Acupuncture
By Brian B. Carter, MS, LAc, Thu Dec 8th

Questions and Answers about Acupuncture

In April 2003, I was interviewed by Anupam Sharma, a journalistwith the magazine from India, Fourth Dimension, which reaches171,000 readers monthly both there and abroad. I thought you’dlike to read it, because I answered a lot of the commonly askedquestions about acupuncture that I haven’t written about on thePulse of Oriental Medicine (PulseMed.org), and because youprobably won’t be able to get that magazine.

Anupam Sharma (AS): Dr. Brian Carter, Thank you for the promptreply and agreeing to do this interview. Tell me, doctor, howdoes Acupuncture work? Please explain the science behind thistraditional method of healing

Brian B. Carter (BBC): Acupuncture is based on Chinese medicine.Chinese medicine (CM) has its own system of diagnosis andtreatment, and acupuncture is only one therapy within thatmedicine. Those who have developed CM since before 2500 B.C.(when our first literary work, the Yellow Emperor's Classic ofMedicine, was written) used both symptoms and signs to diagnosedisease before treating it. They developed a unique form ofdiagnosis called 'pattern differentiation.' Patterns are sets ofspecific symptoms and signs. For us, finding the signs includesthe feeling the pulse and looking at the tongue.

For acupuncture specifically, there is also diagnosis accordingto the channels. It's actually a very complicated system oftheories... not as simple as it first seems. That complexityallows for a sophisticated flexibility in diagnosis andtreatment that can adapt to most clinical situations. Accordingto modern science, acupuncture works via the immune and nervoussystems. It has local peripheral nervous system and centralnervous system effects. Professor and physicist Zang-hee Cho hasbegun to use PET scans to map the brain loci affected byspecific acupuncture points. Acupuncture affects neurons,electrolytes, neuro-transmitters, and neuropeptides. But evenonce all that data is in, the traditional system of channels andpattern differentiation will still be the clearest map of howacupuncture works. The biomedical view of physical phenomena isnot always well-integrated.

My best analogy is that your brain is a computer, and theacupuncture points are the keyboard; you do the right points,and that tells the brain how to change the configuration of themind and body.

AS: In which diseases is acupuncture the most effective?

BBC: Most people are familiar with acupuncture's effectivenessfor pain. Most importantly for pain, it can prevent chronic painsyndromes where the nervous system still produces pain signalseven in the absence of the original problem. In 1997, the NIHcame up with a list of diseases for which the scientificliterature supported efficacy, which included nausea andvomiting, pain, tennis elbow, menstrual cramps, and fibromyalgia.

That list was much shorter than what acupuncture hastraditionally treated, of course. Since 1997, even more studieshave shown effectiveness for early post-stroke, acute spinalcord injury, as an adjunct in alcoholism, labor pain, migraine,post-surgical nausea and vomiting, and as part of a smokingcessation program. These are the highest quality studies:randomized placebo-controlled trials (RCT's) with more than 33subjects per group. There are plenty more studies that don'tmeet that high standard, but still may offer valuable insightsfor clinical practice.

There is currently a study of acupuncture for high bloodpressure going on at Harvard, and early reports are that it'svery effective. I personally got a diabetic man disqualifiedfrom his free blood pressure medication study with a modernChinese point prescription. Our weekly acupuncture treatmentsbrought his blood pressure down below the study's minimumrequirement. Acupuncture also is great for a number ofpsychological conditions. There are 17 other RCT's currentlyongoing, all funded by the National Institutes of Health.

AS: Do you think that the modern western medicine has failed incuring certain kind of diseases like backaches, mental tension,or headaches?

BBC: It always depends on the cause. For backaches, we need anx-ray to see if the spine is involved. For a backache orheadache due to a tumor, I would certainly want MRI's and CTscans, and surgery. Of course, for cancer, we can do drug orChinese herb chemotherapy. Or you can do drug chemo withsupportive herbs to boost the immune system. For headaches,acetaminophen, aspirin, and NSAID's are very useful, thoughacetaminophen is the leading cause of liver failure inhospitals, and NSAID's can cause stomach ulcers. The new triptandrugs for migraines are very helpful for the acute migraine, butmay not be as good as acupuncture and herbs for preventingrecurrence. For any stubborn problems, or those for whichwestern medicine cannot find the cause, acupuncture and herbsare superior.

