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Arthur Yin Fan1,2 , Jun Xu1,3, and Yong-ming Li1,3

1. American Alliance for Professional Acupuncture Safety. Greenwich, Connecticut (06878), U.S.A.;
2. American Traditional Chinese Medicine Association. Vienna, Virginia (22182), U.S.A.;
3. American Acupuncture Association of Greater New York, New York, (10016), U.S.A

The original white paper was published in Chinese Journal of Integrative Medicine:   [AAPAS White Paper on Dry Needling(I-III) Fan AY, Xu J, Li YM]

1. Fan AY, Xu J, Li YM. Evidence and expert opinions: Dry needling versus acupuncture (I) : -The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016. Chin J Integr Med. 2017 Jan;23(1):3-9. doi: 10.1007/s11655-016-2630-y.
2. Fan AY, Xu J, Li YM. Evidence and expert opinions: Dry needling versus acupuncture (II) : -The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016. Chin J Integr Med. 2017 Feb;23(2):83-90. doi: 10.1007/s11655-017-2800-6
3. Fan AY, Xu J, Li YM. Evidence and expert opinions: Dry needling versus acupuncture (III) : -The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016. Chin J Integr Med 2017 Mar; (3):163-165. doi: 10.1007/s11655-017-2542-x.

The white paper includes in 7 topics:
1. What Is Dry Needling? [page3]
2. Who First Used Dry Needling in the West? [page5]
3. Has Dry Needling Been Used in China? [page7]
4. Does Dry Needling Use Acupuncture Points? [page9]
5. What Is New About Dry Needling Points (Trigger Points)? [page13]
6. Is Dry Needling a Manual Therapy? [page16]
7. Summary of Dry Needling [page17]
(1) Academic perspective [page17]
(2) The Problems Dry Needling caused [page18]
(3) Our Position [page20]

Summary[AAPAS White Paper on Dry Needling(I-III) Fan AY, Xu J, Li YM]
In the last twenty years, in the United States and other Western countries, dry needling (DN) became a hot and debatable topic, not only in academic but also in legal fields. This White Paper is to provide the authoritative information of DN versus acupuncture to academic scholars, healthcare professionals, administrators, lawmakers, and the general public through providing the authoritative evidence and experts’ opinions regarding critical issues of DN versus acupuncture, and then reach consensus.

We conclude that DN is the use of dry needles alone, either solid filiform acupuncture needles or hollowcore hypodermic needles, to insert into the body for the treatment of muscle pain and related myofascial pain syndrome. DN is sometimes also known as intramuscular stimulation, TrP acupuncture, TrP DN, myofascial TrP DN, or biomedical acupuncture. In Western countries, DN is an over-simplified acupuncture using biomedical language in treating myofascial pain, a contemporary development of a
portion of Ashi point (Ah-yes point, or tender point) acupuncture from traditional Chinese acupuncture. As developed by Travell & Simons, C. Chan Gunn and Peter Baldry, et al, it seeks to redefine Acupuncture by re-translating reframing its theoretical principles in a Western manner. It reflects the effort of de-acupoint, and de-theory of Chinese medicine by some healthcare professionals and researchers. DN with filiform needles have been widely used in Chinese acupuncture practice over the past 2,000 years, and with hypodermic needles as Dr. Travell described has been used in China in acupuncture practice for at least 72 years. In Eastern countries, such as China, since 1800s or earlier, DN is a common name of acupuncture among acupuncturists and the general public, which has been used 2000 years, and its indications, is not limited to treating and preventing musculoskeletal disorders or illness including so called the myofascial pain.
Medical doctors Travell, Gunn, Baldry and others who have promoted dry needling by simply rebranding:
(1) acupuncture as dry needling and (2) acupuncture points as trigger points (dry needling points). Dry needling simply using English biomedical terms (especially using “fascia” hypothesis) in replace of their equivalent Chinese medical terms. Trigger points belong to the category of Ashi acupuncture points in traditional Chinese acupuncture, and they are not a new discovery. By applying acupuncture points, dry needling is actually trigger point acupuncture, an invasive therapy (a surgical procedure) instead of
manual therapy. Travell admitted to the general public that dry needling is acupuncture, and acupuncture professionals practice dry needling as acupuncture therapy and there are several criteria in acupuncture profession to locate trigger points as acupuncture points. Among acupuncture schools, dry needling practitioners emphasize acupuncture’s local responses while other acupuncturists pay attention to the responses of both local, distal, and whole body responses. For patients’ safety, dry needling practitioners
should meet standards required for licensed acupuncturists and physicians.
DN is not merely a technique but a medical therapy and a form of acupuncture practice. As a form of acupuncture, an invasive practice, it is not in the practice scope of physical therapists (PTs). DN has been “developed” simply by replacing terms and promoted by acupuncturists, medical doctors, and researchers, and it was not initiated by PTs. In order to promote DN theory and business, some commercial DN educators have recruited a large amount of non-acupuncturists, including in PTs, as students and
customers in recent years. The national organizations of PT profession, such as APTA and FSBPT, started to support the practice of DN by PTs around 2010. Currently, there are probably more PTs involving DN practice and teaching than any other specialties. In most states, licensed acupuncturists are required to attain an average of 3,000 educational hours via an accredited school or program before they apply for a license. The physician or medical acupuncturists are required to get a minimum of an
additional 300 educational hours in a board -approved acupuncture training institution and have 500 cases of clinical acupuncture treatments in order to get certified in medical acupuncture. However, a typical DN course run only 20-30 hours, and the participants may receive “DN certificate” without any examination. For patients’ safety and professional integrity, we strongly suggest that all DN practitioners and educators
should have met the basic standards required for licensed acupuncturists or physicians.
KEYWORDS dry needling, acupuncture, biomedical acupuncture, authoritative evidence, experts’ opinions, consensus

http://www.nccaom.org/wp-content/uploads/pdf/AAPAS%20White%20Paper%20on%20Dry%20Needling.pdf

AAPAS White Paper on Dry Needling(I-III) Fan AY, Xu J, Li YM

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Dr. Arthur Yin Fan’ s two articles

GLOBAL VIEWS
Nevada: the first state that fully legalized acupuncture and Chinese medicine in the Unites States — In memory of Arthur Steinberg, Yee Kung Lok and Jim Joyce who made it happen
January 19, 2015 | Arthur Yin Fan (doi: 10.1016/S2095-4964(15)60158-3)
ABSTRACT | FULL TEXT | PDF
Title: The earliest acupuncture school of the United States incubated in a Tai Chi Center in Los Angeles
Authors: Arthur Yin Fan
Abstract | Full text | PDF

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2013-10-24 14:46:59 人民网


毛泽东与保健医生李志绥合影
中医药学是中华民族优秀文化之瑰宝,是我国劳动人民在长期与自然灾害和疾病作斗争中反复实践、总结而逐步形成的一套理论体系和方法。毛泽东历来十分重视民族文化遗产,无论是在革命战争年代还是在和平建设时期,相信和重视发展中医药,都是他的一贯主张。没有专门学过医的毛泽东,在学习历史和社会经验的过程中,学到了许多中医药学辩证思想和中医药学思维方式,他倡导的中医药发展思想对中国医药学的发展发挥了巨大的作用。
毛泽东在杭州刘庄宾馆小憩时说:“中国对世界有三大贡献,第一是中医……”
早在1913年,毛泽东就曾在《讲堂录》笔记中写道:“医道中西,各有所长。中言气脉,西言实验。然言气脉者,理太微妙,常人难识,故常失之虚。言实验者,求专质而气则离矣,故常失其本,则二者又各有所偏矣。”这是迄今为止所发现的毛泽东对中西医学方面的最早论述。
1928年11月25日,毛泽东在《井冈山的斗争》一文中指出:“作战一次,就有一批伤兵。由于营养不足、受冻和其他原因,官兵生病的很多。医院设在山上,用中西两法治疗。”
那时,在井冈山红军医院里,有西医也有中医,许多内科病都是用中医治疗,多数是采用自制中草药。毛泽东曾经指出:鉴于根据地缺医少药,必须发挥中医中药的作用。他说:“草医草药要重视起来,敌人是封锁不了我们的。”当时,红军医院收容200多名参加反“围剿”的伤员,全部采用中医中药治疗病伤。
中医药以它不可低估的药用价值,挽救了许多红军战士的生命,帮助红军度过了艰难岁月。
在延安时,由于环境条件恶劣,毛泽东曾患风湿性关节炎,发作时往往痛得连胳膊都抬不起来。吃了不少西药,仍不见效。一次,开明绅士、名中医李鼎铭到杨家岭来看望毛泽东。他为毛泽东切脉之后,很自信地说,吃四服中药就可以好了。那时,中西医之间矛盾尖锐,毛泽东身边的医生都是西医,他们不同意毛泽东服用中药。
毛泽东则力排众议,坚持把李鼎铭开的四服中药吃了下去。吃完后,疼痛果然消失,胳膊活动自如了。这更使毛泽东认识到中医药的神奇功效。毛泽东又介绍李鼎铭为八路军的干部、战士治病。很快,中医中药成了八路军必不可少的医疗方式。不久,李鼎铭还为八路军培养了一批中医,他们活跃在各个部队。
1949年9月,毛泽东在接见全国卫生行政会议代表时,从保护和发展中医药这一宝贵的祖国文化遗产出发,提出必须很好地团结中医,提高技术,搞好中医工作,发挥中医力量。
1953年,毛泽东在杭州刘庄宾馆小憩时说:“中国对世界有三大贡献,第一是中医……”此说似乎不无戏言成分,但他把中医摆在“三大贡献”之首,表明了其对中医的情结。
1954年,毛泽东作出重要批示:“中药应当很好地保护与发展。我国的中药有几千年历史,是祖国极宝贵的财产,如果任其衰落下去,将是我们的罪过;中医书籍应进行整理……如不整理,就会绝版。”同年,他又指示:“即时成立中医研究院。”于是,在全国范围内调集名医,于1955年12月成立了中国中医研究院,毛泽东还接见了第一任院长鲁之俊。
1956年,毛泽东在同音乐工作者谈话时指出:“应该学外国近代的东西,学了以后来研究中国的东西。就医学来说,要以西方的近代科学来研究中国的传统医学的规律,要发展中国的新医学。”并说:“我们接受外国的长处,会使我们自己的东西有一个跃进。中国的和外国的要有机地结合,而不套用外国的东西。”他还说,历史上中医的一个很大特点是从不拒绝接受外来的好东西,比如中药胖大海,实际上是进口货,但中医拿过来了,现在谁能说它不是中药呢?中医得到发展,是由于兼收并蓄,博采众长。
1958年10月11日,毛泽东在对卫生部党组《关于西医学中医离职学习班的总结报告》的批示中指出:“中国医药学是一个伟大的宝库,应当努力发掘,加以提高。”
毛泽东的一系列讲话和批示,为中医药学的发展指明了方向。

