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Archive for the ‘Acupuncture History in the United States of America’ Category

http://www.singaporetcm.com/a/gongzhong/boke/2013/1114/1593.html

由南京中医药大学、《中国针灸》杂志社、中国针灸学会临床分会主办,南京中医药大学第二临床医学院、南京中医药大学针灸学重点学科、国家中医药管理局澄江针灸学派传承工作室承办的“澄江针灸学派第二届学术研讨会”于2013年10月25~27日,在南京中医药大学仙林校区丰盛楼学术报告厅隆重举行。大会开幕式由南京医科大学夏有兵副校长主持。

http://www.singaporetcm.com/a/gongzhong/boke/2013/1114/1593.html

薪火传承 焰燎四海
——澄江针灸学派境外传播纪实
夏有兵 张建斌 董 勤
引自《中国中医药报》2013、10、19
澄江针灸学派是以一代针灸巨擘、中国科学院首批学部委员承淡安为创始人,首批国医大师程莘农院士以及邱茂良、杨甲三等众多代表性传承人为支撑,以探究和弘扬针灸学术为追求的现代针灸学术流派。上世纪前叶,面对官学失守、非科学责难等,学派众多弟子传人在承淡安带领下,慨然以复兴针灸绝学为己任,秉持兼容并蓄的学术风范,遵循古为今用、洋为中用的致用思想,取石攻玉,纳涓成河,构建了现代针灸学科体系、确立了针灸高等教育新模式、开创了现代针灸临床研究范式,使得针灸仁术在华夏大地重发异彩,并洋溢于境外。

同祖国大陆一样,二战之前,针灸在香港也处于濒临灭绝状态。承淡安在无锡创办中国针灸学研究社(以下简称研究社)之后,影响渐次远播,也吸引了粤港两地才俊追随,如卢觉非、卢觉愚兄弟,曾天治、谢永光等。

创办香港最早的针灸教育机构

曾天治(1902—1948),广东五华人。曾任教师,因家人叠遭病故,弃教从医。1932年春,辞去了佛山华英女子中学的教职,师从承淡安,专攻针灸。然而,学成归里后,却要面对“广州人士,不知针灸为何物?灸字多读作炙字”的尴尬。为此,他一面积极向朋友介绍针灸临床价值,一面对朋友推介来的病人精心治疗,并取得了“十九都获痊愈”的效果,因此医名日盛,并先后被广州汉兴国医学校、光汉中医学校聘为针灸课程老师(其间编著《针灸医学大纲》作为教材)。由于中医学校的针灸课时较少,不能满足学生的学习欲望,本着“针灸不应私相授受,应公开研究”的愿望,曾天治遂自行在广州泰康路开设了“科学针灸治疗讲习所”,亦医亦教,推广针灸。1937年七七事变后,该讲习所迁址香港,并易名为“科学针灸医学院”,成为香港最早设立的针灸教学机构。

与承淡安创办的研究社一样,科学针灸医学院也采用函授与面授并举的教学组织形式。由于学验俱丰,辅以丰富的教学经验,使曾天治桃李满园,并为澄江针灸学派进一步向境外拓展,起到了重要作用。香港针灸名家苏天佑、邓昆明、梁铁生、谢礼卿、吴石垣、庄树民,新加坡针灸名家萧憬我,广东针灸名家如庞中彦、伍天民、李千里,俱出自曾氏门下。其中,苏天佑、邓昆明、萧憬我、庞中彦、伍天民等人,又曾分别在香港、新加坡、广州及内地设班授徒,绵瓞更广。

成立香港第一个针灸学术团体

卢觉愚(1897-1981)出身中医世家,其祖以医名世,其父亦曾修药济人。幼年曾就读于香港公立英文学校,因此不仅中文造诣很深,而且精通英文。17岁时,因母亲患热病吐血不治,遂虔遵父命,拜师学习中医,四年卒业。1926年考入香港东华三院,担任中医内科医生。1932年参加承淡安创办的研究社函授学习。1938年出任东华三院首任中医长。卢觉愚不仅是一位伤寒名家,与谭次公、张公让同为20世纪30年代粤港地区中医科学化运动的先驱,而且也十分热衷于研究与传播针灸。1934年,他在《针灸杂志》创刊号上发表了题为“突眼性甲状腺病针效之研究”的论文,是香港针灸界公开发布的第一篇学术论文。同年,他还根据承淡安编著的《中国针灸治疗学》,结合西医脊椎神经起止循行形状的插图,制成《关系针灸学术之经穴神经表解》,在医刊上发表。有学者因此认为,将针灸经穴与神经系统做出比较精细的对照,全中国以卢氏为第一人。依据研究社分社章程,1935年12月卢觉愚筹备并设立了研究社香港分社。这也是香港历史上第一个针灸学术团体。

淞沪会战后,设在无锡的研究社暂停了一切业务活动。卢觉愚在香港设立了“实用针灸学社”,通过开办针灸讲座和培训,为港粤两地培育了不少针灸专才。

1970年,为继承承淡安弘扬针灸之遗志,传承其治学之精神,扩大针灸学术在境外的传播,部分澄江针灸学派传人在香港重组中国针灸学研究社,由卢觉愚任名誉社长,承门弟子谢永光任社长。该研究社不仅沿袭承淡安的办社模式,出版《针灸医学》会刊,开设针灸专修班,面向全球培育针灸英才,而且主动适应时代潮流,积极扩大与各国针灸同行的学术交流。1979年,该社改名香港中国针灸协会。

薪火传承,铸香港针灸中坚

承淡安再传弟子苏天佑、梁觉玄等学派后续传人,主动接棒,再传薪火,构铸了20世纪下半叶香港针灸的中坚。

新中国成立后,中医工作受到ZF高度重视。特别是承淡安陆续当选为第二届全国政协委员、中科院学部委员、中华医学会副主席,折射出ZF对针灸的肯定与重视。内地对针灸的积极态度,也影响到香港。在此期间,陈存仁创办了中国针灸学院、邓悟隐主办的广中中医学院、方德华主办的汉兴中医学院,以及其他或独立设置、或由各中医师公会附设的中医学院,都先后开设了针灸班,加上一直存续的香港针灸专科学院(苏天佑创办于1940年)、邓昆明针灸学院(邓昆明创办)等传统针灸培训机构,香港针灸教育呈现百舸争流的热闹局面。而这些针灸班的师资,多为澄江针灸学派传人。以最具规模的中国针灸学院为例,该学院虽由陈存仁主办,但院长及主讲教师则由邓昆明弟子梁觉玄担任,学院还同时聘请了香港针灸界的精英谢永光、邓昆明、苏天佑等担任特约讲师,他们俱为澄江针灸学派传人。由于师资力量较为雄厚,因此海内外学员纷至踏来。后来组成的中国针灸学会(香港),其早期会员多为该学院历届毕业同学。

在20世纪80年代前叶,香港针灸学术研究团体主要有中国针灸协会、中国针灸学会、香港针灸协会、香港针灸师会、香港中华针灸医师学会等,这些团体多由承氏亲传或再传弟子主持。因此有学者追本溯源,认为香港针灸界实为由承淡安一脉繁衍起来的。也有专家指出,承淡安的精神和学术,一直对香港针灸的教育、医疗和研究起着重要而积极的影响。

辐射近邻,在台湾、澳门生根开花

由于香港的特殊地理位置与文化渊源,20世纪50年代初至70年代末期,欧美、东南亚人士学习针灸,大多以香港为首选之地。他们或远赴香港,或请名师到本地开课授徒、设馆行医,进一步促进了澄江针灸学派在境外的广泛传播。特别是临近的澳门、台湾地区,前往求学的弟子亦当不少。此外,上世纪五十年代,承淡安亲传弟子申书文(贡噶老人)前往台湾,一边弘扬藏传佛教,一边传播针灸医术,并出版了承淡安编著的《中国针灸学》(1969年)。1962~1972年期间,承淡安再传弟子苏天佑,曾往台湾,设班授徒。原澳门中医学会会长谭伯铭曾师事王珩光学习针灸,王珩光也是研究社的早期社员。这些事实,虽属鳞爪,但也可管窥澄江针灸学派对这两个地区的影响。此外,邱茂良、程莘农等承氏亲传及再传弟子,也都不乏源自这两个地区的衣钵传人。

拓荒新加坡,传播针灸术

针灸疗法是随着中国移民而流传到新加坡的。李金龙教授认为,针灸在新加坡的传授,始于上世纪三十年代。当时,方展纶与陈志群(勉之)合创新加坡耀华针灸学社(1936年)、何敬慈创办针灸治疗院(1937年)、萧憬我创办中国针灸医学总院(1938年)。据谢永光先生考证,新加坡耀华针灸学社是香港总社在新加坡设立的分社。据现任职新加坡中华医院樟宜分院的林英医师介绍,方展纶师从承淡安亲传弟子陈惠民先生。因此,作为新加坡第一家针灸传播机构的耀华针灸学社,与澄江针灸学派可谓血脉相连。另外,何敬慈为承淡安亲传弟子,并于1937年开设研究社“新加坡大坡分社”;同年5月,承淡安另一亲传弟子邓颂如开设了研究社“新加坡小坡分社”。而萧憬我,则是承淡安再传弟子。

除了办学之外,承淡安亲传弟子刘致中,于1938年出版了新加坡第一本针灸专著——《针灸经穴图考》。作者在自序中写道:“致中世家业医,侧身南洋教育界多年,课余辄涉猎医典,尤好研针灸之术而无良师指导。岁丙子,决然弃教鞭回国,就学于吾国惟一之针灸医学专门校,校为吾师淡安所手创,师于针灸之学深通三昧,致中苦心研究,复蒙其悉心指导,自信颇有心得。”

除新加坡本地华人外,也有原本身居内地的该学派传人,因各种原因来到新加坡,同时也将针灸带到了新加坡。如新加坡中华医院第一分院原院长符伯华,1937年师从承淡安,后因抗日战争爆发移居新加坡。

设立针灸总院,构建传播针灸学术阵地

由萧憬我在新加坡实龙岗545号创办的中国针灸医学总院,是上世纪30年代末期直至70年代前期新加坡传播针灸医术的主阵地,影响遍及新、马以及东南亚甚至中东地区。

针灸总院是一个融针灸教育、医疗于一体的针灸专门机构,经十余年的不懈耕耘(日据时期停办三年余),于上世纪五、六十年代发展到鼎盛时期,并曾是马来西亚唯一传授针灸医术之机构(新加坡中兴日报,1955年3月22日第五版)。该社通过面授(学制一年)、函授等不同途径,培养了一大批针灸专才,其中谢斋孙、陈必廉、李金龙等一大批优秀学员逐步成为新加坡中医界之栋梁。其中,谢斋孙曾任新加坡中医师公会会长、中医学院院长;陈必廉教授曾担任新加坡针灸研究院院长、中华医院院长、中医师公会长等职;李金龙教授曾任新加坡中华针灸研究院院长、中医学院院长、中华医院院长等职。此外,针灸总院还培养了大批活跃于新、马两国,甚至东南亚、欧美等地区的针灸英才。

1976年1月1日,萧憬我谢世后,针灸总院由其二公子萧永煌接掌。虽然该院于1977年停办教学,但子承父业的萧永煌,针灸医术声名远播,曾多次应邀赴沙特、苏丹等中东地区为王室成员治病,并为当地媒体所报导。该院院址院舍至今仍保留如初。

开办中医教育,培养中医人才

1953年元月3日,由新加坡中医师公会举办的新加坡中医专门学校(1976年易名为新加坡中医学院,以下一律统称中医学院)开学,揭开了新加坡中医药人才培养的新篇章。该院办学之初,针灸课程以《承淡安针灸学检要》为教材。1966年后,中医学院开始将针灸列为必修科目,并逐步明确学习要求。自上世纪70年代起,在新加坡中医学院主讲针灸课程的老师有李永升(1960年考入厦门大学境外函授学院中医专科学习119,主持针灸教学的是承淡安亲传弟子陈应龙教授)、简健全(1960年考取厦门大学境外函授学院中医专科学习 245)、戴崇武、谢斋培与陈必廉等等。

1980年5月,新加坡中医师公会成立了新加坡中华针灸研究院(以下简称研究院),对外负责联络各国针灸界,对内致力于推动本地针灸的研究和发展。首任院长由澄江针灸学派弟子李永升担任,后历经陈必廉、谢斋培、李金龙、庄或勋、黄进来、陈楷华、刘嘉扬、冯增益、郭忠福等诸任院长。其中,谢斋培师从李永升,之后还随陈应龙学习针灸和气功;刘嘉扬是南京中医药大学李玉堂教授的学生,郭忠福是王玲玲教授的学生,而王玲玲、李玉堂都是邱茂良先生的高足。因此,包括陈必廉、李金龙在内,研究院院长多为该学派传人。

中国改革开放后,中外针灸交流趋于活跃。新加坡中医学院早于上世纪90年代即与澄江针灸学派重要传承地——南京中医药大学签署合作办学协议,该校本科毕业生全部发放南京中医药大学文凭。特别是2004年,两校进一步签署协议,将该院招收的硕、博士研究生全部接受南京导师的培养,从而为更好地扩大澄江针灸学派在新加坡的传播提供了组织保障。

在东南亚其他地区不断拓展

上世纪80年代前,东南亚华裔中医不少是在厦门大学境外函授学院主办的“针灸专修科”或“中医专修科”出身,在该院主持针灸学教学工作的陈应龙教授,是承淡安亲传弟子。历任菲律宾中医师公会主席的高达三,是研究社第二期毕业学员。另一位在菲律宾行医数十年的著名老中医关飞雄,则是曾天治的弟子。

1962年起十年间,该学派第三代传人苏天佑,怀着一颗推广针灸、布施福音之心,开始到日本、韩国、菲律宾、新加坡、马来西亚、文莱、泰国、越南、缅甸、印尼等地施诊、讲学,又培养了众多针灸传人,如马来西亚吡叻州的名中医幸镜清、招知行、丘荣清等。幸镜清还曾在2009年11月获评为“大马国际名医贡献奖”得主。

1976年3月12日,由卢觉愚、谢永光主办的香港中国针灸学研究社,在

汉城设立韩国分社,金容基博士被委任为分社社长。第一批社员共53人,全部系韩国人。

此外,曾先后担任福建中医学院针灸系主任的黄宗勖、俞昌德师徒,先后主持泉州中医院针灸科工作的留章杰、张永树师徒,利用福建独特的地理区位优势,在积极开展与东南亚地区针灸学术交流的同时,亦为该地区培养了不少针灸英才,拓展了澄江针灸学派在该地区的传承范围。

澄江针灸学派躬垦美国

澄江针灸学派传入美国,有案可据的可以追溯到1936年。是年《针灸杂志》第4卷第2期,刊有鸣谢美国罗省社员方复兴捐助出版经费的启事一则。同时,该刊同期还刊载了方复兴撰写的两篇文章,据此可以推算,方复兴是在1936年前即已参加研究社学习的承门传人。方复兴在美国的进一步发展,有待进一步考证。

1972年,尼克松总统访华后,美国掀起针灸热。华盛顿大学首次开设介绍针灸的课程,主讲教师许密甫,是曾天治再传弟子。许氏原居香港,1960年移居美国后,多次在电视上宣传并展示针灸疗效。七十年代初期曾出任俄勒冈州针灸考试委员会委员。

澄江针灸学派传人中,在美国影响最大的当属苏天佑(1911-2001)。1973年,他应华盛顿美国针灸中心及美国南加州大学(UCLA)针灸痛症研究所之邀请,来美工作。同年7月,美国ZF批准的第一间针灸诊疗所在华盛顿正式成立,苏天佑被聘为这家诊所的针灸治疗的主持人。这家诊疗中心还开办学习班,训练美国医生使用针灸医术,有学者认为苏天佑是第一个在美国公开传授针灸的专家。1974年,他加入美国针灸公会(National Acupuncture Association,NAA),并来到麻州创办了两家针灸诊所,分别位于肯莫尔区(Kenmore)和乌士打区(Worcester)。

苏天佑也是第一个在美国开办针灸专科学校的学人。1975年3月,他与两名美国弟子在波士顿共同创办了新英格兰针灸学校“New England School of Acupuncture”,并任首席教授。经该校培训的学生毕业后参加各州执业考试,通过率非常高。后来他的弟子在加利福尼亚州等地开设针灸学校,也都用苏氏编写的讲义作为教材,并在课堂上常常介绍苏氏及其治病方法,因此学生们对苏氏名字大多耳熟能详。1986年2月举行的麻省针灸学会第六届会员大会上,特颁赠他“美国针灸之父”(Father of Acupuncture in America)的称号。2001年8月,苏天佑病逝,而由他创办的新英格兰针灸学校,作为澄江针灸学派在美国的延伸,至今仍在为美国培养针灸人才。

此外,学派第五代传人、梁觉玄亲传弟子周敏华女士,是美国头皮针专家,曾任加州医学院教授、加州ZF针灸执照考试官。1975年,她团结针灸同道共同推动针灸医疗合法化,并时至今日仍能保留中文考试,厥功甚伟。她先后获评为美国加州执针灸医师会杰出领袖奖、中国国家中医管理局特殊贡献奖,又与赵小兰、陈香梅等同列“美国硅谷60经典女性”前十名。

澄江针灸学派深耕法国

澄江针灸学派与法国结缘,当始于上世纪30年代,当时研究社编辑的《针灸杂志》已经发行到法国,证明承门弟子已经分布到法国。

虽然针灸传入法国应不晚于17世纪,但由于法国针灸具有“最好还是让发明针刺疗法的人亲自去操作”的传统,并认为欧洲针灸并非正宗的中国针灸,因此,上世纪五十年代,随着香港针灸教育蓬勃兴起,也吸引了一批批法国学生前来学习、研究中国古老的针灸医术。

Charles Laville-Méry是于上世纪50年代初入学中国针灸学院(香港)的法国人。该学院院长、针灸主讲老师即是承门再传弟子、祖籍广东顺德的梁觉玄。Charles Laville-Méry毕业回法后,以针灸行世并设帐授徒。其徒弟中André Faubert、Jean Louis Blard二氏,在其支持下,亦于50年代末赴港入梁氏门下,前者学成回法后亦从事针灸教育,培育数十名针灸人才,社会影响较大。

1977年,André Faubert的一名弟子Michel Picard在巴黎开办“传统医学研习社(GERMT),后移师斯特拉斯堡,并先后更名为“欧洲中医大学(UEMTC)”、“汉生物学大学(USB)”,请梁觉玄执掌教鞭,授课内容包括针灸、中药、气功等。是时的梁觉玄已经移居北美。在北美、法国之间往返奔波了3年后,梁氏渐感年事已高,不宜经常远游,遂改用录像授课,而他本人则改为每年亲往讲学1次,为学生释疑解惑。该校于1994年停办,毕业生中更有继续办学者,如Fran·ois Marquer创办法国杵针中医学院(始于1993年,现有在校学生约120人,包括10余人的全日制班,在欧洲绝无仅有),该学院也是通过梁氏录像带教授部分课程。又如Patrick SHAN POTAUFEU创办了慈善团体humanitrad,旨在训练针灸医师以免费帮助世界上穷困地区居民,每月安排一个周末授课,每班学生约20人。经上述教育机构培养的学生,皆对梁氏十分敬重,执礼如父。梁觉玄对法国乃至欧洲针灸教育的影响不可谓不大。

在欧美其他地区广泛传播

澄江针灸学派的第四代传人梁觉玄,不仅在香港和法国颇有声誉,而且在北美地区也曾声誉隆盛。1969年,他迁居温哥华后,凭借精湛的业务,很快病患盈门,较之在香港有过之而无不及,甚至有的病人需预约到2年之后。美国兴起针灸热后,他亦曾前往美国,应邀参加加州医生协会召开的年会,为500位美籍医生作即席医疗示范。1973年,梁觉玄获得第一批美国针灸医师执照,此后直至退休,他一直在临近加拿大的美国西雅图设馆行医,并于1986年成为美国Oregon教育部注册针灸教师。

近30年来,身处国内的澄江针灸学派传人邱茂良、杨甲三、程莘农、杨长森等,也为欧美乃至全球培养了大批针灸英才。其中包括许多国内门人,远涉重洋,或医或教,传播针道。香港传人谢永光的门生程在洋、黄煌等,还于上世纪80年代末在纽约创立了“美国中医针灸师联合总会”及“国际针灸学院”。此外,作为该学派传承重镇的南京中医药大学,利用WHO传统医学合作中心和卫生部国际针灸培训中心这两块优势平台,为欧美地区乃至世界各地培训数以千计的针灸英才,被誉为“欧洲针灸教父”的英国人Giovanni  Maciocia便是其中之一!

