's Good Enough for Me
Peter Mole EJOM Vol. 2 No. 5
In this article, Peter Mole discusses the internal causes of disease and explains how he feels that they have been marginalised in TCM, which tends to focus on the external causes of disease. The article also addresses how the practitioner/patient dialogue can affect patients' expectations and experience of acupuncture treatment.
Formula and Experience - Acupuncture and Chronic Pain: A Critical Reflection
Adrian Lyster EJOM Vol. 2 No. 4
Pain relief is the most widely practised application of acupuncture. Research evidence suggests that acupuncture is credible but conceals a number of unanswered questions that are of relevance to practitioners of TCM. What is the nature of the relief provided, is it palliative or therapeutic and is acupuncture a clinical match to different pain conditions? What method of acupuncture is used in research trials and does it correspond with clinical practice? What are the different descriptive and explanatory models for chronic pain? This article critically reviews the current models and examines some of the implications for both our understanding of pain and our application of acupuncture.
This is the second paper on the issues of 'what is the meridian system encoding?' and 'how does needling a distal point affect the visceral and neural life of an organism?' It also discusses the significance of the 12 'regular' and 8 'extraordinary' channels, internally and externally related channels, the six channel axes and so on. The author's first paper on this subject was published in EJOM Vol. 2 No. 3.
A ‘critter’ is used as a simple biological form to model the movements induced by needling. Lines can be seen that link the sensory organs to the caudal pole of the critter; points along those lines induce similar movements. If the critter is restrained in its movement response is felt internally. A new description of muscle function is presented that is based on the primary vertebrate axes. ‘Muscle chains’ are delineated and envisioned as contractile rivers that have long evolutionary and developmental co-histories with the primary facial sense organs. Embryologically, the Wolffian ectodermal ridge integrates the sensory platform, hands, feet and genitals visa line that is intermediately placed between the dorsal (somatic) and ventral (visceral) aspects of the embryo. The limb buds are located on this ridge so therefore act on and are acted upon by both the dorsal and ventral aspects of our being. This ridge also overlies the kidney precursors, an organ that develops from the same embryological layer as the muscles and bones. It is hypothesised that distal points act on the visceral function of the organism by affecting the shape of the body wall via a long lever effect. With dis-ease the organism gets ‘out of shape’; needling in patterns moves the organism back towards better shape and hence function.
Ants and Acorns: Some Thoughts on Complexity, Chaos and the Therapeutic Relationship
Francesca Diebschlag EJOM Vol. 2 No. 2
Diebschlag outlines the main features of the sciences of complexity, those sciences which deal with self-organising systems such as general systems theory and chaos theory and how they might inform what occurs in the therapeutic encounter.
Acupuncture Treatment and the Piezoelectric Effect
Xiang Yi and Weng Encong EJOM Vol. 2 No. 1
The authors, employing the conventional theory of acupuncture and the fundamentals of modern electronic technology, based upon the biological piezoelectric effect of the human body, undertake research to explore the mechanism of acupuncture treatment. Translated by Xy Zhang.
West Meets East: A Model for the Integration and Synthesis of Western Medical Science and TCM
Ted Davis EJOM Vol. 2 No. 1
The author introduces a model to unite the knowledge and perceptions of traditional Chinese medicine with those of Western medical science in a single unifying framework. This area is fraught with diffculties, not the least of which are the completely different conceptual frameworks and languages which attend these paradigms. It is no surprise that such integration has largely defied the efforts of decades past. The model encompasses the jing luo, zang fu, wu xing, pulse and tongue diagnosis, and the micro systems of acupuncture (hand, face, ear, scalp acupuncture). It is built upon a matrix consisting of an integrated notion of Depth, and a three-tiered conceptual structure which creates a homeostatic hierarchy. It is offered to the profession as a mechanism for initiating debate on the matter.
Perfectly Organised Chaos: Acupuncture as the Model for a Mediating Function in Therapeutics
Chris Low EJOM Vol. 2 No. 1
Healing within the patient-practitioner relationship is important in its own right and can be seen to be dependent on three things - the treatment itself, the patient and the practitioner. Meaning, evaluation and appraisal however, pose difficulties using the conventional medical model. In Chinese medicine it is the mediation of complementary opposites via the agency of qi which accounts for the resolution of conflict and restoration to wholeness. Using chaos theory, which allows for the complexity, uncertainty and ambiguity of subtle energy, the properties of qi can be modelled and mapped out on a computer screen. The latter can be perceived as an aesthetic model of a mediating function, with meaning on several different levels, as well as a research tool with potentially far-reaching applications in the holistic investigative field.