延安时期,针对有些西医看不起中医,毛泽东指出:中西医一定要结合起来
有关中西医结合发展创新的思想,毛泽东早在《井冈山的斗争》一文中就提出了要“用中西两法治疗”。在延安时,毛泽东对名中医李鼎铭说:“现在延安有些西医看不起中医,你看边区的医药事业应如何发展?”李鼎铭说:“中西医各有所长,只有团结起来才能取得进步。”毛泽东说:“你这个想法很好,以后中西医一定要结合起来。”
在学习方法上,毛泽东曾认为中医带徒的方法也很好,一面教读医书学理论,一面带他看病,使理论和实践紧密结合起来,这种教学方法很先进,带一个出一个,很少出“废品”,所谓“名师出高徒”不是一句空话,因为他们让学生从一开始就懂理论与实践的不可分割。
1944年10月30日,毛泽东在陕甘宁边区文教工作者会议上的演讲中谈道:针对150万人口的陕甘宁边区内,还有100多万文盲,2000个巫神,迷信思想还在影响广大的群众。……新医的任务“是联合一切可用的旧知识分子、旧艺人、旧医生来帮助、感化和改造他们,为了改造,先要团结”。
在毛泽东中西医结合思想影响下,陕甘宁边区医务界在延安最先开展了西医学习中医的活动。许多西医虚心拜中医为师。例如,鲁之俊、朱琏等就曾拜老中医任作田为师,学习针灸知识。陕甘宁边区政府表彰了任作田与鲁之俊团结中西医的成绩,并授予他们特等模范奖。
1949年9月,在中央军委总卫生部在北京召开的第一届全国卫生行政会议上,毛泽东对中央军委总卫生部部长贺诚和各大军区卫生部部长作了明确的指示:你们的西医只有一两万,力量薄弱,你们必须很好地团结中医。毛泽东为第一届全国卫生会议题词:“团结新老中西各部分医药卫生工作人员,组成巩固的统一战线。”这一题词为新中国成立初期制定卫生工作方针提供了理论基础和思想基础。
1955年1月,毛泽东在一次关于中医工作的讲话中说:中国6亿人口的健康主要是靠中医,不是靠西医,因为西医的人数很少,中医对人民健康的作用是很大的。中国医药有悠久的历史,对人民有很大的贡献,要建立机构研究中医药,应按对待少数民族政策那样对待他们,各机构中应有他们的成员。对有本事的中医要当专家看待,按专家的待遇对待。
1954年,毛泽东发出“西医学习中医”的号召并提出了一些具体的改进措施:要抽调100名至200名医科大学或医学院的毕业生交给有名的中医,去学他们的临床经验,而学习就应当抱着虚心的态度。西医学习中医是光荣的,因为经过学习、教育、提高,就可以把中西医界限取消,成为中国真正统一的医学,以贡献于世界。
1955年12月,在中医研究院成立的同时,全国第一届西医离职学习中医研究班开学,从全国调来76名有经验的西医脱产两年半学习中医。从1955年底到1956年初,卫生部又在北京、上海、广州、武汉、成都、天津等地举办了6期西医离职学习中医班,从全国范围内抽调部分医学院校毕业生及有一定临床经验的西医参加,系统学习中医理论和治疗技术两年半。参加学习的共有300多人。1955年9月间,北京、上海、广州和成都等地的中医学院相继成立。
1958年10月11日,卫生部党组向中央写了《关于西医学中医离职学习班的总结报告》。毛泽东作了“中国医药学是一个伟大的宝库,应当努力发掘,加以提高”的著名批示。在这一批示中,毛泽东还指出:“我看如能在1958年每个省、市、自治区各办一个70人至80人的西医离职学习班,以两年为期,则在1960年冬或1961年春,我们就有大约2000名这样的中西医结合的高级医生,其中可能出几个高明的理论家。”毛泽东的批示,极大地鼓舞了西医学习中医的积极性。据1960年全国西学中经验交流会时统计的资料,全国西医离职学习中医班有37个,学员2300余人,在职学习中医的有36000余人。高、中级医药院校,也大多开设了中医学课程,培养了一大批西学中人员。其中,大多数成为以后中医或中西医结合研究的技术骨干和学术带头人,为今天中医药能够走出国门、走向世界作出了杰出的贡献。
毛泽东认为:“学习各国的东西,是为了改进和发扬中国的东西,创造中国独特的新东西。”“就医学来说,要以西方的近代科学来研究中国的传统医学的规律,发展中国的新医学。”“西方的医学和有关的近代科学、生理学、病理学、生物学、化学、解剖学等,这些近代的科学都要学。但是,学习西医的人,其中一部分又要学中医,以便运用近代科学的知识和方法来整理和研究我国旧有的中医中药,以便使中医中药的知识和西医西药的知识结合起来,创造中国统一的新医学、新药学。”在这里,毛泽东最先指出了中西医结合研究的内涵。
针对歧视、排斥中医的现象,毛泽东严肃地指出:几年来,都解放了,唱戏的也得到了解放,但是中医还没得到解放
近百年来,中国历史上有过许多次歧视、消灭中医的沉痛教训。
尽管中医药教育长期以来以“祖传师承”、“开办学校”两种方式在民间延续着,但在1922年北洋政府时期颁布施行教育系列方案时,中医药学就被排斥于正规教育体系之外,此举曾引起中医界的抗争,引发了近代中医抗争运动。国民党政府在1929年曾提出“废止旧医,以扫除医事卫生之障碍”的方针;1936年又提出“国医在科学上无根据”,一律不许执业的谬论。国民党当局始终也没有同意中医办教育。随着西学东渐,特别是抗生素等药物的产生和应用,西医急性传染病和感染性疾病的诊疗水平有了很大提高,使传统的中医药学临床应用受到了严峻的挑战和考验。如何认识中医药,怎样利用中医药,成为摆在中国共产党人面前的现实问题。毛泽东在充分肯定中医药学的同时,也指出了中医药学的历史局限性,即缺少现代科学的解释,应加以提高。他说:“看不起中医是不对的,把中医说得都好、太好,也是错误的”,“我们对中医必须有全面的、正确的认识,必须批判地接受这份遗产,必须把一切积极因素保存和发扬”。
新中国成立初,一直存在着两种截然对立的倾向。一是有些人对中医抱着一种历史虚无主义的态度,说中医“不科学”,中药“不卫生”。二是在中医界内部,有些人把中医神秘化,认为中医“百病皆治”、“完美无缺”,不需要用现代科学、也不能用现代科学方法来加以整理和研究。因此,团结中西医的方针在新中国成立后的头几年里,卫生部门领导也一直没有认真执行。
1951年,卫生部的个别领导公开发表文章,称中医为“封建医”,把中医中药知识看作是封建社会的“上层建筑”,应该随封建社会的消灭而被消灭。这一错误观点流传很广,并得到一些人的支持,成为有些卫生行政部门的干部实行排挤和逐步消灭中医的理论依据,从而引起广大的中医和人民群众的不满。特别是1951年5月1日卫生部公布的《中医师暂行条例》及实施细则,与1952年10月4日公布的《中医师考试暂行办法》,均规定了一些不切实际的要求和过于苛刻的办法,使大多数中医不能合法执业。在国家实行公费医疗制度中,中医药治疗费用不能报销,中医无法发挥应有的作用。1951年12月,卫生部发出的《关于组织中医进修学校及进修班的通知》,尽管目的是组织中医进修业务,但讲授的大都是西医课程。对中医的提高和改造要求过高过急,不是从保持中医传统的理论和医疗特色出发来发展中医,而是错误地认为中医必将被西医代替,由城市到乡村,由乡村走向自然淘汰。
当时,由中央卫生部直接领导的中医师资格审查,仅就华北地区68个县来讲,竟有90%以上的中医师被认为是“不合格”的。对中医师的考试,由于多为西医内容,使得大多数中医师被淘汰。如在天津中医师考试中,其结果仅有1/10的中医师通过。在高等教育中没有中医药这一学科,使得中医药人才的培养问题没有着落。
针对当时普遍存在的认为中医不科学而歧视、排斥中医的现象,毛泽东在1954年就及时纠正说:“中医对我国人民的贡献是很大的,中国有六万万人口,是世界上人口最多的国家,我国人民所以能够生衍繁殖,日益兴盛,当然有许多原因,但卫生保健事业所起的作用是其中重要原因之一,这方面首先应归功于中医。”他又说:“中西医比较起来,中医有几千年的历史,而西医传入中国不过几十年,直到今天我国人民疾病诊疗仍靠中医的仍占五万万以上,依靠西医的则仅数千万(而且多半在城市里)。因此,若就中国有史以来的卫生教育事业来说,中医的贡献与功劳是很大的。祖国医学遗产若干年来,不仅未被发扬,反而受到轻视与排斥,对中央关于团结中西医的指示未贯彻,中西医的真正团结还未解决,这是错误的,这个问题一定要解决,错误一定要纠正。首先各级卫生行政部门思想上要改变。”
1955年,毛泽东在一次会上又严肃指出:几年来,都解放了,唱戏的也得到了解放,但是中医还没得到解放。中医进修西医化了。看不起中医药,是奴颜婢膝奴才式的资产阶级思想。
为了全面纠正影响中西医团结的错误倾向,毛泽东和党中央采取了一系列重大措施。1954年11月,中共中央批转国务院文委党组《关于改进中医工作的报告》。卫生部于1955年2月2日发出《关于取消禁止中医使用白纸处方规定的通知》,旨在取消对中医行医的限制。1956年11月27日,卫生部发布了《关于废除中医师暂行条例的通令》。《通令》称:本部在1951年5月1日公布的《中医师暂行条例》,与党的中医政策精神相违背,使中医工作受到严重损害,特此宣布废除。
1954年下半年,北京、天津、上海等大城市的各大医院,开始吸收中医参加工作,并设置中医门诊和中医病床,公费医疗也明确规定中医看病吃药准予报销。据1958年统计,当时全国已建立了300多家中医医院。在党的中医政策的指引下,从中央到地方的各级卫生行政机关,吸收中医参加领导工作并设置中医管理机构,从而极大地提高了中医的政治地位。
毛泽东风趣地对施今墨说:“你们同行是不是冤家啊?”
毛泽东不仅关心着中医药事业的发展,而且还与许多名医都有交往,请他们看病,甚至与他们亲切长谈。有一次,毛泽东宴请一些知名人士,其中就有北京四大名中医之一的施今墨先生。施今墨与著名西医专家黄家驷、林巧稚等同桌。毛泽东风趣地对施今墨说:“你很有名啊,我在年轻时就听说过你。你们同行是不是冤家啊?”施今墨回答:“主席,我们团结得很好,互相很尊重。”毛泽东听了很高兴。
1955年,上海名中医章次公先生被调到卫生部任中医顾问。不久,中央“四老”之一的林伯渠患病颇重,呃逆月余不止,章次公赴治,三剂药治好了林伯渠。中央办公厅一位同志在闲谈时对毛泽东说:“卫生部新来了一位老中医章老,那医术可神了……”接着又将林老案例讲给毛泽东听。毛泽东高兴地说:“我早对你们讲过,中医不比西医差嘛,你们还不信。”过了几天,毛泽东身体不适,指名请章次公为他看病。此后,毛泽东曾两次约请章次公彻夜长谈中医学。他看过不少中医书,提了许多问题,章次公均对答如流,毛泽东会心地说了一句:“难得之高士也。”
1957年夏天,中共中央在青岛召开各省、市、自治区党委书记会议。其间,毛泽东到海水浴场游泳时,不慎得了感冒,加上失眠的困扰,病情日渐严重。随行的保健医生用西药治疗,效果不好。中共山东省委第一书记舒同得知后,便推荐山东著名的老中医刘惠民给毛泽东看病。因为刘惠民大夫开起药方来多用一般医生不太敢用的毒性较强的药材,因此,保健医生和毛泽东身边的工作人员都表示担心,不同意毛泽东吃。刘惠民也因事关重大而心有顾忌,一再表示:“药方可以开,但必须由舒书记的夫人亲自跟我去药店抓药、亲自煎药,并亲自看着主席喝下去才行。”
面对两种截然不同的意见,舒同当即表示:“刘大夫治感冒的药我吃过,的确很灵。他要求由我的爱人给主席煎药,我同意。万一有问题,由我们夫妻负责。”
最后,征求毛泽东自己的意见。毛泽东虽在病中,但仍不失幽默地说:“舒同同志担保了的,我不怕!”
于是,舒同的夫人石澜便在这样一种特殊的背景下,担当起了为毛泽东抓药、煎药的特殊任务。
3天后,毛泽东的感冒症状完全消失了,而且睡眠也逐渐好起来。毛泽东感到特别高兴。
毛泽东问起刘大夫的药方里有一味“酸枣仁”是起什么作用的,为什么要“生、熟合起来捣”。
舒同夫人石澜回答:“药用的酸枣仁,数陕北的最好。当年在延安,主席您住过的那个杨家岭满山都是酸枣树。我们常去摘一些酸枣回来,放在衣兜里当水果吃。酸枣仁这东西,生吃能提神,炒熟了吃能安神。生、熟捣碎入药,就能同时发挥两种作用,平衡中枢神经。所以您不仅感冒好了,睡眠也好了。这正是刘大夫的高明之处呀!”
毛泽东听后哈哈大笑,对坐在一旁的舒同说:“看看,你的夫人讲得多细,将来可以改行当医生了!”11月,毛泽东应邀赴莫斯科参加世界各国共产党和工人党代表大会,刘惠民被指定为保健医生,随同毛泽东前往。
1959年冬,刘惠民为毛泽东诊治感冒。在开处方时,毛泽东忽然提了个问题,问刘惠民民间常说的“上火”怎样解释。刘惠民用中医理论解释后,毛泽东笑着说:你讲的这些我不懂啊,你看怎么办?刘惠民略微思索一下,回答说:“西医学了中医,再用中医的话讲出来,主席就懂了。”毛泽东听后,非常高兴地站起来,说:“对喽,所以我说,关键的问题在于西医学习中医。”
毛泽东接受中医治疗最精彩的一幕是针拨治疗白内障。1974年底,毛泽东患老年性白内障,双目已近失明。经过慎重考虑,中央决定由中国中医研究院著名眼科专家唐由之为毛泽东实施针拨术。中医传统方法中有一种“金针拨障法”,民间失传已久,但该方法已由中国中医研究院继承下来并有所发展和改进,唐由之是主要负责专家。毛泽东知道后,欣然同意做手术。
1975年7月23日,唐由之顺利地完成了这一手术。在手术过程中,毛泽东示意播放古典乐曲《满江红》,其心率、血压一直正常。
做了白内障手术后,需要休息几天,但毛泽东只隔一天就忙着看起书来,唐由之劝阻不住。毛泽东看了一会儿,果然感到眼睛不舒服,便停下来说:“唐由之啊,我们的争论,你胜利啦!”他还伸出右手食指和中指做了一个“V”字形手势。唐由之说:“主席,您亦胜利了,因为您要我们用中医中药的知识和西医西药的知识结合起来,今天给主席做的白内障手术,就是在这种思想指引下研究成功的。”毛泽东听后会意地笑了。
毛泽东:“祝针灸万岁!”
中国的针灸,已有2000多年的历史。针灸的起源,可能比药引还要早,是我国最宝贵的医学遗产之一。针灸疗法以操作简单、应用广泛、疗效迅速、安全经济等特点,深受广大人民群众的欢迎。针灸疗法在中国人民对疾病的斗争中发挥了巨大作用,促进了我国医疗保健事业的发展。但是,自西医传入中国以来,由于崇洋媚外思想的影响,有一些人忽视广大人民群众对针灸治病的实际需要,一味地说中医针灸“落后”、“不科学”,是“土东西”,全盘加以否定。
毛泽东熟读史书,对历史上针灸的治疗作用非常了解。他在读司马迁的《史记·扁鹊仓公列传》时就知道,约在公元前5世纪的扁鹊,用针刺法使昏迷不省人事的“尸蹶”病人苏醒过来,经过其他综合治疗,使病人完全康复,被誉为“起死回生”的妙术。《后汉书·华佗传》里,也记载有华佗用针灸治曹操顽固的“头风”。毛泽东在读《旧唐书》时,熟悉名医甄权的传记,当时鲁州刺史库狄苦于“风痛”,两手无法拉弓射箭,虽经不少医生治疗均未奏效,后请甄权诊视。甄权认为只需针刺一次即能痊愈。果然在针刺“肩髁”穴后,两手即能引弓而射。《宋史·许希传》里也讲到宋仁宗的病被许希用针刺医好。这些史书所述,都给毛泽东留下了深刻的印象。
19世纪以后,清政府对针灸疗法蛮横地加以排斥和打击,并于1822年下令永远停止在“太医院”中施行针灸疗法。从此针灸被当成“土东西”而被忽视。
新中国成立后,毛泽东主张对包括针灸术在内的中国优秀传统文化加以批判地吸收继承。他认为:“针灸是中医里的精华,要好好地推广、研究,它将来的发展前途很广。”
1955年4月,毛泽东在杭州邀请著名针灸专家、卫生部副部长朱琏一道吃晚饭。在跟朱琏谈天的时候,毛泽东说起了她的《新针灸学》一书。这本书是3月23日送呈毛泽东的。毛泽东不但全看了,而且颇为赞同其中说到的针灸与现代医学理论发展的关系。毛泽东对朱琏说:“巴甫洛夫的高级神经活动学说的理论,对针灸治病的神秘提供了解释的钥匙。反过来针灸又能够给它提供丰富的实际材料。如进一步研究,一定可以发挥更大的效果,丰富与充实现代的医学,研究针灸,对医学理论的改革将发生极大的作用,是吗?”他征询朱琏的看法,朱琏肯定地回答说是的。毛泽东也频频点头:“很好,医学理论的确要改革。”
开饭了,菜有几盘,却不奢侈。大家都举起面前的酒杯。毛泽东也站起来,举杯说:“今天–”他沉吟着,该说什么祝酒词呢?
叶子龙接过话说:“今天祝各界大团结万岁。”
毛泽东说:“不是。今天–是祝针灸万岁!”他环顾几个在座的大夫,自己先喝了一口酒,接着说:“你们不要以为针灸是土东西。针灸不是土东西,针灸是科学的,将来各国都要用它。”
他打手势让大家都坐下,自己也放下了酒杯,接着说道:“中医的经验,需要有西医参加整理,单靠中医本身是很难整理的啊。”
在毛泽东的鼓励和支持下,朱琏著的《新针灸学》被译成数国文字,在国外出版发行。
在毛泽东“针灸是科学的”正确思想指引下,中国的针灸疗法获得了飞跃发展。针灸不仅在民间广泛地流传和应用,满足了人民群众医疗上的需要,而且不断走出国门,受到世界各国人民的重视和信赖。
1971年7月,美国《纽约时报》驻华盛顿办事处主任詹姆斯·雷斯顿来华访问。《纽约时报》是美国的一份大型传统日报,以及时、准确、权威而著称。该报十分重视选择头版要闻,对于较长的文章,经常是第一段登在头版,其余部分则登在后面。詹姆斯是美国资深记者,擅长时政报道,获过多次新闻大奖。这年7月,詹姆斯被派往中国采访,在北京参观了很多单位,包括到中医院参观针灸治疗。他在访问中不幸患上阑尾炎,在北京一家医院接受阑尾切除手术治疗。当时周恩来指示:一定要把手术做好,千万不能感染。术中使用的是常规药物麻醉。术后他感到腹部不适,便接受了针灸治疗。回美国后,詹姆斯于7月26日在《纽约时报》头版发了一篇报道,标题是《现在让我告诉你们我在北京的手术》,头版只登了一小段,而文章的主要部分登在第6版上,正题为《现在让我告诉你们我在北京的阑尾切除手术》,文章占了将近一整版,并配有作者访问北京一家中医院针灸诊疗室的照片。詹姆斯当时已经62岁,由于他的不平凡的经历和《纽约时报》在新闻界中的地位,在一般美国人心中,像这样的记者写出的文章可信度是极高的。动手术可用小小的银针来麻醉,病人不觉疼痛,还可治疗好多病,没有毒副作用,这在西方可是从来没有过的神奇事。当时又正值白宫刚刚宣布尼克松总统将于1972年访华,美国公众对东方大国–中国有一种神秘感,从而使针灸医术的神奇疗效在美国民众中引发了浓厚兴趣。
1972年,尼克松首次率团访华,参观了中国的“针刺麻醉”胸外科做肺切除手术,神经外科做颅脑肿瘤的切除手术,看到病人都在清醒的状态下接受开胸、开颅等大型手术,感到十分惊奇,难以理解。在向尼克松赠送的礼品中,还有一本外文出版社出版的英文版《中国针刺麻醉》一书。代表团返美后纷纷宣传“针刺麻醉”的神奇,再一次引起美国民众的浓厚兴趣,特别是美国医务界对中国针灸医术开始有学习的愿望。中医针灸也随之传入美国,并在世界上产生了“中医热”和“针灸热”。
目前,世界上许多国家和地区设立了中医药机构,中医药正逐步走向国际化,实现了毛泽东的夙愿。

