Dr Helen Rogers (edited and abridged by Dominic Harbinson)
EJOM Vol. 6 No. 5 (2010-11)

This article is an edited and abridged version of a report, based on a study conducted in Walsall in 2008-2009, evaluating the effectiveness of acupuncture for people with psychosis. The study’s methodology utilised validated quantitative research tools and semi-structured interviews conducted with participants and their carers, relatives or partners. Strong evidence emerges from both the quantitative and qualitative data that there were significant improvements in service users’ mental health and general wellbeing following a course of acupuncture. These included: significantly improved sleep patterns; reduced anxiety and stress levels; better physical health; better eating habits; and increased self confidence and self esteem.
Read the whole article

Patricia Ronan, Dominic Harbinson, Douglas MacInnes, Wendy Lewis, Nicola Robinson
EJOM Vol. 6 No. 5 (2010-11)

This article reports on a small pre-clinical pilot study to explore the acceptability and effects of acupuncture in the treatment of schizophrenia. It outlines the research question and methods used and presents preliminary results of the qualitative and quantitative data gathered. Eleven participants who had been diagnosed with schizophrenia were recruited to the study. They had not had complete remission of symptoms despite treatment, and/or they suffered from the side-effects of antipsychotic medication. In addition to standard care, participants received individual assessment and treatment with acupuncture using a traditional Chinese medicine approach. Treatments were given twice a week for 10 weeks. The preliminary results from this study are very positive, indicating that acupuncture treatment yielded a wide range of benefits in terms of improved quality of life, as well as reductions in the symptoms of schizophrenia and the side effects of anti-psychotic medication. Of particular note are motivational and physical health improvements, especially relating to sleep, energy levels and social engagement.
Read the whole article

Mike Cummings
EJOM Vol. 6 No. 4

In this short but penetrating article the author, who serves as Medical Director of the British Medical Acupuncture Society (BMAS) and editor of the journal Acupuncture in Medicine, reviews the arguments for and against the use of sham acupuncture in clinical trials. He suggests that, until the effects of sham techniques are better understood, clinical research should be designed either to compare acupuncture with the best existing conventional treatments, or to evaluate its potential as an adjunct to conventional care compared to conventional care alone.

Claire M Cassidy
EJOM Vol. 6 No. 4

When practising acupuncturists are asked to explain what they actually do when delivering acupuncture care, a highly fluid and responsive picture of care emerges. This matches well with the East Asian medical explanatory model of Qi Flow. Their practice model gives approximately equal weight to the patient-practitioner relationship and the delivery of techniques of acupuncture such as needling. Most clinical trials of acupuncture care to date have, however, not utilised these features, but instead imposed a rather static 'sham' control model borrowed from biomedicine, which is guided by a different medical explanatory model and practice habits. Imposing one medical model on another medicine creates a methodological fault of model fit validity – in short, until acupuncture is clinically assessed as it is practised, we cannot know much about its capabilities. The author's hopes are that a) there will be more and larger studies of how acupuncturists think about and deliver care, and that b) future clinical trials will increasingly tend the issue of model fit validity and create trials that accurately assess and reflect the capabilities of acupuncture care.

George Lewith
EJOM Vol. 6 No. 4

This strategic overview revisits some of the basic assumptions that relate to the clinical valuation of acupuncture. We look at the clinical and mechanistic evidence available to estimate both the specific and nonspecific effect size of acupuncture (efficacy and effectiveness) and consider the placebo within acupuncture trials. We hope that by taking a broad and rigorous approach we may arrive at a realistic and thoughtful evaluation of its relative value in comparison to placebo treatment.

Andrew Flower
EJOM Vol. 6 No. 4

In this brief but engaging article, the author ruminates on the political nature of research and on the problems this poses for East Asian Medicine, and points to the fact that the thorny business of defining best (or at least 'good enough') practice is of central importance here. He concludes by offering a richly simple model - based on the Five Phases (wu xing) - for defining what best practice is.

Charlotte Paterson
EJOM Vol. 6 No. 4

This paper argues that acupuncture should be evaluated on the basis of whether it improves people's health in ways that are important to individual patients. This focus on patient-centred outcomes and an individualised approach is in keeping with the underlying philosophy of East Asian medicine. In acupuncture practice there is an ongoing dialogue between the practitioner's expert knowledge and the patient's individual knowledge and experience of their health and illness. However when it comes to research, the patient's perspective and subjective experience is often removed, and other 'objective' criteria are used to assess whether the treatment is helpful. There is now, however, a move towards patient-centred outcomes and there are many scientifically sound questionnaires that can be used. Qualitative research has been used to understand what treatment effects acupuncture patients' experience, to prioritise and to develop a number of patient-centred questionnaires, or sets of questionnaires which attempt to measure these. In this paper I briefly describe this work, focusing especially on individualised questionnaires and their use in evaluating acupuncture and other complementary therapies. Using an example from cancer support care I explore how qualitative and quantitative methods can be combined to provide rich and meaningful evaluations of the effects of treatment.

