Philip A.M. Rogers MRCVS

Acupuncture (AP) in Traditional Chinese Medicine (TCM)


Altman_S (1992) The incorporation of AP into a small animal practice. Probl Vet Med Mar 4(1):223-233. Successful use of AP in small animal practice on a day-to-day basis depends on an organized approach. The staff must be trained to answer telephone inquiries and client questions and to obtain a good history before appointments are scheduled. Colleagues must be ethically and professionally assured of a veterinarian's AP credentials and capabilities, so that they will become a source of patient referrals. A proper examination must be conducted that incorporates traditional western veterinary practices with AP, and the results must be properly recorded. A diagnosis should be established before therapy is initiated, and a plan of treatment set up. The prognosis, projected costs, length of treatment regimen, other means of treating the condition, and any possible sequelae should be discussed with the client. The patient should be monitored during the course of treatment, and reevaluated to determine whether or not changes in AP prescription or additional modes of therapy or supportive care are needed. Communication with the client and the referring veterinarian should be a priority.

Chinese Pain Centre (1996) How Does AP Work?. Adapted from WWW. Chinese Pain Centre, 2219 S. Hacienda Blvd., Suite #203, Hacienda Heights, CA, USA. AP is a method of encouraging the body to promote natural healing and to improve functioning. This is done by inserting needles and applying heat or electrostimulation at very precise AP points. In TCM, Qi Channels run in regular patterns through the body and over its surface. These Channels (meridians) are like rivers flowing through the body to irrigate and nourish the tissues, Xue flow and nervous pulses also follow Channels to run through the body to various parts, structures and organs. Qi-Stasis (obstructed movement of these Qi rivers) is like a dam that backs up the flow in one part of the body and restricts it in others. Any Stasis (stagnation, obstruction, blockage), or Xu of Qi, Xue and nervous pulses would eventually lead to disease.

The Channels can be influenced by needling the AP points: the AP needles Clear the Stasis (unblock the obstruction at the dams) to reestablish the regular flow of Qi-Xue through the medians. AP treatments can therefore help the body's internal organs to correct imbalances in their activities of digestion, absorption and Qi production, and in the circulation of their Qi through the Channels.

Modern science explains the functions of AP in 2 major ways:
1.        Needling the AP points stimulates the nervous system to release chemicals in the muscles, spinal cord, and brain. These chemicals will either change the experience of pain, or they will trigger the release of other chemicals and hormones which influence the body's own internal regulating system.
2.        In TCM Yin represents "-" (negative) and Yang represents "+" (positive). The main principle of TCM is to keep the Yin-Yang balance or bring Yin-Yang back to balance. Yin-Yang balance is the healthy state of the body. Modern science reveals that the very basic unit of the body is cell. Cell movements follow the movement of electrons. The electrons inside cells act according to regular patterns. We call these electrons in living bodies bioelectrons.

Qi flow in the Channels is the direct or indirect transportation of bioelectrons. Channels are the conduits where bioelectons move more often than other parts of the body. When positive and negative charges in the bioelectronic movements are not balanced, the cells would act abnormally: this is Yin-Yang imbalance. In TCM it is defined as "disease". It is the start of the movement of electrons in the physiological cells. WM admits to a "disease" only when radical change of the movement of cellular electrons has occurred.

All the external factors, such as mechanical, physical, chemical, biological and internal factors such as mental, hereditary, constitutional can cause and force the body's bioelectrical movement turn to imbalance would lead to disease.

AP can force the bioelectrons resume to their normal and regular movement patterns and Yin-Yang balance. The more AP treatment the patient have the longer the normal movement pattern of the bioelectrons can remain, until finally the electrons inside cells would not follow the abnormal movement pattern any more. Only at this point the problem can be deemed as solved and treated completely.

Dale_RA (1994) Forms of Qi (Vital Energy) in AP. (Adapted from WWW: A condensed version from the 1994 AJA 22(3)). Ralph Alan Dale, AP Educ Centre, 3805 Northeast 167th St., North Miami Beach, FL 33160-3540 USA.

Concepts of Qi-Shui (vital energy and matter) are fundamental in TCM. Conventional allopathic WM has no comparable concepts. While allopathic WM organizes human physiology according to specialized functions, TCM is concerned more with dynamic interrelationships, especially the patterns of Qi.