历史洪流,浩浩汤汤。诞生于学科危机时刻的澄江针灸学派,矢志于针灸学术的推陈出新和发扬光大,主动顺应时代发展潮流,苦心孤诣,筚路蓝缕,薪火相传,形成了蔚为壮观的针灸复兴大潮,并且洋溢于境外,为中医针灸走向世界起到了推动作用。

 

 

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To date, there are 1,035 active acupuncturists in MD. Acupuncture Today indicated the members in Maryland is 752(72.6%). And currently VA active acupuncturists  about 485. In Acupuncture Today, is 352(72.6%).

Total acupuncturists in Acupuncture Today is about 25,000. So in 2014, actual active acupuncturists in USA should be 34,435.

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神针,刺出一片晴空http://epaper.tianjinwe.com/tjrb/tjrb/2010-09/18/content_154695.htm

神针,刺出一片晴空

汪宗禧

1971年,《纽约时报》派出王牌记者詹姆斯·罗思顿前来中国采访。当年7月,罗思顿来到北京。来到一个新奇的世界,罗思顿满眼都是新闻,他发回的报道,也令本就好奇的美国人举国称奇。就连他患了急性阑尾炎,在北京接受针灸治疗的过程,也被当成重大新闻,发在了《纽约时报》最惹眼的版位上。下面是这篇长篇报道的意译:
中国总理周恩来亲自过问我的病情,召集了11位中国医学专家为我会诊。7月17日,由北京反帝医院(即北京协和医院)外科吴医师主刀,切除了我那坏透了的阑尾。手术很成功,也没伴生并发症。可是,到了转天,我的腹部就开始隐隐作痛,那种闷痛隐痛让我非常难过。各位专家又经过一番研讨,建议我接受针灸疗法。让那长长的针刺入自己的身体,想一想都让人害怕。可我觉得这种纯粹中国式的神秘疗法值得一试,就答应愿以身试针……治疗结束。我正在回味这种扎针疗法带给我的感觉的时候,我的腹部不疼了,以后再也没有发作。我还了解到,在针灸那里我这是小病,最近报纸上屡有失明、瘫痪和精神病患者在针下治愈的报道。也许有人会认为,我在北京尝试针灸的经历,只不过是职业记者为达采访目的而惯用的一种冒险行为。而我会告诉你们,我作为职业记者,为新闻可以去冒险,可是若没有把握,我绝不会主动跑到实验室去当一只荷兰猪,让人家在我身上任意动刀试验……

在美国人的心目中,罗思顿是信赖度极高的记者,他发自北京的有关针灸的报道绝对真实可信。对罗思顿的偶像情结和对中国好奇心撞到了一起,由此引发了全美国的一场中国针灸热。紧接着是1972年尼克松访华,他的随身“御医”特意到中国医院细察针灸麻醉过程,并一一详尽记录,此消息无疑又给美国针灸热泼了一桶油。那段时间,似乎全美国的人都迷上了针灸。原来的“巫师”成了神医,“巫器”成了神针。那时候想找针扎就只有去华人区。深藏于华人区的针灸诊所一时间车马云集,人满为患。波士顿东方医学协会张会长这样描述当时的针灸胜景:本地的美国人都接待不过来了,外州的美国人也像赶大集似的,从四面八方蜂拥而来。有的城市还专门开通了针灸大巴,拉着整车整车的美国人去找针扎。仅仅张会长夫妇这里,每天都有两辆大巴定时前来。夫妇俩从早到晚忙得晕头转向,明晃晃的眼前全是针,那感觉就如同一下子落进了几万亩的水田里,银针似乎也成了秧苗,眼前是没有尽头的水田,手里是插不完的秧苗……扎针灸如插秧苗,确实是尼克松访华前后,美国针灸热的生动写照。扎针的人太多,诊室根本就容纳不下,针灸师就只好去租旅馆,带动周围旅馆的生意也一下子火爆起来。有的针灸师只顾扎针,却腾不出手来去拔针,只好高薪请人帮忙来拔。一时间,拔针者也成了高薪族。针灸师当然更是财源滚滚,据说有的针灸师扎针一个礼拜,就能买一套别墅。

看着华人针灸师赚钱如此邪乎,美国人也眼馋了。自此,大批美国人开始涉足针灸,结伴来到中国大陆和香港学习针术。有的人赚钱心急,学了点儿皮毛,懂了几个穴位,就急急赶回美国开诊收钱去了。针灸热到这个份儿上,出些医疗事故就难免了。一直视西医为绝对正统的一些美国医疗权威机构,当然不会放任针灸在自己地盘上开疆拓土。于是,西医机构的强势运作,几起医疗事故的大肆炒作,不只浇冷了美国人的针灸热,还令美国各州纷纷立法,禁止针灸师独立行医。很多州立法命令:擅自开诊扎针者,一律以无照非法行医罪名论处。美国针灸师自可金盆洗手,另谋他业。可华人针灸师却不忍收针,只好退回华人区,隐蔽在小角落继续行医。这是针灸在美国遭遇的最黑暗时代,针灸师简直就成了地下工作者,经常有针灸师在做地下工作的时候,被警察当场捉拿拘捕。

一针扎出针灸合法地位

1973年初,正值美国酷冷季节,也正值针灸在美国处境最难过之时,香港名中医陆易公应邀赴美,在纽约为1500名西医解析针灸学。走下讲台,听说纽约警方刚刚以无照行医罪名,将一名针灸师捉去问罪。陆公内心陡生激愤,随即四处游说,为针灸师打抱不平。“你们难道不知道吗,针灸经过了几千年的临床检验,早就证明它是一种安全有效的疗法,剥夺针灸师行医权,不但是对针灸师不公平,同时也剥夺了美国人民寻求健康的一条途径。”尽管很多有识之士赞同陆公,可是,立法在上,大家也只有叹息而已。这时,有朋友无意中说起内华达州当年4月议会将要召开立法会议,其间会修改某些法律。陆公听说后忽地起身,当众宣布:“走,我这就去内华达,争取内华达州立法给予中国针灸合法地位。”众人听罢,当场讥笑陆公:“就连美国实力派人物想立法修法,都难如搬山,你区区一中国游客,如何能改变美国法律?很可能法没立来,你自己却倒在美国大牢里了。”陆公说:“这世上的壁垒高墙,总得有人去闯去拼,才有迎来一个坦荡世界的希望。这次我西去立法,纵然不成,纵然将这把老骨头扔在美国,也总能给后来者铺条路吧?”陆公立马将针囊披挂在身,就像一个东方侠士,向着内华达大沙漠出征了。陆公的好友亚瑟·史丹伯格先生是纽约退休律师,他与妻子曾远赴香港到陆公门下求医,陆公使出一身针功,很快就治好了夫妻俩多年顽疾。史丹伯格听说老先生花甲之年匹马西征,二话不说就拍马过来,誓要与老先生同行。他说:“好歹我做过律师,就给你做个法律助手吧。”陆公也乐得如虎添翼,于是两人皆豪情干云,并马杀入西部沙漠。到了沙漠,两人正举目茫茫,不知何处下手之际,天降贤才,巧遇公关能手吉姆·乔伊斯先生。乔伊斯听完两位老人的诉说,大为感动,当即就加入陆公团队。

要想申请立法,首先就得获得申请资格。在内华达州,须得拿到3万人的签名支持,立法院才会受理你的立法申请。三人分兵出击,四处游说,逢民居便去敲门,见人就去套近乎。每天都是天不亮就上街,晚上整个城市的窗口都熄灯了,三人才收兵休整。民众果真给调动起来了,排着队去州政府签名支持针灸立法。不消几日,3万人签名支持的申请资格就够了。三人去立法院递交申请的时候,在场的议员吃惊不小:这么短的时间,就有那么多人签名支持一种外国疗法,这在本州闻所未闻。

获得立法院的立法受理,这只是迈出一小步。此时离立法院投票表决还有些时日,陆公拿出针囊,要用针下功夫说服美国人了。可是,既然针灸还未获合法地位,陆公就不能开诊疗病。幸得老律师史丹伯格相助,立法院特别批准给予陆公3个礼拜的临时针灸行医资格。为让立法院诸位议员看个明白,陆公特意把临时诊所开在了立法院对面的旅馆里。此事轰动了内华达州,也波及全美国。美国一些大医院纷纷介绍顽症患者赶赴内华达,本州的患者更是近水楼台先得月,排着队来挂号预约。开诊之日,陆公银针未落,十几个医疗权威和政府官员组成的观察团来了,电视台的全程现场直播开始了。全美许多大小报记者也都涌到最前沿,执着笔,持着采访本,死死盯着陆公的一举一动,唯恐漏过任何一个细节。看着这场面,陆公深知自己手里的针干系重大,稍有差池,自己身陷绝境事小,针灸若再想在美国翻身,那就更难了。好在老先生艺高胆大,身边的大阵仗全不放在眼里,只把全部功力和意念灌注到针尖上。一针刺入,全场尖叫,而老先生却从容不迫,气定神闲。

前来试针者,多由大医院推荐而来,都是些久治不愈的顽症患者。在没扎针灸之前,这些患者大部分都在医院挨过刀,有的挨刀二十几次依旧沉疴不除。越是这样的病人,越能验出针灸的功力。陆公抖出全部精气神,抖出一生功力,每天从早到晚连续诊病扎针14小时,花甲陆公真的要为针灸拼命了。夫人陈贞卿女士听说丈夫境况,心疼不已,当即就飞来内华达,与夫君并肩上阵搏杀。怎奈夫人到底不如陆公强悍,不消几个昼夜就昏倒了。

在那段严酷的考验期里,陆公每天都要针治一百多名患者。患者都是抱着死马当活马医、拿自己当试验品的念头过来的,不曾想这小小银针却给他们的病体带来了福音。20多天过去了,陆公的银针在内华达刺出一地佳话:旅馆老板利用地利之便,抢先请陆公为其瘫痪老母治疗。老妇人是坐轮椅来的,经几番施针,竟能站立行走,自己推着轮椅去了;一位名律师生意盈门之际,却患了神经性耳聋,久治不聪,眼看着客户开庭,自己却不能上庭替人家争辩。心急如火之际,律师投身陆公针下,陆公只给他扎了四次针,那律师就耳聪如旧,最后一针刚拔出来,他就飞奔而去,去帮客户打官司了。

这次针灸试验经媒体倾力报道,在州内州外影响甚大。就连美国《时代周刊》也参与其中。

针灸创下如此战绩,这就为后来的立法过程荡平了道路。陆公带着赫赫战果和满满的自信,来到立法院与各位议员激辩。辩论过后的投票表决,是决定针灸能否获得合法地位的决定性时刻。令全州人大惊的是:州参议院以全票通过给予针灸独立行医资格的法案,州众议院也以30票对1票的压倒性优势通过此项法案。以这样高的票数通过一项法案,在内华达州立法史上绝无仅有。

内华达州州长很快就在该法案上签字,针灸自此在全美各州第一次获得合法行医地位。此后,针灸师和各界同仁奋力争取,攻克了加利福尼亚、得克萨斯、纽约等在美国有影响力的大州。到如今全美已有40多个州都已通过立法,给予针灸独立行医的法定权利。

1997年,美国国家卫生研究院历经漫长临床考查和研究,最终给予针灸一个“补充疗法”的身份,美国国家卫生权威机构正式为针灸立名设位,把针灸定性为一种“有效的、正规的疗法”。 针灸自此在全美获得正统地位。很多保险公司也看到了针灸的妙处,乐意为投保者报销针灸治疗费。因为患者扎针灸总比去医院大动干戈省钱多了,保险公司何乐而不为?自此,针灸不仅在美国重出江湖,还攀上了庙堂之高,堂堂皇皇地进入了美国主流社会。

针灸热再度在美国升温,只是这一次不再盲目狂热,热得温和,热得持久。

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Dr.Fan’s new article about Miriam Lee published recently. 

“Dr. Miriam Lee: A heroine for the start of acupuncture
as a profession in the State of California.
You could read the detail at:

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LicenseCounts as of September 16, 2013
Virginia Occupation Count

Assistant Behavior Analyst 48
Athletic Trainer 1,209
Behavior Analyst 318
Chiropractor 1,730
Interns & Residents 2,996
Licensed Acupuncturist 447
Licensed Midwife 71
Limited Radiologic Technologist 695
Medicine & Surgery 35,747
Occupational Therapist 3,392
Occupational Therapy Assistant 1,098
Osteopathy & Surgery 2,449
Physician Assistant 2,672
Podiatry 493
Radiologic Technologist 3,789
Radiologist Assistant 10
Respiratory Care Practitioner 3,814
Restricted Volunteer 68
University Limited License 19
Volunteer Registration 2
TOTAL 61,067Vi

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沉痛悼念加州中医针灸界的开山元老黄天池博士

由 admin 于 星期二, 08/02/2011 – 9:56上午 发表

尊敬的加州中医药针灸同业, 朋友们,
我们怀着十分沉痛的心情向大家报告, 加州中医针灸界的开山元老, 加州执照针灸医师公会永远荣誉会长黄天池博士因病于2011年6月22日在旧金山逝世, 终年93岁.
黄天池博士是加州针灸合法化运动最早的发起者, 参与者和组织者之一. 1975年以前, 在中医针灸治疗未获合法, 针灸师因无执照开业被逮捕入狱的艰难处境下, 黄天池博土与李衛来, 李奈祖, 李愈之, 周敏华, 卞伯歧, 余庚南等医师率先发起轰轰烈烈的加州针灸合法化运动, 他被公认为竹林七贤之首. 他们带头发动捐款, 聘请葛罗士文大律师起草法案, 他们慷慨奉献, 出钱出力, 游说政界, 侨界和西医界支持针灸合法.
黄天池博士以热情投入, 领导出色, 英文精通和整脊医师兼针灸医师的颇有影响力的特殊身份光荣当选为全美首个为争取针灸合法化而成立的中医组织——加州中医药针灸学会的首任会长. 在黄博士身体力行的带领下, 前辈们同心同德, 团结努力, 八仙过海, 各显神通, 终于使由莫士孔尼参议员提交的SB86针灸职业法案在1975年获得时任州长的杰利.布朗先生簽署成为法律. 中医针灸从始由地下走上地面, 加州中医针灸事业由始茁壮成长, 黄天池老会长作出了不可磨灭的杰出贡献, 值得全体同业和后来人的感激, 敬重和缅怀.
加州执照针灸医师公会建立以后, 黄天池博士历任理事, 理事长, 监事, 监事长, 顾问委员会主席, 永远荣誉会长等职. 黄老会长热爱中医, 忠诚中医. 热心加州中医针灸事业, 为CCAA的创立, 建设和发展付出了许多心力. 黄老会长作风正派, 平易近人, 淡薄名利. 医德高尚, 医术高明, 仁爱待人.深受民众的爱戴. 黄老会长功高不居功, 年老不服老, 将其大半生献给了壮丽的中医药事业, 仁心仁术治病救人永不言休, 为后辈们树立了光辉的榜样.
黄天池博士的逝世, 是加州执照针灸医师公会的损失, 是加州中医针灸事业的损失, 更是广大民众病患的损失.
您安息吧, 我们敬爱的老会长, 您的开拓功绩, 您的良多建树, 您的德术双馨将永垂不朽, 与世长存!
黄天池博士的追悼會于2011年7月3日上午10时在 Halsted 1123 Sutter St. San Francisco, CA举行. 黄博士的家属亲戚, 生前好友, 中医针灸界的新老同業朋友约二百多人参加了悼念活动. 加州执照针灸医师公會會長黄宪生, 副會長朱伯威, 秘书長兼荣誉会长陳熊, 荣誉會長周敏華, 江林, 林黄基碧, 周泽新, 沈華舒, 福利部主任黄庆嫒, 副秘书長林峰, 监事長林克武等代表公會出席了追悼會. 黄宪生會長代表公會致悼词. 黄老會長的老战友, 老同事和老朋友周敏華博士深情发言缅怀黄老會長为中医针灸在加州的合法, 成长和发展作出的杰出贡献, 高度评价黄老會長大公无私, 热情奉献金钱, 精力和时间, 造福广大的中医针灸同业的祟高品德. 加州执照针灸医师公會全体會長, 副會長, 荣誉會長及多位资深會员向黄老會長敬送了花圈. 黄老會長的生前好友, 原三藩市经济发展委员會委员余浩扬先生, 加州中医师联合总會荣誉會長黎剑文夫婦, 屠英, 罗志長, 温平伯, 副會長趙廣伟, 福利部部長趙東桐, 三藩市地区区長欧小坚等业界好友也参加了追悼會, 罗志長医师代表王啸平會長发表悼念演讲. 加州中医师联合总會荣誉會長陈大仁特别发来唁电, 并向黄老會長的家属赠送了安抚金.

