In April 2003,Guest Posting I was interviewed by Anupam Sharma, a journalist with the magazine from India, Fourth Dimension, which reaches 171,000 readers monthly both there and abroad. I thought you’d like to read it, because I answered a lot of the commonly asked questions about acupuncture that I haven’t written about on the Pulse of Oriental Medicine (PulseMed.org), and because you probably won’t be able to get that magazine.
Anupam Sharma (AS): Dr. Brian Carter, Thank you for the prompt reply and agreeing to do this interview. Tell me, doctor, how does Acupuncture work? Please explain the science behind this traditional method of healing
Brian B. Carter (BBC): Acupuncture is based on Chinese medicine. Chinese medicine (CM) has its own system of diagnosis and treatment, and acupuncture is only one therapy within that medicine. Those who have developed CM since before 2500 B.C. (when our first literary work, the Yellow Emperor’s Classic of Medicine, was written) used both symptoms and signs to diagnose disease before treating it. They developed a unique form of diagnosis called ‘pattern differentiation.’ Patterns are sets of specific symptoms and signs. For us, finding the signs includes the feeling the pulse and looking at the tongue.
For acupuncture specifically, there is also diagnosis according to the channels. It’s actually a very complicated system of theories… not as simple as it first seems. That complexity allows for a sophisticated flexibility in diagnosis and treatment that can adapt to most clinical situations. According to modern science, acupuncture works via the immune and nervous systems. It has local peripheral nervous system and central nervous system effects. Professor and physicist Zang-hee Cho has begun to use PET scans to map the brain loci affected by specific acupuncture points. Acupuncture affects neurons, electrolytes, neuro-transmitters, and neuropeptides. But even once all that data is in, the traditional system of channels and pattern differentiation will still be the clearest map of how acupuncture works. The biomedical view of physical phenomena is not always well-integrated.
My best analogy is that your brain is a computer, and the acupuncture points are the keyboard; you do the right points, and that tells the brain how to change the configuration of the mind and body.
AS: In which diseases is acupuncture the most effective?
BBC: Most people are familiar with acupuncture’s effectiveness for pain. Most importantly for pain, it can prevent chronic pain syndromes where the nervous system still produces pain signals even in the absence of the original problem. In 1997, the NIH came up with a list of diseases for which the scientific literature supported efficacy, which included nausea and vomiting, pain, tennis elbow, menstrual cramps, and fibromyalgia.
That list was much shorter than what acupuncture has traditionally treated, of course. Since 1997, even more studies have shown effectiveness for early post-stroke, acute spinal cord injury, as an adjunct in alcoholism, labor pain, migraine, post-surgical nausea and vomiting, and as part of a smoking cessation program. These are the highest quality studies: randomized placebo-controlled trials (RCT’s) with more than 33 subjects per group. There are plenty more studies that don’t meet that high standard, but still may offer valuable insights for clinical practice.
There is currently a study of acupuncture for high blood pressure going on at Harvard, and early reports are that it’s very effective. I personally got a diabetic man disqualified from his free blood pressure medication study with a modern Chinese point prescription. Our weekly acupuncture treatments brought his blood pressure down below the study’s minimum requirement. Acupuncture also is great for a number of psychological conditions. There are 17 other RCT’s currently ongoing, all funded by the National Institutes of Health.
AS: Do you think that the modern western medicine has failed in curing certain kind of diseases like backaches, mental tension, or headaches?
BBC: It always depends on the cause. For backaches, we need an x-ray to see if the spine is involved. For a backache or headache due to a tumor, I would certainly want MRI’s and CT scans, and surgery. Of course, for cancer, we can do drug or Chinese herb chemotherapy. Or you can do drug chemo with supportive herbs to boost the immune system. For headaches, acetaminophen, aspirin, and NSAID’s are very useful, though acetaminophen is the leading cause of liver failure in hospitals, and NSAID’s can cause stomach ulcers. The new triptan drugs for migraines are very helpful for the acute migraine, but may not be as good as acupuncture and herbs for preventing recurrence. For any stubborn problems, or those for which western medicine cannot find the cause, acupuncture and herbs are superior.
As far as mental tension or stress goes, acupuncture and herbs work wonders. Western medicine uses sedatives and antidepressants. Most people don’t want to be sedated, some antidepressants have debilitating side effects like impotence, and others are difficult to come off of safely… some even will create a dependency of sorts such that you get a rebound depression after you’ve been off of them for a number of months.
AS: Alternative healing methods like yoga and meditation and acupuncture becoming more popular among the people in the west? If yes, why?
A lot of people like yoga because it’s physical. Meditation is hard for fast-paced noisy-headed Americans. Most people say they just can’t stop thinking. They don’t realize that they’re always thinking like that. We’re over-stimulated here.
Acupuncture is nice because it helps you stop thinking, reduces anxiety, produces calmness. You can meditate while the needles are in. Acupuncture is more popular here than Chinese herbs are because 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 system of medicine that underpins Chinese herbs. They’re used to going to a health food store and buying the latest single herb for a single symptom. And there aren’t enough Chinese style herbalists in 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 idea that we need to learn true classical Chinese medicine before we can innovate intelligently, so I have a couple of mentors (Philippe Sionneau and Robert Chu) who have been practicing for about 10 years each. The formal school education is just the beginning. Our generation has a lot of translating to do to get Chinese medicine into English. Probably less than 1% of the literature has been translated. We have some of the most important and basic works, but we still have a lot to learn.
My job as I see it is to be a communicator. I have written hundreds of articles on my site (The Pulse of Oriental Medicine, www.pulsemed.org) and in other magazines that have reached more than 100,000 English-speaking patients. I have books and radio appearances in the works. There’s too much for any one of us to know everything, so I keep in touch with a broad range of experts – translators, scholars, MD’s, authors, so that I’m speaking authentically and accurately.
AS: Do you think acupuncture offers a better treatment than the allopathic medicine? If yes, then why isn’t it as popular as the latter?
BBC: Even in its country of origin, Chinese medicine has lost som