INTERNATIONAL ACCEPTANCE OF VET ACUPUNCTURE (AP)
While there are some exceptions, as indicated above, the general official attitude of the international vet profession to AP is one of polite apathy/ scepticism. They accept vets who use AP as rather eccentric colleagues. They murmur "Yes ! how interesting...." and then forget it. They will not learn the method and, with few exceptions, will not have it included as part of the undergraduate curriculum.
Even in those countries with an active Vet AP Association, or where the authorities accept it, AP is a minority speciality, used by < 0.5-3.0% of vets. Belgium (10-20% of vets), Finland and Taiwan (c. 10% of vets) make the greatest use of it. We, who know the value of the method, must take a lot of the blame for our profession's attitude. It is up to us to change that attitude if we want AP to be part of mainstream medicine !
Fundamentally, AP is about reflex phenomena, relationships between points, body parts and function. The basis of AP must be a solid grasp of these material relationships. For some, AP is much more, operating at higher, immaterial levels. It embraces a poetic philosophy of life, almost a religion. But we must remember that few academics and teachers are poets and many find the idea of religion to be "unscientific".
Some enthusiasts see AP as a special modality: an alternative method capable of treating everything from acne to zoster. Others, especially those seers gifted in mental/spiritual aspects of healing, see AP as the highest form of energetic medicine but their view is incomprehensible to materialist science. Purists may insist on talking in classical Chinese concepts and terminology to their western colleagues. This mentality, while valid from personal viewpoints, delays or kills the acceptance of AP by serious scientists. Even the term "complementary" method gives bad off vibes.
The pharmaceutical industry is not enthusiastic about wide-scale replacement of drugs (especially analgesics, tranquillisers and hormones) by AP. Most professions (and their Parent Organisations) are self-protective. Anyone who (or any system which) appears to challenge the financial security or the authority-base of the organisation is usually ignored, ridiculed or disabled for the good of the whole.
It is easy to dismiss the outsiders as cranks or charlatans. Unfortunately, there are confidence tricksters and Diploma sellers hidden among genuine AP practitioners. Unfortunately, untested or inadequately tested instrumentation is being marketed to AP practitioners, who, having paid dearly for fancy toys with flashing lights or computerised controls, may feel psychologically bound to justify their dubious investments by uncritical assessment. Meanwhile AP and its practitioners may get a bad name.
Many academics feel threatened by the esoteric language and concepts of the purist AP schools and by the apparent difficulty in learning it. Surgeons feel threatened by claims that AP can treat many conditions which they regard as needing surgery. Doors close and the troops close ranks. It is the major challenge to IVAS to get its toe in the academic door and to rally the reluctant troops inside.
We have no real hope of introducing AP into the mainstream of Vet science until it is fully integrated into the undergraduate curriculum, alongside of pharmacology, surgery, nutrition, management etc. This must be the primary goal of IVAS, for it is surely not enough to have a few hundred experts practising brilliant AP on the fringes of mainstream medicine.
The principles of vet science include : theory/experimentation, observation /measurement, categorisation/simplification, publication and replication.
Theory/experimentation : To have maximal impact, theory must be in language comprehensible to academics and agencies which fund research. Experiments must be well designed, properly controlled and analyzed.
Observation/measurement in experimental or clinical trials must be recorded carefully and accurately. We need much more evidence from controlled and clinical trials to prove to our colleagues that AP works. Analysis of the results should be sophisticated. For example, a recent paper by Dr. Mabel Yang (Physiology Dept., Hong Kong University) showed marked homoeostatic effects of AP on immune response. Animals with a suppressed response (YIN) increased the test parameters (becoming more YANG) , whereas those with a hyper response (YANG) decreased it (becoming more YIN). (Had Dr. Yang analyzed the data in a crude way, the effect would have been missed, as the overall effect was very little change in mean values).
Similarly, Dr. Jukka Kuussaari's paper on aerophagia in horses (Amer. J. Acup., 11, 363-370) had hidden effects. Of 33 horses treated by electro-AP, 6 were cured and 8 improved (failure rate 58%). This might be dismissed as a poor result. However, on closer examination, 11 horses had NO associated gastro-intestinal signs and not one of these responded (failure rate 100%). (Had Kuussaari not recorded the clinical findings, this effect would have been missed). Of the remaining 22 cases, all of which had gastro-intestinal signs, the aerophagia failure rate dropped to 36% and all had their g/i signs improved or cured. Further analysis showed that in horses with initial g/i signs, the cure and improved rates in cribbers were 25 and 25% respectively (50% failure) but in windsuckers (not cribbers) the rates were 30 and 50% respectively (20% failure).