加州执照针灸医师公會理监事會
2011年7月3日

 

周敏华:为中医求公平 推动针灸在美加州合法化

  中新社广州5月30日电 题:周敏华:为中医求公平 推动针灸在美国加州合法化

作者 廖丽丽

“推动中医针灸在美国加州实现合法化,使中医针灸进入当地主流医学领域,是希望针灸医师与西医医师有同等地位。”美国加州中医药针灸协会会长周敏华近日接受中新社记者专访时表示,40年前自己不遗余力在加州推动针灸合法化,只求人们公平对待中医。

今年82岁的周敏华,出生于广州一个书香世家,1969年随家人移民美国。那时,旧金山华埠中医经常被警察抓捕。周敏华虽有中医专长却不能公开应诊,深感不公的她先后在《金山时报》、《少年中国晨报》等报纸发表文章,宣扬中医独特疗效,呼吁同道团结自救。

 

1973年,周敏华在香港结识的针灸医生陈佐治因非法行医被捕,陈佐治的家属求助于她。她即与当时名医好友李卫来、李愈之、李奈祖、卞伯岐、黄天池及余庚南等积极捐款聘请律师,又成立“加州中医药针灸学会”以作声援。

“那时我们喊出‘针灸应该争取在加州合法’的口号,却被人嘲讽为不知天高地厚。”周敏华回忆说,为让更多人了解中医针灸的疗效,她常常举办讲座,并现场示范针灸疗法。在她和同行们的不懈努力下,1975年美国加州通过立法承认中医针灸,中医师可以合法行医,后来加州还将针灸列入劳工保险开支。

忆起往事,周敏华非常平静。“为什么要将这个东方医疗手段冲破层层障碍,通过繁琐的立法程序,融入美国的医疗体系,就是为了求个公平,让针灸师与西医、牙医有平等的医师地位。”

眼下,周敏华更热心家乡的医疗事业,近20年来,她几乎每年都与家人一起回广州小住,并举行义诊。她和丈夫曹棣华捐助建成广州白云区中医院的CT大楼,并捐献了价值超过500万港元的CT机及其它医疗器械。

她说,此番前来广州是为委托当地杂志社编纂《周敏华自传》一书,该书预计于今年6月与读者见面。

记者注意到,年过八旬的周敏华依然充满活力,一头时髦的短卷发,格子连衣裙、白色小外套,举手投足优雅大方。

周敏华说,自己最喜欢的是文艺、体育和旅行,年轻时喜欢溜冰和游泳,后来又迷上打高尔夫球,“这也许是我保持活力的一个秘诀”。(完)

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美國中醫專業正名勢在必行

二零一三年三月十七日

1984年,舊金山市舉行美國第一批中醫博士畢業典禮。(陳大仁提供)
【大紀元2013年05月03日訊】古老的中國醫術早在一百多年以前已經隨著華裔勞工來美而帶到美國來,少數老中醫也一直默默地在華人社會中行醫,不過這些中國醫術從未被主流醫學界所重視或接受。七十年代初,首先是針灸術,後來接著是中醫各科陸續在美洲大陸的公開傳播,這個過程實際上只有近四十年的歷史。一九七一年七月,美國知名記者、《紐約時報》華盛頓分社社長羅斯頓先生應中國周恩來總理的邀請到北京參觀訪問,期間因患急性闌尾炎入住北京協和醫院急診手術,並因術後反應接受過針灸治療。羅斯頓用他在北京的親身經歷,對中國針灸術的神奇療效向美國公眾發了一個十分生動而有說服力的報導。可以說,這是現代西方主流傳媒對東方傳統醫學所作的第一次正式的報導。羅斯頓一九七一年七月二十六日在《紐約時報》頭版發表的這篇特別通訊,立即在美國,隨即也在西方世界,掀起了一股強烈的「針炙熱」,古老的中國針灸醫術開始受到美國公眾的熱烈歡迎,許許多多美國病家爭相到中國城那些簡樸的中醫診所來體驗針灸的神奇,它標誌著美國近代中醫歷史的正式開始……

早期中醫在美國面臨的挑戰

但是中醫在美國畢竟是一種外來文化,必然受到西方傳統勢力的抗衡和壓制。事實上當時在加州行醫的一些老中醫不時會受到某些政客、警察,乃至個別西醫的騷擾、威脅、誹謗。一些前輩甚至以「無牌行醫」的罪名被拘押起訴。因為根據加州當時的法律規定﹕只有執照西醫師才能從事針灸操作(用器具穿刺人體),而任何非西醫人士進行針灸均屬違法。為使非西醫的中醫師可以合法進行針灸治療,必需修改法律。因此,中醫事業的開拓者們首先要解決的就是合法行醫的權利問題。

「竹林七賢」發動艱辛的針灸合法化運動

七十年代初,三藩市地區的中醫前輩們為了保障自己的行醫權利,更好服務美國公眾,開始逐步組織起來,發動了艱辛的針灸職業合法化運動。一九七二至一九七三年間,當時比較活躍的幾位中醫師,如卞伯歧醫師、李衛來醫師、李奈祖醫師、李愈之醫師、黃天池醫師、周敏華醫師和余庚南醫師等開始常常聚會,商議發起籌組一個中醫專業團體,進而有組織地推動立法運動。

他們於一九七四年正式成立了「加州中醫藥針灸學會」,這是加州第一個以華裔中醫師為主體的爭取職業合法化的組織。他們通過病家朋友的協助,主動和政界人士接觸,終於成功委託當時的加州參議員馬斯可尼先生和韓裔宋參議員等在參議院提出由中醫界自己參與策劃的針灸立法SB86法案,並於一九七五年取得成功。這七位前輩後來被大家譽為「竹林七賢」,深受同業們敬重。

「針灸職業合法化提案」

馬斯可尼(MOSCONI)參議員的母親患有坐骨神經痛症,被卞伯歧醫師治癒,使這位政治家決心支持中醫立法。他在一九七三年提出了SB2117法案(允許非西醫的針灸師在西醫的診斷和介紹的條件下從事針灸治療工作。)和SB2118法案(規定在加州醫務處中設立一個新的行政機構,稱為「針灸顧問委員會」,專司檢核註冊針灸師的考試和管理。)經過中醫界和針灸病家們的努力遊說,這兩個法案在一九七四年初先後通過參、眾兩院,但是最後被當年的雷根州長予以否決,宣告失敗。

新法案雖然沒有成功,但期間激烈的議會辯論和繁重的政客遊說,使大家認識到組織起來的必要性,許多早期在加州地區行醫的前輩們紛紛加入「加州中醫藥針灸學會」的隊伍,進一步擴大了推動中醫立法運動的聲勢。中醫界人士當時在三藩市著名大律師格羅司門先生、灣區工會領袖莫利思列斯先生和吉姆瓊斯先生、病家海倫美爾女士、沙加緬度著名僑領鄧世發先生等十分知名的社會人士的公開協助下,積極團結病家、聯絡媒體、爭取政要,要求針灸行醫的合法地位。


1980年,布朗州長簽署AB3040法案,執照針灸師開始合法從事傳統中醫師業務。(陳大仁提供)

一九七五年州長布朗先生簽署歷史性法案一九七四年十二月六日,中醫界成功委託馬斯哥尼參議員再次在參議院提出針灸法案。參議員將一九七三年的SB2117和SB2118兩案的內容合併為『針灸職業合法化提案』SB86,規定中醫師在一定條件下合法從事針灸治療。該案在一九七五年一月開始辯論,經過長達近半年時間的曲折歷程,直到六月二十七日才成功地通過了上下議院的全部審議過程,並於六月三十日上午十時送交州長辦公室。七月十二日,當時剛剛上任不久的民主黨藉州長布朗先生終於將這條歷史性法案簽署成為法律,並立即生效,開創了中醫在加州合法行醫的新紀元。


1975年,布朗競選州長獲勝,隨即簽署針灸合法化法案,開創公開傳播中醫新紀元。(陳大仁提供)

針灸能代替中醫嗎?

但是當時有關新立法的所有法律文件一律都用「針灸」(ACUPUNCTURE)一詞來表述中醫,這給今天的專業定位在社會上造成相當大的混淆,也在專業內、外遺留爭議。不過今天我們從歷史的觀點理解,當年這種有意識的「誤導」實際上體現了中醫前輩和立法顧問們的政治智慧。

其實,在草擬新立法文本時,多數業者,特別是卞伯岐、李衛來和周敏華等醫師都曾堅持要用「中醫」一詞立法,並向律師格羅司門先生解釋其深遠影響。不過律師經過慎重考慮,鑒於社會上存在著不同族裔的行醫者,建議用「針灸」一詞替代「中醫」,便於被當時各族醫師們所接受。這是一個很有策略性的決策,它不僅大有助於化解「無牌行醫」的訴訟,也順利消除了不同族裔之間的嚴重分歧,既引導我們打贏了官司,也帶領我們爭取職業立法取得成功。用「針灸」一詞替代「中醫」當時有一個重要的原因,那就是要迴避當時韓國人要稱韓醫,日本人要稱漢醫的嚴重紛爭。針灸一詞不帶種族標籤,各族醫師都可以接受,因而彼此合作,有力地推動當時的針灸合法化運動。

但是正如格羅司門(GROSSMAN)大律師於一九七六年在《少年中國報》上公開發表的歷史性文獻〈中醫師在加州的搏鬥〉一文中指出:「針灸職業合法化提案」「還不是絕對的完美」,在當時的歷史條件下,它僅僅為中醫事業在加州的發展打開了門戶。由於必須接受一些必要的妥協,不合理的限制還有待我們逐步加以克服。經過全體中醫師和各族裔中醫針灸組織數十年的共同努力,今天我們已經完全改變了加州中醫事業的面貌。

從中醫立法的發展歷史可以清楚看到名義上的「針灸師」是如何逐步演變成為事實上的「中醫師」的過程:

一九七九年的AB1391取消針灸師診治病人必需先經西醫,牙醫,足醫或整脊醫師診斷或轉診的規定,使針灸師成為獨立的醫務工作者。

一九八〇年的AB3040將針灸執業範圍擴充至包括電針療法,東方式按摩(推拿)及艾灸療法,並授權針灸師開中藥處方。此提案還將針灸顧問委員會升格為針灸考試委員會。

一九八四年的SB2179 提案規定健保組織(HMO)或自身保險或殘障保險計畫以外的醫療保險計畫,包括非營利醫院等集體性的醫療保險計畫都必需具備供選購的針灸福利。

一九八七年的SB840將針灸師在工傷保險系統中列為醫師(PHYSICIAN),有權診治因工受傷的雇員。

特別是一九九九年的SB466 和 2001年的SB341,明文界定並擴大中醫師可以使用的行醫手段。例如:可以使用營養物品、草藥以及膳飲輔助食品等,特別註明中醫師在臨床治療中可以處方使用各種植物、動物及礦物產品。除了過去已經取得合法地位的電針療法、艾灸療法與拔罐療法,以及使用東方式按摩(推拿)、呼吸技術(氣功)、醫療體育(太極拳等)等各治療手段等項外,再增加一項磁療法。


1997年,舊金山市舉行美國第一批中醫骨傷專科醫師畢業典禮。(陳大仁提供)

 從中醫專業教育課程和執照考試制度的發展歷史也可以清楚看到名義上的「針灸師」 是如何逐步演變成為事實上的「中醫師」的過程:

美國的正規中醫教育開始於七十年代初,基礎比較薄弱。加州的中醫教育一直走在全國的最前列,隨著加州中醫專業地位的不斷提高,(例如:成為完全獨立的專科醫療職業,成為第一線醫務工作者,後來在工傷補償系統中被列為醫師等項進步。)社會對中醫師的學術要求也自然逐步提高,而加州的中醫院校多年來也一直在逐步提高教育程度。教學總學時的要求從七十年代的不足2,000學時,到八十年代的2,348學時,乃至九十年代的3,000學時左右。目前許多院校開始提供博士學位課程 (總學時在4,000學時以上),其質素已經達到國際上中醫專業高等教育的同等水平。

同時,加州針灸局核准的所有中醫院校都被要求必須提供中醫師必須修讀的的全套課程,包括:西醫基礎學科的生物化學、人體解剖學、生理學、病理學等,以及中醫基礎學科的中醫基礎理論課、各家學說、中藥學、方劑藥、針灸學、氣功等。臨床學科則必須有內科、外科、骨傷科、婦產科、兒科、皮膚科、眼科、五官科、針灸、推拿、物理治療、運動鍛鍊等。

加州針灸局主持的針灸執照考試,其內容完全按照傳統中醫師資格的要求,包括:中醫理論、診斷、治療,方藥,以及內、外、婦、兒、骨傷和五官等臨床科目,還包括相當一部分的西方生物醫學,甚至醫學法律、臨床法規、倫理等內容。這就是一個中醫全科考試,實際上和中國大陸的中醫高等教育相當的一種資格。

中醫專業至今仍然無法正名的兩大障礙:

正如我們多年來一再強調﹕美國一直沿用的「針灸師」(ACUPUNCTURIST)這一職業名稱具有相當大的誤導成分,因為它在很大程度上不能正確反映當前中醫師服務的實際業務,因而造成社會,尤其是西方社會的許多混淆。隨著中醫立法逐步完善,專業教育逐步提高的同時,我們在專業正名方面的努力也從未放鬆。

就中醫界內部而言,雖然韓裔和日裔中醫師也都認識到「針灸」一詞在加州有明顯的局限性和誤導性。但是出於他們的民族主義的理念,至今無法接受「中醫」一詞。好在我們的華裔前輩具有寬大的胸懷,並沒有用中國的民族主義來與之對抗。他們用智慧的妥協解決了這個矛盾。大家都同意使用「東方醫學」(ORIENTAL MEDICINE)一詞來表達我們的專業,從而維護了團結,共同推動立法和教育的進步。

八十年代開始的中醫博士學位教育使用的就是DOCTOR OF ORIENTAL MEDICINE或 OMD。雖然ORIENTAL一詞多少隱含有對東方民族的歧見,不過三十多年來各族中醫業者,包括白人業者,對此並未曾提出過非議,這一名稱或頭銜也得到官方或中醫教育系統的接受。多數中醫團體和院校,包括華裔和非華裔的組織或機構,現在都還在延用這個名詞,例如:CAOMA, CSOMA, AAAOM, OCOM, PCOM, ECTOM, NCCAOM, ACAOM, CCAOM等等。目前,在主流媒體、在民間、在中醫院校、特別是在華裔中醫團體的英文文件中一般都直接用CHINESE MEDICINE來代替「東方醫學」,或與東方醫學互換使用。不過在有關中醫針灸的法律文件中正式使用CHINESE MEDICINE 或TCM一詞目前尚無法被其他亞洲族裔所接受。這個問題看來還有待通過世界衛生組織水平的國際協商才有機會最終解決。

近年來隨著中醫藥國際化進程日益加快,中醫藥學正在各國迅速發展,目前已傳播到160多個國家和地區,逐漸形成一支數量可觀、涵蓋多個學科、以中醫醫師為主體的中醫藥專業技術人員隊伍。為適應中醫藥國際化的發展趨勢和要求,世界中醫藥學會聯合會參照世界衛生組織的要求,特別制定了《國際中醫醫師專業技術職稱分級標準》,為中醫正名提供了一個權威性的規範。基於中醫起源於中國的世界共識和中國國際地位的日益提高,隨著全世界業界同仁,尤其是美國華裔中醫師們的不懈推動,中醫正名的目標應該在不久的將來可以得到解決。

其實,中醫正名還有一個更大的關卡,那就是來自西醫公會的阻力,因為他們基本上壟斷了「MEDICINE」一詞,不准其他醫療專業使用。2002年,加州中醫界曾委託趙美心議員提出的AB1943,只不過規定加州官方有關中醫針灸事務的法律文件一律統稱之為「針灸與東方醫學」ACUPUNCTURE AND ORITENTAL MEDICINE,以反映中醫界的實際現狀,卻立即遭到西醫公會的強力反對。此項要求甚至無法通過衛生委員會的初步審議而被刪除。隨後,於2006年中醫界又委託眾議院教育委員會哈福議員提出「成立亞洲醫學局法案」 AB2821,簡單地要求將目前的『針灸局』改稱「亞洲醫學局」BOARD OF ASIAN MEDICINE。然而西醫公會還是堅持不讓中醫界使用「醫學」一詞,提案很快就被封殺。顯然,一個只有碩士水平的專業要爭取「醫學」的名銜,阻力必然是很大的。

中醫正名的工作任重道遠,還要我們繼續團結奮鬥:

經過業界全體同仁近四十年的辛勤耕耘和各族裔中醫針灸組織的共同奮鬥,加州執照針灸師已經升格成為「第一線醫務工作者」(PRIMARY HEALTH CARE PROFESSIONAL),甚至在工傷系統中正式列為「醫師」(PHYSICIAN),可以獨立診治內、外、婦、兒、骨傷各科病患。毫無疑問,我們已經是事實上的中醫師。今天加州的中醫事業已經建立起一套比較完善和相當嚴謹的規章條例、教育體制和考試制度;還得到其他醫療職業者,如西醫、整脊醫、心理醫師等的初步肯定;也在廣大消費者中培育起一定的專業信譽。加州中醫正在逐步納入主流醫療體系。這個成果來之不易,應當十分珍惜。為了保證加州中醫事業可持續地健康發展,我們認為極有必要堅定地保持尚未正名的「加州針灸局」的高度專業性。

中醫藥在美國是外來文化,這個專業的力量現在還相當弱小。因此,中醫界不容分裂,我們必須團結一致。同時,中醫學是一門完整的浩瀚系 統,中醫學不容分割。中醫業者要納入主流社會,還必須尊重西方文化,效法西方教育體制和醫療體制的傳統:先修取博士學位,再考取行醫 執照,然後進一步提高成為專科證書醫師。中醫界在當前的立法問題上,在各族裔 中醫業者和中醫團體還有很大的意見分歧的情況下,我們認為應該繼續協商和溝通,沒有達成共識之前似乎不宜匆忙地強行立法。中醫入 主流,教育是關鍵。我們的當務之急是趁布朗擔任州長的寶貴時機, 加緊再次策劃一個中醫專業教育法案,修改入門標準,規定所有中醫從業人員必須修取博士學位後方可參加執照考試,實 現中醫教育與美國其他醫療專業的教育體制相匹配。如此方有利於中醫正名的推動,而全體中醫師的基本權益也才能得到較為可靠的保障。

(責任編輯:鄒宸)

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Original article at http://www.jcimjournal.com/jim/FullText2.aspx?articleID=jintegrmed2013041
Journal of Integrative Medicine: Volume 11, 2013   Issue 4
Dialogue with Dr. Lixing Lao: from a factory electrician to an international scholar of Chinese medicine
Arthur Yin Fan (McLean Center for Complementary and Alternative Medicine, PLC Vienna, VA 22182, USA )

DOI: 10.3736/jintegrmed2013041

Fan AY. Dialogue with Dr. Lixing Lao: from a factory electrician to an international scholar of Chinese medicine. J Integr Med. 2013; 11(4): 278-284.

