Tonic roots, healing needles

By Bill Schoenbart, L.Ac.

Archeological excavations reveal that humans lived in China more than 1 million years ago. These primitive hunter-gatherers spent most of their time on basic survival: hunting, locating and preparing plants for food, constructing shelters, and defending themselves. It’s easy to imagine that over time they would have sampled most of their local plants in their search for food and medicine.

Eventually, an oral record took shape that identified those plants that made the best foods, those that were useful for building materials, those that treated illnesses and injuries, and especially those that were poisonous. By trial and error, a primitive form of herbal medicine and dietary therapy began to emerge through personal experiences.

A natural reaction to pain is to rub or press on the affected area. This response gradually evolved into a system of therapeutic manipulation. While pressing on sore spots, people discovered certain points on the body that had wide-ranging effects. They began to use pieces of sharpened bone or stone to further enhance the sensation, and the art of acupuncture began its course of evolution.

TCM’s recorded beginnings

The written record of Chinese medicine has evolved over the past 3,000 years. Archeological digs from the Shang dynasty (1000 b.c.) have revealed medical writings inscribed on scapulae (shoulder bones). Medical texts written on silk around 168 b.c. discuss diet, exercise, and herbal therapy. From this period, there is a legend of Shen Nong, the emperor of agriculture, who tasted 100 herbs daily to assess their qualities. The book attributed to him is known as the Classic of the Agriculture Emperor’s Materia Medica. When it was finally published, in the later Han dynasty (a.d. 25–220), it listed 365 medicines, consisting of 252 plants, sixty-seven animals, and forty-six minerals.

Between 200 b.c. and a.d. 400, the basic foundations of Traditional Chinese Medicine (TCM) were put into written form. Physicians from all over China were compiling writings of the latest discoveries in acupuncture and herbal medicine. The most important medical book compiled during this period was the Yellow Emperor’s Inner Classic, purported to be a series of conversations between the Yellow Emperor, Huang Di, and his minister, Qi Bo—although many historians believe it’s a compilation of all the medical knowledge of that period. Remarkably, this ancient work is still used; it forms the foundation for the contemporary practice of TCM.

During the Ming dynasty, the most famous physician of the period was Li Shi Zheng (1518–1593), a generous healer who didn’t accept payment for his services. After reviving a prince’s son from a coma, he was appointed court physician and served in the Imperial Academy of Medicine. His most incredible achievement was his forty-year effort in writing the Ben Cao Gong Mu (general catalog of herbs), a monumental work published after his death. Consisting of fifty-two volumes at the time of its printing, it remains an important reference work for TCM practitioners.

Modernizing the practice

The tendency to discover new techniques and integrate them with ancient understanding continued until the nineteenth century, when the Opium War of 1840 turned China into a semicolonial society. As is so often the case, Western colonial powers derided traditional medicine as primitive and outdated. This continued until the middle of the twentieth century, when the Communist Party came to power. Although the Communists brought much turmoil to China, they also saw the need to promote traditional medicine to avoid dependence on the West. Thus, there was a great need for traditional practitioners because there were far too few Western-trained physicians to serve the huge population. It was during this period that the traditional physicians began to recover their lost reputations, and traditional medicine began its course of revival that continues today.

Western-trained physicians and scientists began to do research on acupuncture and herbal medicine in the 1930s, and a gradual integration of the Eastern and Western systems evolved. In 1945, an acupuncture clinic was opened in a Western hospital in China for the first time in history. Since then, traditional medicine and Western medicine have been practiced side by side in Chinese hospitals, sometimes by one physician trained in both fields. For example, a cancer patient might receive radiation or surgery to remove a tumor, but immediately afterward, the patient is sent to the herbal department to receive formulas to strengthen the immune system and normalize blood count. Acupuncture is often used during surgery in these hospitals to reduce the need for anesthesia.

Acupuncture and Chinese herbal medicine in the United States

For more than 150 years, acupuncture and Chinese herbal medicine have been quietly practiced in Asian communities in the United States. The practices remained “underground” as an isolated cultural phenomenon until 1971, when interest was sparked by the experience of The New York Times reporter James Reston. His acupuncture treatments for postoperative pain after an emergency appendectomy in China led him to write an article in which he stated, “I have seen the past, and it works.”

At the time that Reston’s article appeared, no state had any legislation regarding acupuncture. By 1976, eight states had legalized acupuncture and six schools had been established. Today, there are more than sixty schools, and thirty-eight states have licensing laws that regulate acupuncturists.

The Food and Drug Administration estimates that between 8 million and 12 million Americans receive acupuncture each year and that its popularity continues to increase as more people hear of its effectiveness. Acupuncture has been endorsed by the American Osteopathic Association, the American Chiropractic Association, and the American Veterinary Medical Association. It has been incorporated into the substance-abuse treatment programs of numerous U.S. hospitals and is considered so effective that drug offenders in some areas, such as Florida’s Miami-Dade County, have a choice of receiving acupuncture or going to jail. Gradually, hospitals and conventional medical practices are adding acupuncturists to their staffs as the demand for acupuncture grows. Insurance companies such as Blue Cross and Blue Shield are also increasingly providing coverage for acupuncture, and some policies will cover the cost of herbal medicines.

