The Acupuncturist’s Guide to Conventional Medicine Second Edition
The Acupuncturist’s Guide to Conventional Medicine Second Edition Clare Stephenson Publishers: Singing Dragon, London and Philadelphia Hardback: 854 pages ISBN: 978-1-84819-302-4 (eISBN: 978-0-85701-255-5) RRP: £60
(Reviewed by Dr Stephen Gascoigne, EJOM Vol.9 No.1)
This is a comprehensive textbook giving a detailed account of anatomy, physiology and the conventional medical understanding of disease aimed at students and practitioners of Chinese medicine. This book is written by a conventional medical practitioner who subsequently trained in acupuncture and is one of the few brave souls who have gone on to write texts for their nonmedically qualified colleagues. It follows on from Nic Rowley with Basic Clinical Science: Describing a Rose with a Ruler and myself with The Clinical Medicine Guide: A Holistic Perspective. In addition, Bob Flaws and co-authors at Blue Poppy Press have published a number of texts relating specific conventional disease labels to Chinese medicine.
This text by Clare is certainly a significant body of work and has been used by students since the first edition was published in 2011 by Churchill Livingstone.
In Clare’s introduction to the textbook, she describes how her perspective on healthcare has been fundamentally transformed by her subsequent training in acupuncture and her practice of acupuncture. This led her to leave conventional general practice to focus solely on acupuncture and teaching conventional medicine to students. As such, this book is an attempt, as she describes it, to translate from one medical language to another.
Texts such as these are intended to fulfil a number of tasks. Firstly, to present conventional medical information in an accessible form to non-medically trained students and practitioners. Secondly, there is guidance in how to recognise potentially serious situations (‘red flags’). And thirdly, there is an interpretation or translation of conventional medical concepts and labels into Chinese energetic terms and syndromes. This latter may include, as does Clare’s text, discussions of how to understand conventional pharmaceuticals from the perspective of Chinese medicine.
So, to the structure of the book. There is an initial introduction where the approaches of Chinese medicine and conventional medicine are compared and contrasted.
Subsequently, there are comprehensive chapters on the different systems of conventional medicine. So, for example, there is a chapter on the gastrointestinal system, musculoskeletal system, endocrine system and so forth. Each system is covered in some detail with plenty of examples of conventional disease labels. Some of these are pretty rare, I have to say, but all the main important and common conditions are described in good detail.
In addition, there are specific chapters discussing cancer, infectious disease, and the pathological processes such as inflammation which underpin conventional medicine.
At the end of the book there is a section discussing red flags, withdrawal from conventional medication, communicating with conventional medical practitioners, and a series of appendices dealing with subjects such as a comparison of the organ systems of conventional medicine and Chinese medicine, examples of how to interpret the energetic actions of drugs, red flag conditions, drug categories for withdrawal of medication.
The conventional medical information presented includes an introduction to anatomy and physiology before moving into investigations. I am not sure whether there is enough detail of the anatomy and physiology to fulfil students needs. However, it is a useful reminder of these two topics. This is followed by details of conventional diseases which are described with clarity and in depth. Aside from the rarity of some conditions, the conditions commonly seen in clinical practice are discussed.
Clare regularly makes comparisons with ideas from Chinese medicine. This includes discussion of the energetic actions of various medications. To translate conventional medicine, which has only a limited physical view of people and the environment, is difficult. Having said that, Clare does present translations which are clear and she discusses the reasons for her conclusions. As such this is useful information for students.
What is somewhat more difficult is how to understand the actions of conventional pharmaceuticals in terms of Chinese medicine. This is still early days in the development of Chinese medicine in the West yet any attempt to help our understanding is to be applauded as pharmaceuticals are so common and pervasive.
There are also regular references to ‘red flags’, those symptoms and signs which indicate serious disease such that urgent referral or emergency care is needed. These are generally clear. However, one issue that I have with this section is that there are references at times to conventional medical disease labels. This implies that you must have access to a conventional diagnosis before deciding on a ‘red flag’. As most acupuncturists are not able to make such a diagnosis, it would be clearer to focus on symptoms rather than labels as this is a common language of people.
So, what difficulties are there with this text? A particular irritation for the UK is the use of American English spellings. People need to be aware of the differences, as using Americanisms when communicating with conventional practitioners within the UK will be a little jarring.
A more serious issue is the information given by Clare about vaccination. Her conventional background, particularly work in public health, betrays her here. Further sources of information would be helpful or at least to mention some of the debates currently taking place about their effectiveness.
For example, Clare discusses Gardasil which is a relatively recently developed vaccine. It is an attempt to protect against infection with HPV virus. It is hugely controversial worldwide because of reported adverse effects. These can be severe and deaths have been reported. Denmark and Japan have both ceased its administration because of concerns about its safety. Uptake in Ireland dropped from 87 per cent to 50 per cent as a result of parental concerns. Clare merely repeats conventional views such as ‘it is likely to impact positively on the incidence of cervical cancer in the long term’. In reality, there is no evidence that this vaccine changes the incidence of cervical cancer as it has not been on the market long enough. And its safety concerns are a major issue for teenage girls and their parents.
There are further difficulties when Clare discusses vaccinations of babies and children. Her assertions about the ‘benefits’ of vaccination fly in the face of the fact that the vast majority of reduction in the incidence of communicable diseases and their complications occurred well before the advent of vaccination.
There is a page and information box discussing vaccination from the Chinese medicine perspective and the practice of exposure to smallpox scabs from the 16th century in an attempt to prevent smallpox. This is mirrored by the work of Edward Jenner in the UK in the 18th century who showed that exposure to cowpox could reduce the incidence of smallpox.
The conclusion in Chinese medicine, as discussed in the text, states that vaccination can be considered to be similar to a qi tonic. This may be true with these ancient techniques. I cannot see how that can possibly be the case with modern vaccines where multiple agents are given at the same time. In addition, modern vaccines contain toxic substances such as mercury and aluminum and may be grown using aborted foetal cells. And as Clare lists in a vaccination schedule, there are thirty-five vaccines administered before the age of five.
An important part of our work is to lay out information and possible treatment choices for people. And to allow our understanding of underlying energetic principles to guide people to healthy choices. Clare does acknowledge that vaccines can lead to Heat and Phlegm as well as lingering pathogenic Heat. She then goes on to recycle the myth that autism has no connection with vaccination, at the same time as discussing the imbalances seen in autism which include Heat and Phlegm.
So, in many ways this is a good introduction to conventional medicine for its stated audience. However, students and practitioners need to be careful about accepting the references to conventional treatments in this text as the final word. There are many opinions about such treatments, and many alternatives, which practitioners need to check out for themselves.
Dr Stephen Gascoigne, medical doctor, acupuncturist, herbalist, has practised Chinese medicine for over 35 years and works in West Cork, Ireland. He has a particular interest in helping people with serious conditions such as cancer and autoimmune diseases. He is the author of The Clinical Medicine Guide, The Prescribed Drug Guide, The Chinese Way to Health and Understanding Depression. He has taught widely at colleges of Chinese medicine and homeopathy.