TCM Archives - Jessica Kennedy

Is Chinese bloodletting the same as conventional bloodletting?

I get enquiries, from time to time, about whether Chinese medicinal bleeding can be used to remove significant volumes of blood, in a similar way to conventional bloodletting. Whaaaat? I hear you say. Yes, conventional medicine does still include bloodletting. It’s known as therapeutic phlebotomy.

Phlebotomy is when you have a blood sample taken to run some tests on the blood. Therapeutic phlebotomy is when you have a larger quantity of blood taken, simply to get rid of some blood. This can be needed to help with unusual conditions such as polycythemia vera or hemochromatosis. These involve having excessive amounts of iron, or of red blood cells. The blood taken in these procedures is usually not retained, like when you donate blood, but disposed of.

The short answer is no. Chinese medicinal bleeding is not suitable for releasing blood on that scale. And here’s a longer answer …

The quantity of blood

Therapeutic phlebotomy usually extracts 250-500ml of blood. This is comparable to blood donation, which takes 470ml of blood in Australia, or around 8% of your total blood volume.

Chinese medicinal bleeding is done in several ways, but the way that would produce the most blood is by direct bleeding from a superficial vein. We do not take, or extract, the blood. We briefly pierce the vein and let the body release as much as it wants to release.

Often the initial blood is very dark, it can be almost black, showing that the blood is oxidised and has not been circulating in a healthy way. Then it runs a healthier red colour. And then the bleeding stops. The body releases the old stagnant blood that has been stuck in that vein, and then it clots the puncture to stop the bleeding.

I have read that it is possible for the body to release 200ml this way. But in my experience even 50ml is an uncommonly large quantity for the body to release. This is much less than the amounts taken for therapeutic phlebotomy or blood donation.

Releasing large amounts of blood is never the goal. Releasing even a couple of drops of dark stagnant blood result in a very successful procedure.

The diagnosis

Chinese medicinal bleeding is done according to Chinese medical principles. First there must be a Chinese medical diagnosis, based on signs and symptoms, that indicates that bleeding may help. Often this would be ‘Blood Stagnation’.

Without a relevant Chinese medical diagnosis, it would not be ethical to perform bleeding.

Available veins

One possible symptom of Blood Stagnation is superficial veins visible on the surface of the body. These are known as thread or spider veins, and are usually purple, red or blackish, not the blue colour of healthy veins. If you don’t have any of these, it is not possible to do Chinese medicinal bleeding from a vein.

There are other forms of Chinese medicinal bleeding, such as wet cupping, but these tend to produce even less blood than bleeding from a vein.

We never directly bleed varicose veins, which are bulging out from the surface.

Scope of practice & insurance

For all these reasons, we are not registered and insured to provide Chinese medicinal bleeding for purposes which are not related to a relevant Chinese medical diagnosis.

Patient satisfaction

People’s reasons for requesting Chinese medicinal bleeding for the purpose of releasing quite a lot of blood vary. Basically, I have to say, that Chinese medicinal bleeding techniques are unlikely to achieve the desired results.

How much blood will be released is not a matter of negotiation or guarantees. It is not the case that we can promise to release a certain quantity.

If extracting relatively large quantities of blood is your goal, it seems unlikely that you would be satisfied with the results of Chinese medicinal bleeding.

References

Image by allinonemovie from Pixabay

Acupuncture for fatty liver (NAFLD)

Fatty liver disease is unfortunately becoming a widespread problem. It may be ‘silent’, with no obvious signs, or common symptoms can range from fatigue and malaise (feeling ill) to itching to feelings of pressure or discomfort in your liver area (under your right ribcage).

In some cases nonalcoholic liver disease can progress to other forms of liver disease, but the implications are not limited to your liver health. Fatty liver disease also indicates a metabolic imbalance, which unfortunately can promote cardiovascular problems including hardening of your arteries, fatty deposits in your blood vessels, and heart disease.

Conventional medical recommendations include weight loss, cutting out sugar and exercise, to improve insulin resistance, which can be a driver of fatty liver disease. With the right lifestyle changes, your nonalcoholic fatty liver disease may be reversible.

Can acupuncture help?

Scientific research into the benefits of acupuncture for fatty liver disease is one of the areas that has advanced far enough that a systematic review and meta analysis study has been completed. This is a study of the available individual studies, which pools and re-analyses the data from those studies.

A team did this in 2021, and these were their findings:

“8 RCTs with 939 patients were included. This meta-analysis showed that AT [acupuncture treatment] was superior to CM [conventional medicine] in improving overall clinical efficacy … In addition, AT plus CM could significantly improve overall clinical efficacy compared to treatment with CM alone … Moreover, the benefits were also demonstrated in other outcomes, including alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol indexes. However, AT plus CM could not decrease body mass index levels in comparison with CM. The safety profile of Acupuncture therapy was satisfactory.