Joyce K. Anastasi, Bernadette Capili, Ann M. Chung, Richard Hammerschlag
EJOM Vol. 6 No. 4

Distal sensory peripheral neuropathy is a common neurological complication experienced by people living with the human immunodeficiency virus (HIV). Traditional Chinese medicine (TCM) may offer effective interventions in the management of its symptoms. To improve the quality and transparency of reporting acupuncture clinical trials, the Consolidated Standards of Reporting Trials (CONSORT) guidelines were developed in 1996 and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) recommendations were introduced in 2001. Incorporating international guidelines, this paper describes the development of a RCT including rationale, design, methods, procedures and logistics for a pilot study aimed at evaluating acupuncture and moxibustion for neuropathy associated with HIV. Using STRICTA guidelines as a template, aspects of clinical research design are explored to further optimise future studies of TCM.

Merlin Young and Jenny Craig
EJOM Vol. 6 No. 4

A large amount of published research on the potential immunological effects of direct moxibustion remains relatively unexplored in English. In Part One of this study we featured the many indicators in the classical literature of East Asian medicine which suggest that moxa was used in ways that almost certainly had effects on the immune system and also identified more recent research. Here we explore the more recent research evidence which is often inconsistent, and attempt to draw some useable ideas from it. We also suggest a possible mechanism by which moxa dosage may influence the type of immune response. The conclusions, though tentative, seem worthy of deeper exploration. Specific strategies are suggested which might facilitate this.

Stephen Birch
EJOM Vol. 6 No. 3 (2009)

In the first part of this paper (published in EJOM Vol 6 No 2) the author discussed the purposes, traditional explanations and possible mechanisms of the supplementation needle technique and began to model what might be happening when we apply it. He highlighted local and global qi circulatory effects triggered by the act of needling, and also the effects arising out of the interaction between the person needling and the person being needled. In this concluding part of the paper, he proposes various scientific perspectives and models that could explain the same observed effects of the needling and their various interactional effects, including mental interactional effects. Finally he briefly discusses the implications of this for understanding acupuncture practice.

Merlin Young and Jenny Craig
EJOM Vol. 6 No. 3 (2009)

There is a large amount of published research on the potential immunological effects of direct moxibustion which remains relatively unexplored in English. There are also many indicators in the classical literature of oriental medicine that moxa was used in ways that may have had direct effect on the immune system. The purpose of this study is to cast some light on both these sources and to explore their validity based on contemporary context and in the light of clinical experience. The paper is in two parts. In this first part, which explores the more general literature on the subject, we find much inconsistent evidence of immune response but a deficiency of conclusive evidence for specific responses of white blood cells to moxa treatment. There is, however, enough record of a varied immune response to endorse more focused research on the subject.

Stephen Birch
EJOM Vol. 6 No. 2 (2009)

The author contends that traditional forms of acupuncture practice have been hardly, if at all, investigated in the West. While many clinical and scientific studies of acupuncture have been conducted, these almost never involve the traditional practice methods of acupuncture with their clinical observations and theories of practice. In this article - the first of two papers on the subject - he attempts to bridge the gap between traditional practices and their historical sources and theories, and more modern perspectives with their methods of investigation. He discusses the purposes and possible mechanisms of the supplementation needle technique and models what might be happening when we apply it. Effects triggered by the needling itself, focusing especially on local and global qi circulatory effects and traditional explanations of these, are highlighted, as are the effects arising out of the interaction of the person needling and the person being needled, looking in particular at global changes in the vitality of the patient and the role of the mind of the practitioner. Various possible scientific perspectives are described, especially involving electromagnetic phenomena that could explain the effects of the needling and various interactional effects. Implications of this for understanding acupuncture practice are briefly discussed.

Christine Grabowska and Anne Manyande
EJOM Vol. 6 No. 1 (2008)

Expectant mothers with a third trimester breech presentation were offered moxibustion treatment to turn the foetus into a cephalic presentation. In the 76 women who were enrolled in the study, the acupoint BI 67 was stimulated for seven days morning and evening by rolls of moxa (Artemisia vulgaris). The women were instructed in how to use the moxibustion at home and to involve their partners if they could not reach their little toes. In this preliminary study, it was shown that moxibustion treatment can bring about spontaneous version from a breech presentation for a cephalic presentation; this occurred in 45% of the women treated. The results indicate that moxibustion was more successful when administered in the afternoon than in the morning (x2 = 27.86, DF = 14, p < .01) 6 (20.5%) vs 23 (79.5%) respectively. This is in line with the Chinese clock where bladder time rises to a maximum in the afternoon. Most of the versions occurred during the 36th week of pregnancy (r = 0.27, n = 47, p < .05).