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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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加 州 中 医 立 法 历 史 年 表       加州中醫歷史文獻館 陳 大 仁 教授(撰稿)
一九九九年十月初搞; 二零零五年十月定稿 二零一零年八月補訂.(原文http://www.caam.us/resources/califonria_legislation082510.pdf)
美國的中醫藥事業當首推加州,這里的醫師人數、學術水平及政治潛力均遙遙領先于其他數十個州,成為發展美國中醫的主要推動力量。而加州的中醫事業,則首先受惠于前輩們的英勇奮斗,成功立法,開創了在異鄉公開傳播這門古老醫學的新紀元;再加上三十多年來廣大中醫師的辛勤耕耘,通過活躍而又艱辛的政治行動,進一步取得了顯著的進步。其中為數眾多的華人中醫師為在海外傳播中華文化更是作出了不可磨滅的貢獻。中醫今天已經成為美國社會最受歡迎的替代醫學之一。
請看近四十年來加州中醫界所策動的一百多項立法動議或者是立法抗爭所經歷的坎坷事實。這些轟轟烈烈的政治行動對確保加州中醫師的基本行醫權益和廣大病家的合法福利都具有非常重要的意義。以下就是近代加州中醫師們組織起來爭取權益,服務人民的動人歷史﹕
AB 1500 (Duffy, 1972) —— 加州西醫學會(CMA)策劃
加州第一個針灸立法﹕規定沒有西醫執照的人員(稱之為“醫師助手")可以進行針灸治療。但是醫師助手必須在西醫的直接監督之下施術,而且針灸治療必須在核准的醫學院校之內進行,並以科學研究為目的。本案由加州西醫師公會策劃,雷根州長簽署成為法律。
AB 976 (Duffy, 1972) —— 加州中醫藥針灸學會策劃
內容同 AB 1500,但增加一項條款即針灸治療除了可以在核准的醫學院校之內進行,還可在該醫學院校的“校園以外"地方進行。雷根州長予以否決。
AB 1841 (Duffy, 1972) —— 加州中醫藥針灸學會策劃
內容同 AB 976。同時要求撥款四十萬元供作針灸研究之用。雷根州長再次予以否決。
AB 1691 (Duffy, 1972) —— 加州中醫藥針灸學會策劃
要求在醫療職業中增加一種新的醫師助手資格,稱為“針灸醫助"(PHYSICIAN ASSISTANT—ACUPUNCTURE)。承認這種非西醫人員可以在西醫的直接監督之下進行針灸治療,但必須以科學研究為目的。同時規定成立針灸顧問委員會,專司管理“針灸醫助"事務。本案受到針灸界人士的強烈反對,雷根州長亦予以否決。 