Traditional Chinese Medicine (TCM) offers the late 20th century a true complement or alternative to the medical practices of its Western counterpart. Reasons explaining the success of TCM in the modern Western setting are offered and discussed. Apart from its on-going record of positive clinical outcomes, Chinese medicine also offers a unique perspective on life, health and the practice of medicine. Not only is this perspective in marked contrast to the methodologies arising from scientific materialism, but it is readily grasped and understood by Westerners. Part of the Western enchantment with Chinese medicine and part of its success is that some of its foundational philosophies actually resonate with recent scientific theoretical developments. The changing Western paradigm is explored and compared to Chinese medicine's conceptual traditions.
Wei Qi Ying Blood Syndrome: Differentiation Analysis and Origin
Professor Liu Jingyuan EJOM Vol. 1 No. 6
Professor Liu Jingyuan reviews the analysis of Ye Tianshi, a famous doctor of the Ching dynasty, who took epidemic febrile diseases and divided them into four stages, explicating a general progression of exterior to interior. Herbal formulae are given for turning back evil qi at the levels of wei, qi, ying and blood. Translated by Brenda Hood.
Consistency, Internal Coherence & Systematic Practice: Starting Points on the Road to Artistry in CM
Geoff Wadlow EJOM Vol. 1 No. 5
Geoff Wadlow, founding director of the London School of Acupuncture and Traditional Chinese Medicine, responds to an article in the previous edition (EJOM, Vol 1, No 4), called 'Home and Away' by Volker Scheid, who described his impressions during a year studying in Beijing. Mr Wadlow talks about his own visit to China and makes the point that 'diversity flows out of a common heritage...the spirit of which we can only glimpse at and fleetingly experience because we are not Chinese, born and bred in China.'
Korean oriental medicine is a natural medical science with theory and knowledge derived from an experience unique to Korean traditional living culture. It comprises treatment by acupuncture and herbal medicine based on orthodox medical theories.
Medicine in China is an exemplar of action that is informed by experience. Experience is important at the level of the archive - 'a two thousand year struggle against disease' - and at the level of individual doctors and their life in medicine. The ability to differentiate symptoms and to plan treatment comes above all from personal and collective experience. The article is reprinted from the author's book Knowing Practice (1993) with permission of the publishers Westview Press, Boulder, Colorado, USA.
As a medical anthropologist in China, the author paints a picture of Chinese medicine not necessarily visible from within the international training centres. He explores the changing nature of acupuncture in contemporary China and its relationship to western medical practice in that country. He then compares it with how Chinese medicine is presented in the west, often as a search for a systematic approach. His challenge to attempted integration calls for serious reflection.
A chapter from the author's book The Practice of Chinese Medicine deals with early onset asthma especially in children and young adults. The connections and differences between Xiao-Chuan (wheezing-breathlessness) and allergic asthma follow pathology and aetiology of allergic asthma in western medicine. The chapter concludes with a new theory of allergic asthma in Chinese medicine.
Orientalism Revisited: Reflections on Scholarship, Research and Professionalism
Volker Scheid EJOM Vol. 1 No. 2
The author explains why he believes that research in Chinese medicine, in the narrow sense of 'research' as it is defined in the orthodox medical establishment, is a process which is likely to lead to Chinese medicine's being subsumed within the orthodox medical framework. He analyses what may happen when one cultural tradition encounters another, and proposes as his ideal for the Western and Chinese medical traditions an encounter where both traditions meet to forge something completely new and different. To facilitate this process, he proposes a model of research more akin to the broader and more deeply questioning research in the social sciences than to the narrower hypothesis testing of the medical establishment.
Discussion of the nature of meridians is followed by the results of the author's research into the coincidence of various linear rashes in conditions such as eczema and psoriasis and the pathways of the channels.
Wang begins by explaining different meanings of the word shen. He looks at the importance of cultivating shen qi, or 'wholeness of concentration', through which the mind becomes peaceful and empty, at one with one's circumstances. He describes some exercises for rooting the shen in dan tian.
Examining paranormal phenomena by using the framework offered by TCM, the author presents two cases which he ascribes largely to 'wandering hun.' He discusses his herbal and acupuncture treatment of the patients, and concludes with an appraisal of Chinese, Tibetan and shamanistic ideas related to demonic possession.