Claire Blanchard, Phil Hanlon and Mhairi Mackenzie
EJOM Vol. 5 No. 6

This paper reports on a research project investigating the influences shaping acupuncture practice. Semi-structured interviews were conducted with a convenience sample of twelve acupuncturists based in Glasgow and Edinburgh. Themes discussed by the study population included: an increase in acupuncture usage, difficult but improving relationships between GPs and acupuncture practitioners, a growing acceptance of acupuncture practice within the context of integration with conventional practice with some remaining barriers, and the need for further research into acupuncture efficiency and cost-effectiveness. The study population believed acupuncture to be a way of life and defined health as a state of energy balance, with imbalances leading to ill-health. Emphasis was placed on the importance of a good practitioner-patient relationship and patients’ needs being met for the healing process. Finally, particular weight was given by the study population to the differences that are believed to exist between western and eastern philosophies.

EJOM Team
EJOM Vol. 5 No. 6

A poll was conducted of graduates from UK acupuncture teaching institutions in the UK who had joined the British Acupuncture Council (BAcC) in 2005-2006. The e-mail survey examined graduates’ views on how they had been prepared by their teaching institutions for the ‘business side’ of acupuncture, particularly setting up, running and building a practice. The findings of this informal ‘finger in the wind’ poll, which elicited responses from about ten percent of those contacted, suggest that these graduates appeared to be dissatisfied with this aspect of their training and are finding it hard to make a living in their new profession.

Andrew Flower
EJOM Vol. 5 No. 6

There seems to be a general consensus within the acupuncture and Chinese herbal community that research is a necessary process to establish our professional status. It may be regarded as a ‘good’ thing, a bold venture to bring Chinese medicine into the cosy confines of evidence based medicine; or perhaps more cynically ‘a necessary twenty-first century evil’ that we need to grit our teeth and get on with. This is an account of the author's foray into the research world to explore the role of Chinese herbal medicine (CHM) in the treatment of endometriosis. He set off on his journey dressed in a shiny suit of optimistic positivist fervour. Now several years down the line he feels more like Don Quixote lining up his intellectual lance and charging heroically towards the next windmill on the horizon. This then is the story of how a naive would-be knight lost his armour, encountered the dark forces of bureaucracy, and depending upon your point of view either grew up or went quietly nuts.
Read the whole article

Jackie Shaw, Penelope Bidgood & Nasrollah Saebi
EJOM Vol. 5 No. 5

The College of Integrated Chinese Medicine (CICM) in Reading piloted a range of repeated outcome measures to assess change in health status in patients receiving acupuncture treatment in the student clinic. Data was collected from 495 patients treated from 1996-2004. Patients attending clinics 1-6 (CICM cohort) used a repeated measures programme developed in-house following MacPherson and Fitter (1998). Patients attending clinics 7-12 (MYMOP cohort) used the Measure Your Own Medical Outcomes Profile (MYMOP) (Paterson 1996). The study showed a clear trend towards better health over time for patients receiving acupuncture treatment at the clinic. Results are suggestive of positive benefit from acupuncture for patients with a wide variety of predominantly chronic conditions, and contribute to the growing acupuncture evidence profile.

Richard Graham
EJOM Vol. 5 No. 5

This randomised controlled study compares the treatment results in two groups of participants who were found to have Akabane imbalances. Participants in one group were treated using the Akabane protocol currently taught to practitioners of Five Element Acupuncture. Participants in the other group were treated with a bilateral needling of Spleen 21. The group treated using the protocol taught at the College of Traditional Acupuncture, which requires the tonification of luo points of the affected meridians, were found to have improved significantly after treatment (26.55%). However, the group treated using bilateral tonification of Spleen 21 had an even greater measure of improvement (52.12%). This suggests that the bilateral tonification of Spleen 21 appears to be more effective than the tonification of luo points in the treatment of meridian imbalances. Improvement and modernisation of the current testing procedure are recommended. A comparison between the bilateral tonification of Spleen 21, back shu, luo, yuan and jing points, in the treatment of meridian imbalances, is recommended for future clinical trials.

Daniel J. Windridge & Harriet Lansdown
EJOM Vol. 5 No. 5

This article gives an outline of a BSc (Hons) dissertation submitted as part of the BSc (Hons) Traditional Chinese Medicine (Acupuncture) degree programme at the University of Salford in April 2003. The purpose of this quantitative study (Part One) was to measure the skin resistance and thus conductivity of a given set of the Influential points. The aim was to determine any differences in the conductive properties according to the gender of participants involved. Vacancies were a set sample of 30, which involved stratified criterion non-random sampling. Quantitative comparative descriptive was the method design used. The results of readings were compared and were shown to support the yin and yang theory used in traditional Chinese medicine (TCM). The outcome of Part One established that yang acupoints had the highest conductance compared to yin acupoints. Also it was found that the conductivity of all the yang acupoints measured from the male participants were significantly greater when compared with results obtained from the females.