The 5 main TCM forms of Qi-Shui (Qi, Xue, Jing, Shen and Jin-Ye).
Qi-Energy is the Vital Matter-Energy of every living organism and the source of all movement and change in the universe.

Xue-Blood is the Fluid that circulates in the vascular system, but the Qi within the Xue also vitalizes its nourishing function and its flow. Qi-Xue have mutually interdependent functions.

Jing-Essence is the Essential Qi of all living organisms. It is derived both from Yuanqi (inherited energy, Source-, or Original-, or Ancestral Qi) and from the energy we acquire daily, mainly from air and food (LU-Qi and Nutritive Qi

Shen-Spirit is the material/non-material mental-emotional-motivational aspect of consciousness that is stored in HT (the TCM concept of HT, not the WM concept, which views the organ as simply a pump). The HT has many other functions including the seat of the Shen-Spirit. Other organs and organ systems are capitalized to further illustrate this distinction.

Jin-Ye-Fluids are the normal functional secretions of the body. They include tears, sweat, saliva, milk, mucus, hydrochloric acid and genital secretions. Jin are the lighter, purer and more Yang Fluids which, via LU, moisten and nourish the skin and muscles; Ye are the denser, more Yin, turbid fluids which are processed in SP and ST to moisten and nourish the Zang-Fu (internal organs), bones, brain and orifices (mucus for sensory orifices and others).

Functions of Qi
All 5 substances are interdependent; however, Qi is central to each of them since it is both the prime activator as well as the recipient of their various functions. The 5 main functions of Qi in the body are to:
1.        Nourish growth and development;
2.        Warm and maintain appropriate temperature;
3.        Defend against Perverse Qi (External pathogens), stress, trauma etc;
4.        Control Xue and Jin-Ye;
5.        Transform and metabolize Qi, Xue and Jin-Xue.

Channel Theory
In TCM, Qi-Xue (Energy and Blood) circulates along a system of conduits, the Main ones being the Channels (meridians), as well as through the blood vessels. Qi-Xue is vital; it gives life to all living matter. The Qi-Xue conduits resemble those of the vascular- or nervous- system, since each has a network of main Channels and minor capillaries. There are 12 Main bilateral Channels, each intimately connected with its own Fu (Hollow Bowel) or Zang (Solid Organ), and each manifesting its own characteristic Qi, e.g. LV-Qi, SP-Qi, etc.

Hun_YC1 (1934) The Duty of Oriental and Western Medicine: Part 1. Adapted from WWW 1996. Hun Young Cho was a practitioner of both TCM and WM. This interpretation of the difference between TCM and WM comes from his book "Oriental Medicine, A Modern Interpretation", translated into English by Kihyon Kim. It was originally published in Korean in 1934 and should be read with that understanding in mind.

The Duty of TCM and WM: There is a worldwide trend towards TCM. In Tokyo and other areas, serious discussions on reviving Oriental Med are under-way. In Korea, people are still receiving Oriental Med treatments, so discussions on reviving Oriental Med with the implication of re-establishing it are not relevant. However, further development, elevation and improvement of Oriental Med is the vital question confronting us. The first thing that is needed when discussing the subject of Oriental Med, above anything else, is the proper understanding of TCM itself. Whether one promotes, discards, disagrees with or supports TCM, without correct understanding of the medicine itself, one should not criticize its validity. To properly understand TCM, critical comparisons to WM are absolutely necessary.

It is true that bias cannot be avoided in discussing TCM while looking only from the perspective of TCM. Also, a biased opinion cannot be avoided in discussing methods outside of WM when coming from a contemporary scientific standpoint. Hence, through comparing and contrasting TCM and WM to properly understand TCM and after clearly recognizing its medical value, society should be educated so that they can have a strong faith in the significance of the existence of TCM. As the public recognizes its value, public and Govt support can be acquired. Subsequently, necessary facilities such as Research Insts, learning centres, schools, hospitals, etc. will be established. I recognized this point early and devoted every possible effort for 7 yr so far for the modernization, scientific verification and socialization of TCM. At this time, I am writing an outline of my humble opinions open to the friendly criticisms and guidance of the readers.