As far as mental tension or stress goes, acupuncture and herbswork wonders. Western medicine uses sedatives andantidepressants. Most people don't want to be sedated, someantidepressants have debilitating side effects like impotence,and others are difficult to come off of safely... some even willcreate a dependency of sorts such that you get a rebounddepression after you've been off of them for a number of months.

AS: Alternative healing methods like yoga and meditation andacupuncture becoming more popular among the people in the west?If yes, why?

A lot of people like yoga because it's physical. Meditation ishard for fast-paced noisy-headed Americans. Most people say theyjust can't stop thinking. They don't realize that they're alwaysthinking like that. We're over-stimulated here.

Acupuncture is nice because it helps you stop thinking, reducesanxiety, produces calmness. You can meditate while the needlesare in. Acupuncture is more popular here than Chinese herbs arebecause more MD's accept it. There's enough scientific evidence,and a number of MD's are practicing acupuncture full-time.Americans still don't understand herbal formulas, or the systemof medicine that underpins Chinese herbs. They're used to goingto a health food store and buying the latest single herb for asingle symptom. And there aren't enough Chinese style herbalistsin the U.S. to expose everyone to it yet.

AS: How long have you practiced acupuncture?

BBC: I've only been practicing a few years. I follow the ideathat we need to learn true classical Chinese medicine before wecan innovate intelligently, so I have a couple of mentors(Philippe Sionneau and Robert Chu) who have been practicing forabout 10 years each. The formal school education is just thebeginning. Our generation has a lot of translating to do to getChinese medicine into English. Probably less than 1% of theliterature has been translated. We have some of the mostimportant and basic works, but we still have a lot to learn.

My job as I see it is to be a communicator.

I have writtenhundreds of articles on my site (The Pulse of Oriental Medicine,www.pulsemed.org) and in other magazines that have reached morethan 100,000 English-speaking patients. I have books and radioappearances in the works. There's too much for any one of us toknow everything, so I keep in touch with a broad range ofexperts - translators, scholars, MD's, authors, so that I'mspeaking authentically and accurately.

AS: Do you think acupuncture offers a better treatment than theallopathic medicine? If yes, then why isn't it as popular as thelatter?

BBC: Even in its country of origin, Chinese medicine has lostsome popularity. When the communists took over in the 1950's,they almost destroyed the traditional medicine. They wanted tocatch up with the west and get our approval. But when MaoTse-Tung got facial paralysis, it was acupuncture that fixedhim. So he ordered the systemization of TCM. Now there are 3branches of medicine in China: Chinese, Western, and thecombination of the two. The latter is the most interesting, andprobably the future of all medicine. For example, you can havean elevated Alk Phos level (a liver function test), with nowestern gallbladder pathology, but have symptoms of pain ordiscomfort along the Chinese acupuncture Gallbladder channel.

I don't think we should say either acupuncture and westernmedicine is better. Each has their strengths and weaknesses. Andto be accurate, we have to say that most of Chinese herbalmedicine is allopathic, because allopathic means treating withopposites. We reduce excesses, and strengthen deficiencies, forexample. What we do need to do is cooperate; practitioners ofvarious kinds of medicine should work together for the benefitof each patient. To only use one kind of medicine is more of areligion than a medical practice. Chinese medicine practitionersneed to learn what western medicine is good and bad at, and viceversa. Same goes for chiropractors, Ayurveda, Homeopathy,massage, etc.

The popularity or acupuncture in the west is a function of time,politics, and finance. Acupuncture has only been in America for30 years. Now many insurances and workers compensations coverit, MD's are learning it, it's always in the news, sports teamsare using it. There are about 800,000 MD's, and 15,000acupuncturists in the U.S. So it'll be awhile before it's anunquestioned part of the healthcare system. Even then, we'llstill have to deal with some people's egos.

