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Q: I'm planning to  study intensive acupuncture in Goa (India).   I would like to know if I will be able to work in the UK after that and if I could be registered with the British Acupuncture Council.

A:There is regulation of acupuncture by the state in the UK, so in theory anyone is free to practise. However, local authorities operate local laws which govern all skin piercing activities which means that a practitioner has to be registered or licensed to practise. The grant of a licence or registration depends on the practitioner showing that they meet all the requirements for safe practice and that their premises are also sutable. Many local authorities now check the standard of someone's training, and undertake basic checks of being properly insured. The only exceptions are in London where belonging to a professional body on the list of exempt organisations means that a practitioner does not have togold a licence, although they are still required to let the authority know they are there.
 
As far as intensive training courses are concerned, it is only fair to tell you that the BAcC had some quite difficult arguments with other UK acupuncture associations some years ago because of our insistence on a minimum of 3600 hours training over three years. We do not believe that you can train to be a sound and effective practitioner in less time than this, and we regard the clinical element of the training, where someone learns through supervised reflective practice as critical. It is perfectly possible to learn the basic theory in much less time than this, but in our view that is not in itself a good basis for practice.
 
We only give automatic eligibility to graduates of accredited colleges. However, we do have an entry route for practitioners who trained elsewhere which uses the same criteria and we have known of cases where people have taken a shorter training and then succesfully applied to us after they have used their skills in clinical practice for several years, but as the professional standards are being raised year after year, we do not expect to see many people being admitted to the BAcC with less than a three year training. This is, after all, the World Health Organisation's recommendation for a non-medical practitioner in independent practice. 

A: There are no specific points for raising body temperature. There are a number of reasons in Chinese medicine why the body as a whole might be cold or why specific parts of the body may be cold, but the nature of Chinese medicine is that the practitioner treats the person, not necessarily the symptom in itself. Although the practitioner might describe a patient as Yang Deficient, often manifesting in coldness, there are many different ways in which a Yang Deficiency can both manifest and be created. The choice of points would reflect the specific nature of the unique balance of the individual.

There are plentiful lists of 'cookbook' or formula acupuncture on the internet, and there are often generic points which might appear in many of the possible treatments for Yang Deficiency. We always have a concern, however, that used out of specific context these points may have no effect or no lasting effect, and although they are unlikely to cause any harm, our experience is that people tend to walk away from treatments which cause them transient adverse effects, and we believe that point recommendations without specific diagnosis are not to be trusted.

The best advice, if you are experiencing coldness, is to visit a BAcC member local to you and seek their advice from a brief face to face assessment. This will give you a much clearer idea of what may be possible than that which we can give you here.

A: >There are no specific points for raising body temperature. There are a number of reasons in Chinese medicine why the body as a whole might be cold or why specific parts of the body may be cold, but the nature of Chinese medicine is that the practitioner treats the person, not necessarily the symptom in itself. Although the practitioner might describe a patient as Yang Deficient, often manifesting in coldness, there are many different ways in which a Yang Deficiency can both manifest and be created. The choice of points would reflect the specific nature of the unique balance of the individual.

There are plentiful lists of 'cookbook' or formula acupuncture on the internet, and there are often generic points which might appear in many of the possible treatments for Yang Deficiency. We always have a concern, however, that used out of specific context these points may have no effect or no lasting effect, and although they are unlikely to cause any harm, our experience is that people tend to walk away from treatments which cause them transient adverse effects, and we believe that point recommendations without specific diagnosis are not to be trusted.

The best advice, if you are experiencing coldness, is to visit a BAcC member local to you and seek their advice from a brief face to face assessment. This will give you a much clearer idea of what may be possible than that which we can give you here.

Q:  Can you tell me how acupuncture can help with my neurological condition charcot marie tooth, otherwise kown as peripheral neuropathy

A:  The short answer, if we are truthful, is that we are not sure. Charcot Marie Tooth (CMT) is a herditary genetic disorder, and while acupuncture treatment may mitigate some of the symptoms which CMT sufferers experience, there is obviously a limit to what a treatment like acupuncture can achieve, unless one took the extraordinary and unsustainable position that as an energy treatment anything was possible.