Hugh MacPherson and Kate Thomas
EJOM Vol. 5 No. 4

This article reports on a highly significant, high-quality randomised controlled trial to determine whether GP referral to a short course (up to 10 individualised sessions) of traditional acupuncture might improve longer term outcomes for patients with chronic low back pain in primary care, and at a cost that would be affordable by the NHS. 241 patients were recruited to the trial with 160 being randomised to the acupuncture group and 81 to the control group which received usual GP care alone. The results indicate that when patients in primary care with low back pain are referred to a BAcC acupuncturist for a short course of treatment, they will, on average, improve over time and show greater improvement than if they had received usual GP care alone. Although the course of acupuncture only lasted around 3 months, their situation improved over time, and continued to improve between 12 and 24 months. The authors' recommendation from this study is that GPs should consider referring patients with low back pain to a qualified acupuncturist.
Read the whole article

Hugh MacPherson
EJOM Vol. 5 No. 1

This article reports on a prospective study, funded by the British Acupuncture Council, looking into the safety of acupuncture treatment. The study involved 1 in 3 members of the BAcC who between them recruited 9,400 patients as survey respondents. The characteristics of the acupuncture patients and their reason for seeking treatment are outlined. Short-term reactions to treatment are described, along with perceived adverse events reported in a 3-month follow-up questionnaire. The data presented belie alarmist claims that non-physician acupuncturists put patients at risk by delaying conventional diagnosis and treatment and/or advising changes in prescribed medication. The conclusion from this large-scale and rigorously conducted study strongly reinforces existing evidence that acupuncture, when practised by qualified acupuncture practitioners, is a safe intervention. It also provides compelling evidence that the standards promoted by the BAcC have led to qualified acupuncturists being safe in their broader role as healthcare professionals. 
Read the whole article

Stephen Birch, Peter Deadman and Felicity Moir
EJOM Vol. 4 No. 4

This is an extract of the keynote debate, which took place at the British Acupuncture Council’s Conference in October 2004, which was chaired by Mike O’Farrell, Chief Executive Officer Executive Officer of the BAcC. The three keynote speakers were Stephen Birch who has co-authored seven books on acupuncture and regularly contributes to the debate on the use of scientific methods in the integration of Traditional East Asian Medicine (TEAM) in the West, Peter Deadman who is Publisher and Editor of the Journal of Chinese Medicine and co-authored the major acupuncture textbook a manual of acupuncture, and Felicity Moir who is a Course Leader and Principal Lecturer at the University of Westminster, School of Integrated Health. Questions or comments follow the introductory views of the keynote speakers, together with the responses of the speakers.
Read the whole article

Hugh MacPherson and Alison Gould
EJOM Vol. 2 No. 5

The authors have drawn from reviews of the literature reports of adverse events, in particular Rampes and James (1995), Norheim (1996), Rosted (1996), Bensoussan and Myers (1996), and Ernst and White (1997) and have ascertained there are four main categories of adverse events: trauma, cross infection, physiological responses such as fainting or allergic reactions, and clinical misjudgement such as inappropriate removal of drug treatment or failure to refer. Based on their research findings, the authors estimate that the risks associated with acupuncture are very small compared to orthodox interventions. This conclusion is supported by a recent report from the USA National Institutes of Health (1997), which states 'one of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted procedures for the same condition.' 

Alan Bensoussan
EJOM Vol. 1 No. 2

The author urges the close scrutiny of TCM theory, after which the main substance of the article demonstrates the point that most clinical studies of acupuncture have focused on its use in pain management. Findings from studies of the release of different neuro-hormones as a result of acupuncture are summarised. Since these studies were mainly carried out on animals, the author sees them as limited in their ability to further the understanding of TCM theory. He argues that focusing on TCM theory and on the use of acupuncture to promote health is more useful than studying the effect of acupuncture on neuro-transmitters and pain relief.
Read the article as a PDF file (493Kb)

Jackie Shaw, Penelope Bidgood and Nasrollah Saebi
EJOM Vol. 5 No. 4

This article reports on a descriptive outcome study conducted at The College of Integrated Chinese Medicine in Reading, UK. The study, which involved 495 patients, explored patient profile and perception of change after treatment in the College's student clinic during 12 clinical programmes from 1996-2004. The study showed a clear association between acupuncture treatment and positive health outcome as assessed by patients. The majority (82.2%) of responding patients reported a large or moderate change in their main complaint, and 88% a large or moderate change in their general health. These results, from a wide range of predominantly chronic patients, indicate high levels of patient satisfaction.

Barry Nester
EJOM Vol. 5 No. 4

The critical appraisal of acupuncture clinical trials can be important for both the evaluation of the therapeutic effectiveness of acupuncture and for the improvement of clinical practice. A knowledge of how to critically appraise clinical trials is a prerequisite for conducting systematic reviews and meta-analyses, the basis of evidence-based medicine (EBM). The critical appraisal of acupuncture clinical trials also enables practitioners to decide if the findings of trials can be utilised in clinical practice in order to improve client outcomes. This paper provides a brief overview of the criteria for the appraisal of published acupuncture clinical trials for practitioners and novice researchers.