One often hears of developments of WM or Mod Med technology, but the moaning of the sick among us is becoming louder and louder. The increase in the so-called modern diseases such as tuberculosis, neurasthenia and digestive disorders of the digestive system should give us all cause for concern. So-called modern diseases imply that these diseases have increased in recent times among the people of civilized countries. On deeper inspection, it signifies that WM is unable to control these diseases. Undoubtedly, living conditions in a complex society make it easy for people to catch these diseases. The invention of fighter planes was followed with the creation of anti-aircraft guns. When battleships showed their prowess, submarines and torpedo boats were devised. Even with the power of modern science, a weakness of WM that it can do little to alleviate the diseases caused by stress in modern society.

In a country like the USA, non-pharmaceutical, natural Med schools have considerable influence and try to treat diseases without using drugs from modern hospitals. Recently in Japan, there has been a sudden rise in the use of many kinds of folk medicines. This development illustrates that WM has been unable to satisfy those patients who are receiving these natural treatments. However, since we have received great benefits from WM, I am not trying to slight or attack WM. Through its development of serology, many effective preventive measures, such as smallpox vaccines, exist because of WM. Developments in microbiology have helped national health institutions to prevent epidemics and many other diseases. Thus, innumerable people have avoided the misery of epidemics. We must praise the strong points of WM and at the same time supplement the weak points. In my opinion, the method of complementing WM can be adopted only from TCM.

TCM is rooted in philosophy and WM is rooted in natural science. TCM is holistic; WM is analytical. The former puts its effort into the observation of living phenomena and the latter puts emphasis on the investigation of the structure of matter. Accordingly, their methods are different and their roles are divided: the strengths of TCM are the weaknesses of WM and the strengths of WM are weaknesses in TCM. Although WM is better in defending and eliminating External pathogens that threaten life, TCM is better in cultivating the fundamental life force (Qi) to increase health. One can compare the duties of WM and TCM in protecting life or health of the human body to the duties of laws and morals in maintaining peace and order in a society. If both do not support each other, a prosperous society cannot be expected. Faith in the omnipotence of WM based on surgery for acute diseases, or on drugs to cure syphilis, malaria, etc, while disregarding TCM is a biased faith. Unconditional defence of TCM and attack and deprecation of WM in cases where TCM Herbal Med easily cured chronic illness is an equally narrow opinion.

Morality is fundamental and law is temporary. In a similar way, TCM is a "root-treating Med" and WM is a "manifestation-treating Med." The Govt exercises power, for example, in unavoidable situations for the safety of the public, but morality has a more effective function than law in the daily life of all people.

It is natural for the authorities to adopt WM for prevention of epidemics and forensic Med, but TCM has contributed more in quantity than all the free Med treatments by the Govt for the health of each individual.

Holistically Treating Med and Locally Treating Med: TCM is a "holistic Med approach" while WM is a "localized (symptomatic) approach." For example, the cause of sinusitis in WM is attributed to an increase in pyogenic bacteria in the sinus cavities (maxillary, ethmoidal, frontal and sphenoidal), which creates pus. Thus, performing surgery in that region has become the method of treatment.

In TCM, on the other hand, the cause of sinusitis is not found in the nasal region. One's constitution and many physiological abnormalities are holistically observed and synthesized in order to inquire and identify the cause of sinusitis in that person. Even in the treatment, TCM does not directly perform artificial treatment such as surgery on the diseased region. Rather, physiological abnormalities are holistically and naturally regulated in order to eliminate the disease phenomenon in the nasal region.

Besides the experience of the author in the healing of sinusitis without surgery, many researchers have confirmed the effectiveness of TCM herbs.

Let us now put aside whether that treatment is superior or inferior and study the theoretical basis of holistic Med treatment.

It is not incorrect to say that the cause of sinusitis is the pyogenic bacteria acting on the sinus, but thinking one step further, it is true that in any healthy body, pyogenic, pneumonia, diphtheria and influenza bacteria are always present in the nasal and the sinus cavities. Therefore, the cause of sinusitis is not in the pyogenic bacteria but in the reduction of resistance that suppresses and restrains pyogenic bacteria. Sinusitis is called Bi Yuan (nose-pool) and, if severe, Nao Lou (brain discharge). The cause of it can be largely categorized as follows: 1.        Sinusitis due to Internal Injury (Yang Xu sinusitis and Yin Xu sinusitis, which originate from physical constitution);

Hun_YC2 (1934) The Duty of Oriental and Western Medicine: Part 2. 2.        Sinusitis due to External Invasion (e.g. due to the common cold). Regardless of its causal nature (Internal or External), sinusitis that accompanies an abnormality of the urogenital system is called Taiyang Bi Yan and sinusitis that accompanies an abnormality in the digestive system is called Yangming Bi Yan.