And their conclusion:

“Acupuncture may be [an] effective and safe for treatment of NAFLD [non-alcoholic fatty liver disease]. However, due to insufficient methodological quality and sample size, further high-quality studies are needed.”

So we will have to wait and see what further studies will tell us, but the research so far is looking promising for the benefits of acupuncture for fatty liver disease.

Book in for acupuncture

To give acupuncture a try, just get in touch. Jessica will be happy to see you.

References

Chen P, Zhong X, Dai Y, Tan M, Zhang G, Ke X, Huang K, Zhou Z. The efficacy and safety of acupuncture in nonalcoholic fatty liver disease: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2021 Sep 24;100(38):e27050. doi: 10.1097/MD.0000000000027050. PMID: 34559098; PMCID: PMC8462626.

Image by Mohamed Hassan from Pixabay

Acupuncture for post-stroke depression

The short term impacts of having a stroke are well known, but it can be less well recognised that as your experience of a stroke unfolds, depression and anxiety can set in. Around a third of people who experience a stroke will need treatment for depression. Family members too, may go through difficult times emotionally as you all adjust to dealing with the aftermath of a stroke.

Identifying depression

When we’re in a slump, it can be hard to see it clearly. Depression isn’t only feeling very gloomy or sad, it can also affect sleep, drain your joy and interest from everyday activities, and shrink your concentration and self confidence.

Immediate sources of help

If you’re stuck feeling low, the Australian Stroke Foundation has a great page with lots of great suggestions, from trying to be more active and social, to drinking less, to talking things through with a counsellor. They also link through to Strokeline (1800 787 653), Beyond Blue, Lifeline and 13Yarn, to receive support in difficult times.

Acupuncture for post stroke depression

And acupuncture may also be able to help. A 2023 systematic review and network meta-analysis looked at this. This is one of the best forms of research evidence, it is a study of all the available individual studies. They analysed 62 studies, involving 5308 people. Their conclusions were:

“The results of this study indicate that AC [acupuncture] alone or combined with other therapies appears to be effective in improving depression symptoms of stroke survivors. Moreover, in comparison to WM [Western medicine], AC alone or plus RTMS [a treatment with magnets], TCM [Chinese herbal medicine], TCM with WM, or WM, were more effective in improving depression symptoms of [PSD post-stroke depression].”

There are a lot of acronyms there! One of the simpler statements they made was that:

“When compared with UC [usual care], AC [acupuncture] alone or combined with any other therapy (including AC with RTMS, AC with TCM, AC with TCM and WM, AC with Tai Chi, AC with WM, AC with CT, AM, and AM with WM) was superior.”

And that some of these combinations, including acupuncture alone”

“were significantly associated with better neurological function improvement in contrast to UC [usual care] or WM [Western medicine].”

And:

“AC [acupuncture] alone may be more effective in alleviating depression symptoms as compared with WM [Western medicine].”

So, some positive findings there for acupuncture for post-stroke depression.

Book some acupuncture

Everyone’s response to acupuncture is a very individual business, and the only way to find out whether acupuncture may help in your case, is to give it a try.J Just get in touch to get started.

References

Lam Ching, W., Li, H.J., Guo, J. et al. Acupuncture for post-stroke depression: a systematic review and network meta-analysis. BMC Psychiatry 23, 314 (2023). https://doi.org/10.1186/s12888-023-04749-1

Image by Holger Langmaier from Pixabay

Acupuncture for peripheral neuropathy

Can acupuncture help with peripheral neuropathy? Neuropathy comes in many forms, with many causes, but for some it can be a very unwelcome side effect of chemotherapy. Your feet or hands can feel numb or tingly, or have burning or stabbing pains. Weakness and dizziness or impaired balance can follow.

When the neuropathy is a result of chemotherapy treatment, it can be brief, or for some it can become a lasting problem:

“In some cases, peripheral neuropathy can develop or get worse over time, even after treatment has finished. After the end of cancer treatment, peripheral neuropathy symptoms may begin to improve over 6–12 months. In some people, symptoms are permanent and may be severe.”

Australian Cancer Council

What does the science say?

To assess how the evidence base is looking so far, in 2024 a team of researchers looked at the studies that have been done on peripheral neuropathy induced by chemotherapy. They analysed the results for more than 2,000 patients, across 21 separate studies, and concluded that:

“Acupuncture can improve the neuropathic pain intensity, the intensity of the CIPN [chemotherapy-induced peripheral neuropathy], MCV [motor conduction velocities] of the median nerve, SCV [sensory conduction velocities] of the tibial nerve and peroneal nerve, quality of life, and has good safety in CIPN patients. LI4 (Hegu), ST36 (Zusanli), LI11 (Quchi), LR3 (Taichong), and SP6 (Sanyinjiao) are the core acupuncture points for treating CIPN, and this protocol has the potential to become a supplementary treatment for CIPN.”

