The dilemma of acupuncture and modern research why sham acupuncture does not exist: Historical and texthermeneutic perspectives

Abstract

This paper focuses on key elements of acupuncture and surveys basic assumptions underlying the acupuncture doctrine which are accepted by clinical acupuncture research. To assess the treatment efficacy of an acupuncture intervention, acupuncture at real points (verum) is frequently compared to acupuncture at false points (sham). The basic assumption here is that verum and sham acupuncture are indeed valid concepts. A prerequisite of the validity of these concepts though is that it must be possible to localize verum acupuncture points in an exact and reproducible manner. But, from the vague descriptions of the pathways of the “vessels” and “acupuncture loci” in the early sources of Chinese Medicine, how did we arrive at the exact anatomical depictions of the “meridians” and “acupuncture points” in modern textbooks? By tracing the idea of the “meridian” and its course and the acupuncture point and its localization through the history of Chinese Medicine from the earliest primary sources to modern textbooks, it becomes evident that there is no exact definition of the “classic” or real acupuncture point and that reproducible localization of acupuncture points is not possible. Thus, from a historical and texthermeneutic perspective the concept of both the real and the sham acupuncture point remain elusive. The ideas and practices of Chinese Medicine are part of a historical and cultural process with a remarkable continuity in tradition. If, however, consciously or unconsciouly removed from this context and subjected to the imperatives of modern research methodology, both modern research and the traditions face a dilemma.