Tag: acupuncture

Interface

Before a practitioner can start treating people, s/he must first find out what is wrong – as far as that is possible at all. Naturally there are many ways to do that and I am not going into the details of examination techniques. However, I am under the impression, that the Chinese with their intellectual world domination in this area have inspired many westerners in believing and practicing something that is usually “handled” (please observe the expression; there will be a few more instances of this kind of illuminating terms below) a little differently in Japan.

Since I have not had the opportunity to observe things directly in mainland China, reading through (Chinese influenced) reports, research material etc., or also material from China, I am also under the impression, that the authors gather information by taking the pulse, inspecting the tongue and some other bits of information to draw their conclusions based on the classifications the Chinese love so much and/or select the points for their treatment based on the theoretical instructions found in textbooks or the classics. It is of course laudable to know the textbooks and classics, but personally I very much doubt, they can tell you anything about any real patient. Just like the description of “pneumonia” in a textbook of medicine gives you an averaged, generalized model, but not the particular situation you encounter in patient “xxx”.

Although not all Japanese practitioners adhere to the practice I attempt to put into the words I chose below and which a patient of mine once has called “poking around”, I prefer it and believe a substantial number of other (Japanese) practitioners could offer the world here something, that may not really make the EBM enthusiasts happy, but provides a sometimes very enlightening “close encounter of the Japanese kind“.


Interface is a term usually used in relation to computer and machine technology. But I would like to express a few ideas pertaining to (physical) treatment, in particular acupuncture treatment, and borrow this expression for this particular purpose.

In the medical world it is common sense, that individual life forms, including single-celled microorganisms, plants, animals and man, have a body surface that forms the interface of this particular individual with the environment. Yet, in contrast to man-made devices, which are usually one out of a more or less large number of identical devices manufactured at a specific site with identical specifications, these life forms are always UNIQUE. Not one of these many “devices” (let’s call them units below) exactly matches any other unit, even if they are of the same species, like for example “man”.

Each individual unit is slightly different. For that reason the interface between the unit and the environment at any given moment in time is subject to a unique, highly specific set of parameters influencing both the unit and its environment. And because the specifications for each unit are unique, the interaction between the particular unit and the environment occurring at their common interface – in man the skin – also is subject to unique changes. That means, that no other unit would react in exactly the same way to a given, reproducible parameter/influence, like temperature or pressure.

In computer technology the status of the various devices and their respective hard- and software can be checked and a “digital output” of the relevant data prepared. In medicine, here I refer in particular to acupuncture, “running diagnostics” is also largely a “digital” process, because the practitioner uses his/her fingers = digits to literally READ information from the body surface of people/patients. But in contrast to this process in computer technology the diagnostic process in acupuncture exceeds the unidimensional digital level and becomes a “sensual” holistic process, in that it includes visual (inspection), audio (hearing, listening) and chemical (smell, but only RARELY taste) parameters.

In relation to the “EBM frenzy” currently almost everybody is looking for “reproducible, digital readouts” of this information: like temperature, pressure, electrical resistance etc. However, to the best of my knowledge, even if there are devices under development that may be able to test and measure some of these parameters like pressure, which would be essential for examining the pulse, these devices are still very far from reliably and meaningfully measuring the parameters they are designed for. The human touch still exceeds their capabilities.

Even if there were devices that would satisfactorily measure ONE particular parameter, a human (erratic as that may be!) practitioner would still integrate all the different modalities of into one whole (“holistic“) picture quite different from what any machine would produce. In addition, the practitioner him/herself too is a unique unit, which produces naturally a unique and not completely reproducible output. THAT is for all scientifically/technically inclined researchers believing in the holiness of EBM a horrible concept.

Now, the interface used for data collection, namely the two layers of the skin of both patient and practitioner approaching and in most instances also coming into contact with each other, are not unlike a telephone. (This is a metaphor I like to use, when I try to explain the situation to my patients and refer here only to palpation.)

On the “one hand” (please note THIS expression) the practitioner moves with his/her hand(s) over the body of the patient to collect = read the data written on the patient’s body surface. Although most patients are not really aware of them, for a practitioner with a little clinical experience there is a lot of information to read there, that will tell him/her about the past, present and future state/development(s) of the examinee. This is like listening to that person talking on the other end of a telephone.

During the treatment on the “other hand“, for which the hands do not even have to be lifted off the body = cut the connection, the same hand(s) of the practitioner provides some input for the system “patient”. That is then like responding to the person on the other end of the telephone line.

Modern telecommunication technology uses wired networks, where cables are used to connect different devices, and wireless networks using electromagnetic waves and fields. In medicine nothing substantially has changed in the technological setup of the wired and wireless networks (only our understanding of their functioning is growing) since their inception = billions of years ago. Practitioners use the hardware components for the wired networks, like nerves, muscles, bones etc. in order to receive/transmit physical stimuli/information = like nerve impulses traveling along nerves, or moxibustion induced chemical changes/substances propagated via the chemical transport system “blood”. For the wireless networks practitioners tap into energies and information in and also propagated along LAN channels that work without having their own hardware, in the field of acupuncture these are often referred to as meridians or also channels (note the similarity).