SB 2117 (Mascone, 1973) —— 加州中醫藥針灸學會策劃

承認針灸師資格,規定非西醫的針灸師可以獨立進行針灸治療,但事先必須有西醫或牙醫的診斷和介紹。提案順利通過參、眾兩院,但繼續被雷根州長予以否決。
SB 2118 (Mascone, 1973) —— 加州中醫藥針灸學會策劃
規定成立有七名成員的針灸顧問委員會,專司管理針灸事務。提案順利通過參、眾兩院,但同樣被雷根州長予以否決。

SB 86 (Moscone, 1975) —— 加州中醫藥針灸學會策劃
內容與 SB2117 及 SB-2118 兩案基本相同。這是加州第一個成功的由中醫界自行推動的針灸職業合法化提案。布朗州長七月十二日簽署成為法律。
AB 2424 (Keysor, 1978) —— 加州針灸聯合總會策劃
授權加州醫療補助計劃(Medi-Cal)提供針灸福利,布朗州長簽署成為法律。
AB 3105 (Suitt, 1978) —— 加州針灸顧問委員會策劃
本案取消根據經驗頒發針灸師證書的條例。規定要對所有申請針灸師證書者實行考試。本提案還規定考試要包括有實際操作的口試。布朗州長簽署成為法律。 

AB 3568 (Torres, 1978) ——加州針灸顧問委員會策劃
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。此案由加州針灸針灸顧問委員會主席丘德陽醫師開始策劃。當時并未得到西醫公會的諒解,審議中遇到很大阻力,此提案未得通過。
SB 1488 (Sieroty, 1978) —— 美國針灸協會策劃
法案允許持有證書的針灸師注冊成立針灸公司。布朗州長簽署成為法律。
SB 1106 (Song, 1978) —— 美國針灸協會策劃
規定針灸顧問委員會的工作細則﹕包括委員會中增加四名公眾委員,建立針灸學徒制度,建立繼續教育制度,診所必需展示針灸師證書,證書每兩年更新一次,五年沒有更新證書者要重新考試等。並規定針灸顧問委員會的行政關係直接隸屬於加州醫療品質保障部屬下的輔助醫療職業處,專施管理針灸師執業的問題。布朗州長簽署成為法律。
SB 1790 (Campbell, 1978) —— (法案策劃者待查)
允許西醫以外的醫療職業者從事營養及輔助食品咨詢,但必需聲明並非診斷或治療等醫療行為。布朗州長簽署成為法律。
AB 1391 (Torres, 1979) ——加州針灸顧問委員會策劃
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。此案主要由加州針灸針灸顧問委員會主席丘德陽醫師策劃,后獲得西醫公會的諒解,并取得州長的支持。該案交由托里斯眾議員提出,布朗州長簽署成為法律。
AB 3040 (Knox, 1980) —— 美國針灸協會策劃
將針灸執業範圍擴充至包括電針療法,東方式按摩及艾灸療法,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,授予更大的權力。此案主要由美國針灸協會策劃,諾克斯眾議員提出,布朗州長簽署成為法律。
AB 538 (Rosenthal, 1981) —— 美國針灸協會策劃
規定牙醫和足醫必需接受針灸訓練方能施行針灸。布朗州長簽署成為法律。
AB 901 (Rosenthal, 1981) —— 美國針灸協會策劃
建議設立針灸戒酒試驗計劃。該提案因過去類似計劃之結果不夠滿意而未通過。
AB 837 (Rosenthal, 1981) —— 美國針灸協會策劃
加州議會第一項涉及針灸醫療保險的提案。根據保險業界的建議,議案規定患者每一種疾病每年可以接受 24 次針灸治療。後來由于業界人士不同意數目限制,此提案被撤銷。

