When you mention acupuncture most people think of China but that is not the whole story. In 1991 the mummified body of “Otzi the Iceman” a five thousand year old Neolithic hunter was discovered on the mountainous boarder between Switzerland and Italy. He appeared to have tattoos or burn marks on his back indicating that some kind of treatment had been applied. These marks were at a point we now know as Bladder 23, it is a point still considered useful for back pain. The Chinese Medicine theory we have fully translated has been described to me as the tip of the iceberg but there is a landmark reference book known as “The Yellow Emperors Classic of Internal Medicine”. It was written in about 2000BC and is a definitive work generally considered to be the source of most contemporary theory. However, it was not written until approximately a thousand years after the iceman died. So it seems clear that the origin of using needles or heat to treat acupuncture points goes way back into human history. We don’t know who actually did it for the first time, where they were, or even how they developed the idea. But what we can reasonably assume about medical care throughout the ancient world is that it was localised. There was no Internet or any other realistic means of wide communication and healers in different regions would probably practice according to their own traditions. This would have reflected their local environment and the characteristics and requirements of the people. For example, it seems likely that moxabustion was first used in colder places. Chinese Medicine (CM) therefore developed all over a vast continent and over an extended period of time. It is also clear that there are many similarities to both Tibetan and Indian traditions and that Japan and Korea have had a big influence on modern practice as well. If you read the Yellow Emperors Classic (and unless you read ancient Chinese characters it will be a translation of course) you will find that it speaks in an unfamiliar and poetic language. It speaks of living with the environment, the changing seasons, the climate and the Dao. The book takes the form of a dialogue between the Emperor and Chi-Po his medical advisor and it is very much a reflection of its time and culture. We may assume that what we are learning now is “Chinese Medicine” but actually it must be only a selective and interpreted sample of some of it. Sometimes it is difficult to relate what Chi-Po says to what patients want and need in the treatment room today because so much has changed in four thousand years. The classic does not mention electricity, geopathic stress, antibiotics, sugar, meeting deadlines, Catholicism, cannabis or atmospheric pollution. So although it is accepted that the book records the origin of the theory it has still to be seen as only a guide to what we do in a modern context. Some of it will have been lost in translation and there must have been lots that didn’t get recorded for all kinds of reasons. Consideration must be given to issues like politics, power struggles, levels of literacy and the role of religion. We really don’t know how life and practice actually was for the acupuncturists of the past but we can speculate about it. For them the time was now as it is for us and although human nature may not have changed much it seems clear that many other things have.
Traditional methods brought from all over the East and recently revived and modified in the West bring us to the current situation. We are in fact using a combination of different ideas, theories and protocols and this is probably as it has been for centuries. The evolutionary changes have never stopped and it seems clear that CM has been continuously revised and re-invented. I believe we should not be afraid to push forward the process of the evolution of acupuncture to adapt it to a modern context. We should not allow ourselves to be constrained by rules or traditions if we see no benefit. If we find that what we have read and been shown is working well then we can use it. But if something seems unnecessary or we have an easier and more effective alternative then lets use that. Traditions are useful up to the point that they stifle creativity and innovation at which point they can actually become repressive. When I was a student some of my teachers inadvertently convinced me that there were rules or laws about acupuncture. But now I know that beyond sensible health and safety practice there are not. I prefer to call what we do Modern Acupuncture because I think this is a more accurate description of what it actually is. Despite the fact most acupuncturists like to call themselves traditional and will disagree with that, there are probably just a few things that 90% of them would agree about:
1, Acupuncture recognises the presence of Qi running through a system of meridians in the body.
2, Qi can be accessed by using needles at places along those meridians called acupuncture points.
3, The purpose of acupuncture is to rebalance Qi and promote holistic healing.
4, Acupuncture can be a spiritual practice.
5, Acupuncture is not well suited to scientific evaluation.
The other 10% would be those who do what we call Dry Needling or Medical Acupuncture. There are various systems of acupuncture acceptable to science and evidence based research. They are perfectly workable and reasonable and benefit patients every day, but they are not the subject of this discussion. However even though the theories medical acupuncturists are using may be very different to those we are discussing here many of the observations will still apply.
