The short history of acupuncture
Acupuncture, part of Traditional Chinese or Oriental Medicine, has been regulated in Quebec for more than 25 years. Quebec was a pioneer in North America by modifying medical law in 19771 to allow non-physicians to practice acupuncture. It should be noted the contribution of important figures such as Mr. Oscar Wexu who would have been one of the first to introduce acupuncture in Quebec according to his words. It was in 1986 that Quebec adopted the first regulation on acupuncture and determined a program from the Ministry of Education, which was granted and provided by the Collègue de Rosemont which is, since that time, the only recognized organization of the teachings of initial training in acupuncture in Quebec. Quebec was also the first jurisdiction in North America, or even in the West, to grant a professional order to practitioners of Traditional Chinese and Oriental Methods. Today’s acupuncturists can enjoy full and complete recognition thanks to the pioneers of acupuncture in Quebec, who had to fight against all odds, at a time when prosecutions for the illegal practice of medicine were custom. Thus, it is also necessary to recognize from the outset, the contribution of Dr. Augustin Roy, president of the college of physicians from 1974 to 1994, who asked the government of the time to accept the bill on acupuncture before the end June of 19942.
Naturally, even if the history of acupuncture in Quebec is very young, it is quite different when one is interested in its origin. In fact, the amalgam of Chinese medical writings3, better known as the “The Yellow Emperor’s Classic of Medicine” (Huangdi Neijing), was probably compiled around 100-200 BC. J.C., although it even contains writings dating from before that time. It would seem that this compilation period would be closer to the real historical facts than some advanced earlier dates, which would rather belong to legend. In any case, these writings would be the result of an ongoing process of critical thinking, experiments and clinical trials formulated and reformulated by respected clinicians and theorists of the time.
Some speak of a work that provides a complex and detailed model of the universe, the earth, the human as well as scientific proposals still observable today. It defines the anatomical and physiological bases of TCM, as well as an often very colorful and wise explanation, describing the observation of the interaction of humans with their environment. This book includes two parts: the Su Wen (Simple questions) which deals with theoretical concepts and medical cosmology and the Ling Shu (the Spiritual Axis) speaks more of the practical aspect, such as acupuncture and moxibustion. Of course, there are several versions of this work, one of which seems more important, that of Wang Bing who published it in 24 scrolls and 81 chapters. There are many other written works and treatises of Traditional Chinese Medicine that I will spare you for the moment. There are also several translations of these works, I have chosen to discuss a small extract from Dr. Albert Husson’s version of the Huangdi Neijing Su Wen, which is presented as an interview between the Yellow Emperor (Huangdi) and Qi Bo, his minister, who would have lived during the third millennium BC. It goes as follows:
- Huangdi said to Qi Bo: “…I was told that in ancient times people lived for a hundred years without the activity weakening. People today are already weakened at 50. Is it due to a change of era or the fault of men?”
- And Qi Bo’s answer: “Obeying the Dao, the ancients modeled themselves on yin-yang and conformed to numbers. They were moderate in their diet and regulated in their activities. They avoided overwork, took care not to damage their body and mind, and thus allowed themselves to live a century. People today no longer live the same way, they gorge themselves on alcohol, are reckless and luxurious. The passions exhaust their essence and squander their natural breath. Insatiable and inconsiderate, they indulge their inclinations, run counter to the true joys of life and get restless without measure and tire prematurely…”4
In short, basically, the observation and that even at that time, we are talking about approximately 3000 years ago, the same challenges were presented to humans in relation to healthy lifestyles.
Traditional Chinese Medicine was primarily preventive medicine, i.e., at one time Chinese doctors were paid and could keep their jobs as long as the emperor remained healthy. If there was any impairment of health, what might be referred to now as, “disease”, their jobs could depend on it as well as their lives too.
It should be noted that the Chinese doctors of the time treated patients with the various therapies associated with Chinese Medicine, namely the pharmacopoeia, dietetics, zeng-gu/tuina, acupuncture as well as Clinical Qi Gong (Medical Qigong). This included advice on lifestyle, diet and exercises to improve health.
From tradition to science. Is there evidence?
I had fun doing a search with the words, “acupuncture” and “research” on the www.sciencedirect.com site. The result was quite impressive, more than 27,000 articles, documents, books, meta-analyses (research analysis on particular subjects bringing together several studies), in short, there is plenty to keep you occupied.
Of course, these 27,000 titles are probably not all serious or with the scientific rigor that we should expect, but it still gives an idea of the extent of interest on the subject.
It is clear that there is still a lot of research to be done on the mechanisms of acupuncture on the different systems of the human body or living being, but what to say that there is no scientific proof on the subject, this statement might have seemed serious in the 70s-80s and even 90s, but there are recent studies on acupuncture with high levels of evidence that prove the opposite.
Considering that acupuncture is a so-called empirical medicine (whose practice is based on observation and experience), the field of application is vast. Here is an overview, which is not exhaustive of course, of what can be treated based on the current evidence on acupuncture:
There would be for the moment, according to level I evidence with a consistent positive effect as well as a high level of evidence, i.e., the following 8 conditions (McDonald J, JanzS. (2017). The acupuncture evidence project: A comparative literature review (revised edition. Brisbane: Australian Acupuncture and Chinese Medicine Association Ltd.):
- Migraine prevention
- Tension headache
- Chronic headaches
- Chronic lower back pain
- Postoperative pain
- Nausea and vomiting following Chemotherapy (with antiemetics) and Postoperative
- Osteo-arthritis of the knee
- Seasonal and perennial allergic rhinitis.
Still according to level I evidence with a considerable positive effect as well as a medium to high level of evidence, there would thus be at the moment, 38 conditions benefiting from acupuncture, of which here are a few:
- Asthma in adults
- Hot flashes and insomnia from menopause
- Neck pain
- Acute lower back pain
- Depression (with antidepressant)
- Pain from cancer
- Post-traumatic stress disorder and many more…
As you can see, the fruit of acupuncture research is more than considerable, although there is still a long way to go. Acupuncture is an effective and safe therapy when practiced by competent professionals. The order of acupuncturists had submitted a brief to the National Assembly in 2016 (revised in 2020) on the effectiveness, the safety aspect and even on the notion of profitability with a view to integration into the health system.
In closing, this first article in a series, sets the table and gives an idea of the different aspects of Traditional Chinese Medicine that could be addressed. Whether on the concepts of “Qi”, the scientifically recognized mechanisms of the effect of the needle on fibroblasts and others, the theory of the five elements, yin-yang, research on acupuncture in oncology, etc. In short, I will try as best as I can to make you travel between the ancestral theoretical concepts and the explanation of the comprehension as succinct as it is, of what has been demonstrated to date from the scientific point of view.
I’ll leave you on a little philosophical note: “Just because you don’t understand how something works doesn’t mean it doesn’t exist.” Fujaii
Sylvain Audet, Acupuncturist, owner of the Drummonville Integrative Health Clinic (https://www.sante-integrative.ca/)
N.B: Be sure to consult a qualified health professional and in Quebec, make sure your acupuncturist is a member in good standing of the l’Ordre des acupuncteurs du Québec.
1 Taken from the President’s report in the 2011-2012 annual report of the l’Ordre des acupuncteurs du Québec (OAQ)
2 Le Devoir, May 11, 1994, Notebook A4 – source Presse Canadienne
3 Inspired by the book: Understanding Chinese medicine – The web without a weaver
4 Extract from Book I, chapter I p.71 of Huang Di Nei Jing SuWen, Dr. Albert Husson, , Association Scientifique des Médecins acupuncteurs de France.