AB 3601 (Rosenthal, 1982) ——(法案策劃者待查)
要求醫療保險支付針灸治療費用。曾在議會舉行廣泛聽證,包括向議會人士及西醫示范針灸技術。
此提案未得通過。
AB 3806 (Rosenthal, 1982) —— 美國針灸協會策劃
允許不持有針灸師證書的外國或外州針灸專家在教學或示範中從事針灸治療。布朗州長簽署後立即生效。
SB 1158 (Torres, 1983) ——(法案策劃者待查)
規定針灸師可以使用“東方醫學博士"的名銜以提高針灸專業的地位。由于加州西醫學會強力反對,此提案未得通過。
AB 3827 (Filante, 1984) —— 美國針灸協會策劃
建立針灸戒酒戒毒試驗計劃的第二個提案。此提案曾獲得議會通過,但杜美津州長將其否決。
SB 314 (Rosenthal, 1984) ——(法案策劃者待查)

規定針灸師必需每兩年修有 30 個學時的繼續教育學分,提案獲得通過并由杜美津州長簽署成為法律。 

SB 2179 (Torres and Rosenthal, 1984) —— 加州針灸大同盟策劃
提案規定健保組織(HMO)或自身保險或殘障保險計劃以外的醫療保險計劃,包括非營利醫院等集體性的醫療保險計劃都必需具備供選購的針灸治療福利。杜美津州長簽署成為法律。
AB 272 (Filante, 1985) ——美國針灸協會策劃
取消國外訓練的針灸師需在加州先做住院醫師的要求,但規定他們必須在美國內至少住滿九個月才能參加針灸執照考試。杜美津州長簽署成為法律。
SB 1642 (Rosenthal, 1986) ——加州針灸大同盟策劃
將針灸師在工傷保險系統中列為醫師(PHYSICIAN),有權治療受傷雇員。另外規定要向州政府和公立校區之雇員提供針灸醫療福利。此案未獲成功。
SB 839 (Torres, 1987) ——加州中醫政治聯盟策劃
規定針灸治療必須由持有法定合格證書的針灸師執行。禁止無執照者進行針灸。杜美津州長簽署成為法律。
SB 840 (Torres, 1987) ——加州中醫政治聯盟策劃
將針灸師在工傷保險系統中列為醫師(PHYSICIAN),有權治療受傷雇員。該案排除針灸師對患者作殘障評估,此外還附有四年期限的“日落條款"。杜美津州長於 1988 年 9 月簽署成為法律。
SB 841 (Torres, 1987) ——加州中醫政治聯盟策劃
要求所有的健保服務計劃,非營利性醫院服務計劃和集體殘障保險提供針灸治療福利。此案未獲成功。
SB 1362 (Rosenthal, 1987) ——加州中醫政治聯盟策劃
要求針灸考試委員會每年舉行兩次針灸執照考試,委員會必需向考生提供筆試及口試有關內容範圍(包括中藥的內容範圍)的書面通知,考生可查詢自己所考各科成績,設立考生的上訴程序。杜美津州長簽署成為法律。
SB 1544 (Marks, 1987) ——(法案策劃者待查)
將針灸師證書法令改為針灸師執照法令,即針灸師需持有執照方能行醫。杜美津州長簽署成為法律。
AB 4671 (Elder, 1988) ——(法案策劃者待查)
修訂批准針灸考試委員會所提的教育和訓練計劃。杜美津州長簽署成為法律。

AB 2367 (Filante and Rosenthal, 1989) ——加州中醫政治聯盟策劃
針灸考試委員會舞弊案引發之機構改組提案,規定將針灸考試委員會改稱針灸委員會,取消執行執照考試之權力;針灸師委員資格從十年經驗改為五年經驗;委員會中針灸師委員要反映族裔比例。杜美津州長簽署成為法律。
SB 633 (Rosenthal, 1989) ——(法案策劃者待查)
要求針灸考試委員會聘請獨立專家對現行針灸學徒制度以及國外訓練的針灸考生資格進行分析評估。同時要求所有 1988 年 1 月 1 日以 前獲得執照的針灸師在 1993 年 1 月 1 日前完成包括各中西醫學科目的 40 學時繼續教育。杜美津州長簽署成為法律。
SB 654 (Torres, 1989) —— 加州中醫政治聯盟策劃
提案規定健保組織(HMO)或自身保險或殘障保險計劃以外的醫療保險計劃,包括非營利醫院等集體性的醫療保險計劃都必需自 1990 年 1 月 1 日起一律提供針灸醫療福利。此案未獲成功。
AB 3836 (Eastin, 1990) —— 加州中醫政治聯盟策劃
規定將隸屬于加州醫務部屬下之輔助醫療職業處的針灸委員會升格為獨立的加州針灸局(ACUPUNCTURE BOARD)。此案未獲成功。
AB 4368 (Filante, 1990) ——(法案策劃者待查)
所有針灸委員會核准的教育課程必需在 1992 年 12 月 31 日以前,或在針灸委員會核准後 5 年內,再獲得公共教育總監的批准。
AB 400 (Margolin, 1992) —— 加州中醫政治聯盟策劃
將四年前通過的針灸工傷保險法案(SB840)延長四年。威爾遜州長簽署成為法律。
ACR 150 (Burton, 1993) ——(法案策劃者待查)
建立有十六名成員的傳統中草藥顧問委員會,專施管理中草藥品的有關事務。此議案未獲通過。
AB 2494 (Conroy, 1994) ——(法案策劃者待查)
規定針灸師使用中草藥為藥用。此案未獲成功。
SB 1279 (Torre, 1994) —— CSOM 策劃,加州中醫政治聯盟支持
規定執照針灸醫師可以建立針灸專業仲裁委員會(PEER REVIEW COMMITTEE)。威爾遜州長簽署成為法律。
AB 1002 (Burrton, 1995) —— CSOM 策劃,加州中醫政治聯盟支持
要求廢除現行勞工法中有關針灸師醫師身份的”日落條款”。此案被修訂為將日落條款再延長兩年。威爾遜州長簽署成為法律。 

AB 1003 (Burrton, 1995) —— CSOM 策劃
要求針灸師可以在工傷保險系統中作殘障評估。由于阻力太大,作者後來主動將此案撤消。
SB 1360 (Watson, 1996) ——加州中醫政治聯盟策劃
要求廢除現行勞工法中有關針灸師醫師身份的 “日落條款”。此案未獲成功。
SB 863 (Lee, 1997) ——法案策劃者待查,加州中醫政治聯盟反對
規定西醫不必取得針灸執照即可進行針灸治療;同時規定將針灸委員會改為針灸局。此案未能通告議會。
SB 212 (Burton et al, 1997) —— CSOM 策劃,加州中醫政治聯盟支持
廢除現行勞工法中有關針灸師醫師身份的”日落條款”,使針灸師得以醫師資格永久保留在工傷醫療保險系統之中。威爾遜州長簽署成為法律。
AB 174 (Napolitano 1997) —— 加州中醫政治聯盟策劃
規定禁止其他醫務人員(諸如整脊醫師、護士、理療師等)未經正規訓練就從事針灸治療,目的在於保障中醫師的基本行醫權利,並確保病家獲得可靠專業治療。威爾遜州長簽署成為法律。
AB 410 (Gallegos et al, 1997) —— CSOM 策劃,加州中醫政治聯盟支持
《豁免中藥銷售稅提案》。此案目的在於爭取豁免中醫師發售中藥的零售稅,如同其他醫務人員銷售維他命等時免收零售稅一樣。此案未能通過議會而失敗。
SB 1255 (Polanco, 1997) —— 加州整脊醫師公會策劃,加州中醫政治聯盟支持
規定有執照的醫務工作者有權對及時付款的患者以及對無力購買醫療保險的患者給予折扣優惠。此案由加州整脊醫師公會策劃,威爾遜州長簽署成為法律。
AB 2120 (Cedillo, 1998) —— CAAOM 策劃,加州中醫政治聯盟支持
規定針灸醫師有權擁有其他醫療職業公司的股權。威爾遜州長簽署成為法律。
AB 2721 (Miller, 1998) ——(法案策劃者待查)
制裁任何涉及色情活動的醫療職業者。針灸醫師必須向加州針灸局注冊診所地址。威爾遜州長簽署