Specific TCM treatment for this sinusitis will be discussed elsewhere. Holistic or allopathic treatment can be better or worse, depending on the type of a disease. Sometimes the former must be used, sometimes the latter. Sometimes both must be combined. Thus, viewed from the standpoint of Med, both TCM and WM are necessary.

Due to overly venerating localized or analytical Med, strange events can often occur when viewed from the standpoint of holistic Med. The most appropriate example of this is the #606 (penicillin) injection incident regarding a dentist which was repeatedly reported in the newspaper recently. It became a judicial issue and the judgement which was passed made #606 injections by dentists unlawful. This is a truly humorous thing when viewed from a TCM standpoint. It is like lawfully preventing a dentist, who has been granted the privilege to treat dental disorders, from eliminating the cause of the dental disorder. The reason is that an abnormality often occurs in the tooth region due to syphilis, which is easily treated with penicillin. My point is not a discussion of the question of #606 injection privilege, but rather, of the fault of limiting the treatment of the dental disorder to the mouth by isolating dentistry away from treating the cause.

In the Channel theory of TCM, abnormalities or diseases of the reproductive and urinary system react on the CV, GV, BL and KI Channels. Erosion of the nose, loss of the voice and decaying of the tooth root occur often when syphilis invades those regions. Anyone can observe, if they pay close attention, that women develop toothaches and certain abnormalities in the mouth during pregnancy and menstruation. Since the oral region is at the end of the CV, disorders of the reproductive system are clearly reflected in that region and disorders of the tooth-root due to syphilis are a common occurrence. From holistic concepts, it is a major contradiction not to let dentists eliminate the cause of dental disorder. When treating the disease of a human being, who by nature is a holistic organism, such a blunder seems quite obvious due to adopting the "locally treating" theory.

Naturally Treating Med and Artificially Treating Med: One can view TCM as the "natural Med" and WM as the "artificial Med." In a strict sense, natural treatment cannot be a medicine. Also, a purely artificial treatment cannot exist apart from the natural healing power of a living body. It is classified in such a way only through its main focus. The former guides and promotes natural healing power to eliminate disease through the normal functions of the living body itself and the latter puts effort in artificially adopting emergency measures to eliminate the disease.

Here too, we cannot discuss the superiority or inferiority of TCM and WM. Depending on the disease, artificial Med must be used in many cases. Most surgical disorders must be treated by WM.

Orthopaedic Med or optometry, which can be viewed as semi-Med, can easily treat disorders that are quite difficult to treat using TCM. However, it is not proper to advocate the superiority of surgery for all diseases just on those grounds. For example, application of 1-2 packs of TCM herbs has cured many cases of appendicitis and otitis without surgery. In such cases, some doctors of WM say: "Diseases of humans are self-healing (heal naturally), so a cure with TCM herbs means only that the disease was such that it could have been healed on its own, without surgery." This is a statement that will remain unsettled no matter how much one argues. Even if the disease is at the level where Western doctors feel surgery is absolutely necessary, the disease cured by TCM herbs cannot be returned to the original state to be tested. It is also impossible to return a person to life who died because of surgery to check to see whether they could have lived without surgery. Here, we can only wait for fair judgement from the public to see which is correct.

In TCM, appendicitis is called terms such as Xue-Stasis (Shang Han Theory), Xue-Hernia (Hernial disorder) and Inguinal carbuncle (External Medicine). They all have the same meaning, but the treatment methods are flexible depending to the medical terminology.

Another example of Western technique is the application of ice for a febrile disease. Everyone knows that large quantities of heat are consumed when ice is melting and as a general rule, a temperature over 42oC (107.6oF) can be fatal. To prevent this from occurring, cold ice is artificially applied to the head and heart region in order to reduce the heat. This method is not without some benefits, but it has the following disadvantages:

Aside from these points, WM has many other disadvantages when assessed through TCM. In these situations, resolutely adopting the "naturally treating Med" is correct.