2024 systematic review and meta analysis

Like a lot of research papers, it’s not written in the most accessible of English! But, their finding was that acupuncture was helpful in reducing pain and improving quality of life, at the same time as being safe for people with this problem.

I can only echo the researchers’ hopes that lots of people get access to acupuncture to help them in this situation. One of the joys of being an acupuncturist is meeting a really diverse range of people. Some come to me as their first resort, and occasionally I find myself trying to persuade someone to visit their doctor to at least get some possibilities ruled out. But others often come as their last resort, after trying many different avenues in search of help, and suffering for quite an extended period.

It’s great to see the growing range of conditions which are gaining an evidence base to show that acupuncture can help. I was very pleased to see this study come out for peripheral neuropathy after chemotherapy, which is such a difficult experience on top of everything else that you will already be going through if you are going through chemotherapy.

Book in for acupuncture for peripheral neuropathy

If you would like to give acupuncture a try for your peripheral neuropathy, I will be happy to see you. Just get in touch.

References

https://www.cancer.org.au/assets/pdf/understanding-peripheral-neuropathy

Limeng, L., Huang, Y., Chengfei, A., Ning, J., Xu, C., Xiaoyu, W., Li, H., & Tan, T. (2024). Acupuncture in the treatment of chemotherapy-induced peripheral neuropathy: A meta-analysis and data mining. Frontiers in Neurology, 15. https://doi.org/10.3389/fneur.2024.1442841

Image by tookapic from Pixabay

Acupuncture in pregnancy

Lots of pregnant ladies contact me to ask about acupuncture to promote labour, and to check whether I offer acupuncture during pregnancy, which I’m happy to say I do. Often people mention that another health professional has suggested it to them, and it is great to see a growing awareness of acupuncture in pregnancy.

How is the research going?

As in many areas of health and medicine, the evidence base does not yet give us confirmation that every kind of acupuncture that can be used in pregnancy is effective. There are all kinds of interesting individual studies out there, but while the full research picture is evolving we can’t share those with you.

It’s only when a study of the studies is conducted (called a systematic review or meta-analysis) that firmer conclusions can be drawn and we can talk about those results. I just had a quick look for this level of research evidence for acupuncture during pregnancy, for routine birth preparation, and to support you after childbirth, but didn’t find much available yet. So, we would need to say that those treatments are not currently supported by the evidence base, and their effectiveness is unproven.

Acupuncture to promote labour

However one area where there has been a study of studies, and we can talk about the conclusions, is for acupuncture to promote labour. A 2017 Cochrane review looked at this, and Cochrane studies are considered fairly robust studies.

I’m a bit puzzled because the main measure they looked at was whether acupuncture to promote labour reduced the caesarian section rate, and I would be interested in measures like whether it reduces the need for medical inductions or improves mothers’ experience of labour. But, it looks like so far we would have to say that those kind of benefits remain unsupported by the research that’s been done.

The authors’ conclusions were:

Acupuncture does not appear to reduce the need for caesarean section but may improve the cervical readiness for labour … The main limitations were limited reporting of health outcomes. Acupuncture and acupressure appear safe and the review suggests some potential benefit, however the specific timing and how many treatments remain unclear.

So, it will be great when further research is done and there will be more we can say with confidence.

Acupuncture in pregnancy

So if you would like to book in for acupuncture in pregnancy, you’ll be very welcome! Just get in touch to get started.

References

Smith CA, Armour M, Dahlen HG. Acupuncture or acupressure for induction of labour. Cochrane Database Syst Rev. 2017 Oct 17;10(10):CD002962. doi: 10.1002/14651858.CD002962.pub4. PMID: 29036756; PMCID: PMC6953318.

Image by Marjon Besteman from Pixabay

Acupuncture for vocal cord problems

I really feel for people who have a problem that is very visible to others – a problem affecting the face, or ability to walk, or something else that can feel like it’s on display to other full time. Problems with the vocal cords are another one of these – every time you try and speak to someone, a raspy, low or breathy sound may have a bigger impact on your listener’s attention than the thing you’d actually like to say. I can imagine that not being able to express yourself clearly and reliably must be very frustrating. And if your problems also involve difficulties with swallowing, or coughing, then a whole range of normal everyday activities can become an unwelcome challenge.

What are vocal cord problems and where do they come from?

Vocal cord problems can cause difficulty speaking, hoarseness, coughing and problems with swallowing. Medical diagnoses can include laryngitis, vocal nodules, vocal polyps, and vocal cord paralysis.

Our vocal cords are delicate structures within our necks, so a whole range of causes can cause vocal cord problems, including vigorous exercise, airborne toxins, reflux problems and inflammation in the throat and sinuses. Trauma, whether physical such as near-drowning, choking, or surgical injuries, or emotional, can also leave a big impact on our voices. Women, and teachers, are more likely to suffer vocal cord problems.

