Another Tool of Health Quackery? (1973)

Ray L. Casterline, M.D., F.A.C.P.
February 28, 2005

The recent proliferative growth in the number of brief seminars reputedly offering instruction in the technique of acupuncture should be of concern to each member of the medical profession. For improper application of the modality could relegate what may be an effective therapeutic technique to the category of just another tool of health quackery.

Many recent graduates of the three to five day abbreviated courses have been identified as chiropractors, naturopaths or others espousing similar philosophies. Since the statutes of many states prohibit puncture of the skin by such “irregular” practitioners, it is not surprising that many of them are said to use the “essence of acupuncture” by applying finger pressure as part of their treatment programs. Exactly how “finger pressure acupuncture” differs from the usual chiropractic method is not entirely clear. And a recent chance airliner conversation with an official of the American Chiropractic Association did little to clarify the issue.

Earlier this year, the American Society of Anesthesiologists exhibited grave concern “. . . over premature application of acupuncture to American patients for relief of pain during surgery. . .” The ASA statement was based on apparent current departure from traditional scientific evaluation of any therapeutic procedure before it is accepted widely in medical practice.

Several weeks later, the New York State Board for Medicine adopted the position that “. . . acupuncture is not an accepted medical procedure in the state of New York, (that) acupuncture’ involving the human body (is) an experimental procedure which falls within the practice of medicine, can be performed lawfully only by or under the direct supervision of a (New York) licensed physician and in an institution appropriate for human research. . . .”

In early August (1972), California Governor Reagan signed into law a bill permitting the performance of acupuncture and other forms of traditional Chinese medicine by an unlicensed person, hut only in an approved medical school. Sponsored by the California Medical Association, the legislative act stipulated that the procedure must be carried out only under the direct supervision of a licensed physician. Furthermore, its performance must be primarily for the scientific investigation of acupuncture.

Medical associations and medical licensing boards in several other states have assumed variations from positions found in New York and California. The variety of resolutions and rulings range from ban it to try it (you’ll like it?).

Within recent weeks the Food and Drug Administration has detained a number of shipments of acupuncture needles and electric stimulators from entering the United States. Such action has been based on FDA’s responsibility to determine that such device are in compliance with the law (labeling, safety, etc.) prior to condoning their import and! or transport in interstate commerce. With any unproven, unaccepted or unrecognized medical device, FDA generally requires valid scientific clinical research on the use of the device to resolve such question.

Thus, the FDA’s Office of Medical Devices recently called a limited conference in Washington. D.C., inviting representatives of the American Medical Association, the American Society of Anesthesiologists, the National Institutes of Health, the Federation of State Medical Boards and medical licensing officials from the states of New York and California, as well as physicians considered acupuncture authorities from the Albert Einstein College of Medicine and the University of California Medical School (San Francisco).

That day-long session produced general agreement that acupuncture needles and stimulators imported into the United States (as well as those transported in interstate commerce) should be classified and labeled as experimental devices, limited to investigative use by licensed medical or dental practitioners.

Further, it was recognized that pertinent statutory provisions are far from uniform from state to state, nut the consensus of those in attendance was that acupuncture does, indeed, fall within the practice of medicine and/or dentistry.

In addition, accord was found in the need for additional research on acupuncture. It was generally agreed that a controlled scientific atmosphere will be required in the conduct of such studies to expect the conclusions reached to be accepted widely in the medical community. Recognition was given to the limited but significant number of highly qualified anesthesiologists, psychiatrists, and medical hypnotherapists who have been performing acupuncture as part of their regular practice. Personal observations on their experience with the modality could be meaningful when integrated with the body of information expected to come from the: structured research projects.

Without question, time is of the essence, for acupuncture is here. “Crash” courses and abbreviated seminars in the technique (or its “essence”) continue to produce hundreds of self-styled experts in the apparently financially lucrative modality each month.

The unfortunate association of the technique with “irregular” cultists makes it all the more urgent that medical associations and boards of medical examiners take and state their positions on acupuncture soon.

Perhaps the research now under way at the National Institutes of Health, the University of California, New York’s Montefiore Hospital and other equally prestigious institutions may find little: scientific basis to support acupuncture.

Nonetheless, in its public accountability for the health of the people of this country, the medical profession cannot condone continued improper application of acupuncture. The potential hazards in its misuse cover the full gamut of cultistic practice known to be “dangerous to your health:’

Therefore, medical associations and medical licensing authorities in each jurisdiction are urged to enact pertinent resolutions regarding acupuncture, update operating rules and regulations, request legislative action, seek attorney general rulings or whatever is needed to follow the trail blazed by physicians in New York and California. But, in any case act—and now.

For it should be obvious that the point of this extended comment is to needle the medical profession—particularly medical associations and boards of medical examiners—into taking a position on acupuncture before the technique (or its “essence”) becomes further entrenched as another tool of health quackery.

The recent proliferative growth in the number of brief seminars reputedly offering instruction in the technique of acupuncture should be of concern to each member of the medical profession. For improper application of the modality could relegate what may be an effective therapeutic technique to the category of just another tool of health quackery.

This article was originally published in the November 1972 issue of Federation Bulletin, the journal of the Federation of State Medical Boards. Dr. Casterline, who died in 2001, served as the Federation’s president and for 23 years as the journal’s editor. He was also president of the Educational Commission for Foreign Medical Graduates (ECFMG). This article illustrates how the entry of acupuncture into the American marketplace was perceived by prominent medical officials.

This page was posted on February 28, 2005.