Erica Longton and Ivan Birch
EJOM Vol. 5 No. 3

With the profession of acupuncture moving towards statutory self-regulation, developing an evidence base is a challenge that must be met. This article reports on the first study to test for the possibility of commonly perceived barriers to undertaking research among members of the British Acupuncture Council (BAcC). The results show that such barriers do exist, the greatest being not enough time during a normal working day and lack of financial support. 70% of respondents indicate an interest in doing research, 81% think it will improve quality of practice, and 85% feel it is important for the establishment of a knowledge base. The formation of research teams led by an experienced researcher for outcome studies using methods that are efficient, cost-effective and simple to implement could help reduce some barriers and allow practitioners to gain research skills by collaborating with colleagues in the same study.

Barry W. Nester
EJOM Vol. 5 No. 3

This paper examines the role of the ‘pragmatic trial’ (PT) in the evaluation of the effectiveness of acupuncture. In a PT, the therapeutic effectiveness of a therapy can be evaluated by comparing it with other therapies and/or ‘standard care’ (i.e. the pharmaceutical drug or therapy that is routinely used to treat the condition being studied). The PT provides a method to determine the ‘relative’ therapeutic effectiveness of therapies such as acupuncture for a particular condition or syndrome by comparing it with the effectiveness of other therapies. One strength of using the PT to evaluate the effectiveness of traditional acupuncture is that the ‘sham acupuncture’ control can in some cases be omitted, thereby avoiding any possible ethical concerns regarding participant deception and/or participants not receiving and ‘active’ treatment.

Allen Parrott
EJOM Vol. 5 No. 3

The aim of this article is to set out some of the ways in which the basic philosophical assumptions about knowledge and reality that underpin mainstream scientific thinking, and therefore most current research, can be challenged, and to explore the relevance of such challenges to acupuncture research and practice. The author argues that randomised and double-blind clinical trials may be useful in certain contexts, but they no longer need be esteemed as the ‘gold standard’ to which all serious enquiry should aspire. For most healthcare research, a different ‘lens’ is desirable, for practical and ethical as well as for theoretical or more purely philosophical reasons.

Dominic Harbinson and Patricia Ronan
EJOM Vol. 5 No. 2

The medical treatment of psychosis continues to be limited, often with severe side effects. This paper sets out to examine the literature available on the treatment of psychosis and schizophrenia with acupuncture, to outline the evidence already available and to highlight the case for research into this treatment approach in the UK.  A literature search was carried out using Ovid, Medline, Psych-info, Yahoo, Google and author contact to discover what research has taken place to date. This yielded evidence that acupuncture is effective in the treatment of psychosis. Although most of the research is from China and is somewhat dated, a number of studies have also been conducted in the West with promising outcomes. Given the poor prognosis for schizophrenic patients and the side effects implicit in the chronic use of conventional medication, there would appear to be good grounds for further research into acupuncture as a potential treatment modality. Carrying this out under modern scientific research conditions would help clarify whether and how this treatment might work.  However obstacles such as ethics, funding and how such a study might be controlled will have to be overcome.

Doreen Till
EJOM Vol. 5 No. 2

This paper, based on research conducted as part of an MA in Community Mental Health, explores service users’ experiences of acupuncture delivered in a group setting within a mental health day service at the Broadway North Resource Centre in Walsall. The majority of service users felt that acupuncture had improved their health both mentally and physically. Whilst some individuals found a group setting slightly intimidating at first, they also found benefits in the peer support that such a setting facilitated. All participants in the study thought that acupuncture should be more widely available within mental health services, and that a greater range of therapies should also be provided. Acupuncture within a group setting can be a cost-effective way of delivering a popular treatment that service users perceive as helpful to their health.

Sylvia Schroer
EJOM Vol. 5 No. 1

This article reports on a small study to investigate how patients explained the workings of acupuncture in the light of their own experience of treatment. 15 patients of different ages and from socio-economic backgrounds were interviewed and issues such as reasons for having treatment, the effects of treatment, and the importance of the therapeutic relationship were discussed to reveal the explanatory models which they used to describe their experiences. One of the findings of the study was that patients’ narratives shifted during the course of treatment from mechanical theories or physical explanations of illness towards theories of equilibrium, of mind-body harmony, and ethical theories, with treatment seen as a cleansing process. The study found that also found that patients themselves, through their experience of treatment, are moving away from a narrow definition of acupuncture as a treatment for the relief of pain or physical symptoms towards a much broader conceptualisation for its therapeutic potential in the context of their lives.

Hazel Andrews and Janice Booth
EJOM Vol. 4 No. 6

This article reports on research conducted by a team of seven BAcC members practising in North Wiltshire. The research comprised a basic practice and patient audit, collecting information on the type of patient coming for treatment, presenting conditions and their duration, and patient perceptions of changes in their symptoms over the first six acupuncture treatments (using MYMOP2 forms).

Barry Nester
EJOM Vol. 4 No. 6

The case study has been used extensively in many diverse disciplines including medicine, psychology and education. This paper explores the purposes of case study research in the field of Chinese Medicine (CM). Various types of case study including intrinsic case study, instrumental case study and collective case study are examined for their use in research of CM. The case study can be used to understand health, illness and Chinese medicine healing practices holistically. Case studies can provide powerful stories to illustrate the diversity of Chinese medicine practice. They can also be used to document change and development in individuals while having Chinese medicine therapies. Case studies can in some instances generate theoretical positions and sometimes suggest limitations of current theories and practices. Case studies also enable CM students and practitioners to better understand the relation between CM theory and clinical practice.