Received May 12, 2013; accepted June 6, 2013.

Open-access article copyright ? 2013 Arthur Yin Fan.

Correspondence: Arthur Yin Fan, PhD, MD, LAc; Tel: +1-703-499-4428; Fax: +1-703-547-8197; E-mail: ArthurFan@ChineseMedicineDoctor.US

Dr. Lixing Lao, an internationally known scholar of Chinese medicine renowned for his clinical and mechanisms research, is the Director of the Traditional Chinese Medicine (TCM) Program at the Center for Integrative Medicine, University of Maryland (UM) School of Medicine; the Co-Chair of the Acupuncture Research Society; and the former Editor-in-Chief of the American Acupuncturist, the official journal of the American Association of Acupuncture and Oriental Medicine. The Baltimore Magazine has listed Dr. Lao as one of the nation’s top acupuncture practitioners (Figure 1).
Dr. Lao has played a pivotal role in the advancement of TCM in the United States. As the first full professor of acupuncture and TCM appointed to a conventional medical school in the United States, he was invited to be a key speaker at both the 1994 United States Food and Drug Administration (FDA) hearing on acupuncture[1,2] and the 1997 National Institutes of Health (NIH) consensus conference on acupuncture[2]. As a result of the hearing, the FDA reclassified acupuncture needles as a medical device, no longer an investigational device. The NIH conference led to preliminary confirmation of the safety and efficacy of acupuncture. These two conferences were milestones that opened the way to wider clinical use of acupuncture.
Besides research and clinical practice, Dr. Lao has been involved in TCM education for over 20 years. On October 20, 2012, the author, Arthur Yin Fan, interviewed him in the President’s Office of the Virginia University of Oriental Medicine in Annandale, Virginia, USA.
Fan: Dr. Lao, it is nice to see you again. What have you been doing recently?
Lao: As a professor in UM’s Center of Integrative Medicine, I’ve mainly been doing research, and conducting clinical trials and experiments on the safety and efficacy of acupuncture and herbs. As an academic, I’m also involved in teaching.
Fan: I heard you’ve attended some conferences recently.
Lao: Yes, I have participated in quite a number of conferences, domestically and internationally. In November, I will go to Beijing, China, for the anniversary celebration of the Beijing University of Chinese Medicine, which will be combined with an international acupuncture conference. I’ll be one of the main speakers.
Fan: You have been involved in TCM for over thirty years. Now you are an international, leading scholar in this field. What led you to this profession?
Lao: It’s a long story. During the Chinese Cultural Revolution in the late 1960s, formal education stopped. All students became involved in what was called “Stopping Class to Conduct the Revolution” [停课闹革命; Dr. Fan notes: This was similar to school strikes and student occupations in the West, from December 1966 to October 1967]. At that time, “barefoot doctors”— practitioners using acupuncture, herbal medicine, and basic medical procedures like first aid — began to treat the poor rural farmers [Fan notes: more than 90% of the Chinese population lived in impoverished rural areas and lacked basic health care before the barefoot doctors movement]. Such a career was attractive to many young people, including me. There was no strict regulation of acupuncture during the Chinese Cultural Revolution (Fan notes: because the traditional or “old” regulations were dismantled by Chairman Mao Zedong, who was a supporter of barefoot doctors). Many young adults learned TCM in various ways and became barefoot doctors during that period. There was no formal schooling during the Cultural Revolution, and I long to learn something real and useful. I became interested in acupuncture because I had heard many moving stories about the barefoot doctors, which triggered my interest in medicine and health care.
Another reason for me to learn acupuncture or TCM was because of an incident in 1970 during the so-called “Returning to School to Make Revolution (复课闹革命, Fan notes: after October, 1967)”. It was what would have been my last year of high school; students were assigned to factories for half a year and rural areas for the other half to get “real knowledge.” First I was sent to learn farming on Chongming Island, a county of Shanghai City, in the middle of the Yangzi River. One night I began experiencing severe acute abdominal pain, which was later diagnosed as an intestinal obstruction. It was the middle of the night. With great difficulty and the help of my classmates, I walked for miles to see a doctor, Madam Lin, a very nice, extremely proficient old lady who was the doctor assigned to provide medical care for the students from my high school on the island. At that time there was no highway to Shanghai, and the Shanghai ferry ran only during the day. So there was no choice — I could not go to Shanghai despite the emergency. Acupuncture was the only treatment available. It was really magical: Dr. Lin needled me in two places. The pain quickly disappeared and then I slept. I woke up the next morning with no pain. After asking me several questions, Dr. Lin felt there was no need to send me to the hospital in Shanghai and let me go back with the other students. That experience affected me greatly.
Later, during a down period when there was not much to do on the farm, Dr. Lin arranged a class for students. She taught us basic medical knowledge, including the prevention of illness and some basic treatments. I wanted to see how she treated patients and handled difficult cases, so I carried her medical kit when she made home visits. In effect, I was her apprentice, although it was not a formal apprenticeship.
The second half of that year was spent in a factory in the city of Shanghai. There was an elective project —learning medical knowledge. As high school students we had a chance to participate in a three-month training program for suburban barefoot doctors at a district hospital, but only two students per class could be enrolled. I was the class president and had a strong interest in medicine, so I got the chance to attend, and I learned a lot. At that time we were 16 or 17 years old and eager to learn. The school no longer taught normal classes, and the students wanted something to fill their empty brains. The program started with two weeks of classroom teaching; teachers (they were medical doctors) with different specialties taught acupuncture and Western medicine as well as topics such as rescue methods to be used after atomic bomb explosions, how to hold a scalpel when performing an operation, how to interpret an electrocardiogram, and so forth. I remember that when the doctor taught acupuncture, he taught us 30 acupoints a day, including point location, main effects, and insertion techniques for each point. The next day, we would have to stand up to answer questions. We two high school students were always very participatory and liked to answer the questions, while the barefoot doctor candidates, mostly young suburban mothers, were afraid to answer. They were so busy with field and house work after class and they had little time to go over the lessons. That class gave me great pleasure.
After the classroom learning, we interned in each department, starting with the pharmacy. Under supervision, we prepared Western drugs and patent herbs according to the prescriptions that patients brought in. After three days, we were familiar with the names of many drugs and patent herbs and their actions. Then we went to the department of internal medicine. The first few days we copied the doctor’s prescriptions and observed the physical examinations. After that, we could see patients and prescribe medicine under the doctor’s supervision. I started seeing patients on the second day because my supervising doctor considered me ready to practice. We were in a district hospital, patients often came from local factories and the illnesses and disorders were simple. Mostly, I took a patient’s blood pressure, asked some questions, and then refilled a previous prescription; or something like low back pain and patients just wanted pain killers or an excuse for sick leave; rather simple stuff; that was it. My classmate and I sat at two office tables all morning and counted up our patients, competing as to who had seen the most — that was fun and got me interested in medicine.
After that department, we interned in injection room and then in the acupuncture and moxibustion department. There was a doctor, half blind, a graduate of the Tuina (Chinese therapeutic massage) Program from the Shanghai College of TCM. Maybe because of his poor vision, his memory was very strong; he could recall all the acupuncture points and tuina manipulations. At that time, he was single and lived in the hospital dorm near my home. So every night I went to his dorm and learned from him. He talked about the acupuncture and tuina he had learned in college, and I took notes. I became very interested in acupuncture at that time, and it was something like a real apprenticeship. We became good friends.
In 1971, the “old-three grades (老三届) settling in the countryside and mountains” movement (上山下乡; launched by the government) stopped, and middle and high school students and graduates again had a chance to stay in the city. One reason I’d learned acupuncture and moxibustion was to give me a way to take care of myself if I had to live in the countryside. I wanted to be prepared to serve rural patients and my fellow schoolmates who might be resettled there. But when I graduated from high school, I was assigned to the Shanghai Xingzhong Power Machinery Factory (新中动力机器厂) as a factory worker. After training in several jobs, I became an electrician, maintaining the normal operation of the electronic devices there. If there were problems with a device, I would have to work very hard to fix it as quickly as possible in order to avoid a delay of production; otherwise, I’d wait in the office without much to do.
My Shifu (teacher and supervisor) graduated from Shanghai Jiao Tong University. He preferred being an electrician to being a technician, and he taught me a lot. He was a nice man, and to this day we remain friends. My Shifu not only taught me practical skill of repairing electronic devices but also taught me theory of electricity, so I learned faster because I understood the mechanisms. One night, he invited me and his good friend and former classmate, to dinner at his home. His friend arrived with acute low back pain, which began during his bus trip over to dinner. He said to me, “I heard you know acupuncture. Please give me a treatment; I am very hurt.” At that time, I carried acupuncture needles around with me in a pen-like tube. There were no regulations for doing acupuncture at that time, so I gave him a treatment and after removing the needles asked him to move his back as much as possible. To his surprise, his pain was gone; the back muscle spasms disappeared immediately after the treatment. The result pleased him and my Shifu, so by word of mouth, many people found out that I was good at acupuncture.
A few days later, a very old employee in the finance department of the factory came to see me. He had bad intercostal neuralgia. He said he had had three onsets: the first had been cured by a famous TCM doctor, Shi Xiaoshan (石筱山); the second was cured by another famous doctor — I forget the name. Now it was the third onset; he said he’d already seen many doctors and tried many medications, both Chinese and Western, and nothing helped. So he used a lot of pain-killers that only masked the pain for two to three hours, and also upset his stomach. He wanted me to give him acupuncture. I told him I had not treated anyone with such a condition but I would try. His pain was active, so I treated him. He got immediate results and was very pleased. After that, I became very busy — before, people called me only for something electrical, and now people began to call me for their health issues too, especially low back pain and sciatic pain. I had to keep two sets of equipment — my electrician’s tools plus the acupuncture needles and some alcohol swabs for disinfection. I enjoyed helping people for their illness and treated them for free, as a colleague.
Fan: How old were you at that time and when you started your college study?
Lao: I started at that factory when I was 17, and stayed about 7 years. The college entrance examination (CEE) started up again in 1977 after the Culture Revolution stopped in 1976. So I was 24 when I entered college in the fall of 1978. During the Cultural Revolution, I had had formal education only up to actual fifth grade level (although I was a high school graduate) because the classes were disbanded to “make revolution.” I did not think I had enough knowledge to pass the CEE, but my high school math teacher encouraged me to try. I then borrowed middle and high school textbooks and started self-study with some help from my math teacher and my Shifu. I was lucky enough to pass the exam in July 1978 after about 5 months of extensive study.
Fan: How was your experience in college?
Lao: I was accepted and admitted to the Shanghai College of TCM and assigned to the acupuncture major. I initially thought I already knew enough acupuncture and wanted to the major in Chinese herbal medicine. But soon after I started the course work, I found I actually knew very little about acupuncture. The clinical experience I had earlier helped me to better understand TCM and acupuncture theory as well as other courses, including Western medicine. I studied hard and enjoyed the five-year learning opportunity and did not want to waste time that had been lost during the Cultural Revolution. I was elected president of our class and vice president of the Student Union of the college.
Fan: Very impressive experience. Then you enrolled in the University of Maryland for PhD study in physiology and also got your acupuncture license in the State of Maryland?
Lao: After graduating in 1983, I was appointed to the Acupuncture Department of my college as a teacher and researcher. Then China encouraged young people to go abroad for study, which was one of the important policies of the reform. I applied to the Physiology Department of the Dental School at UM because it has a pain research group as I was interested in the mechanisms of acupuncture for pain relief. At that time, the National Certification Commission of Acupuncture and Oriental Medicine (NCCAOM) initiated an acupuncture certificate examination oriented mostly toward TCM. Because of my teaching background, I was invited to review point locations for a group of a local acupuncture school students who were preparing for that examination. Local acupuncturists also told me I was eligible to apply for an acupuncture license in the State of Maryland. So in 1988 I became licensed as No. 300, the 200th licensed acupuncturist in Maryland (the license number starts at No. 101). Later I also passed the exams and obtained NCCAOM certification of acupuncture and Chinese herbal medicine.
Fan: At that time, acupuncturists worked under the supervision of an MD. How did you start your clinic?
Lao: I had to work under an MD’s supervision. A local acupuncturist referred me to Dr. Sores, a very nice Filipino-American doctor. She told me that she had just visited China with a group of American physicians and was deeply impressed by the acupuncture anesthesia she’d observed. One MD could supervise three acupuncturists at that time; I became her second one. Dr. Sores was so kind to let me use her clinic, which was near the Johns Hopkins University, when there were rooms available. She waived the rent for the first several months; even later, she charged a fairly low rent. I studied for my Ph.D. during the day and worked in the clinic from 6:00 to 9:00 pm two or three days a week until graduation.
Fan: How did you get your academic appointment at the University of Maryland School of Medicine?
Lao: A year before my graduation, I had a period of deep confusion. If I took a postdoc position in a laboratory for physiological research, I’d have to move (to other states) and leave my flourishing acupuncture practice; if I stayed in my Maryland practice, I’d have to leave my academic career. I’d studied acupuncture for five years and spent five more on my PhD in physiology. Giving up either would be a pity. By luck, in 1991 I saw an announcement in the school magazine and the Baltimore Sun saying that an MD, Brian Berman, had been awarded a million dollars to set up a complementary medicine program to study the safety and efficacy of acupuncture, Chinese and other traditional medicine, and alternative medicine in the Department of Anesthesia, UM School of Medicine. After I talked to him about possibility to work with him, he offered me a research assistant professor position and wanted me to start work at once. I still hadn’t completed my dissertation and actually couldn’t. But we became friends. In one occasion, I successfully treated his two-year-old daughter with tuina and became his family acupuncturist. On June 15, 1992, the day after my dissertation defense, I started work as an assistant professor in his program.
It was the right time, right place, and right people. In 1992, the NIH established the Office of Alternative Medicine (OAM). Dr. Berman was on their advisory board and took me to many meetings. In 1993, the OAM formally started to award fairly small, $30 000 research grants to about thirty awardees. We applied and were awarded two grants in 1994. I was the principal investigator (PI) of one project named “Acupuncture and Postoperative Oral Surgery Pain”; Dr. Berman was the PI and I was the co-investigator of the second program “Acupuncture Safety/efficacy in Knee Osteoarthritis”. After this seed funding, we got bigger grants, NIH Research Project Grants, also known as R01 grants, to continue both these projects. The clinical trial of acupuncture on knee osteoarthritis (OA) had a great impact. This large sample (N=570) trial found that acupuncture was significantly more beneficial for patients with knee OA than those in sham control[3]. We continued such work on arthritic pain and now are involved in other modalities such as Chinese herbal medicine, laser acupuncture, and moxibustion.
In 1998, we got a Center Grant known as P50 from the National Center for Complementary and Alternative Medicine (NCCAM, former OAM), which consists of funding for three projects focused on a research question; I served as the Project Leader on mechanisms of acupuncture in inflammatory pain and established our first laboratory for the basic science research on acupuncture and TCM. Since the establishment of the lab, we have published many basic science studies on acupuncture and herbology. You were there three years, Arthur. Thank you for your great contribution to our lab’s research on the mechanisms of Chinese herbal medicine. Because of our significant achievements from earlier, we’ve gotten several big grants (known as P50, P01 and U19) over the last ten years and also many smaller ones.
Fan: Your clinical trials, especially on acupuncture for knee OA[3] and on nausea and vomiting caused by chemotherapy, made great contributions toward persuading commercial healthcare insurance companies to cover the use of acupuncture for such illnesses. Since then, more and more insurance companies have begun to pay for acupuncture treatments.
Lao: You’re right. I feel we have done the right thing — choosing to study illnesses commonly seen in clinic and publishing our results in major medical journals. Positive results give practitioners great support.
Some acupuncturists and research colleagues didn’t understand why we chose to study arthritis. They told us, “We use acupuncture to treat arthritis every day. It’s been done for thousands of years, especially in China, and with good results. Unquestionably, acupuncture can treat arthritis. Why waste time doing a clinical trial on that?” The fact is, although there is a consensus among acupuncturists and Oriental medicine professionals and some patients, many Western-trained doctors and their patients have no understanding of the safety and efficacy of acupuncture. We need to demonstrate the effect and safety of acupuncture in treating common illnesses for which medications aren’t too effective. In America there is a high incidence of arthritis, which doesn’t respond well to conventional medication. Most arthritis, especially knee OA, is chronic. Pain medications are only briefly effective, and must be used long term, which lead to serious adverse effects. And the safety and effectiveness of acupuncture on OA is easy to evaluate. In an illness such as diabetes, which has many complications, treatment results may be hard to measure.
Our strategy was to study the condition most suitable to acupuncture treatment first. Positive results would help the mainstream medical profession to start accepting acupuncture, and then we can tackle more difficult diseases. If we had chosen a difficult one first and not gotten a positive result, people might believe that acupuncture is simply ineffective, not that we got a poor result because we didn’t choose a suitable subject. So we picked something less complex first. Also, we wanted to pick a common disease, and there are many OA patients.
I researched textbooks, clinical trials, and case reports to decide which acupoints and acupuncture strategies we should use, and then tested these in a small group of patients to ensure they’d be effective in clinical conditions. Additionally, as you know, success depends on the “right time, right place, and right people”. There was a strong need to show whether acupuncture is safe and effective, and we had a good team. Besides Dr. Berman, me, and our TCM research personnel, we invited Dr. Marc C. Hochberg, a doctor in our school of medicine at UM and an internationally known knee expert, to provide a set of evaluation and assessment methods for knee OA. His support was essential to the project’s success.
Acupuncture and Chinese medicine professionals might also feel that a study on acupuncture for dental extractions[4] is unnecessary since doctors and researchers in China have done acupuncture anesthesia studies showing that acupuncture is an effective anesthetic in major operations. Dental pain is a very small topic. But when I designed the dental project, I wanted to refute the preconceptions of the conventional medicine practitioners and some others who believe that acupuncture is a placebo, i.e., that its apparent effectiveness is only a result of psychological expectation.
In designing that study, I found that there were advantages to doing acupuncture immediately after an extraction. The novel control was established; patients couldn’t easily differentiate between real, needle insertion, and sham, no insertion, acupuncture — right after extraction, the local anesthesia hadn’t worn off and patients were blindfolded, so when acupuncture was performed on Jiache (ST6), Xiaguan (ST7), Yifeng (SJ17) and Hegu (LI4), the patient didn’t see or feel the procedure. Establishing an effective control is a difficult thing in acupuncture studies; sham acupuncture isn’t like a pill that can be the same shape and size as a drug being tested. Although we could have used shallow needle insertion at the real point, these can induce physiological reactions. The best control is non-insertion. Patients might be able to distinguish between insertion and no insertion, but it was not in this project when our subjects were still under local anesthetic.
I modified the model a little for our clinical trial. In the original model, the researchers administered medication about an hour after tooth extraction, when moderate pain starts. I decided to use acupuncture as prevention, with pain-free time being the main indicator, and pain level as the secondary indicator. Before the trial, I did a preliminary study using several patients undergoing tooth extraction. Most actually had no pain after the acupuncture and didn’t need pain medication. My second modification was patient blinding — patients were literally blindfolded during the acupuncture. The test period was only 6 h, very short. A long period might cause a patient to realize if he had received real acupuncture.
The reason I chose postoperative dental pain was because I graduated from the dental school’s PhD program and knew the dental doctors there. I contacted Dr. Bergman, who is an oral surgeon who is interested in acupuncture. We did a few patients to obtain preliminary study data and observed that acupuncture was very good for dental pain after tooth extraction. Then we started a formal collaboration and applied for a research grant from the NIH. Our study showed acupuncture to be much better than sham — or placebo — acupuncture. That study might not have much clinical significance, but it is scientifically significant. It addresses a few questions, such as whether acupuncture is a placebo.
Fan: Those clinical trials that show acupuncture to be no better than placebo — there have been many, such as that of the trial published by a Seattle Group[5]; the results were all similar — I consider the problem to be one of design. First of all, is so-called sham acupuncture really sham? And are its results really placebo effects? Needle insertion effects are not like effects of oral or i.v. medication. Applying a medication model and trial design in an acupuncture study might not produce good research. Also, acupuncture’s time-point effectiveness varies; some effects show up immediately; others require a 10- or 16-session course or six months. Giving 10 sessions of so-called sham and expecting patients not to know if she/he is getting real acupuncture is difficult if not impossible. As you say, if you expect to blind patients but use strong “sham” stimulation, that could induce physiological reactions and amount to actual acupuncture. Also, if the statistical design is wrong, differences won’t show up; this can happen especially if a sample is too small.
Lao: True. I’ll give you an example with a sound methodology, because study methodology is improving so we can have more confidence in the results. A group of researchers in New York led by Vickers did a well-known literature review published in the Archives of Internal Medicine in 2012[6]. Archives of Internal Medicine is one of the archives of the Journal of American Medical Association (JAMA), which is a very prominent journal, and this review was widely reported by the media. Vickers got NIH funding five years ago. He asked researchers who published papers on large acupuncture clinical trials to give him the raw data from their studies. Using those data, Vickers’ team repeated the original statistical analyses to see if they could get the results that were originally published. Twenty-nine high quality acupuncture trials were analyzed, which involved four types of chronic pain lasting more than four weeks: knee OA inflammatory pain; musculoskeletal pain — low back and neck pain; headache — migraine and tension; and shoulder pain. The 29 studies used yielded a total of 18 000 chronic patients divided into at least three groups: acupuncture, sham acupuncture, and routine conventional medicine. The results showed that acupuncture performed much better than the routine conventional treatments and better than sham. The most interesting thing from this paper was that Vickers predicted that if this study were repeated after a few years, the chance of overturning these conclusions would be very low or almost impossible because, statistically, it would take 47 trials of more than 100 patients each, with an effective size of 0.25 in favor of sham controls, to obtain negative results. This study is convincing because it accounted for all possibilities.
Fan: We are both clinical practitioners. So you might agree with my feeling — that the so-called sham acupuncture used in so many clinical trials[5,6]actually is a variation on real acupuncture. Each school of acupuncture has a different style; some use gentle or shallow stimulation in which the patient might not feel the needling sensation at all; some use extra-meridian acupoints. I myself, in different patients and even in the same patient according to different circumstances, conditions, or body parts, might use different stimulation strategies. So it seems to me that gentle or shallow insertion, non-insertion, or extra-meridian insertion isn’t necessarily sham acupuncture. If using a toothpick to mimic acupuncture is sham, then how do we explain the action of the Bian Shi (stone needle), an alternative to the filiform needle? I feel that if metal needles or toothpicks induce a physiological reaction, that’s real acupuncture. In a drug trial the researcher can use an inert pill.
Lao: You are correct. These factors make it more difficult to design an adequate acupuncture sham control. Since the mechanism of acupuncture effectiveness itself is not clear, one can’t design a control that has no such mechanism (like an inert placebo pill). For a conventional medication, its mechanism is relatively clear, such as it works on certain receptors or certain pathways, so it is easy to design a control that does not have that function on these targeted receptors and pathways.
Fan: Why do we still use sham acupuncture in clinical trials?
Lao: The concept of sham control is not bad. The problem is we just don’t know what would be an appropriate “sham”. Some people in the mainstream medical field who have the “speaking rights,” insist on adding so-called sham controls. Although this is not good practice, we have no choice. We have to conform to the status quo. However, in recent years, patient-centered, comparative effectiveness research that more accurately reflects daily acupuncture practice, not using a sham control, has been drawing the attention of many researchers. I believe that type of research will be the next step of acupuncture research – to determine which conditions are most suitable for acupuncture treatment, as compared to conventional treatment.
Fan: What are your comments on the acupuncture research going on in China?
Lao: TCM’s birthplace is China, although none of the papers we’ve discussed were published by scholars in China. I hope that one day soon scholars there will be performing high-quality research. This is why I am so eager to help young scholars in China with study design. As the Chinese economy improves, the Chinese people should take more responsibility for TCM research and produce studies that can’t be dismissed because of poor quality. I want to foster the development of acupuncture and TCM because they really do help patients, are easy to use, and are cost effective. I would like to see researchers in China to conduct more serious and vigorous high-quality studies.
Fan: I admire you. You have been an acupuncture and Chinese herbal medicine researcher for over 20 years and are regarded internationally as a spokesman of TCM research. You’ve met so many difficulties and still have remained mentally strong. What gives you the strength to do so well?
Lao: I am very confident about the development of acupuncture as well as TCM as a whole. Success is based on small daily accumulations. The current situation of acupuncture and herbology is much better than it was a few years ago. Although our profession still has some problems, we should stay optimistic. I believe the proverb: real gold doesn’t fear the fire that smelts it.
Fan: I hope you continue to make contributions, in acupuncture research, in education, and in legislative and political activities.
Lao: Thanks for your interview.
Fan notes: Between June, 1992 (one year after the Center was established) and the present, the center where Dr. Lao works has received more than?35?million dollars in funding from the NIH and other different sources, for carrying out research on acupuncture and Chinese medicine. As a principal investigator or co-investigator, Dr. Lao has been on 28 grants or research projects. Dr. Lao so far has published 142 peer-reviewed papers, 26 non-peer reviewed, invited papers, and 10 book chapters. He is a co-editor of a new acupuncture and moxibustion textbook that will be published by the end of this year. He was the chair of the 2007 Society for Acupuncture annual meeting – “The Status and Future of Acupuncture Research: 10 Years Post-NIH Consensus Conference”, and also chaired the 2010 WFAS (World Federation of Acupuncture and Moxibustion Societies) annual conference in San Francisco, CA.
AcknowledgementsThe author would like to thank Ms. Lyn Lowry for English editing. The interviewer was Dr. Arthur Yin Fan.
Competing interestsDr. Arthur Fan worked in Dr. Lixing Lao’s laboratory and participated in acupuncture and Chinese herbal mechanism studies from 2002 to 2005 as an NIH Fellow in Chinese medicine. The author declares that he has no competing interests.