An injection is artificial while taking medicine internally is natural. For example, insulin (pancreatic hormone) injection is given in diabetes. It is natural for all substances other than air to be assimilated into the body through digestive organs, but injecting a certain substance directly into blood vessels is unnatural. In WM, a hormone preparation must be injected because of the concern for the change in its properties if it is passed through the digestive tract. However, in natural Med, instead of borrowing the pancreatic hormone from other animals, the person's pancreatic endocrine function is promoted. "Earth controls Water(10)" shows the opposing relationship between the pancreas (SP, Earth) and KI (Water). Thus, this endocrine relationship was known in the Orient millenia ago.

To explain the TCM treatment of diabetes in modern terms, the treatment method chosen is to ingest TCM herbs through the digestive organs to have a kind of external hormonal function toward the central endocrine nerves of the pancreas to recover pancreatic endocrine function and to totally restore glucose assimilating function.

Structural (Immobile) Med v Phenomenal (Mobile) Med: WM is "structural Med" and TCM is "phenomenal Med." WM is "immobile (fixed) Med" and TCM is "mobile (flexible) Med." The foundation of the former is in anatomy and the basis of the latter is in the study of Syndromes. The former looks for the cause of illness within the changes in the organism's structure and the latter identifies it by the abnormalities in physiological phenomena. Here also, the relative superiority and inferiority between WM and TCM should not be discussed since aspects of their roles are different. To give a few examples of the diseases that are treated more advantageously with "phenomenal Med" or "mobile Med," I would first of all cite mental illness. Mental illness is a subtle reactive phenomenon to a physiological abnormality. Therefore, to look for the cause of illness in the structures of the brain and the spine can only be considered an impossible task.

Hun_YC3 (1934) The Duty of Oriental and Western Medicine: Part 3. Mental illness, when correctly observed and treated from the standpoint of phenomenal Med, is an illness that can be cured with one to 2 packs of herbs at the time of onset.

The cause of mental illness is diagnosed through observing symptoms of mental illness such as: type of emotional expression; type of illusion or fantasy; movement; pulse quality; facial colour; season of onset; time of progression or decline in the condition of illness; foods enjoyed commonly and abnormal sensation or location on the Channel conduit.

Another example of the disadvantages of "immobile Med" over "mobile Med" is the use of Ca injections for lung disease. From anatomical reports, areas of a cadaver where traces of the tuberculosis organism were overcome are >80%. Since calcification surrounded the bacteria in those areas, Ca injections were given to the tuberculosis patient. This is very inconsistent in TCM because: 1. Even if Ca is needed, it should be taken through the digestive organs with Ca containing foods and assimilated more naturally through other organs. Injecting Ca directly into the bloodstream does not seem beneficial. 2. Tuberculosis bacteria are Yang-type (in contrast to gonorrhoea, which are Yin-type); they are most active when the body temperature is high. This is supported by the fact that LU tuberculosis becomes worse during summer and in the afternoon, dangerous during adolescence and is aggravated during excitement. Since the rise in body temperature by a Ca injection can be proven by the thermometer, it is definitely detrimental to treatment of the disease.

Root-Treating Med and Manifestation-Treating Med: TCM is the "root-treating Med" and WM is the "manifestation-treating Med." TCM is superior to treat the root cause of a disease and WM is superior in emergency management. Take, for example, the condition of hyperchlorhydria or excess secretion of stomach acid. WM is superior in neutralizing the already secreted excess amount of stomach acid with something like Na bicarbonate to prevent harm to the stomach wall, but TCM is a must in order to regulate physiological abnormality to fundamentally stop the over-secretion of stomach acid. Hyperchlorhydria in TCM is called Tun Suan Syndrome and its cause is said to be, "Wood overacting on Earth" or "LV (Wood) overacting on SP (Earth)". In other words, acid digestive juices of LV Channel system are said to overcome alkaline digestive juices of SP Channel system (which includes the pancreas). The secretion of digestive juices is regulated to prevent Shi and Xu through the external hormonal function of TCM herbs. Since most kinds of chronic disorders are like that, Root-treating Med is the superior treatment here.