Lisheng Xu, Kuanquan Wang and David Zhang
EJOM Vol. 4 No. 6

This paper presents modern research on Traditional Chinese Pulse Diagnosis (TCPD). In order to demystify TCPD and prove its efficiency, some fundamental knowledge such as concepts, significance, diagnosis methods, and standard pulse patterns are outlined at the outset. Then we review modern research on TCPD mainly from four aspects: objectifying TCPD, analysis of pulse waveform, the mechanism of pulse formation, clinical observations and comparisons of pulses. For each of these aspects, general background information and brief explanations are given. In particular, it is very important to distinguish the pulse images based on traditional Chinese medicine and those derived from the sphygmogram based on western medicine. As an example, our pulse acquisition system is presented. Furthermore, typical pulse waveforms in our pulse database and their results as processed by modern signal processing methods are demonstrated. Finally, the potential and the problems facing modern research into TCPD are pointed out.

G Walker, B de Valois, T Young, R Davies, and J Maher
EJOM Vol. 4 No. 5

This article reports on a study by the Supportive Oncology Research Team at Lynda Jackson Macmillan Centre, Mount Vernon Hospital, Northwood, Middlesex, to evaluate the experience of women with breast cancer having treatment for the menopausal symptoms associated with Tamoxifen. A total of 16 women participated in focus groups held at least 9 months after their last acupuncture treatment. The discussions addressed the following topics: problems experienced before treatment; anticipation and expectation; experiences of the treatment session itself; effects of treatment; and overall impressions. It was found that traditional acupuncture is an acceptable treatment for women with menopause-like symptoms resulting from Tamoxifen. Patients found the overall experience enjoyable, and felt that their quality of life improved whether or not their symptoms were relieved.

Fan Ka-wai
EJOM Vol. 4 No. 3

Traditional Chinese medicine has been playing an important role in the prevention and treatment of diseases all over the world. It is invaluable for anyone who learns Chinese medicine to also learn the history of Chinese medicine at the same time. This article is divided into four parts: introduction, institutes and societies, special topics, and journals and bibliographies. The purpose of this article is to collect useful and well-known websites and introduce them to interested people for their further study, using the www.

Nick Johnson, Dominique Joire, James Tomkinson, Sammy Reid, Lola Boix, Alex Murray and Paloma Sparrow
EJOM Vol. 4 No. 2

This study observes and monitors the effect of 6 months of traditional Chinese medicine on a group of NHS patients with essential hypertension. The management was in both terms of symptomatology and blood pressure levels. It provides a background, treatment protocol and results, along with specific reports on 8 patients.

Dominique Joire
EJOM Vol. 3 No. 6

The Gateway Clinic is a Chinese medicine specialist centre within the National Health Service (NHS). It offers acupuncture, Chinese herbal medicine, dietary advice and qi gong classes. The emphasis is on helping people to help themselves; preserving their autonomy and quality of life. Listening to the patient’s perception of the problem is considered essential to the process. This represents a new pioneering approach to the many complex health issues of today. In this audit, which looked at patient satisfaction within the clinic, a simple questionnaire based on SF-36 was used. Some questions were added about the most important symptoms seen in Chinese medicine and about patients’ satisfaction with the service and comments. The audit is well illustrated with graphics and has an interesting appendix containing the final comments from patients.

Emma White
EJOM Vol. 3 No. 6

This paper presents the findings from a survey conducted on behalf of the British Acupuncture Council (BAcC). It was conducted among 121 members in June 2001. The aim of the survey was to assist the BAcC to prepare a Continuing Professional Development (CPD) programme for members which takes account of the CPD members are already doing as part of their busy practices, and which also takes into account the acupuncture tradition. This paper sets out the survey design and then goes on to report on three aspects of the survey.

Hugh MacPherson, Kate J Thomas, Stephen Walters and Mike Fitter
EJOM Vol. 3 No. 6

This is a report on the survey (commissioned by the British Acupuncture Council) on the relative safety of acupuncture. Its main finding is that acupuncture is safe in the hands of competent practitioners. 574 practitioners took part in the survey over a 4 week period in May 2000. Results showed that there were no serious adverse events in 34,407 reported acupuncture treatments, 43 indicating an underlying serious adverse event rate of between 0 and 1.1 per 10,000 treatments. A total of 43 significant minor adverse events were reported, at a rate of 1.3 per 1000.

Sean Walsh, Deirdre Cobbin, Karen Bateman and Chris Zaslawski
EJOM Vol. 3 No. 5

This paper reports a study designed to investigate the agreement between TCM students in their discrimination of basic pulse parameters such as speed, depth, volume, length and overall quality of the pulse. Method: a standardised form was used to assess agreement among the sample of students on three occasions: at the beginning of formal pulse diagnosis teaching classes (week 1), at the conclusion of pulse teaching (week 14), and one year later. Students were randomly divided into two groups, with each group randomly assigned three subjects, for whom each member of the group was required to palpate the pulse. Data were analysed using Chi square.