From a Chinese medicine perspective the kinds of problems which a CMT sufferer experiences would be defined as weaknesses in the flow of energy, called 'qi', and their effects on the muscles and nerves in terms of conductivity and movement. In stroke treatment, for example, in China acupuncture is used as soon as possible after the CVA to reinstate flow where the qi is said to have been blocked, causing paralysis and loss of sensation. A similar principle would apply in looking at some of the manifestations of CMT, without the same rapid onset. The practitioner would be interested in establishing whether the problems were entirely local or whether they were indicative of woder problems in the system. However, with a genetic problem it may well be that the best to be achieved is getting worse slower, so one has to be realistic. That said, it is always important to bear in mind that when someone has a major disorder there is often a tendency to attribute every symptom to it, and we have come across cases where a symptom which may be generated by a condition has arisen contingently alongside it and been much more amenable to treatment than expected.

If you want to find examples of research into the use of acupuncture and peripheral neuropathy, the google search 'ncbi acupuncture peripheral neuropathy' will generate a number of hits for research studies which show encouraging results. However, peripheral neuropathy can have many different causes, and how universalisable these studies are is not that clear.

The best advice, if you are at all unsure about the best way to proceed, is to see if a BAcC member local to you is happy to give up al little time without charge to offer a face to face assessment of what acupuncture treatment may be able to do. Each patient is unique and different, and there may be evidence which on a brief examination may point you more clearly towards, or away from (!)), treatment.

Q: I have macular degeneration and I would like your opinion on the work of Dr. Lundgren and his Santa Fe protocol. Has no one followed this up in the U.K.? If I can obtain any reassurance I would certainly go to the States for treatment.

A: We have been asked about the treatment of macular degeneration before, and our most recent answer was:

We conducted a search and the best we could come up with

http://www.ncbi.nlm.nih.gov/pubmed/21355157

a study in Chinese which appears to demonstrate that acupuncture out-performs conventional medical treatment. Otherwise the only direct reference is a Cochrane Review summary which identifies the fact that there is a systematic review or similar on their files as pending

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1705651/

With conditions like this there are a number of difficulties involved in answering the 'does acupuncture work?' question. From a Chinese medicine perspective, although twenty patients may have the same named western condition there could be twenty different treatments. The symptom from this perspective is merely the weak link where an overall imbalance tips something into poor or degenerating function, and although local treatment could achieve some useful short term gains, helping to improve the underlying balance is the key to getting well and staying well. This involves treating the person as much as treating the disease.

Conditions like this can often become unintentional money pits, and it is easy to build up a treatment habit based more on hope than experience. Practitioners are often inclined to fall into the same trap in pursuit of better health for their patients. The best positive result one might achieve could be a decrease in the extent of deterioration, or as one patient put it once, 'do you know, I think I'm getting worse slower'. Of course, this is unverifiable and largely unmeasurable, but there is no doubt that many patients have reported anecdotally that they have exceeded the expectations of their clinicians in maintaining reasonable function longer than anticipated. Naturally there are a great many other factors which make this possible, not least of which is that seeking complementary treatment is itself evidence of a determination to do something which is probably reflected in someone's overall health.

From a Chinese medicine perspective the eyes as a functional unit have close relationships with two or three major Organs (capitalised to differentiate them from the western concept of an organ) and if there is evidence of a generalised weakness in relevant related Organic functions, a practitioner might think that there is some hope that treatment may be of value. There is also plenty of discussion in Chinese texts about local needling and its potential to halt or even slightly reverse decline.

We have to be realistic, though. The kind of deterioration which this condition causes is well-documented as likely to continue, and it would be a foolish practitioner who tried to instil too much optimism in a prospective patient about the chances of major improvement. However, it is always worth while talking to a BAcC member local to you, and we are sure that our members will be only to happy to give you advice on the basis of a brief face to face assessment.

We are aware of the work of the clinic you mention, as well as two or three similar clinics in India. However, we do not have enough independent corroboration of the results claimed to offer a view, although we have to say that the techniques in the Santa Fe Protocol are not traditional acupuncture. The use of ear acupuncture, electroacupuncture and scalp acupuncture are used by an increasing number of BAcC members, but are not within the mainstream traditional acupuncture training.

We are sorry not to be able to give you more positive advice, but it would be remiss of us to support something whose provenance we cannot check. The best we can offer by way of advice is that you try to find someone who has undergone the treatment with whom you can discuss their experience. In our experience American blog sites abound, and if someone has had a very good, or indeed very bad, experience, you are certain to be able to read about it and make contact.