Defensive Med and Health-Cultivating Med: WM is "defensive Med" and TCM is "health-cultivating Med." In artificially defending against external disturbance through disinfection, sterilization, serum injection, etc, TCM cannot compare with WM. In strengthening resistance toward disease by cultivating the internal life force and balancing physiological regulation, WM cannot compare with TCM. When examining these points, TCM and WM absolutely must not oppose each other, but must mutually cooperate to give the best possible Med treatment.

Internal Med and External Med: TCM is "internal Med" and WM is "external Med." The doctor of TCM even tries to treat the external or structural disorders with internal Med and the Western doctor tries to treat the internal disorder through surgical treatment (external intervention). Many cases (such as skin disorders) need Internal treatment when the cause of External disorder is Internal; Other cases need surgical treatment when the Internal disease is in the late stage.

Therefore, if TCM and WM communicate and complement each other well, we can avoid leisurely treating external disorders which could be quickly treated with surgery and we can avoid great sacrifices resulting from surgery for internal disorders which could be cured simply with internal medication.

Standardized Med and Adaptable Med: The proof of validity of any treatment system is best judged by its results; in that respect, there is only one medicine, the medicine that works. In another sense, however, the unity of Med can be subdivided into 2 types; standardized Med and adaptable Med. WM chooses "standardization" and TCM chooses "adaptation." WM, needless to say, does not ignore the uniqueness of individuals, but it is true that when observing the disease, an isolated discipline called pathology is established to always try to put the disease into the frame of certain universally valid rules of science. It even tries to establish a universal treatment method. Undoubtedly, if that were possible, it would be very fortunate from the standpoint of Med application, but it is a difficult problem. For example, in a common cold, there can be among its symptoms, existence or absence of sweat, cough, sputum, nasal congestion, dryness of nose, nasal phlegm, loss of appetite, indigestion, constipation, diarrhoea, chills, etc., the combination of which are clinically different Syndromes in TCM. Thus, the "Common Cold" can present as many different Syndromes which should not be treated in the same way, e.g. by the same medicines. That is the reason for the development of the Shang Han Theory in TCM. Whether it is a LU disease or neurasthenia, the symptoms and treatment methods are not uniform. Very few patients present with exactly the same problems: the best treatment is aimed at the specific needs of the subject at that time.

Beriberi is another example. In WM, the cause is said to be deficiency of vitamin B1. Signs of beriberi may appear in animals not supplied with vitamin B1 and the tissues of beriberi patients are deficient in vitamin B1. WM treats beriberi by giving vitamin B1. However, regardless of the route, or dose of the vitamin used, many cases are not cured. This is a weakness of standardized WM. TCM also recognises a relationship between beriberi and vitamin B1 deficiency. However, TCM sees the cause of the clinical problem not so much as a lack of dietary vitamin B1 (which is possible), but rather as a decline in the ability of the patient to assimilate and use B vitamins. The cause of decline in the assimilative function is in a person's physical constitution and abnormalities in weather conditions such as environmental temperature or Damp. This is supported by the fact that beriberi occurs often during Damp weather and is more severe for the person living in a Damp environment; thus, the relationship between weather and beriberi.

A person's constitution determines why person A gets beriberi and person B does not, though they eat the same foods and lead the same lifestyle in the same family. Therefore, the treatment method does not become fixed by a diagnosis of beriberi in TCM.

Hun_YC4 (1934) The Duty of Oriental and Western Medicine: Part 4.

When viewed from the standpoint of WM which tries to identify the "principal disease" and the "principal Med," it is not unreasonable to have thoughts of ambiguity or insufficiency and to doubt that TCM may treat diseases. Having a guiding principle within the ambiguity is the special characteristic of TCM. This is not limited to medicine, but is true in all aspects of Oriental culture.

India's poet Tagore has said that Oriental civilization is like the forest and the Western civilization is like the brick house. It is a most fitting comment. No matter how large a brick house is, the number of bricks can be calculated. But when one confronts a large forest, its vastness is indescribable. The types and shapes of plants and trees that exist cannot be known and are all different. However, within its complicated distinctive features, we can still find the uniform rule of nature. Plants that breed in Damp ground are located in areas of high humidity, plants of shaded ground in dark, dry areas and plants of sunshine in bright, open areas. Not even a branch or a leaf diverges from this rule. In this way, TCM can make sense of paradox and the profound laws within vastness. TCM, while disapproving of universally valid treatment methods, includes principles which have universally valid legitimacy.

