by Malia Kirby

(This is part one of a three-part series)

Tra•di•tion, noun. An inherited, established, or customary pattern of thought, action, or behavior.

A newlywed couple, preparing for their first family Thanksgiving, started determining whether or not they were ready.  The croutons were seasoned, the vegetables were chopped, the potatoes were peeled, and the turkey was in the sink thawing…with the dish rack set over the bird.  The young husband, curious as to why his wife might have imprisoned the bird asked, “Honey, why do you have the dish rack over the turkey?”

“That’s just how Mom always thawed her turkey, and I figured there was some sort of purpose behind it, so I did the same thing today.  I’ll have to ask her later this evening over dinner when everyone’s here.”

As her family began to arrive for dinner and the young wife started to set the table, she pulled her mother aside and asked the same question, “Mom, why did you always thaw out the turkey in the sink with the dish rack over it?”

“That’s just how your grandmother did it, Dear, so that’s just how I always did it.  Maybe you should ask her tonight, because I really don’t know.”

At that point, the young hostess began herding everyone toward the table.  Once the plates were filled, drinks were poured, and everyone was settled in, she asked, “Grandma, I’ve got a question for you.  Today, as I was preparing for the meal, my husband asked me why I placed the dish rack over the turkey as it thawed.  I told him that’s just how Mom did it, but when I asked her why, she told me that’s just how you’ve always prepared turkey.”

With this, the little elderly woman started to giggle, which made the young wife and her family increasingly nervous.

“What’s so funny, Grandma?  You obviously had a reason for covering your turkey with the dish rack.  Why shouldn’t I do the same?”

At this point, the elder woman broke out into full-on laughter, belly laughs, guffaws, and all.

“Because you don’t have a cat!  If I didn’t cover the turkey with the dish rack, I couldn’t have kept your grandfather’s old tabby cat, Stripes, out of our dinner.”

That word, right there—tradition—is loaded.  Think about it.  “TRADITIONAL Chinese Medicine”  That title alone gives us all a big, warm fuzzy over the fact that we get to feel as if our medicine is thousands upon thousands of years old or that we’re connected in some metaphysical way to any and all practitioners of East Asian medicine ever.

I’ll admit it.  I dig on the warm fuzzy.  I’ll be the first one to tell you that I enjoy it.  I like using my mortar and pestle on bulk herbs because it was used in Shawn’s grandparents’ pharmacy back when herbs were still considered medicine and I enjoy the feeling of the same physical exertions used by so many other people through time.  I enjoy that sense of history.  I like the smell of the herbal pharmacy because it reminds me of a time where everything wasn’t sterilized or reduced down to a single component that could be snagged off the shelf.  I like having to take my time around herbs or with my needles.   I enjoy the meditative sense of calm.  I’ll also be the first one to tell you that I know it’s all crap, because it’s an over-romanticization in my own mind, but I keep my “traditional” practices anyway.  That really doesn’t make much sense, does it?  While we’re on the topic not making much sense, there’s a lot of these traditions where we should break ourselves of the habit.

"From ancient grudge break to new mutiny, where civil blood makes civil hands unclean."

Throughout history, we have case after case after case of outright prejudice and racism.  During and after the two World Wars, there was marked resentment toward anyone with the same racial descent of the Axis nations.  Colorado owes its current Japanese-American population to the fact that, following Pearl Harbor, a number of these citizens were rounded up and placed in an internment camp down in Grenada, regardless of their level of loyalty to the United States.  There was McCarthyism, J. Edgar Hoover, the Red Scare, and the Cold War.  Or, for a more modern example, following the events of 9/11, a number of Americans started calling for retribution against all Muslims, regardless of the fact that Bin Laden only represented a small group of extremists and not the religion as a whole.  Even today, these grudges die hard, as I still hear people claiming that President Obama shouldn’t hold his office because “he’s a Muslim,” that the mosque shouldn’t be rebuilt at Ground Zero, and a number of other ridiculous and outrageous claims based entirely in fear and ignorance that I can’t even bring myself to write or repeat them here out of embarrassment for those who have spoken them out loud.