Mary Herbison
EJOM Vol. 3 No. 4

Dr Zhang Jia Sheng
EJOM Vol. 3 No. 3

This article (translated from Chinese Acupuncture and Moxibustion 1987 Vol. 7 No. 1) reports on the treatment with acupuncture and moxibustion of 248 cases of male infertility over the period 1981-1985. Treatment was deemed effective in 166 cases. Patients with impotence and ejaculatory dysfunction responded better than cases with sperm abnormalities. Translated by Xiao Y Zhang.

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.

Mark Bovey
EJOM Vol. 3 No. 1

This article reports on the proceedings at the Fourth Annual Acupuncture Research Symposium organised by the Acupuncture Research Resource Centre and held on May 8, 1999. The Symposium began with David St George who outlined his vision of the future, calling for research that meets the needs of acupuncturists and their patients. Ruth Endicott spoke on the contribution of qualitative research to health care, and Charlotte Paterson reported on her ongoing research into concepts of wellbeing and its measurement using the MYMOP (Measure Yourself Medical Outcomes Profile) questionnaire. Stephen Birch spoke about the difficulties of designing credible research to test traditional forms of acupuncture practice and defined the steps necessary to do this appropriately. Edwina Webb presented a retrospective observational study of her acupuncture practice in Manchester over the period 1989-1996 which included measurement of treatment outcomes and average cost per course of treatment. Hugh MacPherson reported on the ongoing York back pain project and the development of the research protocol for the project’s NHS-funded pragmatic randomised controlled trial. The presentations concluded with Kevin Ergil’s overview of acupuncture research in the USA.

Jennifer Dale
EJOM Vol. 3 No. 1

This paper aims to continue the debate arising at the 1998 BAcC conference by arguing the case for a pluralistic approach to research methods. It does not claim to provide a comprehensive overview of methods or the underlying debates about what constitutes ‘evidence’ in research. Rather, it considers some of the varied purposes of research and illustrates some of the ways in which the sorts of questions which arise in the real world of research lend themselves to different methods.

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.

David Mayor
EJOM Vol. 2 No. 5

In this second article on chronic pain and its measurement (the first was published in EJOM Vol 2, No 4), Mayor provides a thorough literature analysis about the complex inter-relationships between pain, anxiety and depression. He discusses which comes first - pain or anxiety. He also explores how the emotional state of a patient relates to the task of pain prevention, particularly in regard to chronic pain sufferers.

Chang Jin Yang, Ma Qin and Yue Ling
EJOM Vol. 2 No. 4

This article was first published in Chinese Acupuncture and Moxibustion Vol. 16, No. 1. Good therapeutic effects can be achieved when using eye acupuncture to treat brain diseases and a variety of pain syndromes. In recent years acupuncturists have used eye acupuncture to treat 108 cases of acute pain in the biliary system and received satisfactory results. Translated by Xiao Y Zhang.

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.

Pamela Boxx
EJOM Vol. 2 No. 4

As a consultant obstetrician and TMC acupuncturist, Boxx conducted a trial into the use of acupuncture analgesia during labour. The results were generally very favourable with patients expected to need pethidine or entonox getting by without either. Babies born to mothers using only acupuncture as an intrapartum analgesia mostly emerged 'howling lustily and in the pink'. The 'pros' and 'cons' of acupuncture during labour are discussed as are practical issues of justifying the acupuncturists presence in the delivery room.

Bonnie Horrigan
EJOM Vol. 2 No. 4

This insightful interview with Dr Pomeranz examines his view of alternative medicine and particularly acupuncture. He discusses how he came to the acupuncture endorphin theory and he explains the scientific methodology using 'lines of evidence' to prove or disprove an hypotheses. We find that Dr Pomeranz has meditated for 30 years and is fascinated with 'borderline stuff' i.e. parapsychology. He says rather than discredit TMC he wants to find out how it works. His research follows the protocol of a skeptical yet open mind. This is a brilliant man.

Alison J Gould
EJOM Vol. 2 No. 3

This article reports on the Second Annual Acupuncture Research Symposium (held in London in March 1997) and shows how we as acupuncturists have moved ahead with our attitude to research. A more focused and coherent out look on on acupuncture research has developed. Participants were encouraged to find that they had common interests and were able to give strong support to approaches to research that upheld the central value of being true to traditional practice. Whilst at the same time understanding an external need for proof exists and and there now also exists a pragmatic desire to be involved in guiding and participating in clinical projects ensuring these studies respect the real practice of acupuncture in this country.

Bob Flaws
EJOM Vol. 2 No. 2

In this article, the author presents functionally translated abstracts of a number of Chinese journal articles on the treatment of chronic and ulcerative colitis. Protocols include both orally administered decoctions and retention enemas.