Med Used by Govt and Med Used by Common People: WM, in contrast to TCM, is the Med most appropriate for use by the Govt. For the prevention of epidemics in a country or for judicially related Med needs such as blood type, finger prints, autopsy, etc., WM is most effective. That is why the support of the Govt has always been given to WM. TCM is always at a disadvantage compared to WM, which has formed a trinity with Govt, academic authority and monetary resources.

WM and TCM should not oppose each other. It is not a matter of which one is superior. Though the duties undertaken and the direction of contribution may differ, from a medical viewpoint, TCM and WM are like the two wings of the same bird. When both fully communicate, complement and cooperate, then it will be possible to fly to great heights, to give the best medical treatment.

Jaggar_D (1992) History and basic introduction to veterinary AP. Probl Vet Med Mar 4(1):1-11. This chapter offers a brief introduction to the basic principles of AP and a description of its development since its probable origin in China circa 3,000 yr ago. The AP paradigm and its theories of health are compared and contrasted with those of orthodox Euroamerican medicine. TCM is asserted as distinct in its reliance on astute observations of a patient that tend to be more detailed and subtle than those to which practitioners of orthodox western medicine are accustomed. TCM also tends to adopt a more holistic approach. The historic account of the development of veterinary AP begins with a brief history of human AP followed by a discussion of the history of veterinary AP as it developed in China, and subsequently spread to Korea, Japan, Europe, North America, and elsewhere. The International Veterinary AP Society is mentioned with regard to its role in promoting and coordinating veterinary activities in countries outside Asia.

Joshi_YM (1992) AP: a critical evaluation. J Assoc Physicians India Mar 40(3):184-189. Bhatia General Hospital, Bombay. TCM has used AP-therapy for >3000 yr. Mainly due to cultural barriers, AP was rejected in the West. However, research in the last decade has shown the physiological basis of AP. Although it is mainly used in the West to treat chronic musculoskeletal, it also has a place in the treatment of disorders unrelated to pain, such as functional gastrointestinal disorders, bronchial asthma and addiction to alcohol and nicotine. Published controlled trials have many methodological flaws which could be rectified by a standardised AP technique. Since TCM and WM differ in their concepts of anatomy, physiology and systems of diagnosis, it is impossible to reconcile them into a common language. However, it is possible for them to co-exist.

Kass_R1 (1990) TCM and Pulse Diagnosis In San Francisco Health Planning: Implications For a Pacific Rim City: Part 1. Adapted from WWW ( [Richard Kass, Dissertation, Social Welfare Dept, Univ of California, Berkeley. Copyright, (c) April 1990. Questions, comments, or requests may be addressed to: Michael Broffman LAc or Michael McCulloch LAc at Pine Street Chinese Benevolent Assoc, 124 Pine Street, San Anselmo, CA 94960: WebMaster].

The purpose of this dissertation was twofold:
1. to provide background material on the Asian American culture and dual health care system in San Francisco; 2. to examine how TCM Pulse Diagnosis (a renowned ancient diagnostic technique) can be used to help integrate the dual health care system in San Francisco. The overarching vision for the project is a culturally responsive health care system in San Francisco which effectively controls the spread of chronic disease.

Data collection was carried out at On Lok Senior Health Services in San Francisco. 10 subjects were examined by 2 TCM physicians; one using a Traditional hand palpation method and the other using a computer assisted pulse detection device. The physicians examined the pulse of the same 10 subjects and attempted to:
1. obtain the same pulse readings on a given subject (a test of the reliability of Pulse Diagnosis);
2. match subjects with their corresponding Med files on the basis of pulse analysis alone (a test of the validity of Pulse Diagnosis);
3. precautions against experimenter bias were observed: a. the subjects sat behind a screen with only the diagnostically relevant area of their wrists visible to the 2 physicians (a special glove was worn); b. no contact was allowed between the 2 examining physicians at any time during the study; c. the pulse examination schedule was altered in the middle of the day in order to avoid any detectable patterns.

In the sections on general and individual pulse assessment, the physicians achieved significant results. There was some validity to TCM Pulse Diagnosis; one of the physicians achieved a significant result.