Can acupuncture help vocal cord problems?

So, can acupuncture help? Well, as ever, it’s not professional for me to share anectodal stories from my own experience. But, happily, some research has been done in this area.

The evidence base

In 2017 a systematic review was published – systematic reviews are near the top of the evidence pyramid, they are studies of all of the published studies on a topic. The scientists in this case were looking at a range of interventions, including massage and physiotherapy, and for acupuncture they were only able to find one study that had been done so far. Nonetheless, their conclusion was:

“The literature regarding the effectiveness of physiotherapy and complementary therapies was good in both quality and results, indicating that massage, TENS, and acupuncture seem to be effective treatments to reduce voice complaints and improve voice quality, supporting the inclusion of complementary therapies but mostly physiotherapy interventions in the treatment of patients with voice disorders.”
a 2017 systematic review on allied health treatments for vocal cord problems

Specifically about acupuncture, they said:

“Yiu et al. conducted a high-quality study … In this RCT [randomised controlled trial], 84 participants with dysphonia were divided in three groups: genuine acupuncture group that received needles in nine voice-related acupoints … A significant improvement in vocal function … was verified in both the genuine and sham acupuncture groups, but not in the no-treatment group. About perceived quality of life, genuine acupuncture groups showed significant results comparing to sham acupuncture group (p = 0.003) and no-treatment group (p = 0.01). No significant difference was found between the no-treatment and sham acupuncture group (p = 0.83). Only the genuine acupuncture group demonstrated a significant reduction in the size of the vocal fold lesions.”

So, one study is only a start for our evidence base, but certainly it’s encouraging. They summed up their findings by saying:

“The literature regarding the effectiveness of physiotherapy and complementary therapies was good in both quality and results. The evidence from the studies included in the review suggest that manual therapy through laryngeal massage and massage of the neck or shoulder girdle is an effective treatment to reduce dysphonia complaints and muscle tension and to improve voice quality. It is important to emphasize that the TENS and acupuncture also presented good results. The knowledge of the relationship between body posture, laryngeal muscles, voice production, and dysphonia is of paramount importance because a transdisciplinary action can optimize evaluation and treatment in order to provide clinically significant benefits to patients with voice problems.”

So, if you’ve been suffering with vocal cord problems, this feels like a really positive message, that there are a number of things that may be able to help you. You don’t necessarily need to feel stuck at your current level of vocal problems. And acupuncture may be one of the things that could be able to help.

Get in touch

If you’d like to give acupuncture a try for your vocal cord problems, just get in touch to get started.

Reference

Cardoso R, Meneses RF, Lumini-Oliveira J. The Effectiveness of Physiotherapy and Complementary Therapies on Voice Disorders: A Systematic Review of Randomized Controlled Trials. Front Med (Lausanne). 2017 Apr 24;4:45. doi: 10.3389/fmed.2017.00045. PMID: 28484700; PMCID: PMC5401878. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5401878/

Image by Florian Pircher from Pixabay

Acupuncture evidence is underused by other health professionals

Unfortunately, it’s quite frequent that people tell me that another health professional has told them that acupuncture will not be able to help with their problem, when those statements are not supported by the current evidence base.

Of course it would be unfair to expect the average GP to have a deep expertise in acupuncture in the way that an acupuncturist does. And it’s a challenge to keep up to date with all the great research that is being done. Although it’s worth noting that all health professionals do have an ethical obligation to keep themselves up to date on the evidence base for therapies that may help their patients.

So in this context, this article in the British Medical Journal in February 2022 was a breath of fresh air: Evidence on acupuncture therapies is underused in clinical practice and health policy.

What did the research team find?

The article examined the systematic reviews that have been published for acupuncture – a systematic review is a study of the studies. So whereas one particular trial might reach a certain finding and another study a different conclusion, a systematic review seeks to identify all the relevant trials for a particular topic, and look at what conclusions can be reached overall. So what did they find when they did a study of the studies of the studies for acupuncture?

“Despite minor limitations, systematic reviews of acupuncture therapies are generally methodologically rigorous.”

“A recent overview of acupuncture systematic reviews found … acupuncture showed a moderate or large effect with moderate or high certainty evidence in eight diseases or conditions … However, instead of endorsement in health policies and wide use in clinical practice, only a few healthcare systems incorporated acupuncture into clinical practice guidelines.”

“For example, acupuncture is underused in practice for treatment of post-stroke aphasia … by 2015 compelling evidence had accumulated that acupuncture provided important improvement, relative to the best existing therapy … To date, however, only one Chinese clinical practice guideline has recommended acupuncture therapies for treatment of post-stroke aphasia. In the US alone, 10 million patients with post-stroke aphasia could have benefited from acupuncture treatment.”

