The Fascination of Tradition: the case of Acupuncture.
Beyens François, MD
Brussels
Centre d’Etudes de Médecine Chinoise et d’Acupuncture, rue de l’Amazone 62, Brussels 1060, Belgium. Tel: 3225393900. Fax: 3225393692. E-mail:
Tradition is a power. Tradition is an illusion. It is a reference which one misuses, and still one can get out of it an impressive amount of information. It is the valley where are deposited the sediments of history, and where one goes to fish what is necessary or what is suitable. It is the mirror of the “Ancients” thoughts, the trace of their considerations and individual experiences. Haloed with the prestige of Tradition the impact of any idea is more forceful, because you do not argue with tradition. To question it amounts to doubt of the knowledge of our elders, to criticize a whole culture, to judge, with our modern resources, a subject which has gone through the trial of times, rooted in the theoretical or practical ritual of a civilisation, supported by a way of life, a network of particular concepts. Tradition is an undeniable asset. It can also mean an excuse for stating anything, because the data have characteristics of multiplicity at all levels; origins, places and times, different schools, parallel theories, mixture of reference systems, absence of the obligation to forward a proof. It is therefore possible to appropriate any idea by referring to Tradition. It has broad shoulders, it is enough to mention it, and opposition or questions are silenced.
In the field of medicine it is no more the way. Tradition is not bad in itself; on the contrary, it represents a filiation, a continuity, and guarantee of a certain homogeneity. But coherence only exists inside the system, which is handed down, and because of it. This proves true for all the medical traditions, including ours. In some ways the example of acupuncture is rather representative.
For the Chinese who have never been in contact with our modern scientific methods, the question is not even raised. This technique is part of the ancestral inheritance; it is not proper to discuss neither its justness nor its usefulness. The characteristics of Chinese thought are such that two contradictions are of no inconvenience; one can very well live with two conflicting ideas or informations. The art is to never consider them simultaneously, but to choose one or the other for the purpose of a theoretical argument or a practical application. In order to justify this or that therapeutical move, the traditional acupuncturist will have recourse to several systems of reference, but never at the same time. He will lean on the Law of Five Elements, or on a chain of reasoning according to the Eight Diagnostic Principles, or on an ancient text, the interpretation of which can be more or less stretched, or on a classical quotation, taken out of its context, and eventually contradicted by another quotation which will not be mentioned, or on a quotation of unverifiable origin, or on the authority of a modern treatise, of his masters, or simply on the fact that “it works”, which represents the facts of experience, from far the most interesting.
The Chinese acupuncturist who has followed the occidental, scientific education, is not at ease with these contradictions, and the ambiguity in which he is obliged to live in. It is also the case of most of the western medical acupuncturists. Since the technique has been introduced in our countries, an infinite variety of attitudes have been observed regarding the contents of the theoretical information, but not so much on the practical and clinical contribution. It has been possible to free the latter of its historical and cultural background, and to use it as such. In fact this is the great strength of acupuncture, and the seal of its unique character among all traditional techniques. It can be reduced to efficient gestures, producing fairly quick results when a certain number of conditions have been fulfilled. This basic nucleus, which can be found at a second level in most modern Chinese treatises, but strangely enough not in the western works, except those which draw directly from original sources, is the practical knowledge which allows to treat a sciatic neuralgia, hay fever or cervical arthritis more or less in the same way from one book to the other. This level of acupuncture technique, which largely satisfies many, but which others run down as a substitute of the “true” acupuncture, is nevertheless that which has brought success in the West, because up to a point, the therapeutical procedure complies with the demands of objective thought, and even sometimes of experimental methods. Thanks to this level acupuncture is practised nearly everywhere in the world.