Actually, I have been called for help in my capacity as an acupuncturist via mail. However, as I said above, both patient and practitioner are unique individual units with their own unique specifications and therefore without exactly predictable reactions (to interventions). Thus, helping people over long distances is usually not working very well, because I as a practitioner have to do almost completely without data readouts from the malfunctioning unit (person). Therefore the attempts are in most cases bound to be unsuccessful.

The advice would be: get a piece of real “first-hand” human touch experience up close …… again those expressions …

Projects

  • 外国人が日本で鍼灸を見学/勉強したい場合の応援
    • 日本の鍼灸師 - 力を貸して下さい!
    • 外国人見学希望者を自分の治療院等で見学させて下さい
    • (中に暫く「弟子」になりたい人もいるようです)
  • 鍼灸/東洋医学に関する和英(+独)の用語集を作成する
  • 可能であれば日本語の本を外国で出版してくれる出版社を見つける(翻訳作業)
    • 「治療家の手の作り方-反応論・触診学試論」 -  [形井秀一]
    • 出版社: 六然社 (2002/01)、ISBN-10: 4901609106
  • この本に関して以前オーストラリアから来た見学者が帰国後一所懸命宣伝してくれたため、出版社2件から「興味有り」との反応があった。
  • そのため本の所々から「サンプル」を取って英訳した事ある。ここに参考までのせる。
  • 中国ではどちらかと言うと「理論」が優先的に考え、○○証だと決めたら例の「標準経穴」に治療する。患者がその場所に反応が有るか否かが余り興味がないようだ。そこで形井先生が纏めてくれた日本の触診の優れた技術を是非とも海外の方に知って欲しい!
  • 私は翻訳者が単にある文章を他の言語の文章に翻訳する物だけではなく、どのような*** 文章 = 本 ***が翻訳する価値がある事を仕事柄上で見つける「専門家」である。残念ながら実際に翻訳される文献の選択はそのような「価値」と無関係で選ばれる。以前私の意見が雑誌で出版された:
  • The above book describes the highly sophisticated Japanese palpation skills acquired and required during good acupuncture therapy. Many Japanese practitioners rely in their treatment on the findings obtained through this kind of very sensitive touch, instead of the theory and pattern driven selection of the so-called “standard point locations”. I believe, a translation of this book would be an invaluable asset to western oriental medical community in general!
  • (The link points to an article I wrote about a translators function as a “bookfinder” (in analogy to pathfinder).
  • Translator as “Bookfinder”
  • Sample -> below

自作を通して養生を促し、(国の)医療費削減に貢献する (医療+金)

須原先生との出会いが私の人生に大きな影響を及ぼしたため、最近須原先生の本:
「出なおせ・見直せ」
を翻訳する許可を得て、これから翻訳の作業に入る。
出来たら電子書籍として公開する予定。2013年12月・・・少しずつ翻訳し始めた・・・

“True” or “authentic” acupuncture

Well, this is a very much discussed topic. Although there is a serious lack in research into the scientific basis of acupuncture, an not insignificant number of studies have been performed, trying to verify the efficacy of acupuncture. For that purpose one thing that always pops up is the distinction between “true” and “sham” acupuncture. Like the distinction between the real drug and a placebo in clinical trials. Apart from the fact, that the design of pharmaceutical clinical trials cannot really be applied to research into acupuncture, the concepts of “true” and “sham” acupuncture present a problem, I believe.
Naturally, performing “sham” acupuncture, not considering the ethical implications of “knowingly deceiving” the patient, is always difficult to realize technically. But the real problem is not the “sham” acupuncture – it is the “true” acupuncture.
The Chinese try to make everybody on earth believe, that their way is the only “authentic” = “true” form of acupuncture. Yet, it uses needles almost as think as sharp-pencil mines, that are inserted “free hand”. This requires some REAL (!) skill to do it in such a way, that it is NOT painful.
I have tried a lot of different brands of needles, but by now come to the conclusion, that “Made in China” represents a very low manufacturing quality. Needling with needles “Made in China” is almost inevitably painful. I tried that myself. And on top of that, the assertion is, that unless you do not elicit the so-called “de-qi” feeling, which is according to definitions by most physiologists a kind of pain, the acupuncture will not be effective.
MOST of my patients, including myself, do NOT like the pain called “de-qi”, or “tokki”, as it is called in Japan. Thus, one type of pain coupled with another type of pain (from the technically poor needles) causes the patient CONSIDERABLE dyscomfort! In fact, and I have been told so by people who underwent such treatment in Germany or the USA, the dyscomfort is so intense, that even though the patients received money from the government, in order to participate in a study designed to show the efficacy of acpuncture, they rather choose to drop out of that study. It was just too painful. And the treatment had been delivered by professionals with something like +20 years clinical experience!
If the treatment is something like a medieval torture, so that patients break into cold sweat even before the third or fourth treatment session and therefore leave the study, the obtained results can hardly verify the value of acupuncture treatment.
Using Japanese needles, technically superior, which are much thinner and inserted with the help of a tube, so that there is usually no pain or dyscomfort whatsoever, “Japanese style” acupuncture treatments still relieves many of the patient’s symptoms – without pain or dyscomfort. Usually my patients leave with much improved symtoms and a feeling of satisfaction.

I think, the world should know about this! And put the true acupuncture into perspective.