“Identified research opportunities are underfunded … Promising acupuncture therapies (large effect supported by low certainty evidence) represent potentially fruitful future clinical research targets, and thus require further investigation and research funding support. The overview of systematic reviews found that in 33 outcomes for 22 conditions, acupuncture showed a promising effect. Existing funding and research endeavours in these areas have, however, increased little in the past decade.”

“Take three diseases or conditions in which acupuncture showed promising effects as an example. Depressive disorders, migraine, and opioid use disorders are prevalent and associated with a high disease burden globally … Even though acupuncture therapies have shown large effects supported by low certainty evidence for all three of these prevalent and high burden diseases, they received limited funding for further investigation.”

The authors’ recommendations included using the acupuncture evidence base properly in health system decision making, and a better organised approach to funding acupuncture research.

What’s standing in the way?

A wide range of factors undoubtedly lie behind this, but sticking to just the topic of clinical research, one point to note is that acupuncture research doesn’t have the financial might of big pharma behind it. The profit motive that drives a proportion of medical research is not there for acupuncture treatment. But apart from funding, there are quite a few other interesting issues to consider in creating good quality acupuncture research.

Often a trial will seek to assess acupuncture using ideas that were developed to test drugs, for example using comparisons to an inert placebo. Concepts like ‘sham acupuncture’ are sometimes used, when from a Chinese medical perspective even touching a point (acupressure) is an active therapy. Acupuncture is more akin to a minor procedure than to popping a pill, and not all studies do well in recognising that.

Meanwhile the master practitioners of our medicine, and the practitioners who are well integrated into research institutions and can gain access to research funding, may not always be well aligned. The ‘acupuncture’ used in some studies can feel like a bit of a puzzle.

For example, I was surprised to see a study on acupuncture for pubic symphysis pain (a condition of late pregnancy), which used a number of acupuncture points that are considered unsafe in pregnancy. (Say what now?) Debra Betts, an acupuncturist in New Zealand and probably the foremost expert in obstetric acupuncture globally, wrote an interesting analysis:

“Although no serious complications were reported during treatment it is of concern that the acupuncture points Hegu LI-4, Kunlun BL-60 and Ciliao Bl-32 are listed with no mention of their function in traditional Chinese medicine to induce labour … The study states that these distal points were chosen due to their well known pain relieving effect … This is an interesting study as while it confirms the benefit of offering acupuncture for pelvic pain in pregnancy it also raises questions about the way point prescription acupuncture can be used by physiotherapists and medical acupuncturists.”
Debra Betts, author of The Essential Guide to Acupuncture in Pregnancy and Childbirth

Meanwhile, there are lots of other issues around achieving good quality acupuncture research – meaning both good science, and good Chinese Medicine. The same edition of the British Medical Journal also had a very interesting article about how to improve the quality of acupuncture research.

So, when the benefit of acupuncture has managed to shine through all of these kinds of hurdles, it’s all the more disappointing that the resulting evidence is not always being listened to by medical decision makers.

Conclusions

In summary, it is a great pleasure for me to see the evidence base for acupuncture becoming more complete over time. I am in admiration of all the practitioners and researchers who are dedicating time and energy to building the scientific recognition of our venerable healing art.

Unfortunately it is not an infrequent experience to see acupuncture receiving ill-informed negativity. Sadly this sometimes comes from other medical professionals, despite their relevant ethical obligations.

And so I very much concur with the authors’ recommendations that the evidence base for acupuncture should be used properly in mainstream clinical practice and health policy. As wide a group of people as possible should be able to benefit from the evidence-based benefits of acupuncture.

References

Betts, Debra, Acupuncture Research, https://acupuncture.rhizome.net.nz/acupuncture/research/pelvic-pain/

Elden H, Ladfors l, Fagevik Olsen M, Ostaard H, Hagberg H. Effects of acupuncture and stabilising exercisers as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised singleblind controlled trail.BMJ 2005;330:761

Lu L, Zhang Y, Tang X, Ge S, Wen H, Zeng J et al. Evidence on acupuncture therapies is underused in clinical practice and health policy BMJ 2022; 376 :e067475 doi:10.1136/bmj-2021-067475

Zhang Y, Jing X, Guyatt G. Improving acupuncture research: progress, guidance, and future directions BMJ 2022; 376 :o487 doi:10.1136/bmj.o487

Wellbeing during social distancing – Qi Kung & acupressure

Greetings! I hope you’re well. Here are some traditional ideas and practices from Chinese medicine, that you may find useful in supporting your wellbeing during the challenges of social distancing.

(And it’s important to say that the things I’m sharing here are not claims of medical benefits backed up by scientific evidence. These tips are not any kind of substitute for medical advice or treatment. In particular in no way am I suggesting that anything here can prevent or treat Covid 19.)