SB 1980 (Greene, 1998) —— 加州中醫政治聯盟策劃
規定將隸屬于加州醫務部之輔助醫療職業處管轄下的針灸委員會升格為獨立的加 州針灸局。威爾遜州長簽署成為法律。
AB 204 (Migden, 1998) —— 加州中醫政治聯盟策劃
在工傷法中明確規定雇主及管制醫療組織向工傷雇員提供的醫療服務中都必須加上針灸福利項目;規定雇員有權選定自己的 “私人針灸醫師";規定工傷患者在要求轉換主治醫師時有權選擇針灸師。威爾遜州長簽署成為法律。
AB 1185 (Baugh,1998) —— 加州中醫政治聯盟策劃
在加州工傷補償處產業醫務委員會中添加一名針灸醫師委員,同時允許針灸師經過規定的專業訓練及考核後可以對工傷患者進行殘障評估。此案未能通過議會而失敗。
AB 1252 (Wildman, 1999) —— 加州足醫公會策劃,加州中醫政治聯盟支持
AB 1252 法案案的內容之一是規定在加州工傷補償處的產業醫務委員會中增加四名委員,包括兩名西醫、一名足醫和一名針灸醫師。戴維斯州長將之簽署成為法律。並於 2000 年一月任命聯合總會名譽會長楊自國醫師為首位中醫委員。
AB 231 (Battin, 1999) —— 外州利益團體策劃,加州中醫政治聯盟反對
試圖立例允許非執照人員從事戒毒耳針治療。此案遭到加州中醫界的強烈反對,因而遭到挫敗。
SB 466 (Perata, 1999) —— 加州中醫政治聯盟策劃
《中醫師行醫規範提案》,明確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,特別注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,新法案還要求增加小能量激光療法
和磁療法。此案順利通過議會,但被戴維斯州長予以否決。
AB 1751 (Kuehl, 1999) ——(法案策劃者待查)
即《保障患者訴訟權力法案》。禁止保險公司在合約中強行病家在糾紛中接受仲裁,賦予患者必要 時采取法庭訴訟的權力。這是年來眾多旨在對付管制醫療體制的法案之一。該案未能通過議會而失敗。
AB 2764 (Knox, 2000) —— 加州中醫政治聯盟策劃
《豁免中藥銷售稅提案》,内容同 AB410 (Gallegos et al, 1997)。此案目的在於爭取豁免中醫師發售中藥的零售稅,如同其他醫務人員銷售維他命等時免收零售稅一樣。此案未能通過議會而失敗。
SB 341 (Perata, 2001) —— 加州中醫政治聯盟策劃
泊拉塔參議員重新提出《中醫師行醫規範提案》,内容大致同去年的 SB 466。新法案還要求增加一項磁療法。戴維斯州長於二零零一年九月將之簽署成為法律。
AB 208 (Frommer, 2001) —— 加州中醫政治聯盟策劃
《豁免中藥銷售稅提案》,内容同 AB410 (Gallegos et al, 1997) 及 AB 2764 (Knox, 2000)。此案目的在於爭取豁免中醫師發售中藥的零售稅,如同其他醫務人員銷售維他命等時免收零售稅一樣。此案未能通過議會而失敗。
AB 249 (Matthews, 2002) —— 加州中醫政治聯盟策劃
《豁免中藥銷售稅提案》此案目的在於爭取豁免中醫師發售中藥的零售稅,如同其他醫務人員銷售維他命等時免收零售稅一樣。AB410 在一九九八年失敗後,AB 2764 在二零零零年再失敗,AB 208 二零零一年也未能通過議會。二零零二年改由馬修斯眾議員重新提出,即 AB 249 法案,終於順利完成了參、眾兩院的全部審議程序。但是戴維斯州長最後以財政短缺為由否決了此項提案。至此,中醫界努力運作近五年的《 豁免中藥銷售稅提案》再次受到挫折。
抗議刪除針灸醫療補助 (2002) —— 加州中醫政治聯盟參與修訂
戴維斯州長在其財政預算中曾一度將針灸醫療補助(MEDI-CAL)在於預算中予以刪除。后經廣大同業的努力遊說,參眾兩院聯合預算委員會曾將此決定否決,使針灸福利得以保留至 2003 年 7 月。
SB 573 (Burton, 2002) —— 加州中醫政治聯盟策劃
內容是將目前只要求商業醫療保險具備“可供選購"( OFFER ) 的針灸福利條款,改成規定所有保險公司都“需要提供"( PROVIDE ) 針灸福利。此案未能通過議會而失敗。
SB 1951 (Figueroa, 2002) —— 外州利益團體支持,加州中醫政治聯盟反對
即“修理加州針灸局提案"。該案給加州針灸局設定諸多苛刻條件,例如謹批准給予針灸局兩年的再復審期限(按慣例應為四年)、要求針灸局召開會議至少必需有五名委員出席方為有效(但針灸局尚有多位委員名額空缺)、要求針灸局必需有一名委員是中醫院校教師( 針灸局為避免利益沖突,歷來不得任用現職教師)等。此外提案還要求由消費者事務廳對加州針灸局工作進行全面審查﹕包括中醫師職業規範、中醫師教育標準、 要求 對外州私人團體的考試權及中醫院校審批權進行評估其適用于加州的可能性,等等。全部評估過程所需之費用要由針灸局支付(來自中醫師的執照費)。戴維斯州長簽署成為法律。
SB 1705 (Burton, 2002) —— 加州中醫政治聯盟策劃
授權通過附加培訓的中醫師參加合格醫療評估醫師資格考試後從事殘障評估工作。此案未能通過議會而失敗。
AB 1943 (Chu, 2002) —— 加州中醫政治聯盟策劃並參與修訂,外州利益團體反對。
《中醫專業教育改革法案》規定目前加州官方有關中醫 針灸事務的法律文件一律統稱之為『針灸與東方醫學』,較為符合中醫師的臨床實踐。 AB1943 的最主要條款是對中醫院校的教學大綱及教育課程提出了明 確的要求: 2003 年至 2007 年間入學的新生必需完成 3200 學時專業教育,而從2007 年開始中醫專業教育課程將增加至 4000 學時。由於外州利益團體的強力反對,本案被大幅刪改后通過,(如刪除有關專業名稱之規定,將必修學時減為 3000 等)戴維斯州長簽署成為法律。
SB 582 (Speier, 2003) —— 加州中醫政治聯盟參與修訂
根據中醫政治聯盟提出的修正案,SB582 將添加兩項豁免條款:(1)執照醫務工作者在其行醫規範内的治療過程中可以開麻黃處方或配藥。(2)含有麻黃成分的食物補充產品只能銷售給執照醫務工作者作為治療之用。如此,中醫師繼續使用麻黃的專業權力遂得以保全。戴維斯州長簽署成為法律。
SB 228 (Alarcon, 2003) —— 加州保險業界策劃,加州中醫政治聯盟參與修訂
由參議員阿拉坎提出的 SB228 提案強行將工傷醫療服務的收費標準和明顯低於市場價格的『聯邦醫療照顧』(MEDICARE) 支付標準直接挂鉤。更有甚者,凡聯邦醫療照顧並不提供的醫療項目,例如針灸,其收費則只能和用來救濟低收入家庭的『加州醫療補助』(MEDI-CAL)的支付標準直接挂鉤。
中醫政治聯盟成功提出的修正案,中醫師將不受此條款限制。斯瓦玆内格州長簽署成為法律。
SB 867 (Burton 2003) —— 加州中醫政治聯盟策劃
內容是要求商業醫療保險 提供針灸福利。此案未能通過議會而失敗。
SB 907 (Burton, 2003) —— 加州中醫政治聯盟參與修訂
根據最新版本的 SB907 修正案 ,自然療法醫師的行醫規範有了更加明確的限制:即自然療法醫師
將不得從事執照中醫師根據加州商業及職業法第 4927(c) 條授權從事的各種醫療項目,包括針灸,
中藥及推拿等。如此,加州中醫師的基本行醫權益終于得以免受自然療法醫師可能的侵犯。戴維斯
州長簽署成為法律。
小胡佛委員會評估加州中醫行業 (2003-2004) —— 加州中醫政治聯盟積極參與
由於加州中醫界和外州利益團體在如何在加州施行中醫服務的基本政策發生尖銳的衝突,州政府決定將矛盾交給小胡佛委員會進行分析評估。中醫界曾經多次總動員,出席聽證會,投寄請願書,力圖協助小胡佛委員更全面地了解加州中醫行業的實際情況。五位聯合總會成員參加了顧問委員會工作。他們是劉美嫦(加州中醫政治聯盟主席),楊自國(國家衛生署輔助醫學顧問委員會委員),屠英(全美華裔中醫組織聯合會主席),羅志長(聯合總會秘書長)以及陳大仁(聯合總會名譽會長)。可惜小胡佛委員會一直忽視乃至排斥中醫專業團體的意見,最後編寫出明顯偏袒一方的報告。
SB 899 (Poochigian, 2004) —— 加州商會策劃,加州中醫政治聯盟堅決反對並參與修訂
治療工傷患者仍必須一律按照《美國職業及環境醫學學院指引》的標準施行。這份完全由西醫編訂出來的指引,完全忽視中醫藥在治療工傷疾病中的價值和療效,嚴重妨礙工傷患者獲得針灸治療的機會。斯瓦玆内格州長簽署成為法律。
SB 356 (Alarcon, 2004) ——AIMS 策劃,加州中醫政治聯盟支持
肯定中醫診斷權提案。此案未能通過議會。
SB 840 (Kueh, 2004) —— 加州中醫政治聯盟支持
要求建立『加州健康保險機構』以提供全加州的醫療保險。此案未能通過議會。
AB 681 (Vargas, 2005) —— 加州中醫政治聯盟支持
要求將當前工商補償醫療費用標準延長三年(及至 2007 年。)此案未能通過議會。
AB 1549 (Koretz, 2005) —— AIMS 策劃,加州中醫政治聯盟支持
授權通過附加培訓的中醫師參加合格醫療評估醫師資格考試後從事殘障評估工作。此案未能通過議會。
SB 233 (Figueroa, 2005) ——外州利益團體支持,加州中醫政治聯盟反對
“日落"(撤銷)加州針灸局,並取消中醫師診斷權。經加州中醫政治聯盟發動全體同業堅決反對,此案最終被迫被擱置。
AB 871 (Keene, 2005) —— 由保險業者策劃,加州中醫政治聯盟反對
取消針灸師及整脊醫師被工傷患者自選為『指定醫師』的資格。
AB 1113 (Yee, 2005) —— 加州中醫政治聯盟策劃
肯定中醫診斷權提案;本案涉及中醫師最基本的行醫權益,至關重要。最終實施余胤良議長的這些提案對提高中醫素質,更好服務社會將起到積極作用。本案以壓倒性多數通過議會。斯瓦玆內格州長以法案措辭含糊為由否決此案。
AB 1114 (Yee, 2005) —— 加州中醫政治聯盟策劃
增加中醫師繼續教育提案;將每兩年需要 30 學時繼續教育增加至 50 學時。本案以壓倒性多數通過議會。斯瓦玆內格州長簽署成為法律。
AB 1115 (Yee, 2005) —— 加州中醫政治聯盟策劃
針灸師助理提案;要求針灸師助理具備一定的培訓資格。本案以壓倒性多數通過議會。斯瓦玆內格州長否決此案。
AB 1116 (Yee, 2005) —— 加州中醫政治聯盟策劃
針灸師臨床訓練提案;要求中醫院校畢業生必須先參加一定期限期臨床實習方有資格參加執照考試。由於外州利益團體的強力反對,本案未能通過議會。
AB 1117 (Yee, 2005) —— 加州中醫政治聯盟策劃
用『亞洲醫學』代替 『東方醫學』提案。本案以壓倒性多數通過議會。斯瓦玆內格州長簽署成為法律。
SB 248 (Figueroa, 2005) —— 加州中醫政治聯盟參與修訂
加州中醫政治聯盟為保全針灸局進行了非常艱巨的政治運作。我們不但成功動員了中醫界自己的力量,我們還成功結合了社會各界的力量,形成了一股前所未有的政治勢力。終于和菲格儸阿參議員達成重建針灸局的妥協。本案以壓倒性多數通過議會。斯瓦玆內格州長簽署成為法律。
AB 2287 (Chu, 2006) —— 加州中醫政治聯盟策劃
要求使用明確的法律條文重申:加州工傷補償系統必須包括中醫治療福利,並將加州中醫政治聯盟負責編訂的『中醫工傷治療指引』納入加州工傷補償系統的執行條款之中。該案以壓倒性多數通過參眾兩院,斯瓦玆内格州長最終在二零零六年十月予以否決。但州長同時明確地強調指出“鑒于針灸治療的重要性,我指示工傷補償處採取任何必要的措施,加速制定一個重新確保針灸合法地位的工傷醫療指引,以便讓工傷患者獲得針灸治療。……"工傷補償處主要官員多次和政治聯盟負責人舉行會談,態度也十分友好,在整個編寫過程中和中醫政治聯盟負責人和諧合作,二零零六年十二月七日,工傷補償處公佈了勞工法修訂草案文本,包括針灸治療在内的新『工傷醫療標準程序』遂于二零零七年六月十五日正式生效。
AB 2152 (Chan, 2006) —— 加州中醫政治聯盟策劃
眾議院衛生委員會主席陳煥英議員提出的『針灸師執照行醫法案』(AB2152),將使用明確的法律條文重申任何人必須擁有加州中醫執照方可施行針灸治療的規定。這項由加州中醫政治聯盟策劃的,專門為保障中醫師基本行醫權益的提案對確保加州公眾獲得安 全可靠的中醫服務意義十分重大。 由於『針灸師執照行醫法案』牽涉到其他醫療職業者的既得利益,特別是勢力強大的西醫界的既得利益,因此我們很清楚:這是一項極具挑戰性的法案。審議一開始就面臨西醫牙醫足醫三大反對勢力強大的聯合攻勢,形勢十分嚴峻。更遺憾的是,業界中又有少數人持有相反意見:以白人針灸師為主体的加州中醫協會(CSOMA)對此案表示不支持,還斷言此案將絕對不會成功。而針灸產業醫學專家協會(AIMS)的米勒醫師則在聽證會上宣稱他希望本提案失敗。所幸絕大多數中醫專業團體(包括華裔,韓裔,日裔,越南裔等職業公會)都認為這項提案完全合情、合理、合法,它宣示了中醫界要維護病家利益及保衛自身權力的堅定決心,明知有難度和風險,但還是要堅決推行。由於外州利益團體的強力反對,本案未能通過議會。
AB 2821 (Huff, 2006) —— 加州中醫政治聯盟策劃
眾議院教育委員會委員哈福議員提出的“成立亞洲醫學局法案"要求將目前的『針灸局』改稱『亞洲醫學局』。正如我們多年來一再強調﹕美國今天一直沿用的『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。本提案將有效澄清誤解,有利於中醫事業的繼續發展。非常遺憾的是:西醫公會堅持要壟斷“醫學"(MEDICINE)一詞,不准其它醫療專業使用。『亞洲醫學局』使用了醫學一詞,因此此案已被西醫公會所封殺。
AB 3014 (Koretz, 2006) —— 針灸與綜合醫學專家協會策劃
備受爭議的“亞洲按摩法案"是針灸與綜合醫學專家協會策劃的一項提案。考慮到這個法案有可能限制中醫師的行醫範圍;同時,“亞洲按摩"一詞在社會上與色情行業密切相關,將嚴重破壞中醫專業形象,加州中醫政治聯盟對此一直保持“不支持"的中立立場。該案通過議會後被阿諾州長予以否決。
SB 840 (Kuehl, 2006) —— 加州全民醫療保險法案 提案人:庫尤爾參議員
加州目前尚無全民保健體制,奇尤爾參議員希望建立這樣的新體制已保證低收入家庭也能獲得醫療保險。這個法案引起我們的關注是因為其中有一個條款規定:患者看中醫針灸必須事先得到西醫的介紹或轉診。這是和三十五年前的『針灸職業合法化提案』(SB86)的條款如出一轍,中醫界對此有所保留。該案通過議會後被阿諾州長予以否決。
SB1476 (Figueroa, 2006) —— 醫療職業局日落條款案 提案人:費格洛亞參議員
參議院商業與職業委員會就各醫療職業局或委員會之日落條款生效日期作出延期一年至三年的調整。
加州針灸局僅獲得一年之延期。即有效期從原來的2008年順延至2009年。
AB 54 (Dymally, 2007) —— 加州中醫政治聯盟策劃
加州中醫政治聯盟委託第五十二選區眾議員戴馬力先生在加州衆議院提出新的針灸保險法案要求將現行保險法中的歧視性條款(只要求醫療保險計劃備有“可供選購"的針灸福利)改為“規定提供"針灸福利﹐以保障投保人獲得針灸治療的權利。該案通過議會後被阿諾州長予以否決。
爭取豁免中藥銷售稅 (1997 – 2009) —— 加州中醫政治聯盟與北加州中藥聯商會共同推動
1997年,加州中醫界曾委托加州眾議員格里高斯醫師提出《豁免中藥銷售稅提案》,編號為AB410案。但未獲成功。後來在1999年,加州中醫政治聯盟又委托加州眾議員諾克斯提出了內容相同的 AB2764 法案作為繼續,也宣告失敗。中醫界再接再厲,在2001年又委托加州眾議員法魯
莫重新提出此案,編號 AB208 。可惜法案第三度被擱置。2002年由加州眾議員馬修斯接手辦理此案,改編號 AB249 。該法案雖然順利完成了參、眾兩院的全部審議程序,但是當年的州長戴維斯卻以財政短缺為由否決了此項提案,最後還是以失敗告終。2008年,中藥課稅問題的不合理性得到平等稅務局(BOARD OF EQUOLIZATION)趙美心局長和余淑婷副局長的關注,終于取得突破性的進展:二零零八年九月四日,中醫藥界代表與平等稅務局官員以及平稅局法律部門和稽查部門的負責人在沙加緬度進行了一次很有成果的會議。隨後,在二零零八年十二月,平等稅務局修改條例,不再將“聲稱有治療疾病功效的中藥定位為藥品"而予以課稅,並宣佈:既然中藥材在加州一向被列為“食物",就應當按食物免徵銷售稅,立即生效。至於“加工后中藥"(如粉劑、片劑、膠囊等產品)的食品定義問題,經過加州中醫政治聯盟的進一步交涉,平稅局法律部門最近提出了新的法律補充解釋:加工過的中藥材只要在其包裝或説明標簽上沒有“SUPPLEMENT”或“ADJUNCT”等字樣,則平稅局將認定此等產品仍然屬於“食品”,免予課稅。至此,抗爭多年的豁免中藥銷售稅問題終于獲得圓滿解決。 