Figures and Tables in this article: 



Figure 1  Dr Lixing Lao at Virginia University of Oriental Medicine This picture was taken by Byung Kim.

References

1. Fan AY, Fan Z. Dr. Wu: a beautiful, moving and meditative song — in memory of Dr. Jing Nuan Wu, a pioneer of acupuncture and a Chinese medicine doctor in the United States[J] J Chin Integr Med, 2012, 10(8) : 837-840.
2. Fan AY, Fan Z. The beginning of acupuncture in Washington, D.C. and Maryland: an interview with Dr. Yeh-chong Chan[J] J Integr Med, 2013, 11(3) : 220-228.
3. Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AM, Hochberg MC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial[J]. Ann Intern Med, 2004, 141(12) : 901-910.
4. Lao L, Bergman S, Langenberg P, Wong RH, Berman B. Efficacy of Chinese acupuncture on postoperative oral surgery pain[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1995, 79(4) : 423-428.
5. Cherkin DC, Sherman KJ, Avins AL, Erro JH, Ichikawa L, Barlow WE, Delaney K, Hawkes R, Hamilton L, Pressman A, Khalsa PS, Deyo RA. A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain[J]. Arch Intern Med, 2009, 169(9) : 858-866.
6. Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE, Sherman KJ, Witt CM, Linde K; Acupuncture Trialists’ Collaboration. Acupuncture for chronic pain: individual patient data meta-analysis[J]. Arch Intern Med, 2012, 172(19) : 1444-1453.

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中医针灸在美国第一个州的立法经过

作者:祝君平安  于 2013-4-6 12:30 发表于 最热闹的华人社交网络–贝壳村

中国针灸医学近百年来的发展很快,水准也越来越高,主要原因是疗效优良。当今西洋医学面临着2个大问题:一个是药物治疗后引起的毒害性,另一个是手术治疗后引起的后遗症。还有很多疾病,西洋医学只有诊断而没有治法的。

现代的医学家极力寻找不杀伤性的、温和的新治疗方法。进入20世纪70年代,中医针灸终于成为他们的研究对象,在西洋医学最先进的美国第一个州———内华达(简称内州)就率先立法承认中医针灸的医学地位。

1.内州立法前美国中医针灸发展概述

美国立国200多年,直到20世纪70年代,对中医针灸并不重视。但在华人社区中,尤其是在洛杉矶、三藩市、纽约、华盛顿,中医针灸仍是华人治病的主流。美国人民也喜欢游唐人街,其中的中药店、凉茶铺很多。有人还会去尝试接受治疗,因此,小部份美国人对中医针灸并不陌生。

1947年,美国西医师公会在ATLANTIC城召开医学大会,有医生报道中医针灸的疗效,可惜人数太少,未得到重视。1949年,JOHNSHOPKINS大学研究生ILZAVEITH把《内经》译成英文,在序言中赞许中国医学的防病治病理论,这书后来再被译成意大利文,对推广中国医学起了一定的作用。1953年,PRINCETON大学开设了GEST东方图书馆,收藏75000册中医针灸书,为有识之士提供了接触中国医书的门径。

1971,中国向世界公开宣布针刺麻醉成功的消息,打破了西方医学家蒙昧保守的思维模式,开始接触中国医学,从而热烈的学习研究起来,就这样拉开了“中国针灸热”的序幕。次年2月,中美建交,美总统尼克松访华,其随行医师W.TKACH大力表扬中医针灸的优良疗效,就这样再把“中国针灸热”提升到高峰。医学界纷纷组团来向东方取经,当时到香港学习的不下万人,更多的到中国学习,回国后,就是一窝蜂开设诊所及学习班。以华盛顿地区为例,当时有针灸诊所十多所,但不足2年,差不多全部倒闭。其中的主要原因是水准低,常发生医疗事故,西医师公会多方面攻击阻拦,公安常来检控,禁止东方医师无执照行医。

中医针灸发展到这阶段,开始蕴酿出一场“美国医学革命”,它的“起火”地点就是在内华达州,要求中西医分体独立管治。

2.内州立法经过

1973年1月,纽约西医师公会邀请香港名中医针灸师陆易公氏在纽约亚美利加纳宾馆(AMERICANA)大会堂,为1500名西医师演讲针灸学。事后,得知纽约公安因中医针灸师无执照行医,曾加以拘捕处罚。当时陆氏认为此种做法对于美国人民的健康不公平。因为针灸治疗在中国已有数千年历史,人们赖以治愈病痛,延长生命,假如能够立法认可,人民得到治疗机会,则会对人民健康与生命有利无害。闻悉内州于4月间将会修改法律,何不趁此机会,要求立新法律俾中医针灸合法化。但问及亲朋好友,莫不大笑,认为痴人说梦话,因国有国法,家有家规,岂能由一位旅客身份的中国人改变美国国法,似此不可能的事,决没有成功希望,却有坐牢的可能。

虽然当年陆氏已有61岁高龄,但为了人类健康及提高中医针灸的国际地位,决定亲赴内州,争取立法。当时,惟有一位纽约退休老律师亚瑟·史坦勃(ARTHURSTEINBERG)先生大力支持,因其夫妇曾在香港经陆氏以针灸治愈多年病痛,对中医针灸极有好感及信心,愿协助同行,可免陷法律上的错误。抵达内州后,又因人地生疏,无可适从,幸得介绍认识一位初入公关公司服务的年轻人詹姆·乔埃斯(JIMJOYES)先生,从此,3人便联手进行这个极艰巨的任务。

3人为争取本地民众支持,日夜奔走,拜访居民,加以说服,一时竟引起针灸热潮,短时期内,估计已有3万人赞同。有此成绩,随即赶赴立法院申请立法,准予中医针灸合法行医。立法院诸位议员不相信有3万人的支持。于是,3人连夜赶印详细签名单,幸得大众热心,争相签名支持,州长更将其办公室隔壁小间放置签名单,不数日,名单已堆积如小山,当签满15000份名单时,州长认为人数已足够申请要求。

3人为了证明针灸能在无痛苦、无伤害的情形下安全治愈病者,以免费示范的形式,让真实疗效以示大众。立法院以3天为限,特许陆氏临时行医执照,几经磋商,才批准3个星期示范。此期中,对病者是好是坏,相信会有一个肯定的结果。所有病人均由全国各大医院、政府团体介绍随身带详细病历而来,并选取首府卡森(CARSON)城立法院对街新开业的宾馆奥姆斯贝(ORMSBYHOUSE)开诊。每天由晨8时至晚10时,扶杖及坐轮椅的病人,排若长龙。每天针治120名,无一简单易治之症,每多已在医院开刀一、二次至20余次者。电视台派员由早及晚现场播录治疗经过,若有病人因针刺死亡、或误伤、或疼痛呼叫等情况,即成为最强的医疗事故的证据;还有各大报社记者24小时轮候追随记述;在旁还站有十数位医学专家、政府要员,静观操作,约20分钟换班1次。

在场唯一的助手乃陆易公之夫人陈贞卿女士,精神上的压力,无止无休的体力疲劳,均已达到顶点,当夜11点晚餐时,陈女士昏倒在餐桌上。

宾馆主人的老母中风瘫痪,行动不便,坐轮椅请治,经针治后,自推轮椅归去;一位当地名律师因神经性耳聋,无法医治,无法出庭为客辩护,经针治4次而愈;有患佝偻20余年的小学教员,经针治1星期后,霍然而愈,她的1个二年级的小学生对其母亲说他的驼背老师这几天不知吃了什么东西,高了许多。诸如此类的疗效,不断在街头人群中传播。

美国《时代周刊》4月23日在首页报导针灸疗效犹似神迹,形容示范的宾馆仿佛变成了法国小镇LOURDES显圣迹之地。示范于3月19日至4月6日止,近500名病人得到治疗,结果相当满意。