Claude Larre and Elisabeth Rochat de la Vallée EJOM Vol. 1 No. 1
A short article on the fundamental importance of jing shen, and the significance of the spirits on a level beyond the polarity of yin and yang. The style of commentary on quotations from the classics will be familiar to readers of the Monkey Press publications by these authors.
Remodeling the Arsenal of Chinese Medicine: Shared Pasts, Alternative Futures
Volker Scheid EJOM Vol. 4 No. 3
This article, which first appeared in The Annals of the American Academy of Political and Social Science, Volume 583, September 2002 (pp 136-159; copyright 2002 by The American Academy of Political and Social Science and reprinted by permission), examines the definition of Chinese medicine as being based on four key concepts: (theoretical) principles, treatment strategies, methods of treatment, and concrete medicinals including drugs or acupuncture. This definition of Chinese medicine was first explicated during the 1930s and has since become a standard adopted by the Chinese medicine community in China and the Chinese government. The origin of these concepts dates back much further, however, and physicians have used them to define their tradition at least since the late Song. This suggests that despite all outside change Chinese medicine can be thought of as being built around a stable core that constitutes, as it were, its very essence. The author sets out to deconstruct such a reading by showing that although the terms have remained the same, the meaning attributed to them and the manner in which they are integrated with each other have undergone significant change. He therefore cautions us to assume that Chinese medicine is a stable tradition and argues that the idea of stability stems precisely from a mode of discourse that allows for the continuity of key terms but does not hesitate to fundamentally manipulate their significance.
This article briefly describes Yoshio Manaka's model of acupuncture practice, 'yin-yang channel balancing therapy', with its unique theories of acupuncture and systematic four-step treatment process. The essential diagnostic assessments necessary for choosing the common step one to three treatments are described, as are their typical techniques. Step four is briefly outlined. The author is teaching workshops and programs on these treatment methods in London, York and a number of locations on the continent. Several books describing these treatment approaches are already published. The article is very well illustrated.
Medicine as Signification: A Reply to Scheid & Bensky
Mike Fitter EJOM Vol. 3 No. 2
This paper is a reply to an article by Volker Scheid and Dan Bensky entitled 'Medicine as Signification: Moving Towards Healing Power in the Chinese Medical Tradition' which was published in EJOM Vol 2, No 6. While it commends their article as an important contribution to the debate on the history and future of Chinese Medicine, it is critical of the simplification of setting the 'middle way' (Chinese medicine as intention or yi) against stereotypes such as the 'reductionist' biomedical paradigm or the 'romanticist' New Age model. The paper contends that there is good and bad medicine, and that the difference depends not so much on the conceptual foundation of the practice, but more on the practitioner and their relationship to their practice. It suggests that Chinese medicine practitioners could do well with marrying texts from the Neijing with modern day concepts such as the 'therapeutic encounter', the 'spirit of enquiry', 'presentational knowledge' and others, developed through epistemology, modern day psychotherapy and Western philosophy.
Pluralism or Plurality: More Reflections on 'Medicine as Signification'
Volker Scheid and Dan Bensky EJOM Vol. 3 No. 2
This article is a reply to Mike Fitter’s comments (published in EJOM Vol 3, No 2) on the authors' paper entitled 'Medicine as Signification' (published in EJOM Vol 2, No 6). The authors maintain that their original paper is an example of engaging the tradition on its own terms and that we must develop Chinese medicine 'by assimilating other elements into it rather than by assimilating elements from CM into other practices.' They advocate 'an unlimited pluralism of personal and professional syntheses.' Such syntheses, they argue, must be guided by valuing the heritage that has enabled the present practice. This is in contrast to the interests of the modern Chinese state, which, they argue, is fitting CM into the context of their own desired reality, out of which the currently dominant model of TCM seems to have evolved. Their position also contrasts with the trend among Western practitioners, with their almost universal refusal to learn Chinese, that one can possess elements of what the East has to offer, but does not have to engage with it on equal terms.
According to the author, 'the meridian system is an invitation to meditate on the nature of our lives in human form.' The article examines the topography of the Jing Mai, their direction of flow, as well as the Chinese names of the points, in relation to the elements they relate to and the deeper meaning of many Chinese medicine concepts.The ideas are presented as mere possibilities of what the Han dynasty authors may truly have meant.To quote the author again: 'My own understanding of these ideas is influenced by who I am as a 20th century human with a Jewish and Buddhist background, and teachers who are a Taoist priest, a Japanese practitioner, and a French sinologist.'
