Volume 1, Number 4 | Winter 2006

Foreword
The Melancholy of Acupuncture Researchers
In the context of modern medicine, acupuncture is often placed in the same category assuperstitions or supernatural phenomenai). The statement of the National Council Against HealthFraudi) (NCAHF) is a typical sample of the skeptical attitude to acupuncture. One of the majorcomplaints has been that quality of clinical trials of acupuncture have been poor for proof of
specific effects of acupuncture.
In Japan there has been recognition since the early 1960s, the importance of randomized
controlled trials (RCTs) to demonstrate the effectiveness of acupuncture. Despite the early
implementation of RCT, the goal of determining specific effects has not been actively pursued.
Clinical trials began somewhat later in the West, but focused on specific effects from the
beginning of Acupuncture RCT.
Importance of randomization was recognized by both Western and Japanese researchers.
However, Western researchers developed several types of sham acupuncture method as aself-evident placebo equivalent. The suitability of the methods used is an issue that should beaddressed separately. This meant that no major adjustment of the clinical pharmacologicalresearch model was required fundamentally. Since 1975, it has been possible in those countries totest propositions regarding the specific effect of acupuncture therapy within a clinical trialcontext.
In drug studies, it is relatively easy to conceal the active ingredient that provides the drug's
pharmacological effects, and to create a placebo tablet that is completely indistinguishable fromthe active drug. This is very different from the situation facing non-pharmacologic methods ofmedical intervention.
There is a dogmatic view that the methodology of clinical pharmacology should be applied
to non-pharmacologic interventions as well. But it seemed that this idea be accepted a priori
without exposing to the skeptical scrutiny that was being applied to acupuncture itself. It is
impossible to gain an accurate understanding of acupuncture and moxibustion while ignoring
the physical interaction between practitioner and patient. This is particularly a problem forJapanese acupuncture and moxibustion, in which palpation play important role on diagnosis..
It may be obvious to anyone that acupuncture treatment is realized through a process ofphysical interaction between the hands of a practitioner and the patient’s skin. The concepts ofJapanese acupuncture and moxibustion have been widely discussed in Europe and America inrecent years, but Japanese acupuncture is not simply characterized by the use of finer needles
and the application of lower levels of stimulus. Emphatically, the process also builds on thephysical contact between the practitioner and the patient. We need consideration of such
relationship in order to understand concepts and practices of Japanese acupuncture.
i. National Council Against Health Fraud. Acupuncture: the position paper of the National Council Against Health Fraud. Clin J Pain.
1991:7(2):162-6

Hiroshi Tsukayama
Center for Integrative Medicine
Tsukuba University of Technology
Tsukuba, JapanThe Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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