议员们在立法院与陆易公医师经过一番舌战,公认疗效确切优良,毫无异议。最后投票结果:州众议院以30票对1票,另1票缺席,州参议院以20票对0票,通过法案。立法院内共和党和民主党完全合作,创立法院通过议案的绝对票数纪录。

陆医师及其夫人在获悉大功告成时,随即回房蒙头大睡两日夜,才开始出门见客。据陆医师说虽然精神健康以及经济濒临绝境,但能为中医针灸在国际上开出一条大路,已宿愿得偿了。

3.内州中医针灸法律几项重点

4月19日州长MIKEO’CALLAGHAN正式签署法案,立即成立中医医务局,执行本州内一切中医医务行政、教育、执照及注册等等工作;成立中医教育机构,开设中医各项学位课程;成立中医技术顾问委员会,指导医务局各项医务工作,审核资历,设计考试内容及教育研究工作等。每年考期2次,每次可用中英语作答,分笔试、口试、临床3部份,每部份均要取得合格水准。执照分4种:甲.传统中医学医师DOCTOROFTRADITIONALCHINESEMEDICINE;乙.中草药医师DOCTOROFHERBALMEDICINE;丙.针灸医师DOCTOROFACUPUNCTURE;丁.针灸助理员LICENSEDACUPUNCTUREASSISTANT。法律规定,一切未经中医医务局核准而行医者,均属违法。

4.内州立法后对各界影响

1973年内州中医针灸合法化后,其它各州也相继效法起来,如加州、德州、纽约、华盛顿、夏威夷、阿勒岗、蒙特那等诸州。可惜各地环境因素有异,加上西医师公会的强横势力,中医针灸师依然得不到独立开业权,需要依靠西医师先替病人诊断,然后发出介绍书,方可接受中医针灸治疗,这当然是一种职业歧视。有鉴于此,各州中医针灸界只好继续奔走,争取独立行医法律,其中最受嘱目的要算德州中医针灸法案了。1979年8月由联邦地方法院接手主审,邀请内州陆易公医师及其公子陆伯明医师上庭答辩并放映平日摄录的医案及电脑纪录,以示针灸疗效确切,由早及晚。事后,法官即命搜集有关修改法律的资料。余后数天,由各方代表陈述,其中加州的康宁(RICHARDKRONEING)医师亦掀起高潮。康氏为美国针灸权威,曾首次公开发表针刺止痛乃是脑吗啡分泌增强的作用,申辩的阵容如此坚强,西医医务局最后放弃上诉权。次年7月,判决书由联邦法院审结。这份判决书使日后各州争取独立开业行医权有例可援。

美国中医针灸合法化,亦引起欧联国家的重视,意大利在1997年立法院也有议案准备把中医针灸合法化。据《国际针灸交流手册》(山东科技出版社1992)记载,世界上有100多个国家均有中医针灸医师,深信中医针灸的国际地位会日益增强。

5.结论

美国中医针灸立法的正式起步,先由陆易公医师以深厚的学养、高水准和丰富的临床经验为基础,加上各方面人事的和谐协作,打破了各种政治利益的冲突,又在一个适当的时机和环境中,成功地建立起来了。

这个合法化,首先保障了美国人民应得的有水准的中医针灸治疗机会,造福于美国人民的健康,更重要的就是提高了中医针灸的国际地位,与西方医学共进。有鉴于此,内州政府为了感谢陆氏的重要贡献,特选于1992年7月16日陆氏80寿辰时,由州长BOBMILLER代表本州人民颁布宣言,详述内州为全美第1个州接受中医针灸合法行医,并宣告该日为“陆易公医师日”,嘉许为本州“杰出居民”,加授衔为“内州东方医学之父”。就这样,陆氏名垂于美国中医针灸史上,同时也是我们中国针灸传海外的一项光荣。

Read more: 中医针灸在美国第一个州的立法经过 – 祝君平安的日志 – 贝壳村

Dr.Arthur Fan notes: On March 20,2014, I met a patient who is Jim Joyce’s daughter(Marilee Joyce), mentioned her father’s story in Acupuncture legislation in Nevada in 1973. Both of her grander mother and mother had chronic headache, Jim brought them to see Dr.Lok and got recovery. Her father already passed away in 1993 due to his lung disease. Marilee published a book called “Gentle Giant” to tribute her father.

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Fan’s new article “The beginning of acupuncture in Washington, D.C. and Maryland: an interview with Dr. Yeh-chong Chan” was published todayon Journal of Integrative Medicine http://www.jcimjournal.com/articles/publishArticles/pdf/jintegrmed2013028.pdf.

Dr. Yeh-chong Chan (Y.C. Chan) is one of the earliest acupuncturists in the United States (US). He served for seven years in the first acupuncture center in the US, which was established in Washington, D.C. in 1972. In 1979, he moved the clinic to Rockville, Maryland and continued to practice acupuncture there for over 30 years. He is a well-known licensed acupuncturist (LAc), one of the developers of the acupuncture profession, and a scholar of acupuncture and traditional Chinese medicine (TCM). He has treated two US Governors (In the US, the title Governor refers to the chief executive of each state or insular territory and the political and ceremonial head of  the state.) and many sports stars. He is the author of books entitled Acupuncture Practice in the United States [1], Dr. Chan’s Cancer Healing, Prevention and Self-healing and others. To record the early history of acupuncture in the US, on September 30, 2012, the author, Dr. Arthur Fan interviewed Dr. Chan, 70 years old, who is still in practice.

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19th Century Medical Self-Help

 Historical Essay by Dr. Joan B. Trauner
Dr. Trauner is a research specialist at the University of California, San Francisco, Medical Center in the History of Health Science Department. Excerpted from the version which appeared in California History, Spring 1978, Vol. LVII, No. 1, courtesy of the California Historical Society.

Image:chinatwn$chinese-medical-clinic-1890s.jpg

Chinese Medical Clinic in Chinatown, c. 1890s

Photo: California Historical Society

Another aspect of the story of the Chinese as medical scapegoats in San Francisco is the effect of public health policy upon the Chinese community itself. Throughout the nineteenth century, city officials were reluctant to finance any health services for the Chinese population even though Chinatown was popularly viewed as “a laboratory of infection.” Early Chinese immigrants realized the necessity of banding together and providing for their own health care needs. In the 1850’s they first grouped together into associations based upon loyalty to dan (family associations) or place of origin (district associations). In the 1860’s, the district associations federated into the Chung Wah Kung Saw, which later became known as the Chinese Consolidated Benevolent Association, or the Chinese Six Companies. During this period, each of the district associations maintained a small “hospital” in San Francisco for use by their aged or ailing members, a facility usually consisting of little more than a few bare rooms furnished with straw mats.[55] The existence of these hospitals was in direct violation of city health codes, but local officials allowed them to operate. In fact, during the leprosy scare of the 1870’s, health officers ruled that lepers should be “debarred from hospital maintenance” at city expense and that “the Chinese companies should be compelled to maintain them and send them back to China.”[56] Thus, from August, 1876, to October, 1878, known lepers were housed in the so-called Chinese “hospitals”; thereafter, health authorities ruled that all lepers were to be isolated in the Twenty-Sixth Street hospital.

Not only were local authorities ambivalent about admitting Chinese patients to municipal facilities, but they also were hesitant about providing sanitary services within the Chinatown area. Dr. A. B. Stout, a prominent physician and member of the California Board of Health, testified before a congressional investigating committee in 1877 that “the city authorities undertake to clean the city in other parts, but the Chinese are left to take care of themselves and clean their own quarter at their own expense.”[57]

Whenever a major epidemic threatened San Francisco, however, health officials descended upon Chinatown with a vengeance. During the smallpox epidemic of 1876-1877, for instance, city health officer J. L. Meares bragged that not only had he ordered every house in Chinatown thoroughly fumigated, “but the whole of the Chinese quarter was put in a sanitary condition that it had not enjoyed for ten years.”[58] Similar comments were made at the time of the bubonic plague in 1900-1901 when nearly every house in the district was disinfected and fumigated.

In the nineteenth century medical care in Chinatown was largely provided by herbalists and pharmacies in the classic tradition of Chinese medicine. As late as 1900, no Chinese physicians appear to have been licensed to practice medicine in the state of California; in fact, not until 1908 was the Medical Department of the University of California in San Francisco to graduate a physician of Chinese origin.[59] Some Chinese of the merchant class did seek treatment from Caucasian physicians, usually for surgical care not available from Chinese practitioners.[60] In the I880’s a few church missions in Chinatown also began offering the services of white female physicians for pediatric and obstetrical care. Throughout the nineteenth century, however, the vast majority of Chinese were unwilling to consult Caucasian doctors because, as one historian has noted, “the language barriers, the higher fees, and strange medications and methods were too much to assimilate.”[61]

The reluctance on the part of the Chinese to seek medical attention outside of Chinatown accounted in part for their low admission rate to the San Francisco City and County Hospital and to the Almshouse during the last century. An examination of the statistics on admissions to the city and county hospital for the years 1870-1897 reveals that less than .1 percent of the hospital inpatients were of Chinese origin, whereas the Chinese population in the city varied from 5 to 11 percent of the total population. Statistics on admissions to the Almshouse disclose an even lower admission rate: of 14,402 admissions from 1871 to 1886, only 14 cases were of Chinese origin.

Obviously, the low admission rate of the Chinese to municipal facilities cannot be attributed entirely to reluctance to seek Western-style care. An 1881 article in the San Francisco Chronicle, headlined “No Room for Chinese: They are Denied Admission to the County Hospital,” referred to a resolution of the Board of Health, adopted several years earlier, that had essentially closed City and County Hospital to Chinese patients.[62]

The article pointed out that in the fall of 1881 the Chinese consul had petitioned the Board of Health on behalf of an ailing Chinese immigrant who desired to gain admission to the city and county facility. Fearing an influx of Chinese patients with chronic diseases, the board passed a resolution that all Chinese patients who thereafter requested care were to be assigned to a separate building on the Twenty-Sixth Street hospital lot.[63] Apparently, this policy remained in effect throughout the remainder of the nineteenth century. A document dated 1899 noted that the City and County Hospital only opens its doors to a limited number of [Chinese] patients. The remainder of the patients are taken to the small, dismal Charnel-house established by the Chinese Companies, and known as the “Hall of Great Peace,” or else to the Leper Asylum or Pest-House.[64]

Although the ban on Chinese patients at both the City and County Hospital and the Almshouse was common knowledge, city officials continued to claim that San Francisco opened its municipal facilities to the sick and poor of any nationality.[65]

Because of the difficulties inherent in obtaining care at municipal expense, the Chinese community sought from an early date to fund a well-equipped hospital within the Chinatown area. Dr. Stout, in his congressional testimony in 1877, mentioned that the Chinese desired very much to establish a general hospital and a smallpox hospital, similar to those built by the French and German communities. Reportedly, the Chinese were willing “to pay liberally and freely” to establish a hospital, with patient care to be provided by both white and Chinese physicians.[66] (In order to secure approval from the Board of Supervisors for the erection of such a hospital, the Chinese community recognized that their Physicians would have to work in conjunction with state-licensed Caucasian physicians.)

Nothing more is heard of any hospital plans until the early 1890’s when land was purchased in the southern outskirts of San Francisco in the name of the Chinese consul general of San Francisco. Plans were drawn up for a hospital, and funds were collected both locally and from foreign sources. When construction of the hospital was about to begin, “city authorities forbade further proceedings on the ground that the promoters only intended to use objectionable Chinese systems of medical treatment.”[67] It can be surmised that the real objections were to the proposed location of the hospital outside the perimeter of Chinatown.

In 1899, the community planned to rent a house in a “suitable locality” to be fitted up as a hospital and dispensary where only practitioners with American or European diplomas were to be allowed to visit the patients. The dispensary was to give free advice and medicine to indigent clinic patients; the hospital was to consist of twenty-five beds for use by both clinic and paying patients. The Chinese Hospital (Yan-Chai-i-yn) was incorporated under California law in March, 1899. At that time, twenty-one persons (including twelve Caucasians) pledged to become members of the hospital by payment of an annual subscription of $5. Except for the Chinese consul general, the officers of the hospital’s first governing board were to be prominent members of the white community.[68] This project, too, must have been shelved because no further trace of this hospital can be found.

Image:chinatwn$tung-wah-dispensary.jpg

Tung Wah Dispensary, opened in 1900 by the Chinese Six Companies at 828 Sacramento St.

Shortly thereafter bubonic plague was discovered in Chinatown; public officials suddenly were faced with the fact that no health facilities existed in Chinatown for the care of plague victims. As early as May, 1900, the surgeon general of the Marine Hospital Service, Dr. Walter Wyman, suggested that one of the more “substantial” buildings in the area should be converted into a pest hospital.[69] The War Department, on the other hand, preferred to see the Chinese quarantined on Angel Island. Neither plan went into effect, and in April, 1901, the San Francisco Board of Supervisors appropriated funds for the erection of a hospital in Chinatown. The city auditor immediately declared that the appropriation was illegal, and accordingly, the hospital was never constructed.[70]

About the time that plague was discovered in Chinatown, the Chinese Six Companies realized that it was imperative for the Chinese community to organize its own health care system. The result was the Tung Wah Dispensary which opened in 1900 at 828 Sacramento Street. The dispensary, which employed both Western trained physicians and Chinese herbalists, was funded entirely by the Chinese Six Companies, and this dispensary was to be the forerunner of the present-day Chinese Hospital which opened its doors in April, 1925.[71]

In 1900, in addition to financing the dispensary, the Chinese Six Companies instituted legal action to prevent local, state, and national officials from enforcing discriminatory measures aimed at the Chinese. In court, their attorneys won the right for non-licensed Chinese physicians to attend autopsies conducted under the jurisdiction of the San Francisco Board of Health. Similarly, their lawyers forced the courts to end the quarantine of Chinatown as ordered by the Board of Health. In May, 1900, when the U.S. Marine Hospital Service imposed a ban on interstate travel by Asiatics, the secretary of the Chinese Six Companies obtained a restraining order from the U.S. circuit court, arguing that such a ban was unfair class legislation.[72]

Public health officials were infuriated by the legal tactics of the Chinese Six Companies. Dr. J. J. Kinyoun, federal quarantine officer for San Francisco, expressed his indignation in the following statement:

The various injunctions which have been entertained by both state and federal courts … have all conspired to convince the Chinese Six Companies that they in nowise consider the Chinamen amenable to observe or comply with the health laws of the city, state, or United States. The attitude assumed by this powerful corporation forms a good excuse for the individual Chinaman to follow suit and set at naught and defiance any or all rules and regulations which are considered necessary for the sanitary protection of the citizens of this state and country.[73]

Although the Chinese were extremely hostile to the official anti-plague measures, this lack of cooperation stemmed in part from their unfamiliarity with public health procedures. When quarantine of Chinatown was first instituted, the Chinese attempted to prevent door-to-door inspection by locking up their homes and shops.[74] When health officials attempted to vaccinate the Chinese with Haffkine prophylactic serum, riots broke out in Chinatown.[75] Finally, when health officials came into the area to search for victims of the plague, the sick were reportedly hidden in the cellars and “subterranean passages” of Chinatown.[76] Health officials despaired, neither understanding nor sympathizing with the motives of the Chinese. In the words of J. J. Kinyoun: “We never can expect to accomplish in our dealings with this race what we intend to do.”[77] Accordingly, in 1905 after the first episode of the plague had ended, public health officials retreated from Chinatown, unofficially delegating the Chinese Six Companies with the responsibility of caring for the health needs of the Chinese community.

In the years to come, the overcrowded living conditions in Chinatown were to result in a high incidence of tuberculosis. For instance, the average yearly death rate from tuberculosis for the years 1912-1914 was 622 deaths per 100,000 as compared to a citywide average of 174.[78] In 1929, after the introduction of tuberculin testing of cattle and pasteurization of milk, the Chinese mortality rate was 276 deaths per 100,000 as compared to a citywide average of 8 3.[79] Yet, until 1933 no public health facilities existed within Chinatown for the diagnosis or treatment of tuberculosis. One 1915 health report noted the absence of clinics in the Chinatown area and stated as follows: “The Six Companies is probably in a better position than any other group to cooperate with the Board of Health in instituting curative and preventative measures among their own people.”[80] In other words, the city had adopted a “hands off” policy with regards to health care among the Chinese. Not until March 1933, when the Chinese Health Center was established in the nurses’ room at the Commodore Stockton School, would the city attempt to cope even half-heartedly with the tuberculosis problem in Chinatown.[81]

Today, the outright discrimination against the Chinese has ceased. Nevertheless, a continuing phenomenon is the reluctance of many Chinese–particularly among the aged or non-English speaking immigrant groups–to seek health services outside of the Chinatown area. Thus, while members of the Chinese community routinely seek medical care in hospitals, offices, and clinics throughout San Francisco, Chinatown itself continues to present a unique situation for the organization of health services. In one sense, the Chinese ceased being medical scapegoats by 1905; after that date, advances in medical science made obsolete the nineteenth-century policy of condemning the Chinese as “carriers of alien disease.” However, the failure of the City and County of San Francisco to provide health services within Chinatown was to have a more enduring effect. As late as 1967, the only outpatient facility furnishing acute medical services to the Chinese indigent in Health District IV (Chinatown-North Beach) was the Telegraph Hill Neighborhood Clinic, located in North Beach and funded in part by the United Crusade and by the San Francisco Department of Public Health.[82] The city facility–the Northeast Health Center–was housed during this period in the basement of the Ping Yuen Housing complex; a tuberculosis clinic, a well-baby clinic, dental services, an immunization center, and a public health nursing service were all provided in 1200 square feet of converted laundry space.[83] In other words, a paucity of medical services existed in Chinatown as late as the 1960’s; not until the 1970’s was the situation finally remedied.