First and best known of the alternative medicine theories is what is called Traditional Chinese Medicine (TCM). Most colleges teach this and most acupuncture books are written about it. What we are calling TCM was essentially invented in the 1960’s when Chairman Mao demanded the establishment of a standard. It seems almost certain that during that process much was lost, ignored or not collected from the far corners of the country. TCM is therefore a rationalised and restructured sample of Chinese philosophy, traditions and theories. The system uses theoretical standardised patterns of disharmony of the organs to make a diagnosis. In very simple terms you learn to recognise syndromes and what combination of syndromes are present.
One key problem with TCM theory is that it lends itself to herbal medicine more than it does to acupuncture. Herbal medicine tends to be about the effect of nutrition (herbs) on the organs, whereas acupuncture is about Qi running through the meridian system. These things are related but they are not the same. This contradiction has even prompted one expert to say that most TCM has no relevance to acupuncture at all. I think it is quite a revelation that colleges all around the world are teaching TCM theory to acupuncturists when it is almost irrelevant. And how can you call a fifty year old methodology traditional anyway, shouldn’t it be called MCM? Despite this we still teach basic TCM because it is useful and it is the standard system used everywhere. It is a good starting point because you can work with a formula or a very simple interpretation of the original theory. This builds comprehension and confidence while students find their feet. More on this anomaly later when we discuss how and why acupuncture works.
The other popular theoretical perspective that you will hear a lot about is “Five Element Acupuncture” (5E). This is an idea that confuses the Chinese because five elements theory is part of TCM and it is used extensively in Japan and elsewhere. You might even say that TCM was created by one mans directive and 5E on another mans whim. His name was Jack Worsley and he was an Englishman who travelled to Korea and Japan in the 1960’s. He put together various ideas and techniques that he learned and founded one of the first acupuncture colleges in the UK. His style of 5E talks about Qi in that some of the techniques are directly Qi related. For example the akabani test which is a method of checking the balance of Qi in the meridians. But he also incorporated other traditional methods like the possession treatment, which is an updated version of an ancient ritual best classified as demonology. The main emphasis of 5E is customarily in diagnosing according to observing the nature of the five elements reflected in a person. This is done by observing colour, sound, odour and emotion (CSOE) and then using those observations to establish which element is key. However in my view the consultations usually focus most attention on emotion and building rapport by understanding emotional responses. What the system does well is to speak a language Westerners understand and can relate to through their own feelings and life experience. It seems to be about people rather than their signs and symptoms of illness and this is the main difference. Many people in the field of alternative healthcare use the term Mind/Body/Spirit omitting to mention emotion. But emotion is the key and we find that we return to it again and again as we seek to understand the process of acupuncture and its healing potential. Our lives are all about emotion and it is through emotions or feelings that we find ways to access a higher vibration. We can give that higher vibration various names such as Spirit, God or Dao as best suits us, I’m calling it Consciousness most of the time. 5E also includes certain protocols you will not find in TCM and some of these like the Aggressive Energy drain (AE) and Possession treatment can be really useful in their own right. No system is perfect but understanding and emphasising the role of emotion was Worsleys great contribution to acupuncture.
A practitioner I know uses the possession treatment a lot, probably on about 20% of his patients. It works well and he see’s possession quite often especially as a consequence of relationship breakdown. According to the signs and symptoms associated with a diagnosis of possession it must be treated before any other treatment can take place. This is because possession is a block to other treatment working and it must be cleared. In one college where I worked we did not teach possession, so obviously we never diagnosed or treated it. This must mean that lots of possessed people treated by acupuncturists who don’t have this protocol as part of their repertoire are treated while still possessed. Or does it, does possession exist or does it only exist for practitioners who are looking for it? Or is it that people sometimes treat possession without recognising it as such or calling it possession? In any event there is no doubt that some amazing results can come from possession treatment. Just as some amazing results can come from all kinds of acupuncture treatment.
