Importance of TCM theory

tutor

It is my first post on this forum since I joined Medboo TCM distance training programme, and it seems to be time for me to ask you the following question: How important is the TCM theory (qi, yin-yang, 5 elements, zang-fu, 6 exogenous factors etc.) for the successful PRACTICE of acupuncture in the real clinical situation?

Although, as it is advised somewhere on the Medboo forum, I have joined the ABCD option rather than the CD option only, you programme actually permits skipping the AB (TCM theory & diagnosis) part, and I have noticed that about one-third of the graduates from your list have done just so. The actual reason of my asking you has been the article of Dr. John A. Amaro, D.C., FIACA, Dipl.Ac. (NCCA) called "Contemporary Chinese Medicine (CCM) or Traditional Chinese Medicine (TCM)" ( http://www.iama.edu/articles/ContemporaryorTraditional.htm ). (Dr. Amaro is one of the oldest acupuncture practitioners in the U.S. and the holder of the board certificate in acupuncture #A000003). In his article Dr. Amaro writes:

"(...) To practice TCM by way of herbal or acupuncture application, it is imperative one know what conditions exist by proper analysis of numerous factors and to be able to pick the appropriate diagnosis from the Classical Syndromes, Disorders and Pathologies which exist. (...) However, just as we have Republicans and Democrats and Straights and Mixers, we also have Traditional Chinese Medicine (TCM) practitioners and Contemporary Chinese Medicine (CCM) practitioners. Don't be fooled into thinking that if you are not well versed in TCM, that you cannot be effective as an acupuncturist or Chinese herbalist. The bottom line, is the percentage of patients that respond favorably in the CCM or TCM practitioners office is literally the same. (...) Contemporary Chinese Medicine (CCM) is a new descriptive term for those practitioners who practice acupuncture, Chinese herbal medicine, tui na (manipulation) and who are achieving outstanding clinical results without being immersed in the academics and time constraints of ancient TCM. These are contemporary times, we are contemporary doctors and most of all we are dealing with contemporary patients. (...)".

In another article, the one of Dr. Sheldon C. Deal, D.C. called "Acupuncture Shortcuts" (Applied Kinesiology 2002: 14), one of such simplified approaches to clinical application of acupuncture treatment is described ( http://www.kinmed.com/ak14.html ).

In his article "The 2-Needle Technique", Dr. Alejandro Elorriaga Claraco, M.D. from the McMaster University describes a simple two needle technique to treat painful musculoskeletal conditions and trigger points, which he considers a traditional acupuncture treatment, although it seems not to use any aspect of TCM theory at all ( http://www.medicalacupuncture.org/aama_marf/journal/vol12_1/needle.html ).

Those publications (and many others) reminded me that similar approaches to Chinese Medicine have not been unknown in China herself. When Chairman Mao Zedong officially united Traditional Chinese Medicine with Western Medicine (after acupuncture had been virtually banned in 1882 by the Chinese Royal Medical Academy, and acupuncture and Chinese herbology were further suppressed and replaced by Western Medicine following the revolution of 1911), thousands of practitioners were rapidly trained on short-term courses of simplified TCM to bring health care to the countryside. It is interesting that Chairman Mao is reported by some biographers to have actually rejected TCM for himself, alhough he accepted it for political reasons: "even though I believe we should promote Chinese medicine, I personally do not believe in it. I don't take Chinese medicine...." (Li Z. The Private Life of Chairman Mao: The Inside Story of the Man Who Made Modern China. London: Chatto & Windus; 1994: 84). A few years later, in 1956, the famous "New Acupuncture" book of Dr. Zhu Lian, M.D. (she was the first director of the China Academy of Traditional Chinese Medicine, the one co-sponsoring this same study programme) was published in Beijing. Although I obviously have not been able to read the original Chinese version, I have read the one published in Russian in Moscow in 1959 (available online at http://eastbook.by.ru/chju-lyan/menu.htm ). In her book, Dr. Zhu Lian describes the simplified approach to acupuncture and moxibustion according to Western medical diagnosis (she was trained in Western Medicine). The 5 elements, zang-fu, 6 exogenous factors, and even meridian routs are not used (the former not even mentioned).

In effect, my question to you would be whether the New Acupuncture (Zhu Lian), Contemporary Chinese Medicine - CCM (J.A. Amaro), or any other approach to Chinese Medicine (especially acupuncture) according to Western medical diagnosis rather than TCM diagnosis and principles is used in P.R. China, and whether you know any clinical studies DIRECTLY comparing the two approaches (TCM and CCM), in order to CORROBORATE OR REFUTE Dr. Amaro's statement that their clinical effectiveness is "literally the same".

Thank you in advance for your answer.

tutor

There are differences between the traditional and contemporary Chinese Medicine. From what I observed, contemporary version is more to western based diagnosis. During the process of learning, the student/practitioner will memorize the acupoints according to the pathological conditions. When he becomes the practitioner later, he will treat according to the acupoints that he know for that particular disease. However, the variety of diseases that can be treated effectively is limited if compare to the treatment based on chinese classical theory and philosophy. Contemporary version is good for beginner, and also the best way to promote chinese medicine to those who are not familiar with the Chinese culture and philosophy. However, if you have the opportunity, please try to learn the Classical/Traditional version as well. It helps you a lot. In the classical version, you treat the patient's problem in different point of view from the western diagnosis, and you can apply different acupoints that are mostly suitable to your patient's condition (not just merely the chief complaint given by the patient).

In cases like musculoskeletal problem or pain relief, there are not much differences between the treatment (or acupoints selected) by using contemporary or classical version. However, acupunture is not confined to treat these two problems. There are a lot of conditions that can be treated by the classical version effectively and successfully compare to contemporary version.