Introduction

Wellbeing during social distancing – Introduction
Introduction: Wellbeing during social distancingTraditional ideas and practices from Chinese medicine that you may find useful in supporting your wellbeing during the challenges of social distancin
Posted by Jessica Kennedy – Acupuncture Perth on Tuesday, 24 March 2020

Complete sequence of 18 Qi Kung exercises

20: Complete sequence of 18 Qi Kung exercises
20: Complete sequence of 18 Qi Kung exercises(Traditional ideas and practices from Chinese medicine that you may find useful in supporting your wellbeing during the challenges of social distancing)
Posted by Jessica Kennedy – Acupuncture Perth on Sunday, 12 April 2020

Acupressure points summary

21: Acupressure points summary
21: Acupressure points summary(Traditional ideas and practices from Chinese medicine that you may find useful in supporting your wellbeing during the challenges of social distancing)
Posted by Jessica Kennedy – Acupuncture Perth on Tuesday, 14 April 2020

Next instalment coming soon! Follow me on Facebook to stay in the loop.

So many styles of acupuncture in Australia!

OK so I wrote a little bit before about the various styles of acupuncture available in Australia. Then, well, one thing led to another, and I ended up doing a poll of acupuncturists…

Here’s a snapshot of just how many styles of acupuncture are available in Australia and beyond. It’s a lovely diverse picture.

Who did I ask?

I put polls in two Facebook groups for Australian Acupuncturists – TCM Practitioners Share Group Australia, and the Australian Chinese Medicine Union Group. Then I got interested in an international comparison, so I put one in a big international group, with a big US membership, called Acupuncturists on Facebook.

What did I ask ’em?

This was my question:

“Pop quiz! What style of acupuncture are you practising? (As a primary approach within your practice, not something you might add in from time to time ?) “

I created a few answers, and left it open for people to add additional ones of their own. Answers popped up that I’d never heard of ! Love it.

What did I find?

Unsurprisingly, given the rich ancient tapestry that is Traditional East Asian Medicine, many styles of acupuncture are available in Australia.

Truthfully, there’s stuff in there that I don’t know too much about myself. I look forward to learning more one day! When I get to pick the brains of my fabulous colleagues, or when I go to a mind blowing seminar about yet another beautiful part of our heritage of wisdom on health and medicine.

How does this compare to overseas?

Well, there are some common themes. TCM and distal styles are popular, and there’s a broad spread of styles. Japanese styles look a little less popular overseas, and Five Element a bit more so, but we’re bumping up against the limitations of my little poll here. And who knew there was a whole ‘orthopedics’ style of acupuncture? Great stuff.

One difference that does maybe jump out is that the overseas participants look to be more likely to be practising a single style of acupuncture, rather than a combination of styles. Make of that what you will.

Is there a ‘best’ style?

No sirreee.

I luuuuurve the two styles I practice – TCM and Five Element. But over the years I’ve received amazing treatments from acupuncturists using other styles too.

None of this is about a better or worse style, just finding a great fit for you. I tend to think that individual patients are drawn to the right practitioners for them.

If I’m looking for a particular kind of therapy or treatment for myself, I tend to be less worried about which style they belong to (chiropractic vs. osteopathy, anyone?), and more about finding a recommendation for a really great practitioner.

Is there any more data out there?

Not on this exact topic, as far as I can find. It doesn’t seem like either AHPRA, our regulator, or AACMA, the largest professional body, collect info on our styles of acupuncture.

And I should emphasise that there’s nothing scientific about my results. Even just collating the answers from Facebook was a bit of a messy manual process.

But anyway, my little poll gives an interesting flavour of what may be out there.

Meanwhile, the Chinese Medicine Board of AHPRA does publish other interesting data on Australia’s acupuncturists in their annual report.

And Jason Chong, over on the east coast, did a great survey and blog post about how much acupuncture costs across Australia. I followed that up with a little bit myself on the cost of acupuncture in Perth.

Wow I’m feeling all fired up and I want to book some acupuncture!

Yes! Quite right too. Get in touch and we’ll get started.

What styles of acupuncture are available in Australia?

The style of acupuncture which is most widely available in Australia is called Traditional Chinese Medicine, or TCM. Well, that’s obvious right? Because acupuncture = Traditional Chinese Medicine = TCM, right? Well, actually, it’s a richer and more interesting story than that…

For example the way I practice uses both TCM and another acupuncture style called Five Element constitutional acupuncture. This is also traditional, Chinese, and medical! Confusing, right?

A diverse ancient body of wisdom

Well, it’s because the term TCM is used in two different ways. Firstly it’s used to mean a huge body of ancient East Asian wisdom, that dates back 3,500 years. Another term for this is Traditional East Asian Medicine (TEAM).

But, the term TCM is also used to describe a particular subset of all of that wisdom, which is a specific standardised system introduced in communist China during the 1950s. If an acupuncturist trained in China, or was trained by someone who trained in China, there’s a good chance that this is the style of acupuncture they’re practising.