Qi is energy, so it influences everything since everything can be described in terms of energy. Some people theorise that to practice acupuncture you have to have good Qi yourself. This seems to make sense and it is why people sometimes spend years doing martial arts like Qi-Gong to develop their Qi. It is impressive to see the power that a good Tui-Na or martial arts practitioner has to direct Qi as they wish. This cultivation of Qi would appear to be fundamental to a healing modality that appreciates the nature of energy in the body. That may seem obvious but is it right? I have a story that suggests that Qi may not always be exactly as expected:
A friend of mine had terrible problems with a mysterious and incurable condition lasting for fifteen years or more. At one time he had been hospitalised and close to death with searing pain in all his joints. He had been treated with steroids that saved his life but was still in a lot of pain with quite limited mobility. He was passed from specialist to specialist and received all the NHS could offer. Most of the people had been lovely but it was one of those cases where the bottom line truth was that no one had a clue what to do with him. He finally gave up on them when he was prescribed drugs that almost drove him to suicide. Then a course of treatment from an alternative herbal specialist damaged his Liver and made him even worse. Kinesiology, hypnotherapy and Emotional Freedom Technique had helped temporarily but acupuncture had not. One acupuncturist had said it was necessary to see him three times a week for three months. At the end of the time she had said that although there was no change in his symptoms his pulse was improving! He had walked away destitute having spent all his savings and then run up a debt. He was so desperate for help he still tried acupuncture again but this time from a Chinese practitioner someone recommended.
The room was cold and the practitioner was frail and appeared to be ill. My friend lay shivering on the couch wondering why he had listened to the person who had referred him. The practitioner even had to leave the room at one point and he could hear him coughing outside. But when it came to the actual treatment the Qi sensation he experienced was something special. The practitioner used the same common points as everybody else (the ones you will be using) but seemed able to do something different with them. My friend described the needling as painless but that he could feel the warm, dynamic, healing Qi coursing through his body. I wont pretend that the treatment cured him because that is another story, but it did offer relief of symptoms in a way that nothing else had. So if you do need good Qi to practice acupuncture we probably need to redefine what good Qi is. It seems that the nature of Qi may sometimes be dependent upon things other than traditional Qi cultivation methods. It is not as simple as to say there is only one way or type of Qi or one way of developing it. Qi is a mysterious form of healing energy and the forms it can take are ultimately indefinable and infinite. Certainly the idea proposed by some people that practitioners always need to be physically, mentally and emotionally balanced people does not hold true at all in my experience. If it did half the practitioners I know would have to retire.
Jack Worsley was described by one observer as: “The greatest shamanic healer I have ever seen”. He went on to suggest that he may in fact have been relying upon his Christian faith and beliefs more than his acupuncture ones. We don’t know how much of what he was doing was acupuncture and how much was something else. But what we do know is that the system of acupuncture he created still works well and has many devotees. So whether he was more Shaman, Priest or Acupuncturist does not seem to matter when others use his methods that are still very real to them.
Dr Van Buren founded The International College of Oriental Medicine in East Grinstead (ICOM) where students had the opportunity to observe his clinic. Sometimes he would use unusual methods like horoscopes and charts to plan his treatments. This is a method known as Stems and Branches and it draws upon another rich vein of Chinese theory and philosophy that is not mainstream. Occasionally he would even look at the charts and decide which points he was going to use before the patients arrived. One time he did this and said it was a day when acupuncture was forbidden. I asked what he was going to do and with a little smile he said he would use moxa. He didn’t, he used acupuncture as normal and it still seemed to be effective. So he must have had more than one theory and methodology at his disposal. It seems that so long as you have a system of practice available you can use one in place of another as it suits you. There is never only one way to do an acupuncture treatment even when the alternatives contradict one another. Some of the students and staff at ICOM were of the view that Van Buren was also drawing upon his shamanic abilities. He was certainly a man of mystery and you never knew quite what he was up to.
A colleague of mine went to China and spent quite a time in conversation with one of the doctors there. She had noticed that almost every patient seemed to be treated using an acupuncture point on the ankle known as Ki3. So when they came to discuss a case she thought she could show him how well she understood Chinese Medicine. He listened and nodded politely as she explained in detail why she had chosen Ki6 (also on the ankle) as an ideal alternative point for one patient. He agreed that she had made a really good case for it using sound CM theory. Then he carried on and used Ki3 after all. It seems that with all his experience he could do everything he wanted to do with Ki3, even when there was a good case to be made for Ki6 being a better option.