An education in acupuncture

Generally, schools that teach both acupuncture and herbal medicine will train students in the basics of Chinese medical theory. This same foundation is used as the basis for diagnosis and treatment for both acupuncture and herbal medicine. For example, when I attended acupuncture school in California in the late 1980s, there were five semesters of traditional medical theory, five semesters of acupuncture, and five semesters of herbal medicine, in addition to numerous other medical classes. Because California law has always required proficiency in herbal medicine as part of an acupuncture license, it receives as much attention as acupuncture in the curriculum. Schools in other states may have herbal medicine as an elective, or they may incorporate it as part of the main academic program.

Finding the best practitioner

Now that acupuncture and TCM are rapidly entering the medical mainstream, an increasing number of people are interested in finding a qualified practitioner. As in all professional services, the best route to take is through a referral. Many people feel safe consulting a practitioner that a trusted friend or relative has had favorable experiences with. Getting a referral is relatively easy to accomplish in places such as California, where there are thousands of practitioners and most people know somebody who has received acupuncture or herbal therapy. However, in many areas this isn’t the case, and it becomes necessary to find a practitioner without the advice of someone you know. If you don’t know someone who can recommend a good practitioner, there are certifying agencies that establish standards that practitioners must meet in order to be considered qualified.

The most established of these agencies is the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), in Washington, D.C. After three to four years of training, a student is qualified to sit for the commission’s licensing examination. The NCCAOM’s extremely high standards of scholastics and clinical training become evident to anyone who has been through this rigorous examination process. Since 1984, the NCCAOM has certified more than 8,000 practitioners of acupuncture and more than 3,000 practitioners of Chinese herbology. NCCAOM certification is used as the basis for licensure in 90 percent of the states that have set standards for the practice of acupuncture. The organization will provide a list of its certificate holders to anybody seeking a qualified practitioner (visit www.nccaom.org).

California is currently the only state that requires practitioners to be proficient in herbal medicine to pass its state licensing exam. For this reason, schools in California have four-year programs, whereas many schools outside California have three-year programs. This is rapidly changing, and some schools outside of California are now offering thorough programs in herbal medicine.

There are also a number of national acupuncture and Oriental medicine organizations that provide referrals. The American Association of Oriental Medicine (www.aaom.org) will advise a prospective patient where to find qualified local practitioners. Another good website to visit is www.acupuncture.com. The site has a listing of practitioners in the United States and throughout the world, and it’s also a source of interesting information about TCM.

Which is better, acupuncture or herbs?

For most conditions, a combination of acupuncture and herbs is optimal. For example, a person with a facial twitch around the eyes might get immediate relief from an acupuncture treatment directed at that area. Following up with an herbal formula that nourishes the liver and calms rising energy may help prevent a recurrence of the condition. The most effective use of either herbal medicine or acupuncture occurs when a qualified practitioner accurately diagnoses the problem. As the person goes through the healing process, the nature of their imbalance will change, so the herbal formula and/or acupuncture treatment can also change along with them. Some herbs or acupuncture points will be deleted when they are no longer needed, and others will be added to more closely follow the changing pattern.

Most practitioners in the United States use a combination of acupuncture and herbs. However, in some conditions, such as an acute bacterial infection, an herbal treatment alone is more likely to be effective. In other conditions, such as drug or smoking withdrawal, acupuncture is more likely to have a positive result. There are many practitioners who use only herbs or only acupuncture. The ultimate choice of which type of practitioner to consult is up to the patient, who may have a fear of needles or a dislike of herbs. What’s most important is that the patient finds a qualified practitioner with whom the patient feels comfortable and who practices the preferred modalities.

What to expect when seeing a practitioner

At first, a visit to a practitioner of acupuncture and/or herbal medicine seems familiar. The patient typically fills out a medical history form and participates in an intake interview. At this point, the experience takes a different course. The acupuncturist will ask to look at the patient’s tongue and will feel the pulses on the patient’s wrist. These are very important diagnostic methods that give the practitioner information needed to make an accurate diagnosis. After a diagnostic pattern is deduced, the patient lies down on a treatment table. Acupuncture needles are then inserted at specific points known to treat that condition. After an occasional slight sting, there is no discomfort caused by the hair-thin needles. In fact, most people find the treatments very relaxing, and many people even fall asleep!

After approximately twenty to forty minutes, the needles are removed. People usually report a deep sense of emotional grounding after acupuncture, no matter what condition is being treated. If the practitioner performs only acupuncture, the treatment is complete until the next visit. If the practitioner is also an herbalist, the patient will often receive an herbal formula designed for their particular condition. The formula can be in the form of dried herbs that the patient brews into a strong tea at home, or it may be in the form of pills, powders, or liquids. This way, the herbs can synergistically continue the progress made by the acupuncture treatment.

Many people turn to this ancient system of medicine when conventional medicine hasn’t been successful in treating their particular ailment. Although TCM may sometimes take longer than the drug approach common to allopathic medicine, many people are finding that this ancient system of medicine provides an excellent way to cope with the stresses and challenges posed by life in the modern world.

Bill Schoenbart is the author of Pocket Guide to Chinese Patent Medicines (The Crossing Press, 1999) and Chinese Healing Secrets (Publications International, 1998). He practices Traditional Chinese Medicine in Asheville, North Carolina, and is a researcher and consultant in the field of medicinal herbs.