Nothing “traditional” about acupuncture

AS I write, New Year’s Day is in recent memory and Chinese New Year is upon us, so thoughts of the new – and of the old – come to mind.

I’ve just been rereading an article about so-called traditional Chinese medicine (TCM), acupuncture, what’s really old, and what’s new.

It is well established that what we call TCM – often lauded as ancient wisdom – is neither traditional nor ancient. It is thought that ancient references to “needling” were describing methods of lancing lesions, such as abscesses, or blood-letting – not the insertion of ultrathin needles, which could not have been manufactured with the technology of the time.

In fact, TCM was a reinvention by Chairman Mao, who, himself, respected scientific medicine. As part of the Cultural Revolution, and facing the health care needs of an astronomical population, the so-called “TCM” was born. These two articles (here and here), detailing evidence for these developments, are fascinating to read.

The so-called “West” – largely the anglophone world – became fascinated with “ancient Chinese wisdom”, paradoxically, during a time that the major advances in conventional medicine – antibiotics, surgical techniques and vaccines – had already occurred.

This reaction against the so-called “reductionism” of the clinical sciences may be seen as a backlash against what was being perceived as a loss of mystery – or mysticism – which also accompanied a turn away from traditional religion. It also coincided with Nixon’s visit to Beijing in the 1970s.

Meanwhile, China survived Mao’s regime and began to build up enormous knowledge and technology in science-based medicine, and still leads the world in fields such as cardiology and the surgical specialties. This reflects a very important point: there is no “Eastern” or “Western” medicine, there are therapies that are scientifically plausible, effective and acceptably safe (aka medicine), and those which are not.

It has previously been argued here that registration of TCM practitioners by the Australian Health Practitioner Regulation Agency, although useful for regulation and oversight, risks lending a professional legitimacy equivalent to conventional medicine.

Of further interest to me, though, is the incorporation of acupuncture within conventional medical practice.

Australian medical practitioners are well versed in the clinical sciences. We know that there is no evidence for “meridians”, nor for the “humours” postulated by Hippocrates, nor for the “like treats like” model of Hahnemann, and nor for chiropractic “subluxations”. We understand the placebo mechanism and we test new therapeutic substances against it.

So, my question is this: is acupuncture the last bastion of acceptable placebo use in Australian medicine?

Dr Sue Ieraci is a specialist emergency physician with 30 years’ experience in the public hospital system. Her particular interests include policy development and health system design, and she has held roles in medical regulation and management. She is an executive member of Friends of Science in Medicine.

 

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