I once found myself in the unfortunate position of being employed to teach acupuncture to a group of people who already had their own theoretical viewpoint. They were members of a cult like organisation with a leader who had suggested that they learn from me (I don’t know why). The situation was very difficult because they were uninterested in most of what I was trying to teach. However they did want to take pulses and I was able to give feedback on that. One of the best ways to learn pulses is to monitor them in a treatment environment. This is because even if you are unable to recognise and name pulse qualities you can still observe pulse changes as treatments progress. We were taking the pulses of one of the group one day and observed a very wiry Liver pulse. I suggested a point on the Liver meridian known as Liv3 to calm and smooth the Liver Qi. We did that and noticed that the pulse did not change very much. Then one of the group suggested needling a point on the arm, it was a point I knew nothing of. Apparently their leader had his own points based upon his theory of 30,000 chakras (energy centres) and this one on the arm did something according to that. He also had his own brand of needles and needle technique not involving Qi as I know it. They did the treatment and contrary to my expectations the pulse I felt changed completely. It was now much smoother, softer and less wiry. So the level of their conviction (as patients and practitioners) about what worked was enough to alter the pulse from my perspective and against my expectation as well.
A practitioner friend of mine treated a young woman who had a chronic bad back. She was in constant pain and had been x-rayed and told that she needed an operation to correct spinal damage. With little to lose she tried acupuncture and made a rapid and complete recovery. It transpired that the cause of the problem was actually her marriage and treatment had helped her to see that and decide to end it. I asked my friend what she had done, to which she replied that she had used the point known as Sp3. Since she was trained in 5E she saw the patient as an Earth person and simply used the Source point of the Spleen. Why did that treatment work so well, was it because the theory she used was so profound and powerful, was it because she was committed to it, or was there some other reason? None of the books I have read mention that Sp3 is a good point for back pain. I wonder if the treatment would have worked if someone else had done Sp3 and would it not have worked just as well if she had justified Sp4 to herself and used that?
There is no standardised Japanese acupuncture technique because there are many different styles used in Japan. But speaking to people who use Japanese techniques I note that the diagnosis tends to be done more on the body than with other approaches. The idea is to sense where the Qi is blocked, excess, or deficient in the meridian system and balance it. When it comes to needling they often seem to use long needles, sometimes made of precious metals but only insert them a couple of millimeters deep. I also note that whereas most acupuncturists expect their patient to feel Qi as some kind of ache, dullness or tingling these practitioners do not. With this system only the practitioner needs to feel Qi in order for the treatment to be effective. This seems to contradict most Chinese systems of acupuncture quite directly. But the treatments obviously still work and from a nervous patients perspective this is a great way to experience acupuncture.
I have worked with many students and one I remember particularly for her intellectual brilliance. We would sit down to discuss a case she was treating in clinic and she would explain her reasoning and diagnosis with such clarity that all I could do was nod in agreement. Her knowledge of CM theory and her ability to apply it surpassed mine. When it came to the treatments themselves she was similarly able in every way. Her practical skills were good, her patients liked her, her time management was spot on and there was nothing to criticise or feed back. She had absorbed all that the course had to offer and then added more of her own. I saw that there are people who just have that kind of ability and they can use their intellect to do anything they like with ease. Even those skills that on the face of it do not require that kind of intelligence but rely more on senses were no trouble for her. She could have easily covered all the material and development in a typical three-year course in a year. She was able to learn and use acupuncture theories or scientific ones and apply them with equal ease. She went on to specialise in an area of acupuncture and did pioneering research and a PhD. She has gained the respect not only of the alternative healthcare profession but also of the conventional medical profession as well. All acupuncture was easy for her.
