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Editor's Correspondence
April 24, 2006

Acupuncture May Be Ineffective for Stroke—Reply

Arch Intern Med. 2006;166(8):930-931. doi:10.1001/archinte.166.8.930-b

In reply

We thank Moffet for his thoughtful contribution to the discussion on our work.1 He identifies precisely the dilemma of acupuncture research today—how to respectfully preserve a practice based on accumulated clinical observation over many centuries, and at the same time apply a rational approach to biology.

A clinical diagnosis that is made in traditional Chinese terms is based on the identification of patterns of symptoms—just as Western diagnosis is. Therefore, it is not surprising that the traditional diagnostic categories reflect real differences between patient groups.2 It is possible, indeed, that traditional methods can identify more subtle patient types than Western diagnosis can, although genomics may well change this. However, even though traditional diagnosis seems to have biological meaning, we accept that traditional point selection also needs to be validated, and we have seen little scientific evidence to substantiate certain practices. For our study, it seemed important to us not to reject patterns of practice that are currently in use, even if we cannot think of a basis for them. We had nothing to lose in doing this because we are treating stroke rehabilitation, which is a “general” indication and can benefit from acupuncture stimulation. We understand that acupuncture is not attempting to remove or heal the lesions in the brain, as modern pathology suggests, but rather to stimulate the human body to strengthen the level of rehabilitation. We therefore decided to use the approach of experienced practitioners in the real world instead of imposing Western methodology onto an ancient practice by addressing the location of poststroke lesions (which acupuncture practitioners were not able to locate when acupuncture techniques were developed because of the lack of modern imaging techniques).

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