As an acupuncturist, I am often asked if I “believe in science.” This is a strange question, and I often don’t know how to respond. Remember, science is the systematic study of nature using the scientific method. Science is not an end unto itself, nor is it an organized system of beliefs, recent conflagrations with religion notwithstanding. As such, there really is no way to legitimately have or lack belief in science – one can only agree or disagree with the conclusions specific scientists have reached.
I think what people mean when they ask that question is: can acupuncture be explained through science? More importantly, is acupuncture still a valid form of healthcare if science cannot explain its mechanism of action? These are the questions I’d like to touch on in this, my first actual blog post.
Can acupuncture be explained through science? The answer is yes, but not yet. Remember that science is not a system of set beliefs, but an ever-expanding process of understanding the world around us through investigation and the testing of hypotheses. Therefore, science will eventually be able to explain acupuncture if we continue to study it. Meanwhile, although it is both fair and appropriate to point out that qi, yin and yang are not concepts that can be proven in a “scientific” way (i.e. according to the principles currently understood and accepted in the scientific community), this should in no way negate the value of acupuncture to our society. In fact, this reality should only serve as a strong incentive to explore acupuncture through the scientific method, in order to gain a greater understanding of its effects on the body and expand the knowledge base of science to include these currently foreign concepts.
In recent years there has been a lot of activity toward this end, with flaring tempers and controversy on both sides of the issue (see here for a good overview of the valid attempts to scientifically explain acupuncture, or see here if you’d prefer to get all riled up). Like everyone else I have strong opinions on this subject, but for now suffice it to say that objectively speaking we cannot explain acupuncture in scientific terms.
With that in mind, is acupuncture still a valid form of healthcare? The unequivocal answer is, “yes.” Remember: our current inability to explain acupuncture’s mechanism of action through the scientific method does not invalidate the experience of billions of people over thousands of years. Instead, it is this experience that mandates scientific inquiry. In other words, all scientific discoveries are predicated by experience and circumstantial evidence – it cannot work the other way around. Through the observation of initial experiences comes a hypothesis, then an objective attempt to test that hypothesis in an appropriate setting. It is simply not true that the initial experience is invalid (or “un-scientific”) until it is explained, and indeed science could never have advanced at all if we only accepted observable phenomenon that conformed to the contemporary understanding of the world.
The classic example of this idea is gravity . Did gravity exist before Newton was able to explain its mechanism through the scientific method? Was it a mistake for every known civilization to use the effects of gravity (i.e. in agriculture, or weight training) before it was described mathematically? What would we have said to a pre-Newtonian skeptic who claimed gravity was un-scientific and should be avoided until double-blind clinical tests proved it’s efficacy in certain situations? Most importantly for our current topic: must gravity have conformed to pre-Newtonian ideas of the world to be considered valid? Obviously the answer is no. We are much better off having accepted the reality of gravity and stretching our minds to figure out how it works, rather than mandating gravity to conform to our previous understanding of the world – in fact, it seems kind of silly to suggest otherwise.
Perhaps you’re thinking that gravity isn’t a good example, because gravity is a natural phenomenon, while acupuncture is an intervention designed by human beings. In that case, a better example is might be the use of fire. The controlled act of setting and maintaining fire was, to early humans, a seemingly miraculous intervention developed over time to greater and greater degrees of sophistication. Its initial purpose was most likely to keep warm, but eventually the use of fire was expanded to easing pain and suffering, cooking food, keeping predators at bay, and lighting houses to allow socialization well past sunset (among very many other things). Can you imagine the early human who refused all the benefits of a controlled fire until s/he could draw out the process of friction heating kindle wood to its ignition temperature on the side of a cave? Would it have been a good policy for early cultures to refuse the advancement of fire until we understood its mechanism in a scientific way? On that note, would it have been sensible to demand that fire operate according to our contemporary understanding of the world, rather than change our understanding of the world to encompass this phenomenon?
In the case of both gravity and fire, we clearly gained a lot of benefit from them before they were scientifically understood. However, it is also true that those benefits were compounded exponentially as our scientific understanding deepened. I believe the same will eventually be said of acupuncture. In my view, the acupuncture community should strongly support and participate in attempts to describe acupuncture through the lens of science. Not only will doing so advance the practice of acupuncture and allow us to more effectively develop quality medical care, it will also advance science, and expand our understanding of the world.
Future topics: An Ode to Placebo, The Evolution of Acupuncture.