On the other hand I have also worked with students who just don’t get it. Even after years of training they still ask the most obvious questions demonstrating their lack of comprehension. Or they have such deep-rooted emotional or psychological problems it is almost impossible for them to focus on anything other than their own neurosis. In such cases they are usually able to demonstrate competence in terms of safety so the question arises as to what to do with them. When a student has paid thousands in college fees, passed exams and progressed they cannot really be removed from a course. Whether we like it or not these people are out there with their qualifications using acupuncture and getting results. I have met and heard about such practitioners from many different colleges and doubt that any can claim this has never happened. The question is does it really matter because in many cases it is arguable that they are just as effective in terms of what they achieve for patients as anyone else? The skills of networking, promotion and building a successful practice are quite different from those you need for acupuncture theory and Qi development. Which probably explains why so many really good graduates of acupuncture give up before they get started. What most patients care about is how they personally feel about the practitioner and the effectiveness of their treatment. So how do people get away with having such limited self-awareness, ability and skills? The answer is they practice easy acupuncture using the most basic principles!
The Yellow Emperors classic is a deeply philosophical book and it has been studied and translated extensively. Like any great work of its kind its true value is in the way it inspires and changes the student. Having met Claude Larre who studied it for many years it was obvious he had been profoundly influenced by it. The important point to me is not that the book teaches you to be an acupuncturist (it doesn’t) but that the practice of studying such deep and profound material fundamentally changes you. Coincidently I was speaking to a wise man about acupuncture theory and he said it was very interesting but that you need to see it for what it really is, he said…
“Just supposing I were to invent my own therapy, let’s call it toothpick therapy. I’d go and find out about lots of different kinds of tree and what the wood we get from them is like. Then I could go and find someone who could tell me all about those trees and how they were traditionally grown, where they were planted, what spirit and energy they have etc. I could develop some great stories about the history of the trees and how their energies came to be recognised and appreciated. I’d get toothpicks made using different types of wood and wood from different regions and of different ages of tree and parts of the tree. As I researched a story would develop about the way in which the energy of these trees can be transmitted through the toothpicks. For example I might feel that the Yew tree gives more flexibility because it’s a very flexible tree, or that the Oak gives stability and longevity. I love trees so it would not be difficult for me to really get into this and pretty soon Id be feeling that what I had created was real. The treatment itself could be done by holding or placing the toothpicks onto points representing roots and branches of the body. Perhaps I could use the established system of meridians because they have been quite well accepted as energy pathways both in the East and the West now. What I’m saying is that to the extent that I could convince myself and others of the authenticity and effectiveness of such a system it would work.
This is because all traditions and all the theories and protocols do only one thing and that is to change us. I know it may be a radical idea but I want to suggest that everything you have been told and everything you believe to be real in your life is a story. Ancient China, Daoism, Yin/Yang, TCM, 5E? That’s a story used to create something called acupuncture. No matter how profound and revered the theory may be it still requires an observer. It still requires that you are here to understand it, accept it, believe it and put it into practice. Without you here and now as a co-creator and believer it cannot exist and is utterly meaningless. You are the focus, the centre, the moment in which it is and the only way it can be. Chinese sages and others have told us that wisdom comes when you can allow yourself to let go of everything you think you know. The trouble is we don’t listen and we still think we can intellectualise our way to enlightenment.
It is completely up to you where you find inspiration. If we were to seek it by consulting another great dynasty such as that of the Mayans for example, we would find they say the era in which all the great theories were developed ended in 2012. So that would call into question how relevant they really are now? For myself, I feel that we are in a new age altogether and I see it as the age of awakening consciousness”.
How and Why Acupuncture
 Burning a herb known as moxa (mugwort) on or near the body to create heat.
 Translates as: way, road, path, course or method.
 Chinese Medicine
 Qi roughly translates as energy.
 Bob Flaws
 Modern Chinese Medicine
 Some people have been known to call it Worsleypuncture
 Translates as big Qi or Qi cultivation exercise.
 Chinese Massage.
 National Health Service
 A discussion of point classifications will follow.
 Also known as Taoism – Chinese religious tradition.
 Theory of opposites, will be discussed later.
 Wise men or teachers such as Confucius.
 Pre Columbian culture of Mesoamerica and Northern Central America.