Acknowledgments: The kind cooperation of John Shen, On Lok Senior Health Services staff and clients, Dr Michael Broffman LAc, and Dr Michael McCulloch LAc is greatly appreciated.

TCM Pulse Diagnosis: Introduction & Review of Current Literature.
TCM physicians use palpation to differentiate 31 pulse patterns at 18 positions on the right and left wrists. This delicate technique reportedly provides:

1.        A genuine early diagnosis of functional disorders which, if left untreated, eventually will produce degenerative or malignant organic changes;
2.        The specific and comprehensive, all-inclusive determination of all factors having a bearing on complex pathological processes (at the roots of chronic or constitutional diseases);
3.        Specific and comprehensive and direct appreciation of the immediate effects of any applied drug or therapeutic measure or agent (indispensable for the immediate follow-up of any therapeutic measure, as well as in the assaying of new drugs) (Porkert 1983).

TCM Pulse Diagnosis is the main technique in TCM diagnosis (Broffman & McCulloch, 1986). One problem with TCM Pulse Diagnosis in the USA is that it tends to be unreliable; rarely will 2 physicians come up with identical pulse assessments for a given patient. This circumstance has: 1. discouraged physicians from performing comprehensive pulse examinations on their patients jeopardizing treatment success); 2. increased scepticism toward TCM (Pulse Diagnosis and other aspects of TCM are suspected of being invalid); 3. been a barrier to the scholarly investigation of TCM (clinical trials which are not based on accurate and comprehensive pulse diagnoses are inconclusive).

Advocates of TCM Pulse Diagnosis contend that the problem lies in the application of the technique and not with the technique itself. They argue that: 1. Pulse Diagnosis is extremely difficult to learn (few physicians have the tactile acuity to detect subtle variations at 3 levels of palpation pressure); 2. few physicians are willing to devote the necessary time to master the technique (5-10 yr of supervision is often needed).

Several electronic devices are said to accurately measure the energy at AP points and Channels, as well as make such technology more accessible to physicians (Laub 1983; Lee & Wei 1983; Broffman & McCulloch 1986; Tiller 1982). These devices and their associated techniques have not become an accepted part of conventional Med for 3 major reasons: 1. the techniques are often unreliable (Kenyon 1984); 2. no body of scholarly research exists to show their effectiveness; 3. the metaphysical theory upon which these devices are based is untenable to most health professionals in WM. Although several recent studies have supported the efficacy of this technology (Tsuei et al 1984; Sullivan et al 1984), none have appeared in major Med journals.

An evaluation of both traditional and electronic pulse-taking techniques was undertaken in this dissertation research. The aim was to: 1. assess the validity of TCM Pulse Diagnosis; 2. determine if electronic devices can be used to increase the accessibility (with respect to requisite training) of this diagnostic method; 3. assess whether TCM Pulse Diagnosis can be used to help integrate the dual health care system in San Francisco. Significant positive results would place TCM on a stronger scientific footing and suggest a greater role for TCM in the orthodox Med system in San Francisco.

Investigation of TCM Pulse Diagnosis
Ten subjects from On Lok Senior Health Services in San Francisco participated in this study of TCM Pulse Diagnosis. These subjects were recruited on the basis of the contents of their Med file at this centre; a Med file was considered appropriate for the study if it: 1. did not contain references to physical or physiological conditions at the pulse examination area that might constitute a confounding variable; 2. referred to such conditions at the pulse examination, but these conditions could be controlled. Of great concern was any Med file reference (direct or indirect) to: pulse beat abnormalities, the consistency of the radial artery (e.g. hypertension), the physical condition of the area surrounding the wrist area (e.g. an overweight individual has fatter wrists), abnormal shaking at the wrist area (e.g. some manifestations of Parkinson's Disease), the sex of an individual (e.g. women generally have smaller wrist bones).

The aim was to eliminate or obscure unfair clues that could positively influence the physicians' attempt to correctly match anonymous Med files with subjects on the basis of pulse analysis alone.

The following selection criteria were used to select the subjects: all were female Asian Americans; age and weight differences were minimized (the mean age was 80.5 yr); no subject suffered from skin problems at the wrist area; all had a history of hypertension; all were free of pulse beat abnormalities; all were free of shaking Syndromes at the wrist area; each subject suffered from a unique set of disease conditions (so as to enable the physicians to distinguish one subject from another).