Unfortunately, our medicine isn’t free from the same prejudices and old grudges, and I’m not entirely certain we’re even aware of them when we continue to teach them to students and pass them on.  I distinctly remember one of my instructors telling us all that using a guide tube was the equivalent of using training wheels, and consequently, we were forbidden to even use them in class.  Every single person in my graduating class had to practice their free needling with 30 gage needles on Kidney 1 on their fellow students.  I don’t care who you are, that’s pretty hardcore, and I still have PTSD over it.  Anyone coming at the soles of my feet with an acupuncture needle is at risk for a kick to the teeth because of it and I know I’m not alone there because I know that’s something most of us have heard at one point or another in our careers.

Let’s take a good, hard look at that statement: using a guide tube is like using training wheels.  That’s a pretty derogatory statement in itself, implying that only beginners would consider using guide tubes, that if you’re using one, you obviously don’t know what you’re doing and that you shouldn’t be trusted on your own without adult supervision.  Now, here’s a question: why would any practitioner give a rat’s ass if another practitioner chose to use guide tubes?  Does the other person’s guide tube trash your needle skills or your practice?  Is the use of a guide tube hurting you in any way?  Do our patients even know that someone using a guide tube is considered a beginner or care about the controversy?  And, most importantly, why is the use of the guide tube even an issue?

The guide tube was invented by a Japanese practitioner, WAICHI SUGIYAMA, during the 1600s.  Acupuncture, at that time in Japan, was in its decline due to the pain of needle insertions and, if inspiration hadn’t struck him after wiping out and landing near a pine needle and a piece of bamboo, it may have died out completely…and not just in Japan.  Acupuncture was also dying out in China and, had Cheng Dan-an not hopped the pond to Japan in his efforts to revive the practice in the 1930s, our field as a whole—including Traditional Chinese Medicine—might have turned out to be a pipe dream.  And, let’s face it, painful needle insertions do not equal the achievement of de qi.  For added fun, the guide tube allowed for clean needle technique, preventing the spread of pathogenic infection in our patients and giving our medicine even more credibility in the general patient (not to mention, healthcare) population. Think about that the next time you consider bashing the use of guide tubes.

But, wait a minute.  “It’s Chinese medicine, not Japanese medicine,” I can hear you saying.    Exactly.  Cheng Dan-an (amongst others) was looking to promote nationalism by supporting a “traditional Chinese medicine” following the influx of Western medicine and concepts coinciding with the collapse of imperial China in the early 1900s.  Then in the 1950s, when Mao and the communists came into power, “traditional Chinese medicine” was spared once again (1) in hopes to promote that warm-fuzzy feeling in Chinese citizens regarding their country.  The key word here?  Nationalism.  It’s awfully difficult to promote nationalism in your “traditional” healing methods in a country when you’re using a foreign device—and not just any foreign country, but the country responsible for the Nanjing Massacre during World War II.  If you’d like more information on the emotional scars of China following the event, The Rape of Nanking, by Iris Chang, illustrates them well.  Be forewarned, however, it isn’t an easy read due to the brutality (in the same vein as Bury My Heart at Wounded Knee) and the author has come under some scrutiny for misinformation and serious flaws in the book (2).