Categorisation/simplification : Relationships between variables can be more easily examined when they categorised, as in the above examples. For easyuse in the field, science tries to simplify its relationships. Obfuscation and esotericism are anathema to scientists. Why have a rigmarole about ancient ways of choosing points when a simple way may work just as well ? For instance Luc Janssens' Cookbook points for chronic thoraco-lumbar disc disease (tender points, local points + GB34) or Jan Still's use of GB34 alone in acute cases are easy for the beginner to use and gave excellent results.
Publication : Two basic criteria of a top-class professional journal are :
a. a tough system of peer-refereeing and
b. selection of the best from a surplus of the good.
For instance, journals like the Vet Record (London) or the Journal of the American Vet Med Assoc have so many articles submitted that a good article may be redrafted many times, cut to 30-50% of its original length and delayed for as long as 2 years before space can be allotted for its publication. However, many clinical and some "research" articles published on vet AP (even on the international level) have not satisfied these criteria yet.
AP is still a minority speciality and most practitioners seem to be allergic to ink. Therefore, the volume of solid AP material for publication is pitifully small. This is a problem for the IVAS Newsletter and Journal as well as for many national (and even international) AP journals, including the human AP journals. Some have folded and some are just hanging on precariously.
The primary purpose of the IVAS Newsletter is to be a forum for exchange of useful ideas between vet AP colleagues and those interested in the study of AP. The IVAS Journal aims at a higher standard of publication. At present, it does not attempt to challenge Vet Record or JAVMA for strict scientific excellence. Its secondary purpose is to stimulate interest in vet AP among open-minded colleagues, especially those in research and academia. If AP is to be part of mainstream medicine, it must be taught at undergraduate level as part of the basic vet course. We need researchers and academics to become involved. Our Newsletter and Journal are their windows to the world of AP. Therefore, their quality must be as good as we can make it.
Because of shortage of well documented copy, we have included occasional anecdotal copy or longer items from newspapers or magazines. We have been criticised for this, especially by non-American readers, whose national vet ethical codes discourage publication of articles which might be misconstrued as forms of personal advertising.
You can help us to improve the Newsletter and Journal. If you suffer from ink allergy, try homoeopathic desensitization, or (better still), use a cassette recorder as you do your practice rounds ! A friendly teenager may help you to transfer the taped conversation to a wordprocessor. If you send the disk to IVAS, the editors will help you to tidy it up, if necessary. Encourage your expert friends to record their results (positive and negative). Let us know how you feel about your failures. Have you any explanations for them ? (My failures taunt me and I can not really explain them). If you see interesting abstracts/summaries which have not appeared in the Newsletter or Journal already, send them in.
For knowledge to spread, it must be published. But if it is to spread widely and quickly, it must be published in refereed top-quality national or international journals. The reporting of AP must be truthful, including the partial successes, failures and relapses. Where combined therapies are used, these must be reported also. In this way, AP can become a credible modality. At present, much of the reporting is anecdotal, biassed and incredible.
Replication : One of the beauties of science is its approximation to an estimate of objective truth: results attained by one worker/group should be attainable by another if the same procedure is followed, under similar conditions and in similar types of subjects. The sloppy or fraudulent worker will be exposed when the published work is replicated by others.
Most practitioners properly trained in AP know that it is effective in many disorders but, before we can convince most of our scientific colleagues, we have a long march ahead, one which may turn out to be longer and harder than that of Chiang Kai Shek or Mao Tze Tung.
The Chinese have the wisdom to incorporate the best of western science into their system. Can we not convince our academics that it is in the best interests of the west to adopt the best of eastern science and art ? We must convince them if we are to get AP onto the standard curriculum of the vet schools. Today is a good day to begin. But, first, let us see AP as only a small part of our approach to vet medicine and healing.
ACKNOWLEDGEMENTS
The history of AP was summarised from Parkinson (1974-1977), Klide and Kung (1977), Anon (1980) and Janssens (1987). Janssens' manual (1987) and the Proceedings of the 1991 Sydney Vet Postgraduate Course are recommended highly to students of vet AP.
The current status of AP was assessed mainly from questionnaires sent to vet AP practitioners and/or academics in 38 countries. I thank all those who replied and apologise to those whom I did not mention in this paper.
REFERENCES