And TCM is a great style! I’m a total fan.

I’m also completely in love with Five Element constitutional acupuncture, which is widely taught in the US and Europe, but not here in Australia. Used together, I find TCM and Five Element make the most fantastic toolkit.

Ancient texts, secret lineages

My expertise is in practising acupuncture, rather than explaining its history. But it seems like, back in the day, you couldn’t just go along and enrol at an acupuncture college. Families of doctors guarded their knowledge closely, and Chinese medical knowledge was passed down from master to apprentice, in lineages stretching all over east Asia.

This is how the British Acupuncture Council describes it:

“Until the 1940s, when the Chinese government commissioned the development of a uniform system of diagnosis and treatment, somewhat misleadingly referred to as TCM (Traditional Chinese Medicine), nearly all training had been apprentice-style with masters and within families…
As a consequence of this there are many different styles of acupuncture which share a common root but are distinct and different in their emphasis. You may read of TCM, Five Elements, Stems and Branches, Japanese Meridian Therapy, and many others, all of which have their passionate devotees. The BAcC, though, has long embraced this plurality under the heading “unity in diversity” and sees the variety of approaches as the mark of a healthy profession.”

Standardisation of TCM in China in the 1950s

I like this description from the Association of Registered Acupuncturists of Prince Edward Island:

“TCM is commonly used to describe two overlapping, yet distinct medical systems.
The first, and broader usage refers to the entire body of knowledge, clinical experience and commentaries accumulated through several thousand years of traditional Chinese medical history and recorded in such seminal medical classics as the Yellow Emperor’s Classic of Internal Medicine (Nei Jing), the Classic of Difficulties (Nan Jing) and the Systematic Classic of Acupuncture and Moxibustion (Zhen Jiu Jia Yi Ying). These classics and the principles they codify form the foundation of all styles of acupuncture in usage today.
The second, more narrow usage of the term, TCM refers to the official state-sponsored standardization and implementation of Chinese Medicine in the People’s Republic of China after 1949.”

After reading all this, I ended up making the diagram that you can see at the top of the page, to try and make clear what they’re saying.

So what’s the difference?

All the beautiful forms of Traditional East Asian Medicine around today have wonderful things to offer. Personally I’ve had fantastic treatments from practitioners of all different styles.

Five Element constitutional acupuncture is one of my favourites, and here’s a nice description of its origins from Anjua Acupuncture:

“Five Element acupuncture is very old and dates back to the Chinese philosopher Tsou Yen approximately 300-400 BC. This is in contrast to the more modern style of acupuncture currently taught in most Chinese medical schools in the U.S., known as Traditional Chinese Medicine (TCM). TCM is the result of the standardization of Chinese medicine during the rise of communism in China in the 1950s.
This standardization made it possible to teach acupuncture and Chinese medicine on a mass scale in schools instead of the traditional master/apprentice approach. It also combined many family lineages into one system.”

Where did Five Element constitutional acupuncture come from?

JR Worsley studied with masters in east Asia in the 1950s, and went on to become a hugely respected teacher of Five Element acupuncture in the west. Here’s how the Worsley Institute describes the start of his journey:

“Worsley practiced physiotherapy and began to study osteopathy, naturopathy and acupuncture. In the early 1950s he travelled to Taiwan, Singapore and Korea to further his studies and was awarded a Doctorate in Acupuncture. It was during his time there that he first came across the Five-Element system of acupuncture and was drawn to the way it looked at every aspect of a person’s physical, mental and spiritual well-being in order to diagnose the root cause of his or her imbalance.
After studying under his Five-Element teachers Ono and Hsui, in 1955 Worsley was awarded the title of “Master” of Five-Element Acupuncture. The following year he returned to Britain and founded the College of Traditional Acupuncture in Kenilworth, Warwickshire.”

I had the pleasure of studying with teachers at the College of Integrated Chinese Medicine in the UK, who were trained by JR Worsley. They teach, and I practice, an integration of TCM and Five Element acupuncture.

More focus on the emotions

Why bother with both? Well, they are a great combination.

TCM has some huge strengths around what are called the External Causes of Disease – cold, heat, damp, external pathogens, etc. – and the Miscellaneous Causes of Disease – overwork, injury, diet, etc. (These strengths were what led my teachers to study and then teach TCM, after their own original training in pure Five Element acupuncture.)

Relatively speaking, Five Element constitutional acupunture is very interested in the Internal Causes. These are the relationships between your inner world and your physical health. How are you doing emotionally? Are you at the end of your tether with stress? Poleaxed by grief? On a hair trigger of irritabililty? Or just feeling flat and lacking in joy? The impact of these, across your whole mind, body and spirit, can be huge.

A very neat pair of approaches, right?

