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Why Explaining Acupuncture Seems so Hard

For many people acupuncture is an unfamiliar idea and so part of my job is to explain what I do and why its works. Doesn’t sound so hard but I think I really struggle with it (anyone who read my last blog post might agree). So I thought I’d write something and see if I can explain why I find it so hard. As I’ve thought about how to explain East Asian medicine I’ve tried to find suitable analogies. I think the best I’ve come up with is the game of Go, sometimes called Chinese Chess.

Go is a game for two players, one playing black the other white. They take turns placing their pieces on the board and once the pieces are placed they don’t move again. In fact the game is so simple there are really only two rules. But from this simplicity is built a game whose great complexity meant that solving Go was one of the milestones in the development of Artificial Intelligence. In fact its complexity is such that it makes Chess look like noughts and crosses (apologies to any Chess players – I’m exaggerating a little for effect). But what has any of that got to do with Chinese medicine?

At its simplest East Asian medicine is concerned with the balance of Yin (black) and Yang (white) within the body. In order to provide greater clarity these things are divided further.

For instance one of the most common diagnostic frameworks in East Asian medicine is called ‘8 Principle diagnosis’. The eight principles are:

Yin & Yang

Excess & Deficiency

Hot & Cold

Internal & External

And so any condition a patient may have can be categorised as being either Yin or Yang, as being due to excess or deficiency etc. Sounds really simple right? It should be pretty easy to determine the nature of the patient’s problem with such a simple rubric? Well yes and also no.

The problem is that these terms are all relative. There’s no objective standard for excess for example. Excess only exists relative to something else, relative to a deficiency or to a state of balance toward which treatment will hopefully move the patient. Of course that state of balanced health isn’t a fixed thing either, varying according to the age and constitution of each patient. So what started as a set of simple binary categories has managed to become a seemingly infinite combination of shades of grey where everything can only be understood relative to everything else. – how did that happen?

Well maybe its just how things are. No two people are the same, we’re all made up of a unique combination of influences, genetics, personal history, relationships, injuries, illnesses and on and on and on. The theory underpinning East Asian medicine has grown vast trying to capture this infinite variety and that’s where my attempts to explain East Asian medicine founder. I start off trying to explain one simple thing and then find myself explaining three other things in order to make sense of the first thing. And because the theory is vast that’s a process that seems like it could extend indefinitely.

Explaining these theories might be difficult but the attempt to capture the uniqueness of each patient in the diagnosis is the great strength of East Asian Medicine. And in the clinic the theory sits in the background. Diagnosis is really about paying careful attention to the patient, how they sound as much as what they say, their demeanour, colour, pulse, abdominal palpation etc and this attention to the patient as they are provides a far more objective basis from which to work. In East Asian Medicine theory comes second to practice.


Bruce Bell is an acupuncturist working from clinics in Midsomer Norton and Keynsham.

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