AS: How can one become an acupuncturist? What are thequalifications required for becoming one? Is there a similardegree as an MBBS?

BBC: The average in the U.S. is 3-4 years of school, graduatingwith a Master's of Science in Traditional Oriental Medicine.Regulations vary by state. California has the highest standards;we are tested on the medicine, acupuncture, herbs, law, etc.Actually, acupuncture is only 17% of the test! Again,acupuncture is only one of Chinese medicine's therapies. Thestandard is slowly being raised to the PhD level. There are now3 nationally approved PhD programs for Chinese medicine. All 3are on the west coast. I think eventually that will be the entrylevel. We have to do that to get on par with the chiropractors,MD's, and DO's.

AS: What do you think is the future of Acupuncture? I mean restof the world.

BBC: Chinese medicine has been in Australia for more than 100years. It's all over Korea, Japan, and Taiwan. I haven't heardmuch about it in South America. They have it in Canada, but Ithink it's not well regulated or accepted. In France, you haveto be an MD to practice it. So it's different everywhere. Buthere in America, we are doing more and more research, and theresults are affirming and interesting. So I think that the MD's,who hold most of the political and financial cards ininternational medicine, will be less and less able to resist theimportance of acupuncture. Herbal medicine has a longer battle;because, in a way, it competes with pharmaceutical medicine. Itshouldn't have to, though, because some studies we have readshow that herbs ameliorate drug side effects and increase theireffectiveness. This has to be done in accordance with bothwestern and eastern medical principles, though.

I think they will merge to some degree, and work together.Western medicine has great standards and tools. Chinese medicinehas valuable insights and perspectives that could even helpdesign studies and interpret study results more effectively.

AS: Why did you become an acupuncturist? What influenced you inbecoming one.

BBC: Number one, I wanted to help people. I wanted to make useof my talents. Number two, I was fascinated by the fact thatChinese medicine had never separated mind, body, and emotion. Iwanted to find out more about this. I've always wanted to growand be more effective. I thought perhaps Chinese medicine couldhelp me do that, and then I could help patients do that too.

AS: What according to you is the best thing about acupuncture,meaning how and why is it better than other systems of medicine?

BBC: Acupuncture, and Chinese medicine, both look at the wholeperson. We know how every part of your body links up with everyother part. We know how the lungs manifest emotionally. We knowwhat green or blue skin means. We know what foods are best forwhich types of people. Western medicine is compartmentalized.They study e.g., the immune system, the digestive system, or thepsychology of the individual. We know how those are related. Wecan take symptoms from each, diagnose a pattern, and treat allthree at once. Those inter-systemic insights are one of the mostimportant contributions of Chinese medicine. Acupuncture has anormalizing, regulating effect. Chinese herbs can strengthenyou, while western drugs generally just attack or reduceexcesses (like viruses, bacteria, inflammation). We canstrengthen and reduce at the same time. We're a bit moreflexible. We can almost always diagnose and treat everyone.Western medicine's approach often leaves them baffled aboutcauses and searching for silver bullet treatments. In manysituations, western surgery or drugs are superior. But there arejust as many situations where they need us.

AS: Is acupuncture effective in all diseases, I mean the complexones like cancer, etc?

BBC: Acupuncture can regulate and boost the immune system. Thisis important in cancer. However, for the serious and complexillnesses, Chinese herbal medicine is better. I've written abouthow we can treat AIDS, cancer, lupus, etc. Acupuncture isessential right after a stroke. The sooner you do that, the morefunction you can recover.

About the author:Acupuncturist, herbalist, and medical professor Brian B. Carterfounded the alternative health megasite The Pulse of OrientalMedicine (http://www.PulseMed.org/). He is the author of thebook "Powerful Body, Peaceful Mind: How to Heal Yourself withFoods, Herbs, and Acupressure" (November, 2004). Brian speaks onradio across the country, and has been quoted and interviewed byReal Simple, Glamour, and ESPN magazines.