Alison Gould
EJOM Vol. 2 No. 1

This article reports on the First Acupuncture Research Symposium (held in London in March 1996) which aimed at raising awareness of research within the acupuncture profession by looking at the philosophical and methodological contexts in which research occurs. It also sought to inspire and support practitioners taking a more active role in research, providing a forum for practitioner-researchers to discuss their own practical experiences of research.

Jennifer Dale
EJOM Vol. 2 No. 1

A survey was conducted between April and July 1995 of practitioners belonging to the five separate professional associations meeting as the Council for Acupuncture (just prior to their unification into the British Acupuncture Council) and members of the British Medical Acupuncture Society, the Acupuncture Association of Chartered Physiotherapists and the British Academy of Western Acupuncture. The survey provides a broad overview of acupuncture practice in Britain with respect to the type of acupuncture practised (ie. traditional and/or biomedical approaches).

Richard Blackwell and Sue Sutton
EJOM Vol. 2 No. 1

Against a background of reports of hepato-toxicity from the use of certain herbal prescriptions, Blackwell and Sutton examine the research material on the herbs which most commonly appear in the reported prescriptions. They conclude that the evidence on gan cao, bai shao and di huang does not suggest that they are directly hepato-toxic.

Mike Fitter and Hugh MacPherson
EJOM Vol. 1 No. 5

Mike Fitter, research director of the Foundation for Traditional Chinese Medicine and Hugh MacPherson, co-founder and principal of the Northern College of Acupuncture who helped set up the Acupuncture Research Resource Centre in York report on the first stage of a feasibility study to evaluate the effectiveness of an acupuncture service in the treatment of people with low back pain, comparing the overall 'cost effectiveness' with an orthodox service available through National Health Service GPs. The research method is outlined and four case histories are cited.

Seung Cheong-Wong
EJOM Vol. 1 No. 4

93 patients were selected for treatment by either direct moxibustion (65 cases of arthritis, all presenting with yang deficient symptoms and signs) or indirect moxibustion (28 cases suffering from multi-neuritis, all of whom were also diagnosed as yang deficient). Cellular immune function was assessed before and after. The results suggest that treatment with moxibustion has a modulatory effect on immune function.

Gretchen De Soriano
EJOM Vol. 1 No. 4

A short retrospective pilot study shows that ME follows the pattern described in the Shang Han Lun, a traditional Chinese medical text. The Shang Han Lun describes the symptom patterns and treatment for acute diseases using diagnostic techniques based on the six divisions, while its sequel, the Jin Gui Yao Lue, describes those for chronic disease using diagnostic techniques based on the three substances.The article suggests that significant understanding towards relief from the suffering of ME can be achieved using these Kanpo diagnostic techniques which are explained using modern Japanese commentaries on the original text.

Francesca Diebschlag
EJOM Vol. 1 No. 3

The second of two articles exploring some of the methodological problems surrounding scientific research into acupuncture. The first article (published in EJOM Vol 1, No 2) dealt with developing an appropriate control for acupuncture treatment in experimental designs. This article describes some alternatives to controlled trials.

Hugh MacPherson and Richard Blackwell
EJOM Vol. 1 No. 3

This review article has three sections. The introduction looks at the western medical understanding of RA and identifies a role for Chinese medicine. There follows a critique of a number of controlled trials and studies. The final section considers Chinese medicine in clinical practice, its approach to treatment and patient management.

Richard Blackwell and Mike Fitter
EJOM Vol. 1 No. 2

Analysis of the results of a Council for Acupuncture survey in the UK. The aims of the survey were to identify the extent to which acupuncturists were interested in undertaking research and development activities, to identify reasons for engaging in research, and to assess the need for specific research skills.

Elinor Freilich
EJOM Vol. 1 No. 2

An article inspired by the 16th Mystics' and Scientists' Conference, focusing on ideas about research. The article contains much reference to the contributions of Larry Dossey.

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.

Francesca Diebschlag
EJOM Vol. 1 No. 2

In this, the first of two articles, the author begins by describing how clinical trials, including double blind trials, operate. She examines the purpose of trials before focusing critically on various types of placebo acupuncture. She discusses the difficulties of 'standard treatments' in clinical trials of acupuncture, as opposed to the individualised treatments used in holistic practice.

Richard Blackwell
EJOM Vol. 1 No. 1

Based on the optimistic premise that orthodox medicine is becoming more holistic, the author argues that this is the time to instigate research into acupuncture. After discussing the overall aims of research, he outlines various research methods and the environments in which they can be carried out. He details clinical trials, comparative studies and clinical audits.

Richard James
EJOM Vol. 1 No. 1

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.

Russ Chapman, Rosemary Norton and Dr Charlotte Paterson
EJOM Vol. 3 No. 5

This article describes prospective and descriptive study of acupuncture patients' outcomes. It involved 13 acupuncture practices in South-west England, of which 12 were private practices and 1 was an NHS pain clinic. Over a year 291 patients were recruited to record their symptoms using the ‘Measure Yourself Medical Outcome Profile’ questionnaire. This was completed at the first and third visits, and by post 4 months after the first visit. There are extensive graphics illustrating the results.