I talk to Dr. Varini Naidoo BVSc(Hons) about Acupuncture as derived from Traditional Chinese Medicine and how it holds up with modern-day thinking.
My guest today is the lovely Dr Varini Naidoo who graduated from Onderstepoort in 2005 and subsequently completed her honours degree in 2013. She has worked in several practices in South Africa but ultimately came to Cape Town in search of multi-vet clinics that offered a wider spectrum of casework and a little more time for focussing on diagnostic work-ups.
Varini worked for a busy practice in the southern suburbs of Cape Town from 2016 to 2020 where she was first introduced to Acupuncture as a treatment modality. One of the co-owners of the practice at the time, Dr Mark Barron, offered Acupuncture to a loyal clientele. Impressed by the successes that invariably followed treatment, Varini studied at Western Veterinary Acupuncture Group (WVAG) in 2019.
Varini works for a pet medical insurance company. After-hours and weekend work is where her true passions lie. She loves being in a consult room with her patients and her Acupuncture needles. Improving their quality of life fills her with a sense of pride and satisfaction.
Before we get to the million-dollar question about Acupuncture, let’s imagine those old-fashioned wavy lines and take a step back through the mists of time.
As with many creationist philosophies, the written history of human culture and its evolution often contains accounts that many people find impossible to accept in modern times. Religious creationism, for example, is a belief that life, the earth and the universe originated from divine and supernatural acts.
Aboriginal creation philosophy states that supreme beings with shapeshifting powers moulded the earth and could change forms even to the point of becoming mountains. The legend of a flood that destroyed all life save for a boat that contained two of every kind of animal may seem difficult to accept these days. Modern science has shown us that mountains are made by the movement of the earth’s crust and that when a species reaches two, it is extinct. But for those times, authors explained events according to their understanding of the world.
The earliest human remains in China date back 1.7 million years. Fast forward through Neolithic and Bronze Age to Ancient China and we find a complicated history that speaks of a mythical Xia dynasty. The history varies according to sources but it is generally accepted that China was controlled by three sovereigns and/or five emperors. These were mythical demi-gods that rode around on dragons. The Yellow Emperor, in particular, was credited with the invention of (among other things) the Chinese calendar, Taoism, wooden houses, boats and carts, the compass needle, coined money, the wheel, armour, music, arts, government, law, writing, civilisation and football.
In terms of the history of Traditional Chinese Medicine (TCM) and Acupuncture, we find that The Yellow Emperor (reigning from about 2698 – 2598 BC), penned a medical tome in two parts. The first text (Su Wen) is considered the foundational doctrine of TCM and the second (Lingshu Jing) describes Acupuncture therapy. The text is set out in the form of a discussion about health, disease and treatment between the Emperor and his physician. It seems more acceptable that the texts were a compilation of traditions that had been handed down over many years by learned healers and physicians.
All too often in many early cultures, demons and magic were blamed for disease and malady. But, by the time The Yellow Emperor’s Classic of Medicine was published disease was viewed more holistically as a result of nutritional, mental, spiritual and environmental causes which were bound by a life force called Qi within the Hun and Po (Yin/Yang or body and soul).
TCM encompasses the Taoist philosophy that harmonises body, mind, spirit, food, animal and plant medicine, environment, massage, Acupuncture, Acupressure* and moxibustion**.
*Acupressure applies pressure to the same meridian points but because it may be too painful for some people they choose acupuncture instead.
**Moxa, traditionally made by rolling Mugwort leaves into a cigar shape, is used to pre-warm the points before needling begins.
At the heart of Acupuncture, TCM describes the meridian (an invisible channel network throughout the body along which a life force (Qi) flows), kernel (the acupoint that is made up of neurovascular bundles) and the shell (cleft/tunnel formed by bones, muscle and fascia). To correct disease or ease pain, the theory of TCM states that the Acupuncture needle can be positioned at various points to balance the patient and restore the flow of Qi. The philosophy also gives credence to the intention and Qi of the practitioner.
Considering the West’s rejection of the concept of Qi and the philosophy that underlies TCM, what form does Western Medical Acupuncture take? I find an interesting reference to this question in an article about Acupuncture for small animal neurological disorders 1. The authors state that the meridians may be an ancient metaphor for electrical stimulation of the nervous system and the functioning of Yin and Yang can be paralleled with our understanding of anabolism and catabolism (the creation and destruction of complex molecules in the body).
So, just as religion cannot fully describe an all-consuming, omnipotent and all-encompassing force, the Chinese believe that Qi cannot be adequately described by modern language. If Science is only starting to understand how Acupuncture needles relieve pain; how are we to begin to understand the workings of a timeless God or Qi?
Eastern Acupuncture recognises 361 points (plus 48 extra) along 14 primary and 8 extraordinary meridians. Through trial and error, the original number of points that were employed for over 2 000 years were adapted and compounded to include the whole system which was formalised by 300 AD.
