The teaching of western medicine does not change very much from one country to the other. Topics, methodology, techniques, procedures, diagnostic, treatment possibilities, and the practical applications are similar. The whole curriculum is set up by medical faculties, under the control of a ministry or a government official body. The huge network of medical communication throughout the world allows for consistency. There are some differences, usually depending on financial possibilities or the level of development of a country.
The case of acupuncture techniques is rather special.
1. It is not the direct product of the evolution of western medicine in the last 150 years, so it does not fit naturally within its frame.
2. It originated more than two thousand years ago in a country where the levels of knowledge, of culture, of habits, depended on the profile of the civilization at that time.
3. Because of the characteristics of that civilization the evolution and improvements were slow. However the corpus of acupuncture as it is presented today in China does show some progress, especially in the last 100 years, and more precisely since the communist regime took over China. Since then, all over China, in every Institute, College, University, the material of what is considered as Chinese acupuncture is the same. This is the result of a government decision. The contents of the manuals seem to convey the essence of what is called sometimes pompously the “Tradition”, as something that cannot be questioned. The overall impression is that since remote times all practitioners and authors agreed on every topic, that there was only one big school of thoughts and one way of practicing the technique.
A flagrant contradiction to that way of presenting Chinese acupuncture appeared when in 1972 the archeologists discovered a tomb near Mawangdui, in the province of Hunan and near Chansha. It had not yet been found nor looted. more than three thousands objects were unearthed, including medical texts which were very revealing. They mentioned the meridians or channels, with some differences between the texts as well as with the most ancient books we possess on the matter. The treatment technique consisted on applying heat on the meridians. But there was nothing on acupuncture points or on the use of needles!
What is interesting is that the tomb can be very precisely dated to 168 BC. This does not mean that the practitioners did not use needle instruments on points, but most probably that there were different schools. This is a logical situation which certainly continued up to recently, as witnessed by the different theories and trends found in the old books and manuals. However these findings became a kind of embarrassment to the united front presented by China today, and are seldom mentioned anywhere except in sinologists publications.
4. The nature of teaching acupuncture in China, apart from brief moments when there was some control by the central government, depended mostly on local initiatives, and relied mainly on the master-disciple system of knowledge transmission. This situation led to a certain degree of freedom in the conduct and contents of teaching. One must add that in general Chinese doctors or acupuncturists were not really well considered by the scholars who had to undergo lengthy studies and difficult examinations in order to reach a decent level in the administrative network.
What about at the present time out of China? There are many ways of transmitting knowledge, and acupuncture courses can greatly differ.
1. Quite a few associations haven’t changed their teaching in more than thirty years. The reason is that they usually are just transmitting what their teachers learned from the Chinese, without asking themselves if it is right, wrong, out of date, inappropriate or simply too exotic or even dangerous. It is what I call “parrot” teaching. It can be quite heavy in terms of hours and contents. These strong believers of the “Chinese word” can become fanatical and refuse any kind of criticism or objection. The student listens, reads, asks information, but does not object or argue. 2. In some groups or schools there is an amount of enquiring and sorting out amongst the texts of manuals and treatises. This pragmatic attitude leads to more practical applications, and is often guided by scientific information and methods, resulting in a traditional acupuncture more adapted to modern times. This questioning of the “Tradition” is often efficient because it tries to retain, amongst the huge bulk of information that is proposed, what can be useful and efficient, allowing to discard the rest. There is nothing bad about traditional thoughts, and that is valid in every civilization. But nowadays, with our thinking methods, our scientific engineering, our medical knowledge, theories and practices from the past must be analyzed and evaluated, not just blindly accepted. If the procedures are correct the results can only lead to improvement, more understanding and a better efficacy.
3. There is a particular attitude in acupuncture: you don’t have to prove what you say. It is enough to say: I tried it and it works. Or: I found out that this technique is good. Or: it is written in this old classic Book.
As a result, during the seventies and the beginning of the eighties, a few practitioners “invented” their own acupuncture system, usually based on some traditional texts, but following abstract though elegant theories far from efficient practice. If these teachers had charisma and spoke well they had a lot of success and filled the classrooms. But when the participants went back to their practice they was hard put to apply what the speaker had so brilliantly explained, and even if they remembered what the lecturer had said the results would be disappointing. This kind of gifted orator has more or less disappeared from the usual scenes. Personality, charm and the gift of speach are not enough anymore.
4. Some lecturers see through their practice that the technique can be of a great help, but they are reluctant to accept it, as if they had a hot potato in their hands. Therefore they seem riddled with guilt, nearly ashamed to inform the students of how to do acupuncture with this or that kind of disorder. They are the tormented who doubt and suffer constantly pangs of uncertainty.
5. Quite a few are more interested in the “sinologist” aspect of the topic. Fascinated by Chinese history and culture, captivated by the ideograms and the Chinese ways of expressing themselves, although they don’t really know how to read, write or speak Chinese. They become dreamers, philosophers, pure thinkers, living in an artificial world far from the daily realities and forgetting that the aim of acupuncture is to produce positive results concerning the patient’s complaints.
6. The tenants of modern or contemporary acupuncture adhere strongly to their scientific training. From the whole corpus of acupuncture they retain the concept of points or zones, they use sometimes the meridians to position a point, but think mostly in terms of segmental distribution of pain and treatment, using trigger points as references. They are not interested in the concepts of Qi, Yin-Yang, Five Elements, and the whole theory of Chinese medicine. Their courses are often well structured, practical and efficient, but they have lost the flavor of the past.
7. There is a new trend in the approach of acupuncture, which existed before but has become recently quite consistent. The technique has been completely absorbed and integrated within the Chinese medical system, obeying all the rules, arguments and treatment procedures, as if a point was identical to an extract of plant, of animal or a specific mineral, therefore obeying the complex rules of Chinese medical theories. As a result, in order to use acupuncture, one is supposed to know the whole corpus of the Chinese medical system! This is clearly an abuse of assimilation, as it is quite possible to practice good acupuncture with a limited knowledge of Chinese medical theories. The fairly recent incorporation of acupuncture within the Chinese medical system, as if the technique followed completely the rules governing herbal prescription, is also to be examined under the light of history, science and logic.
8. Teaching online is the last development. Within the frame of distant learning adapted to the possibilities of Internet, using progressive material and eBooks, acupuncture learning online is becoming one of the interesting consequences of global information. It lacks however the practical aspects, and solutions will have to be found, mostly for those who have no medical knowledge or experience.
9. And in between these categories there is a multitude of grades, nuances and subtleties that I have the impression that I am missing the complexity of the topic. I must add that acupuncture books and manuals can be of great help, but there are so many that it is difficult to make a proper choice!