Well adapted to the modern world

That Anjuna Acupuncture article I quoted earlier makes an interesting point about how the Internal Causes are all the more relevant in the modern developed world:

“TCM modernized acupuncture and Chinese medicine in a way that could be understood by western medical physicians. This; however, diminished its focus on the mental/emotional aspect of a person because it was difficult to translate “the spirit” into something equivalent in western medicine. The “spirit of the points” was still very much embraced in Five Element acupuncture theory in classical texts.
People today do not suffer from famine, war and poverty to the same extent as our ancient predecessors. Most modern diseases come from stress, the stagnation of our minds and the suppression of our emotions. This makes Five Element acupuncture a particularly good approach for treating health problems in today’s society.”

As a side note, I’m not suggesting that TCM has no interest in emotional health – of course it does. And of course many great TCM practitioners have a deep interest in the full spectrum of their patients’ wellbeing. Five Element constututional acupuncture just adds in an extra lens of perception, and an extra toolkit for treatment.

Apparently one reason why emotional and mental health were relatively downplayed when TCM was created in the 1950s, was because of political diktat that said that mental illness could not exist in communist countries.

“TCM developed in China under the guiding light of dialectical materialism. As such, it has needed to reject those historical aspects of TOM [Traditional Oriental Medicine] that reflected spiritual issues, especially practices and attitudes that derived from the shamanistic roots of TOM.
Essentially it has focused on somatic complaints and relegated most complaints of mental, emotional and spiritual distress to the realm of politics. Of course there are exceptions to this generalization, but it is a useful distinction in getting a ‘feel’ for TCM.”
Peter Eckman, In the Footsteps of the Yellow Emperor

Either way, hurrah for all of the diverse lineages across East Asia that have preserved so many fascinating strands of ancient knowledge for us to use today!

An example in practice

For my registration here in Australia, I was asked to do a viva exam, where I diagnosed and treated a real patient. Having reviewed the info I’d received, I put my best ‘Pure TCM’ hat on, and flew to Sydney. It was an interesting experience! A little bit of a TCM / Five Element culture clash.

I really felt for the young patient I treated, who had been struggling to shake off a heavy cough / chest infection for two months. I asked plenty about the cough, but what jumped out at me was their underlying thoroughly depleted, distressed state, based on extreme work stress and family difficulties.

At the end, the TCM examiners suggested I had ‘spent too much time on background questioning’.

From a TCM point of view, yes, there was a straightforward diagnosis of a stagnant / obstructed Phlegm Syndrome (lovely eh!)

But my Five Element training led me to a strong interest in the Internal emotional / spiritual cause for this stuck pathogen, that to my mind that far exceeded the proximate External cause.

Seeking to help the patient from both of these angles can only be a good thing.

Finding the right style for you

There are amazing practitioners out there, from every style of acupuncture!

It’s a different strokes for different folks kind of deal. Finding a great fit for you.

If you’re in Perth and you’d like to experience the joys of Five Element constitutional acupuncture, I think it’s the case that I’m the only person practising it here. So just get in touch to get started…

A side note for acupuncturists

Publishing this post set off some really interesting dialogues about the heritage of Five Element acupuncture. It’s clear that Five Element medical theory does go back a loooong way.

In a very scholarly article, the esteemed TCM writer, Giovanni Maciocia writes here about the prominence of Five Element thinking in the Nei Jing (a key classical text of Chinese medicine, which dates from around 200-300 BC):

“The Five Elements in the Nei Jing: The 5 Elements are mentioned in very many chapters of the Su Wen and Ling Shu. The most common correspondences of the 5 Elements are with the following: Colours, odors, directions, organs, seasons, flavours, numbers, orifices.”

And it seems that Worsley’s learning from Japanese masters was also much influenced by the Nan Jing (another text from a similar era). In these writings, Five Element thinking was even more integral, see this short article on TCM Wiki (The Five Elements are referred to here by their Chinese name, Wu Xing).

Ready to give it a try? Give me a call…

Five Element acupuncture now available in Perth

Your individual constitution can be the source of your greatest strengths as well as your greatest challenges. The beautiful and ancient Chinese Five Element framework is keen to look not just at how you are right now, but who you are in general. Five Element acupuncture supports your wellbeing from that perspective.

Chinese Medicine is strong in general in looking at you as an individual. A good acupuncturist is always looking at you as an individual, and looking at you holistically. We don’t just see you as ‘a case of …’. Like, you’re more than just your sore knee or your migraines! Obviously.

Seeing you clearly

And a good Five Element acupuncturist takes that to a deeper level, spending quality time to really listen and look, to deeply hear and see how you are and who you are, to reflect on what help it is that you need.

This helps to create the very best treatment plan for you. Like, really, for you.

An interesting idea, right? If you’re keen to see what Five Element acupuncture might be able to do for you, your luck is in. Jessica is now available in Perth, bringing Five Element acupuncture within your reach.

Experience the difference for yourself

Just get in touch to book your first appointment.