The advent of Western medicine is one of the reasons that Acupuncture has only gained popularity in the West over the last 60 years. And this can be attributed in part to its effectiveness in pain relief and in part to the fact that scientific studies have begun to prove its efficacy.
So interested was the West in the success of Acupuncture in fact, that mountains of effort (from the 1980s) made it possible to officially agree on the names and locations of all the points (a publication by the World Health Organisation in 20092 states that in the early 1980s there was about a 25% difference in the location of acupoints by practitioners in the Western Pacific Region). Added to this impossibly complex task was the fact that a cosmos of dialects affected the pronunciation of the points as well as the fact that the Han characters confer philosophical concepts too (The Han language was chosen because it is understood in China, Japan and Korea).
The West has separated itself from traditional eastern Acupuncture by calling the modality Western Medical Acupuncture (WMA) or Western Veterinary Medical Acupuncture (WVMA)—a different name only since it has begun to define the scientific mechanisms and neurophysiological effects of the modality and because it rejects the traditional concepts of Qi and Yin/Yang. WMA and WMVA does not consider itself to be an alternative medical system either.
In the quest to understand the practical differences between traditional and modern techniques, the only clear statements I found were from an article called ‘Western Medical Acupuncture: a definition’ by Dr Adrian White, 20093.
“The main therapeutic effects of needling are achieved through stimulation of the nervous system (sensory stimulation) … It is practised using the principles of evidence based medicine, though it has to be admitted that there is scope for more clinical trials … Practitioners who employ a WMA approach to acupuncture would not generally consider using it as a ‘‘tonic’’ for generalised ill health, nor claim that it can maintain good health, both of which have been traditional indications for acupuncture.
Traditional acupuncture holds that individual points have specific effects, but in WMA attention is less focused on choice of one point over another.
Classical points are used by many—though not all—practitioners of WMA on the assumption that they are probably optimal for sensory stimulation of the nervous system.
More attention is focused on the tissue level (eg. muscle rather than skin) and the type and amount of stimulation given. The classical nomenclature of points is generally used for convenience of communication with other acupuncturists. Thus there are relatively few differences between traditional acupuncture and WMA in terms of treatment techniques. Both manual and electrical stimulation of needles are used; duration of needling is variable, ranging from very brief to up to 20 or 30 minutes.”
WMA also clarifies how needling stimulates ascending and descending pain pathways that reduce our sensation of pain by the release of endogenous painkillers.
Based on these two different approaches it seems that what can be agreed on is that Acupuncture reduces pain, relaxes muscles and increases blood flow.
I am beginning to understand that the success of traditional Acupuncture came about over centuries of trial and error. Its theories may have changed over the years as well, but the practice remained the cornerstone of the modality. As the traditional model is based on practice, so it seems the western model is based on theory and the west’s need to explain why things work instead of relying on proof.
The two approaches to this modality reside on opposite sides of the same coin. Acupuncture—whether you are comfortable with an eastern or western approach—works. Even though we may never fully understand the beauty and the intricacy of its secrets, east and west may still agree to disagree.
Varini says, “I was sceptical of acupuncture before seeing the positive effects in practice, and was keen to learn about it from a western, scientific/literature-based approach. After some experience using it clinically, it made me realise why TCM was so popular. There were no scientific studies or articles at that time but clients saw a positive response. So in my opinion we should be more open to other treatment modalities and understand that TCM and Western veterinary Acupuncture have a lot in common and are synergistic practices.
Many patients respond positively to Acupuncture which is often performed in conjunction with other rehabilitation modalities or medicines.”
The fact that there are five practising veterinary Acupuncturists in the Western Cape alone is a great indication that the modality is gaining acceptance. More of Varini’s clients are exploring alternative and complementary methods to heal disease and reduce pain. It may be time for more vets to incorporate Acupuncture into their practices as a mainstream therapy and not an alternative.
- Patrick Roynard, Lauren Frank, Huisheng Xie, Margaret Fowler. Acupuncture for Small Animal Neurologic Disorders. Veterinary Clinics of North America: Small Animal Practice, Volume 48, Issue 1,2018 https://doi.org/10.1016/j.cvsm.2017.08.003
- World Health Organization. Regional Office for the Western Pacific. WHO standard acupuncture point locations in the Western Pacific region. 2009. https://apps.who.int/iris/handle/10665/353407
- White A. Western Medical Acupuncture: A Definition. Acupuncture in Medicine. 2009;27(1):33-35. doi:10.1136/aim.2008.000372, https://www.medical-acupuncture.co.uk/Portals/0/BMAS%20files/MD%20files/Acupunct%20Med-2009-White-33-5.pdf?ver=2021-06-23-153734-817
©Liz Roodt 2023