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Toy Avenue

Well-respected Chinese herbalist and landowner Toy Wah Hing was born in Sacramento in 1869.(There also are avenues names Wah and Hing.) The family name, however, was Yee. His father was Yee Fung Cheung, a Chinese herbalist who treated Leland Stanford’s wife, Jane, when she was deathly ill. Stanford called him Dr.Hing, and he came to assume that name, said Melvin Hing, a great-grandson of Yee. Toy Wah Hing also too up the name and herbalist trade, but also invested in large tracts of land, including the land from Auburn in Placer County to areas south of the city of Sacramento. His herbal practice sometime ran afoul of authorities  who accused him of possessing morphine, heroin and opium when he was raided in 1920. Nevertheless, his family, including 16 chilren, was the only Chinese family lived in downtown, and he was the first Chinese man in town to own a car. Grandson Melvin Hing remembers going around to collect rents in the 1930s in an “old jalopy”. Toy Wah Hing’s land holdings included an area now know as Woodbine, where in 1915, he plotted out streets named Toy, Wah and Hing. The streets were plotted on a map. They did not appear on the grounds for years. Song, a street named for his wife, was never built. Three other streets were named Yee, Lock and Sam, the herbalist’s  Chinese names…….(until now, only Lock was built, Fan’notes). Toy Wah Hing’s home was at 725 J street.

Carlos Alcala.Sacramento Street Whys: The Whys Guy’s Wise Guide to Sacramento Street names. Big Tomato Press. Sacramento. 2007 page 71-72.

Yee Fung Chung, Sacramento Pioneer.

Yee Fung Chung came to Sacramento during the gold rush. In 1862,Jane Stanford, the wife of Sacramento businessman and California governorLeland Stanford, became sick…..After moving to Virginia City, Noveda, in 1869, he bagan using his second birth name Wah Hing, a name he utilized until returning to Sacramento. The exact date of his return is unknown, but advertisements for his business at 1209 Third Street, under the name of Yee Wah Hing, appeared in 1901, and he opened an office at 725 J street in 1905. His son, Yee Lok Sam, adopted the name T. Wah Hing in about 1897, continueing his father’s business on third street, but he resumed the name Yee Lok Sam in 1910. Yee Lok Sam’s son Henry grew up in the United States and later continued the family tradition of herbal medicine at another office on J street.

William Burg. Sacramento’s K street, where our City was born. The History Press.Charleston.2012.Page 37-38. (03/25/13 searched)

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国医节的回顾与前瞻

(作者:陳明 三藩市 )http://singtaousa.com/031811/sq01.php

三月十七日,是中國第八十二屆國醫節。八十二年前的一九二九年,任上海醫院醫務長的醫生余雲岫,早年留學日本,受日本明治維新取締漢醫的影響,主張「廢醫存藥」,他向南京國民政府提出《廢止舊醫以掃除醫事律法之障礙案》。此案經南京國民政府衛生部召開的第一屆中央衛生委員會之議通過,準備正式施行。中醫面臨生死存亡的鬥爭。兵書有云:「置於死地而後生」。國民政府通過廢止中醫法案,把中醫醫務人員推向背水之戰,全國中醫界空前團結,群起反對。結果取得了勝利,並定每年三月十七日為「國醫節」。

中醫是中華民族幾千年來生產生活實踐和與疾病鬥爭逐步形成並不斷豐富發展起來的醫學科學,為中華民族的繁衍昌盛作出了重要貢獻,對世界文明進步也產生了積極的影響。一百多年前隨著華人移民到美國,也把中醫中藥帶到美國。據筆者所知,第一位來美國的中醫師就是黎普泰,他是廣東順德人,一八五四年四月,黎普泰在《金山日新錄》(The Golden Hills’ News)刊登中醫館廣告。以此算起,中醫中藥傳入美國三藩市已有一百六十年。

黎普泰的中醫館最初設在華埠華盛頓街,後遷至都板街夾企李街的錦生堂樓上。黎普泰以中藥治療奇難雜症,名揚遐邇。由於求醫甚眾,他一個人難以應付,便叫他的外甥譚富園來幫忙。  譚富園就讀於北京太醫院,是當時全國唯一的最高中醫學府。一八九零年譚來三藩市,襄助普泰醫館,聲名鵲起。三年後因黎普泰病逝,譚的父親譚子山在廣州行醫,命他回去幫忙,譚富園便回到廣州。

一八九四年,富園攜妻子及三子一女來加州,在南加州的列連埠(Redlands)創立富園醫局(Foo and Wing Herb Co.)。由於富園醫術精湛,妙手回春,聲譽日隆,引起西人醫師的妒忌,在報上攻擊中醫中藥不科學。譚富園把自己的醫案交給記者發表,證明中醫的奧妙,其功效一點也不遜於西醫,甚至有些西醫無法治療的奇難雜症,中醫能夠對症下藥,藥到病除。這場關於中醫是不是科學的筆戰,由於富園既有理論,又有治癒病例醫案佐證,終於取得了最後勝利,為弘揚中醫中藥作出了貢獻。

但是,歧視中醫中藥,並不因譚富園的貢獻而結束。一八九九年創辦金山華人仁濟醫院,只設西醫部,沒有中醫部,當時旅美華人有病多喜歡中醫診治,仁濟與華僑需求有矛盾,一年後停辦。

一九零零年,華人在三藩市創辦東華醫局,一九二五年改為東華醫院,始設立中醫門診。可是,中醫中藥立法的道路,在美國還是十分漫長的。在美國的五十個州中,只有佔人口五十萬的內華達州,於一九七三年四月二十日通過第448號法案,第一次為中醫中藥立法,在法律面前承認中醫中藥的合法地位。而作為中醫中藥的兩大重鎮的加州和紐約州,至今仍沒有取得合法地位。目前中醫中藥唯一生存空間,就是在美國把中藥當作「保健品」經營。「中藥」的經營不是某個人某個組團的專利,藥材舖有商業牌照,就可開舖立市,有合法地位。「坐堂醫」開出保健菜單(處方),自然是合法的。中醫師在美國名不正言不順,美國學界稱中醫中藥為「替代醫學」。美國醫學會的標誌是「蛇」,奧巴馬醫改法案只有「蛇」,而不見有中醫中藥的「龍」。美國只在商業上承認中藥作為保健商品的合法地位,而沒有作為醫療衛生的專業領域承認中醫中藥的合法地位,豈非咄咄怪事。

針灸是中醫的一個科目,而中醫才是主體,目前加州州政府只承認針灸合法,而不承認中醫中藥合法,確是本末倒置,令人費解。

在迎接第八十二屆國醫節的時候,筆者倡議全美國的中醫中藥醫務人員,不分甚麼政治觀點,不論甚麼宗教信仰,大家團結起來,為爭取中醫中藥的立法而鬥爭。在這裡,筆者提出四點建議:

第一,吸取內華達州中醫中藥立法的經驗,以針灸立法為突破口,繼承和發展前輩爭取中醫中藥立法精神。

第二,中醫中藥全體醫務人員團結起來,不要「岐黃相輕」,而要「岐黃相親」。不要「同行如敵國」,要「同行如一國」。兩岸關係不是「一中原則」嗎?我們中醫中藥醫務人員也要樹立「一中原則」,就是爭取中醫中藥立法的原則,一切言行都要以有利於中醫立法為原則。

第三,贊同加州執照針灸醫師公會會長沈華舒的意見「實行學院教育與師徒教育相結合」。中醫傳統教育,是先有師徒教育,後來才發展為學院教育。現在卻出現只重視中醫高等教育,而輕視名中醫的授徒教育。這兩者各有優點,學院重視系統教育,師徒則重視專長教育。前者注重理論修養,後者注重臨床經驗。把二者結合起來,取長補短,培養出一批既有高深的中醫基礎理論素養又有豐富臨床診療技術水平的醫務人員,才能投入美國主流社會,征服美國社會民眾,進而為中醫中藥立法創造充分條件。

第四,把中醫中藥提高到哲學思想和世界觀來認識。過去一些著名中醫稱為「儒醫」,就是他有具有儒家思想的根底。也有一些道觀的道士為名中醫,就是他們具有道家養生的根底。可見,沒有真正認識和領會儒家和道家的哲學思想和世界觀,也就不可能真正瞭解和領會中醫中藥的真諦。中醫中藥是姓「中」,即使你已入了美國籍,但只要你是中醫中藥的醫務人員,你就永遠改變不了姓「中」。中醫中藥是中華民族文化的瑰寶之一,只有維護民族的特色,才有利於中醫中藥的走向世界,而要做到這一點,其根源正是淵源於儒家和道家的思想。

近年來,加州華裔參政人士取得很大的成績,我們希望這些參政的華裔官員和議員,不要忘記支持你們走向政壇的華裔選民。你們最好的回報,就是利用你們力所能及的影響,爭取中醫中藥早日立法。

 

 

 

譚頴秀 – 註册針灸師 http://kaywin.ca/WellnessCentre/LingLanWellnessCentre.aspx

7725 Birchmount Road Unit 29/30, Markham, Ontario L3R 9X3
Phone: 647-282-3996            Email: LingLan333@hotmail.com

譚氏曾祖父譚富園公受其父親中醫譚子山之薰陶, 就讀於北京太醫院學習中醫,曾在清朝末年任太醫,後跟隨舅父中醫師黎普泰(第一位到美國之中醫師),到美國三藩市行醫,再與康有為弟子在南加州的列連埠(Redlands)創立富園醫局。由於富園公醫術精湛,妙手回春,引起西人醫師的妒忌,在報上攻擊中醫中藥不科學化。富園公把自己之醫案交給記者發表,證明中醫之奧妙,其功效一點也不遜於西醫,甚至有些西醫無法治療之奇難雜症,中醫也能夠對症下藥,藥到病除。這場關於中醫是不是科學化之筆戰,由於富園公既有理論,又有治癒病例醫案佐證,終於取得了最後之勝利,為弘揚中醫中藥作出了貢獻。其四子譚少富繼承衣砵在加州行醫,退休後回港飬老。那時譚氏年幼未能跟隨叔公學習中醫,但他留下不少清代名醫陳修園之書籍及治療札記,令譚氏獲益良多。

譚氏從小移民來加,初習太極,後醉心於氣功,不斷研習各派氣功如少林禪功、道家氣功及治療氣功(五雷神針和日本靈氣)等。因先祖均是中醫,耳濡目染,便到加拿大中醫藥學院(北京首都醫科大學分校)修讀中醫針灸,畢業後跟隨多倫多中醫針灸臨床學院創始人沈清瑞中醫師學習運用多種臨床針灸療法。譚氏所用之治療針法,不限於傳統針法。她辨証論治,根據不同患者之病患,施以不同療法,例如:薄氏腹針、董氏奇穴、王氏刺血及黃氏耳穴等。譚氏精於氣功,扎針時運用五雷神針指法將氣輸入患者體內,同時配合氣功、靈氣或水晶療法等,推動患者體內之內氣,喚醒患者體內沉睡的臟器起來工作。本着醫者父母心,用心與患者共同對抗病魔,達到理想療效。

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Dr. Ralph Coan: a hero in establishing acupuncture as a profession in the United States

Journal of Integrative Medicine: Volume 11, 2013   Issue 1

http://www.jcimjournal.com/jim/FullText2.aspx?articleID=jintegrmed2013007

1.         Arthur Yin Fan (McLeanCenter for Complementary and Alternative Medicine, PLC. Vienna, VA22182, USA )

2.         Ziyi Fan (McLeanCenter for Complementary and Alternative Medicine, PLC. Vienna, VA22182, USA )

DOI: 10.3736/jintegrmed2013007 Fan AY, Fan Z. Dr. Ralph Coan: a hero in establishing acupuncture as a profession in the United States. J Integr Med. 2013; 11(1): 39-44. Received July 23, 2012; accepted August 25, 2012. Open-access article copyright ? 2013 Arthur Yin Fan et al. Correspondence: Arthur Yin Fan, PhD, MD, LAc; Tel: +1-703-499-4428; Fax: +1-703-547-8197; E-mail: ArthurFan@ChineseMedicineDoctor.US

Figure 1  A recent photograph of Dr. Ralph Coan This photograph was taken during the interview. He had recently partially recovered from a stroke while also suffering from heart disease.

1 Introduction

Dr. Ralph Coan is not well known to the general public. Originally, we had wanted to interview him as he was the medical director of the first acupuncture center in the United States that opened in the early 1970s[1]. We wanted to know more about that center’s history. Prior to visiting Dr. Coan, we found an article written by Dr. Sherman Cohn that mentioned Dr. Coan. The article noted that Dr. Coan was the founder of the American Association of Acupuncture and Oriental Medicine, which is the national association of acupuncturists and Chinese medicine practitioners in the United States[2]. While interviewing Dr. Coan on February 18, 2012, it became apparent that he truly is a leading light in establishing acupuncture as a profession in the United States.?Dr. Coan is 75 years old and retired several years ago from his busy medical practice in Kensington, Maryland, USA. As he had recently partially recovered from a stroke while also suffering from heart disease, he could not talk much (Figure 1, Dr. Coan was in the interview). To collect further information about him, we also consulted his former colleagues and relatives, and researched articles written about him.

 

2 An acupuncture believer

“I put an advertisement in the Washington Post stating Looking for a Physician Position. To my surprise, I immediately got a call in the same day. He said, ‘Are you interested in working in an acupuncture clinic? If so, please come.’ I was not familiar with acupuncture before this. However, I had to get a job to support my family after I left the United States Army. At that time, most of the medical doctors (MDs) and politicians did not believe in acupuncture; some media treated acupuncture as a ‘quack’ profession. I started the work with great suspicions. It was at the beginning of 1973.” Dr. Coan recalled 40 years later.

Dr. Coan graduated from the Georgetown University School of Medicine in Washington, D.C. in 1963 as an honors student, had a one-year internship in the University of Chicago Hospitals, and completed his residency at WalterReedArmyHospital in Washington, D.C. He joined the United States Special Army and served at Fort Bragg, North Carolina, in the Canal Zone, Panama, at Lowry Air Force Base, Colorado, and Walter Reed in Washington, D.C. In 1972, Dr. Coan left the Army after serving for eight years due to the end of the Vietnam War. He was one of the three earliest staff physicians, with six Chinese medicine doctors or acupuncturists, to work for the Acupuncture Center of Washington, the first legal acupuncture center in the United States[1]. At that time, Western-trained MDs performed the diagnoses and decided which patients needed acupuncture, and the Chinese medicine doctors would perform acupuncture treatment under the MDs’ supervision. The first MD director of the Center was Dr. Arnold Benson, a New York internist and one of the three founders. Dr. Coan became the second MD director a year later, since Dr. Benson was busy and could not work full-time. As the staff director and co-founder, Dr. Yao Wu Lee recalled that Dr. Coan worked part-time initially, then became a full-time doctor, and at last, served as the MD director, while Dr. Chingpang Lee, a Chinese medicine doctor, served as the office manager.

“I was not sure whether acupuncture was safe and effective, so I wanted to do a little research by myself before I finally decided to work there. I collected the contact information of the first 50 contiguous patients and examined them — the Center had an official copy; I collected by myself secretly. Over approximately two months, I called all of those patients. The results were very encouraging: more than 80% of the patients told me that they got better without any obvious adverse effects. I became a believer, so I decided to work full-time there. I stayed in that Center for approximately 10 years.” Dr. Coan said.

At that time, there were very few acupuncture clinics, and patients came from throughout the United States as well as from many other countries. The Center was immensely popular and had to split into two separate clinics: the Acupuncture Center of Washington and the WashingtonAcupunctureCenter. At their peak popularity, both clinics saw about one thousand patients per day. Within one year, there were thirteen acupuncture clinics open in Washington, D.C., leading it to become a capital of acupuncture. The acupuncture business was so successful that buses full of patients came from New York, New Jersey, and other cities daily to visit the Center[1]. Such scenes and the effectiveness of acupuncture amazed many open-minded MDs like Dr. Coan[2]. However, the booming acupuncture business aroused anxiety and unease within conservative Western style medical institutions and drug manufacturers. In 1974, the Washington, D.C. Board of Medicine gave the Center orders to close acupuncture offices six times. To save the acupuncture profession, as well as the Center, the directors decided to respond. From mid-1974 to the early 1975, they were involved in two lawsuits in the Superior Court of the District of Columbia. The court conducted a serious hearing on acupuncture. Judge Fred Ugast listened to the testimonies of the Washington, D.C. Board of Medicine, the Acupuncture Center of Washington and WashingtonAcupunctureCenter, as well as the public for three months. Dr. Coan was one of the key MDs who attended the hearing and played an important role[2,3].

Dr. Coan remembered very clearly, “One day I was in court. I testified that in Washington, D.C. there were no MDs or dentists trained in acupuncture. It is impossible to get rid of acupuncturists in an acupuncture practice, because they are the experts. Then, Judge Fred Ugast let the doctor who was in charge of the Washington, D.C. Medical Board in. The judge asked him, ‘Dr. Robinson, your regulation wants to limit the right to practice acupuncture to licensed physicians and dentists in Washington, D.C. Do you know how many Western-trained doctors in Washington, D.C. were trained in acupuncture? How many patients need acupuncture everyday?’ The doctor replied, ‘I don’t know.’ Then the judge said, ‘Oh, you can go now.’”

“I predicted that we would win the case. At last, the judge announced that the new Washington, D.C. regulation which wanted to limit the right to practice acupuncture to licensed MDs and dentists is unconstitutional. The rights of physicians to choose proper treatment based on his best judgment, acupuncturists to perform acupuncture, and patients to get professional acupuncture services have been protected. So, acupuncturists could continue to perform acupuncture as long as it is under a MD’s supervision.”

Dr. Coan was a diligent doctor and held at least six qualifications in subspecialties of internal medicine, such as endocrinology and infectious diseases, which is many more than what doctors today may have. He worked with those acupuncturists in his office from 1972 until late 1990s. He said, “I am a believer of acupuncture, although I did not insert any acupuncture needles into any patient. When my family members were sick, I always suggested them to use acupuncture first. Acupuncture works!”

3 A pioneer in acupuncture research

There was very little acupuncture research reported in the 1970s and 1980s, Dr. Coan was one of the pioneers in conducting acupuncture clinical trials. When I mentioned his name to Dr. Lixing Lao, a well-known researcher in acupuncture and Chinese herbology, and a Chinese medicine doctor at the Center for Integrative Medicine of the University of Maryland, he gave Dr. Coan very high praise, “Dr. Coan was an important acupuncture researcher with historical status. His two papers in acupuncture clinical trials on neck pain and low-back pain have been cited by many researchers today.”