Another controversial topic due to the same nationalistic prejudices includes the achievement of de qi.  Chinese-style practitioners are wont to spout that Japanese-style practitioners believe they don’t need to achieve de qi while Japanese practitioners are wont to spout that Chinese-style practitioners simply haven’t cultivated the sensitivity to achieve de qi without the patient jumping off of the table in pain.  Both sides are incorrect and behaving in an unethical and unprofessional manner because, it all comes down to interpretation of one passage in the Nan Jing, which roughly translates to “the arrival of De qi must occur.”  Chinese-style pracs interpret that to mean that the patient must feel the arrival of de qi, while Japanese-style pracs interpret that to mean that the practitioner must feel the arrival of de qi.  And, before anyone gets up on a high horse about the proper translation and terminology in Chinese medical language, consider the fact that every single word in the Chinese language has multiple interpretations.  Consider that we’ve had multiple practitioners, fluent in Chinese, look at the scrolls we have hanging on the walls in our office and not be able to translate them, or that the one person who could translate them recognized the poetry because her calligraphy instructor had scrolls with the same poems written by another artist hanging on his wall.

The last Chinese vs. Japanese prejudice I’d like to discuss today involves the implication that Chinese medicine is intellectually stimulating, while Japanese medicine is merely a physical therapy based on tactile palpation only and doesn’t require much brain power at all.  Honestly, I’m a little surprised I need to address this particular claim, because it’s just...rude.  Yes, Chinese zang-fu pathomechanism theory can make you jump through mental hoops.  Yes, Japanese meridian theory does require a certain level of tactile skill.  But, you know what?  Being able to regurgitate every possible pathomechanism doesn’t necessarily mean that you’ll be a good acupuncturist or herbalist.  It might improve your diagnostics, but if you don’t have good needle technique and adjunctive therapy skills, you’re not going to be able to do much for your patient.  Conversely, having extraordinary tactile sensitivity, technique, and skill isn’t going to make you a spectacular acupuncturist or herbalist either.  If you can notice a butterfly’s wing flapping on the other side of the world, but you don’t know the theory—any theory—well enough to determine a diagnosis, you’ll be equally ineffectual.  Like it or not, to truly excel in this medicine, you must cultivate both the knowledge and sensitivity to get anything accomplished.  Valuing one skill over another is just ridiculous and really only manages to highlight your own self-perceived inadequacy and becomes your poker tell.

Sadly, Chinese vs. Japanese isn’t the only problem in our field; there’s also Asian vs. British, aka Worsley Acupuncture or Five-Element Acupuncture.  Here, I’ve heard the gamut:

• “Five-Element practitioners are where you send your shen-disturbed patients.”
• “The CF was created to keep patients in the office indefinitely.”
• “Only Worsley/Five-Element treats the root of disease.”
• “If the five elements aren’t taken into consideration, then you aren’t in harmony with nature and can’t be practicing a natural medicine.”

Really?  We’ve actually gone there?  In those four statements, we’ve ridiculed patients and admitted we were ineffectual at treating a particular complaint, questioned the ethics of an entire tradition, placed ourselves on a pedestal by not understanding the theory and traditions outside of our own, and ventured into statements that just don’t make any logical sense.  Here, I just don’t see the point behind any of these statements.  We SHOULD be rallying together for a unified political lobbying body to strengthen a branch of alternative medicine, rather than quibbling over authenticity and slinging insults on traditions we haven’t studied or fully understand.

In these modern times, I don’t think it’s ridiculous to expect our field to realize that the quarrel is with our masters and it does not need to be with us their men.  Let’s not continue unethical, unprofessional behavior that has nothing to do with modern practice and everything to do with old hurts and personal insecurity.  We’re only embarrassing ourselves and hindering out students’ progress in the process.  What’s important is becoming a better practitioner and helping our patients see results, not what tradition you practice, or what tools you may use.  If you have personal prejudices that got you where you are today, that’s your business…just don’t make it everyone else’s problem by teaching it to your students and call it basic training when it’s anything but.

1. Ellis, Andrew, Nigel Wiseman, and Ken Boss. Fundamentals of Chinese Acupuncture. Revised Ed. Paradigm Publications. Brookline, Massachusetts. 1991.
2. Fogel, Joshua A. August 1998. “Reviewed Work.” The Journal of Asian Studies. 57 (3): 818-820.