AB 1260 (Huffman, 2009) —— 加州中醫政治聯盟反對
意圖修改加州針灸局職能的 AB1260 法案提出取消對考生臨床實習的要求,以及要讓外州的認證機構參與加州針灸局對中醫院校的審批工作等項,有可能降低加州中醫師素質,從而對加州中醫事業帶來負面影響。加州中醫政治聯盟予以反對。作者賀弗曼眾議員后來對本案條文作出重大的修訂—僅保留原提案的第一部分,(即將七人加州針灸局的議事法定人數由五名降為四名,包括至少一名針灸師);其餘不利加州中醫事業的條款已經全部予以刪除。
AB 1391 (Eng, then McLeod, 2010) —— 加州中醫政治聯盟支持
允許加州針灸局繼續運作至2013年的 AB1391 提案由伍國慶眾議員提出,其內容後來納入麥克利歐的 SB294.目前該案已經通過參眾兩院,等待州長的簽署。
爭取農夫保險公司支付針灸 (Eng, 2010) —— 加州中醫政治聯盟參與推動
加州針灸合法化以來,作為美國最大汽車保險公司之一的農夫保險公司 (FARMER INSURANCE COMPANY) 數十年來堅持不支付汽車意外受傷者針灸醫療費用。伍國慶眾議員通過和農夫保險公司高層領導人的多次直接溝通、協商、交涉,終於獲得公司方面的讓步,同意改變公司的理賠政策,
從今年六月十五日起支付汽車意外受傷者的針灸醫療費用。
聯邦層面的立法進展:


針灸針在美國醫療體系中的地位
1973 – 1975年間,針灸在美國許多州已經取得合法地位。但是,政治上的合法化并不等于學銜上的被承認。代表西醫界的美國醫學會直到1996年還不承認針灸的醫學價值。其官方立場是“針灸在美國還屬實驗性質”。基于這種立場,負責管制醫療器械的美國食品及藥物管理局(FOOD AND DRUG ADMINISTRATION)只能勉強將針灸針列為“三級醫療器具”,即所謂的“實驗研究用器具”(INVESTIGATIONAL DEVICE),規定只能用于科學研究目的。1994年,針灸界人士委托華盛頓的斯萬金-陀諾(SWANKIN & TURNER)律師事務所,采取公民請願(CITIZEN PETETION)的法律程序嚴正要求藥管局根據專家們提出的研究報告,重新考慮針灸針在美國醫療保健體系中的地位,將之從三級器具提升為二級即 “核准醫療器具”(APROVED MEDICAL DEVICE)。藥管局的專家們足足用了近一年半時間對針灸界提出的研究報告進行分析評估,終于在1996年3月作出了裁決。
聯邦針灸保險法案(FEDERAL ACUPUNCTURE COVERAGE ACT)
HR1038 (Hinchey, 1996) ~ HR646 (Hinchey, 2009) —— 加州中醫政治聯盟支持
這條稱為『聯邦針灸福利法案』規定聯邦醫療照顧計劃(MEDI-CARE)以及聯邦雇員健康福利計劃都要給有資格的針灸醫師支付醫療費用。本案如果獲得成功,將在全國範圍内有力地推動中醫事業的發展。十幾年來由興奇聯邦眾議員多次提出,至今未獲成功。在全國中醫師,包括加州中醫政治聯盟的積極支持下,本案在國會逐步取得進展。但距離成功還有一段距離。
聯邦健保改革法案(FEDERAL HEALTH CARE REFORM ACT, 2009-2010)—— 加州中醫政治聯盟支持
加州中醫政治聯盟認為歐巴馬總統正在推動的這場醫療改革也是中醫界爭取納入美國主流醫療體制的時機。改革如果成功,則中醫界必須在法案審議過程中確保中醫福利納入其中。政治聯盟聯絡全國中醫界人士發動大規模的請願活動:說服政要們認識到接納中醫不僅可以提高醫療品質,還可以降低以醫藥費用,完全符合醫療改革的目標。相關法案目前仍在國會審議辯論之中。

http://www.caam.us/resources/califonria_legislation082510.pdf

陳大仁:完善中醫教育 才是正名根本

加州中醫師聯合總會榮譽會長陳大仁嘆 SB628法案正名僅是「贈予」地位而非認同 提昇中醫專業教育進一步為中醫正名才是中醫界所樂見

圖:加州中醫師聯合總會榮譽會長陳大仁,他期望加州中醫的正名能在教育上真正著手,獲得西方主流社會的認可。(攝影:李歐/大紀元)

【大紀元2012年08月30日訊】(大紀元記者李歐費利蒙採訪報導)導言:中醫在美國爭取正名幾經波折,SB628今年終於通過加州參眾兩院的投票,並進一步等待州長布朗簽署正式立法。雖然這是一項好消息,但並非所有針灸師都適用,加州中醫師聯合總會榮譽會長陳大仁表示,其實真正提昇中醫的專業教育才能獲得美國主流社會的重視,也才是正名的根本。

加州最早的中醫法案可推溯到1972年,而且還是西醫主張立法,但當時只是西醫的助手,陳大仁說,那時有針灸熱的歷史背景,結果造成中醫的混亂,過後的40年間透過在美中醫師的努力,至今針灸師可以獨立行醫,還可納入保險給付。

但可惜的是,目前博大精深的中醫只能被侷限在「針灸局」(Acupuncture Board)底下,中醫師也只能稱針灸技師,醫術方面也受到限制,有多種中醫方濟還有正骨手法不可使用。因此陳大仁表示,現在最急迫的其實是趕快對中醫正名,並且提昇中醫的專業教育。他說,連眼鏡驗光師都得是博士學位,中醫當然更要是具有完備的教育體制。

陳大仁一家幾乎都是醫生,對中醫尤其專精,他說,針灸師其實早已超出針灸的範圍,是真正在行使中醫職業的專業人士,廣大中醫師都期望以中醫(Chinese Medicine)或東方醫學( Oriental Medicine)來取代針灸(Acupuncture)一詞。但在2002年及2006年分別有提出立法,都遭到西醫的阻撓而失敗。

美國是一個重視教育且術業專精的國家,陳大仁表示,中醫經過這幾十年的努力,終於從原本的不用執照到現今需通過3,200個學時的課程,再通過考試方可成為合格的針灸師,但仍是不足以獲得西方社會的認同,這也立法失敗的主因之一。現在加州中醫師聯合總會主張提升為4,000個學時,並且獲得博士學位才能有中醫考試資格。

儘管現在美國白人學針灸的人數多餘亞洲人,但有鑑於中醫在美仍被是為一門「替補醫學」,陳大仁說其關鍵原因就是──中醫教育制度的缺陷。因此盡快完善中醫教育制度才是根本的正名之道。

而目前的SB628法案僅僅只是讓具有中醫博士學位的針灸師合法使用「Doctor」一詞,陳大仁感嘆這種被「贈予」的地位,並非真正的認同。在教育上的提昇且進一步為「針灸局」改名為「中醫局」或「東方醫學局」才是廣大加州中醫界所樂見。http://www.epochtimes.com/b5/12/8/30/n3670966.htm%E9%99%B3%E5%A4%A7%E4%BB%81-%E5%AE%8C%E5%96%84%E4%B8%AD%E9%86%AB%E6%95%99%E8%82%B2-%E6%89%8D%E6%98%AF%E6%AD%A3%E5%90%8D%E6%A0%B9%E6%9C%AC

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http://www.positivearticles.com/Article/The-History-of-Acupuncture-in-the-United-States/16719 By: ashu

Acupuncture has been an excepted medical practice throughout Asia for thousands of years. The history of acupuncture in the United States is less lengthy.

The History of Acupuncture in the United States

Acupuncture found its way into the United States in the same manner that so many other things have reached this country. It was brought with the immigrants. In this case, it was with Chinese immigrants brought into the West to work on railroads and in the fields. Large Chinese enclaves grew up in San Francisco, Los Angeles, and in New York City on the east coast. Acupuncture was a standard form of treatment in these settlements just as it had been back home in China. The Chinese had been using acupuncture for centuries and also had very little trust for Western Medical treatments.

Although there were a few incidents of Westerners becoming involved with the study and practice of acupuncture in the United States during the 19th century, it was never widely practiced outside Chinese areas. It also was never widely accepted. It was considered superstition and totally unscientific and little attempt to understand it was ever made. When the Communist Government started a campaign to rid China of all traces of Classical Chinese Medicine, many acupuncturists made their way abroad. Some of these came to the United States which increased the number, but still little was done to understand and adapt it to Western use.

One of the big turnarounds for acupuncture in the United States occurred during a State visit to China by Richard Nixon in the 1970’s. During this visit, a member of the U.S. delegation was given an emergency appendectomy. The only anesthesia that was used was acupuncture. The President was duly impressed and when he returned to the US, he called for further study of the procedure. It was the beginning of the move of acupuncture from a foreign voodoo-hoodoo type of thing to a respectable and accepted alternative Medical treatment procedure.

In 1994, the Washington Post was reporting that almost 15 million Americans had tried acupuncture. This was almost 6% of the total population. In 1995, The United States Federal Drug Administration classified acupuncture needles as medical instruments. The biggest turnaround came in 1997 when the National Institute of Health issued a report titled, “Acupuncture: The NIH Consensus Statement.” This report stated that acupuncture was indeed very useful in the treatment of certain conditions. It also stated that the side effects of acupuncture were less adverse than those resulting from either surgery or drugs.

The NIH report further encouraged Insurance Companies to give full coverage to acupuncture treatments for certain conditions. This was a major endorsement of the procedure. Today, acupuncture is becoming more and more accepted as an alternative treatment and is gaining acceptance by the Western Medical Community. Some Medical schools including UCLA have begun to offer acupuncture as part of the curriculum.

Acupuncture has been an excepted medical practice throughout Asia for thousands of years. The history of acupuncture in the United States is less lengthy.

Dr.Fan notes: Some of the points are not correct, such as the Nixon’s team member got sick and had operation under acupuncture anesthesia.

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