In mid-September, 1973, the National Institutes of Health (NIH) held a special workshop for acupuncture scientific study. Dr. Benson and Dr. Coan reported their clinical observation of acupuncture’s effectiveness in 36 cases of rheumatoid arthritis (RA)[4] which was conducted by Dr. Coan.

The presentation at this NIH meeting showed that during the first six weeks after the center was established in December 1972, there were 64 patients with RA who were treated with acupuncture. The first follow-up was conducted three months later. They were able to contact 55 patients, of whom 36 had been given 5 to 24 acupuncture treatments (average 6.6). Of the 36, 25 patients (69%) reported improvement, including less need for pain medications and in some cases, reduction of the nodules which occur on arthritis sufferer’s joints. Of 19 patients who had fewer than 5 treatments, only 5 cases (16%) reported improvement. The second follow-up was conducted six months later, which showed continued improvement by 16 of 27 patients (59%) from the original group. The average age of patients in this study was 55 years, and they had been suffering from RA for an average of 11.5 years.

Many newspapers in the United States reported this news, which encouraged more patients to try acupuncture.

An article entitled The acupuncture treatment of low back pain, a randomized controlled study[5] was reported by Dr. Coan and his colleagues in 1980. The study was conducted within the Acupuncture Center of Washington and Acupuncture Center of Maryland.

Acupuncture treatment was effective for the majority of patients with lower back pain, which was shown by the use of short-term controls and long-term controls, although the latter were not intended in the study design. After acupuncture, there was a 51% pain reduction in the average pain score in the immediate treatment group. The short-term controls and the delayed treatment group showed no reduction in their pain scores at the comparable follow-up period. Later, the patients in the delayed treatment group were also treated by acupuncturists, and 62% of patients reported less pain. When these two treatment groups were compared at 40 weeks with long-term controls (inadequate treatment group), the inadequate treatment group still had the same pain scores, on the average, as when they enrolled in the study. Both treatment groups, on average, had 30% lower pain scores. Furthermore, 58% of patients in the treatment groups felt that they had definitely improved at 40 weeks, while only 11% of the inadequate treatment group felt definite improvement at 40 weeks. There was a significant difference between the groups.

Another article entitled The acupuncture treatment of neck pain, a randomized controlled trial[6] was reported in 1981 by Dr. Coan and his colleagues.

Thirty patients with cervical spine pain syndromes, course of disease 8 years on average, were assigned randomly equally into treatment and control groups. After 12 weeks, 12 of 15 (80%) of the treatment group felt improvement, some dramatically, with a mean 40% reduction of pain score, 54% reduction of pain pills, 68% reduction of pain hours per day and 32% less limitation of activity. Two of 15 (13%) of the control group reported a slight improvement after 12.8 weeks. The control group had a mean 2% worsening of the pain score, 10% reduction in pain pills, no lessening of pain hours and 12% less limitation of activity.

Such study design may be seen as flawed if judged by today’s criteria. However, they were considered impressive by the researchers at that time, especially the studies were the first time in history endorsed by NIH, the United States Food and Drug Administration (FDA), and the American Medical Association (AMA), whichis the main stream medical society. The reports had been documented in the United States Congress in 1979 and was one of key documents used for FDA relabeling acupuncture needle as a medical device from an investigational device in 1994. The later two studies were conducted by local acupuncturists and MDs using their own money, time and labor, with great difficulty, and totally followed the restrict NIH clinical trial rule (control, and random) at that time, which might be the only case in the United States medical research history. Dr. Coan was invited to give lectures throughout the United States. Such studies do therefore have some value. Dr. Coan said, “Acupuncture is a process of a needle piercing the body, to some extent, it is similar to a small operation. As a clinical doctor, I strongly believe it cannot be compared with so-called ‘sham’ acupuncture (which is used as a placebo, mimicking that in medication’s clinical trials; however, it is a real piercing or similar to that). We used the methods of comparing the effectiveness and adverse effects before and after acupuncture in the same patient group, or between the treatment group and waiting-list group. Like an operation, how can we compare the cut of a scalpel with the ‘sham scalpel cut’?”

I agree with him. Indeed, acupuncture is very different from medication; the design of the study should not be the same as the drug model, the so-called “golden criteria”.

4 A key person in establishing acupuncture as a profession in Maryland

“I was an MD who had witnessed so many patients getting better after acupuncture treatment and became an acupuncture believer. In the 1970s, I had strong motivation — I felt that I should do something to push the acupuncture profession forward in the United States. I decided to change something at the local level first. I convinced ten more local acupuncturists, and established a professional organization Acupuncture Association of Washington Metropolitan (AAWM). I was its president for more than 10 years. We met every Saturday morning to share news with each other and discuss the role of the acupuncturists. One day, we met in SuburbanHospital (which was the affiliated hospital of NIH). We were aware that the first quarter of each year is the legislation season in every state, so we decided to remove the obstacle in law for acupuncture in Maryland.” Dr. Coan recalled.

The members of AAWM included local acupuncturists mainly from Hong Kong and Taiwan of China and Korea, such as Grace Wong, In-Su Kim, Hansheng Gu (Hanson Koo) and Sumei Zhang. They met once a month in China Garden Restaurant on Wisconsin Avenue, Bethesda, Maryland. The basic procedure was: ate lunch together (about half hour), and then discussed something new and what needed to be done — like most societies today but we met more often and sometimes held seminars. Maryland was one of the earliest states that allowed acupuncturists to practice acupuncture (Fan notes: similar to the nurses working under the supervision of MD, without license) in the United States in 1973. However, in the early 1980s the Board of Medicine with the conservative Western-trained doctors did not want acupuncturists to have a license and wanted to deprive the acupuncturists’ rights. During 1981 to 1982, Dr. Coan and his colleagues were involved in acupuncture licensing legislation in Maryland.

“At that time, there was a five-person committee representing the Governor and State of Maryland in the hearing. The MD’s representative who attended that hearing was a very, very famous neurosurgeon from JohnHopkinsHospital, a ‘top guy’ in the Western medical field, who did not like acupuncture and tried to block the acupuncture licensing legislation.” Dr. Coan reminisced about the great achievement, “I am a nasty person. I knew him well and I knew he would oppose acupuncture. So I brought three local patients who had surgery from him, which is a secret weapon I used later all the time.” The neurosurgeon told the committee: “acupuncture is just a no-use therapy, especially for neurological issues, such as spinal disc problems that cause back pain and sciatica; only surgery could cure such disorders.” Then it was Dr. Coan’s turn. Dr. Coan brought out patients and asked them, “Do you know that doctor (the neurosurgeon)?” The patients replied, “We were patients of his and had operations from him.” “Did the operations help?” Dr. Coan asked. “No, after the operation, the pain got worse. However, acupuncture stopped the pain.” one of patients replied. The surgeon felt embarrassed and left the hearing immediately. And then Dr. Grace Wong, Dr. Coan’s partner and a well-known acupuncturist, made testimonies for acupuncture. So, acupuncture licensing legislation was passed very smoothly and successfully in Maryland in 1982 [Fan notes: due to the special political environment in Maryland, the Acupuncturist Licensing Act was changed to Acupuncturist Registering Act in 1982. So, the legislation passed in that year was the Acupuncturist Registering Act. The Acupuncturist Licencing Legislation was passed at last in 1994, 12 years later].

“You should understand it is so important to bring patients with you when you try to make testimonies in court and convince people about acupuncture. The patients will give you great support,” Dr. Coan said.

Dr. Lixing Lao once was Dr. Coan’s colleague. He recalled, “I participated in the events of AAWM, because I taught a point-locating class for National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) acupuncture examination preparation for the Tai Sophia Institute in 1986 as a part-time job, while I was a PhD candidate of physiology in the University of Maryland. Tai’s teaching, focusing on five-element acupuncture from England, is very different in content from traditional Chinese medicine (TCM), the main stream of current Chinese medicine. Dr. Yin-sue Kim attended that class and invited me to participate in Dr. Coan’s monthly events. I actually joined them in 1987. One day, we got interest to start an acupuncture school with focus on TCM in Maryland. So, several people became involved in this topic. After the normal meeting completed and other acupuncturists left, we discussed the school issue. The school was started in late 1991, and the first class was in 1992.”

The school was called the Acupuncture School of Maryland, and later, Maryland Institute of Traditional Chinese Medicine (MITCM). After eight years of preparation, the school was initially started in a Catholic elementary school where it held lectures in the evening. After several years, it moved into a professional building in Bethesda, Maryland, which was very close to a metro station, and had all lectures during normal hours. “I was the founder and the first president of the school, and ran the school by myself for two years. My daughter worked there as a secretary.” Dr. Coan said. According to Dr. Lao, Dr. Coan spent a lot of energy, time, and even his own money for the school. Before the school could become financially independent, Dr. Coan lent his money to the school for support. The teachers at the school, mostly from mainland China and well-trained in TCM, included Drs. Lixing Lao, Jingyuan Gao, Eugene Zhang, and more. “Dr. Lao and Dr. Gao were fantastic teachers and scholars, when I was the president there, I attended their lectures for two years. I should give them my heartfelt praise,” Dr. Coan said. The first graduates were twelve students in December 17, 1994. MITCM was very sound in its academic and financial condition. It was a prestigious TCM school on the east coast. However, it closed at the end of 2002.

During the 1980s to 1990s, Drs. Coan, Wong, Lao and Bob Duggan (the founder of Tai Sophia Institute) worked as the main board members in the Acupuncture Board of Maryland for many years. The Board is a state government agency that is in charge of acupuncture licensing and administrates acupuncturists’ practice.

5 The founder of the American Association of Acupuncture and Oriental Medicine

Almost ten years passed from the opening of the first acupuncture center of the United States in 1972. In more and more states, such as Nevada, Maryland and Massachusetts, acupuncture legislation got passed. More and more patients considered acupuncture as an option, and more and more students studied acupuncture and Oriental medicine in the United States and became acupuncturists. These led to the birth of a national organization for the acupuncture profession[2].

Dr. Coan and Louis Gasper, PhD, were co-founders of the American Association of Acupuncture and Oriental Medicine (AAAOM). Dr. Gasper, who died in 2004, was a professor at Los AngelesInternationalUniversity. They sent letters nationally to invite people to attend the first AAAOM meeting at the Los AngelesInternationalUniversity on June 27, 1981. Neither Dr. Coan nor Dr. Gasper practiced acupuncture; however, they are acupuncture believers. The 75 attendees included MDs and dentists who used acupuncture, acupuncturists (non-MDs), and MDs who did not use acupuncture themselves but supervised acupuncturists, like Dr. Coan, as well as friends of acupuncture or those with interest in acupuncture, like Dr. Gasper. The first board was elected at that meeting, and consisted of seven members: two MDs, four acupuncturists, and another doctor without indicating designation. Dr. Coan served as the treasurer. At that time, MDs were the largest groups represented at that meeting. The second AAAOM meeting, held at the Del Coronado Hotel in San Diego in March, 1982, had a much higher attendance than the first. Most of attendees were acupuncture and Oriental medicine (AOM) practitioners. In the third AAAOM meeting, held at the Shoreham Hotel in Washington, D.C. in May, 1983, non-MD AOM practitioners strongly protested MD members’ intentional delay of AOM development, tension between the MD acupuncturists or supervisors, and the non-MD practitioners surfaced without resolution, resulting in all of the MD members walking out of AAAOM except for Dr. Coan. In that difficult time, Dr. Coan was elected as the new president of the AAAOM, which just became AOM practitioners’ own organization. “I was president of the second board and then vice-president of AAAOM for over ten years. During those years, I helped thirteen states finalize acupuncture legislations,” Dr. Coan said.

“I gave testimonies in person in twelve states’ hearings for acupuncture legislation, gave testimony over the phone for Alaska (I did not go there, it is too far),” Dr. Coan said. He wrote the name of thirteen states for us on a paper with his hand, slight-shaking due to the stroke: Alaska, Delaware, Maryland, Missouri, New Hampshire, New Jersey, New York, North Carolina, Rhode Island, Utah, Vermont, Virginia, and Washington, D.C.

“In Utah, there were twelve MDs who were strongly against acupuncture that attended the acupuncture legislation hearing. A representative of the AMA came too. The side that is in favor of acupuncture had only two people in attendance: one acupuncturist and me. The MDs tried to make the law to block all non-MD acupuncturists to perform acupuncture. The reason is that such non-MD acupuncturists had not had the appropriate medical education as MDs. I asked, ‘In your MDs’ clinics, there are nurses who use needles. How many years were these nurses required to study in Nurse Schools?’ They replied, ‘Three years.’ ‘Acupuncturists have education and training for four to six years, longer than the nurses. If the nurses have right to use needles, acupuncturists should be overqualified to use the needles under the supervision of a MD.’ I protested. And then, a MD stood up and said, ‘acupuncture is not useful to treat carcinoma. Acupuncture will cause carcinoma patients delay in getting the right treatments. So, acupuncture will harm patients.’ I stood behind the sponsor who wanted to introduce the acupuncture legislation and gave him the reply of our side. He responded according to my words, ‘Okay, you said acupuncture harms patients. Could you call your clinic and let your secretary use expedited mail to mail me a real medical record which indicates that acupuncture harmed your patients by tomorrow? I will pay the shipping fee.’ The doctor could say nothing. So we won the hearing, and acupuncture legislation passed.” Dr. Coan smiled, “Acupuncturists should remember, never say you could treat cancer (by acupuncture only, although you may help such patients to some extent). In the hearings, the MDs always used this as an example to block acupuncture legislations.”?Regarding Vermont, Dr. Coan said, “During the hearing there were also only two people in favor of acupuncture: a local acupuncturist and me. We won. The weather there that year was extremely cold, and this lady (the acupuncturist) had no money to pay for a hotel for me. So, I stayed in her house, without any heating, for one night. I used ten cotton blankets. That is an unforgettable experience.”

“In 1988 in Virginia, there were five surgeons in attendance who tried to block legislation which allows acupuncturists to practice acupuncture; I went there with In-Su Kim, a Korean acupuncturist, to fight with them,” Dr. Coan recalled. According to a report from a newspaper[7], at that time in VirginiaState, the law made by MDs only allowed licensed MDs to practice acupuncture. Such MDs only had 100 hours of study and 100 hours of practice in acupuncture training. The acupuncturists, mostly with 4 to 6 years extensive training, could not practice acupuncture. Dr. Coan protested in the statehouse, “This law is unjust, unfair, and immoral.”

Per the arrangement of Dr. Coan, on June 22, 1979, George Brown, Jr., an acupuncture skeptic, had acupuncture during a hearing in Congress of the United States. Dr. Grace Wong, Dr. Coan’s partner, did acupuncture on him for smoking cessation; it was very successful. At that time, Brown was the Chairman of the House Science, Research, and Technology subcommittee. It was a breaking news, reported in many newspapers[8].

As another pioneer in the acupuncture profession, Dr. Finando, commented on Dr. Coan[9], “He campaigned and lobbied anywhere and everywhere to lobby for acupuncture.” Not only did he campaign and lobby for acupuncture anywhere and everywhere, his mother influenced by him, also became a volunteer lobbyist for acupuncture.

It is true that Dr. Coan is a great hero of the acupuncture profession, even though he did not insert an acupuncture needle in any patient. He is an MD, but he has contributed his dedication and whole life to support and promotion of acupuncture; all of this as a volunteer.

6 Acknowledgements

The authors would like to thank Dr. Lixing Lao, Dr. Yick-chong Chan, Dr. Sherman Cohn, Ms. Judy Coan-Stevens and Mr. John Coan who provided some detail information about Dr. Ralph Coan, and Ms. April Enriquez for English editing. The interviewer was Dr. Arthur Yin Fan.

7 Competing interests

The authors declare that they have no competing interests.

References

1.         Fan AY. The first acupuncture center in the United States: an interview with Dr. Yao Wu Lee, WashingtonAcupunctureCenter[J] J Chin Integr Med, 2012, 10(5) : 481-492.

2.         Cohn S. Acupuncture, 1965-85: birth of a new organized profession in the United States (pt. 2). Am Acupuncturist. 2011; Spring: 22-25, 29.

3.         Superior Court of the District of Columbia Civil Division. Civil action No. 11005-74. Urie, Coan v. Washington. cited by the records: Lewis v. District of Colombia Court of Appeals (1978). [2012-06-26]. http://www.tx.findacase.com/research/wfrmDocViewer.aspx/xq/fal.19780427-0003.dc.htm/qx.

4.         Sawislak AB (UPI). Two-third of 36 patients treated with acupuncture had pain relief. Williamson Daily News, 1973-09-20 (15).

5.         Coan RM, Wong G, Ku SL, Chan YC, Wang L, Ozer FT, Coan PL. The acupuncture treatment of low back pain: a randomized controlled study[J]. Am J Chin Med, 1980, 8(1-2) : 181-189.

6.         Coan RM, Wong G, Coan PL. The acupuncture treatment of neck pain: a randomized controlled study[J]. Am J Chin Med, 1981, 9(4) : 326-332.

7.         Criticism of acupuncture laws called racist by Asian groups. Afro-American. 1988-08-16(3C). [2012-06-26]. http://news.google.com/newspapers?id=LEpAAAAAIBAJ&sjid=WvUFAAAAIBAJ&pg=2980,674502&dq=ralph+coan+in+su+kim&hl=en.

8.         How to prevent mildew. The Spokesman Review. 1979-06-23(10). [2012-06-26]. http://news.google.com/newspapers?id=yeURAAAAIBAJ&sjid=Ie4DAAAAIBAJ&pg=5438,3626027&dq=wong+grace+acupuncture&hl=en.

9.         Finando S. AOM pioneers and leaders 1982-2007, a commemorative book of challenge and courage. Vol. 1. AAAOM, NCCAOM, CCAOM & ACAOM. 2007: 29-32. [2012-06-26]. http://www.aaaomonline.info/docs/pioneers_and_leaders_vol1.pdf.

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