Paradigms Lost: Why a Little Philosophy is Important to Chinese Medicine
Simon King EJOM Vol. 3 No. 5
This article aims to apply philosophical reasoning to the broad issue of Chinese medicine’s relationship to Western science. In particular, it looks at attempts to justify Chinese medicine using terms from Thomas Kuhn’s theory of science such as ‘paradigm’ and ‘incommensurable’ and argues that the inconsistencies and implications of that theory and its application to Chinese medicine have not been rigorously explored. It is proposed that, rather than engage in extensive speculative endeavours, philosophers of Chinese medicine should limit their ambitions to clarifying concepts, pursuing implications and exposing inconsistencies, for the sake of our own self belief and so as to better enable fair dialogue with Western scientific and medical doctrines.
This paper discusses the liver's shuxie function by examining the separate or distinct actions of shu and xie. Shu means coursing, dredging, combing and smoothing. Shu-coursing is a well-known function of the liver, which keeps the channels, tissues and organs in good order so that the circulation of qi, blood, and fluids throughout the body is smooth and free of obstruction. Xie means discharge and includes external discharge as well as internal secretions. Xie-discharge/secretion is rarely emphasised in modern texts. Shu and xie are shown to have a mutually supportive and mutually engendering functional relationship. Traditionally, shuxie benefits and enables traditional Chinese medicine (TCM) physiology generally, and has a close relationship with male and female reproductive functions. With a more detailed understanding of shuxie it is evident that the xie-discharge/secretion function is particularly important, for example, for ovulation, menstruation and lactation in women and emission in men. In this context, the discussion also highlights the liver-kidney relationship. The liver and kidney pairing forms a fundamental axis of TCM physiology, and the harmonious integration of liver shuxie (dredge and discharge) and kidney fengcang (seal and store) is an essential component of their relationship. Various examples of shuxie function are examined to show how TCM has adapted classical interpretations so that Chinese medicine discourse today includes aspects of neural, endocrine and immune physiology.
The Space Shared Between Patient and Acupuncturist
Elisa Rossi EJOM Vol. 3 No. 2
This article sees itself as the starting point for a discussion about the aspects in its title. It starts out by examining what the classics (Ling Shu and Su Wen) had to say about the practitioner-patient relationship, their internal attitudes and the space in which they interact.It looks at the definition of a good acupuncturist, including the governing of Shen, the arrival of Qi and the observing of the patient’s reaction.It talks about the darker side of illness, when we are ignorant, or when the doctor is drawn into being ‘contaminated’ by the patient’s pain or suffering.It focuses on 'the concepts of transference and counter transference, the setting, therapeutic alliance, empathy and neutrality, contract and recovery', and the avoidance of errors arising from the deeper dynamics of the relationship, which may cause anti-therapeutic responses.
Acupuncture and Related Practices in Japan: Common Themes and General Diversity
Stephen Birch EJOM Vol. 3 No. 2
This paper describes the situation of acupuncture, moxibustion and massage (Shiatsu) in modern day Japan. In a westernised industrial society a variety of socio-cultural, political, historical and economic factors have led to an astonishing diversity of acupuncture schools.All in all there are at least 15 schools of acupuncture, 20% traditionalists, 20% biomedicine based, the rest a mixture of the two.It is an interesting fact that 40% of acupuncturists are blind in Japan, acupuncture being a preferred profession for the blind since the late 19th century, leading to a greater emphasis on sensory awareness.The paper explains why there is a great emphasis on pragmatic approaches, particular techniques of pulse and point location, abdominal palpation, the use of thinner needles, less depth of insertion, and a highly specialised use of moxibustion techniques.It argues that it would be a mistake to think of Japanese acupuncture as one school of thought.
Out of the Dust: The Origins of Chinese Medical Epistemology
Warren M Cochran EJOM Vol. 3 No. 2
This paper traces the origins of the epistemological imperatives of Yin and Yang and Wu Xing (Five Phases), with particular reference to the Shang Bronze Age era of around 1500 BCE.It examines how the practices of divination and prognostication (i.e. reading turtle carapaces and water buffalo shoulder blades), perfected in that period, and their emphasis on seeing the world in terms of balanced opposition and finding an underlying harmony in all living things, became the direct antecedents of the above concepts, developed in their present form during the Han period which followed immediately after.The title ‘Out of the Dust’ reflects the fact that these ideas arose from and through the practice of pyromancy (divination by fire), as well as stemming from a proto-historical period of Chinese culture.