However the acupuncture technique has reached us coated with a system theory, which the scientific method cannot accept as such. On the other hand, to strip the motions of the acupuncturist, to allow only modern terminological references and avoid all mentions to its original vocabulary or the to the theories which support it, amounts to provide a very dry therapeutical instrument, not even fully explained yet from the point of view of medical science. This situation is difficult to assume for a practitioner, and the problem was detected quickly by all those who teach acupuncture in the West, and explained to those who were receiving their lessons, in order to make clear the reasons for such a paradoxical choice in teaching matter. Calling upon science, they propose an efficient therapeutical technique, then in a parallel and simultaneous discourse, nearly always clear minded, they offer the theoretical support as a memory base, as a teaching structure enabling to obtain more easily the practical and necessary data. That is why, although they think in terms of neurones and transmitters, segmental distribution and nerve conduction, and because they know that from this point of view the explanations are not yet complete, they provide the information in terms of meridians, energy, antique points, etc. Learning becomes possible, lessons become understandable, and their contents become useful in clinical practice, without the western doctor having to discard his identity.
These doctors did not always realize that they had learned part of the Tradition. For many years the information on this subject was scarce, and already altered by translators! What one believed to be pure Tradition, which in itself is a catch, represented only one of the many aspects of this formidable bulk called traditional Chinese medical theory. Following contacts with the Far East, with translated and published texts and with direct teaching, the landscape of knowledge in acupuncture gradually changed. The West gained admission to Chinese medical tradition, which revealed itself progressively. One observed then that it embraced in its system all the techniques of acupuncture. But this technique, as we know, as such, is above the system. It is this characteristic which allowed us to incorporate it in our modern medical practice without too many difficulties. And here we find it, claimed and authenticated, recuperated and assimilated by a theoretical and practical system prisoner of a history, of a culture, even sometimes of politics and economics. Confronted with this new vision of acupuncture, the medical practitioner doesn’t know what to believe, what to take, where to position himself.
Tradition claims to be coherent, monolithic, inspired, unchangeable, and logical. And it is very tempting to accept this point of view. No need to ask questions any more. Immersed in a system, one just applies it, playing its game; there is something comforting in the idea that one is reproducing the thoughts and movements of somebody who could have lived centuries ago. Something reassuring. Unfortunately Tradition has many qualities, but it is neither coherent, nor monolithic, nor logical, especially if of one compares all the data. It is obvious that by becoming selective, it is possible to build within the incongruous construction of Tradition a system which holds more or less together and which appears like an organised structure, providing one does not require a scientific approach. That is why the acupuncture that is presented to us by the Chinese, the acupuncture that is also taught in their universities, is the result of a careful selection of texts and theories amongst the most reasonable, provided in a language where the archaic is mixed with the scientific, the traditional with the modern, up to the arguments and thoughts which borrow their lines from philosophical and political theories.
Other acupuncture systems saw the light in the West. They were based on insufficient information, or on a misunderstanding of Chinese fundamental way of thinking; they disregarded the special characteristic of these people to be resolutely pragmatic on one side, and strongly faithful to the cultural form of their existence on the other, both attitudes being eventually totally conflicting. So some western acupuncturists tried to impose a certain logical structure in which the western mind could be at ease, and built their own acupunctural system! They always refer to the Tradition, but their respective sources are not always the same, and the translations from which they drew their information were not of the same quality. Moreover, confronted which each other and, what is more embarrassing, confronted with the original Chinese system, they do not agree! The therapeutical solutions proposed when following each time the reasoning specific to their system do not correspond! Even the basic nucleus, which I mentioned earlier, is chipped and questioned. These “systematisers” have forgotten that practice is more important than theory, because it is the only solid brick laid in the acupuncture construction.
Tradition moves within the system. It is good to enter it in order to see it in the proper cultural light. Out of the system, Tradition becomes fragile, and must be scrutinised by science. It should not be discarded. There is abundance and richness of experience and information in it. The acupuncture Tradition is the same. But we must always remember the relativity of its contents, the necessity to replace them in their cultural setting, and to use all our modern knowledge and techniques, human and scientific, to understand it better. Then Tradition will not be a trap any more in acupuncture, but will become one more dimension, one more approach, one more information, for the better understanding of this unique phenomenon which we have all chosen to defend, to practice and to improve.
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