The beginning of acupuncture in Washington,D.C.and Maryland:an interview with Dr.Yeh-chong Chan

Dr. Yeh-chong Chan （Y.C. Chan） is one of the earliest acupuncturists in the United States （US）. He served for seven years in the first acupuncture center in the US, which was established in Washington, D.C. in 1972. In 1979, he moved the clinic to Rockville, Maryland and continued to practice acupuncture there for over 30 years. He is a well-known licensed acupuncturist （LAc）, one of the developers of the acupuncture profession, and a scholar of acupuncture and traditional Chinese medicine （TCM）. He has treated two US Governors （In the US, the title Governor refers to the chief executive of each state or insular territory and the political and ceremonial head of the state.） and many sports stars. He is the author of books entitled Acupuncture Practice in the United States,

Decoding an Old 1907 Prescription of Dr.Ing Hay(“Doc Hay”):One of the Earliest Chinese Medicine Doctors in the United States

Objectives:Chinese medicine doctors have practiced in the United States since April of 1854,the world's first Chinese medicine doctor's memorial is Kam Wah Chung Museum in John Day,Oregon,U.S.,to commemorate Dr.Ing Hay(“Doc Hay”伍于念)and his business partner Lung On(梁光荣).There were few studies to explore Doc Hay's real practice and prescription,while most of papers focused on Doc Hay's legend life.This paper aims to analyze and interpret one of the intriguing herbal prescriptions that Doc Hay had hand-written.Materials and Methods:Dr.Arthur Yin Fan made an academic travel to Kam Wah Chung museum on August 5,2018 and examined the books and hand-written prescriptions of Doc Hay,which were not exhibited to the public at that time.This paper analyzes and interprets one of herbal prescriptions that Doc Hay had hand-written in 1907.Interpretation process included four steps:(1):Transform Doc Hay's hand-written prescription(with original herb names)to standard herb names in Chinese.(2):Induct and rearrange the herb name into groups based on herb property characteristics and then translate them into both PinYin names and English names.Analyzation of the prescription may include in what classic formula(s)routinely introduced in Chinese medicine textbooks.(3):Analyze the herbal action for each group and potential symptoms or conditions the patient may have had.An analysis of classic formula(s)used in the prescription may represent what clinical condition was being treated at that time.(4):Combine the analysis to give a comprehensive picture of the patient.Results:The prescription consists of 67 herbs,total 934.6 grams,and including Yin Qiao Powder(银翘散),Sang Ju Decoction(桑菊饮),Zhi Sou Powder(止嗽散),Qing Ying Decoction(清营汤),Xi Jiao Di Huang Decoction(犀角地黄汤),Long Dan Xie Gan Decoction(龙胆泻肝汤)and Chai Hu Shu Gan Powder(柴胡疏肝散).Speculation indicated that the prescription was for a patient who had obvious pulmonary infection accompanied by severe cough,and probably had prolonged pulmonary tuberculosis(TB)also with acute respiratory infection caused by other bacteria or viruses.Based on the analysis of composition of this prescription,it can be used for the treatment of epidemic diseases.Conclusion:The majority of herbs used in this prescription are commonly included in the herbal medicines in China used to effectively counter severe acute respiratory syndrome(SARS),H1N1 and currently COVID-19,it might be Doc Hay's basic formula for patients with“Spanish Flu”during the 1918-1920 pandemic.

Acupuncture Legislation in Virginia,United States:A Personal Experience and Beyond

Virginia was once considered as one of three states in the United States that was particularly resistant to acupuncture and its legislation,due to the historically strong conservative force in Virginia.In this article,the author aims to review and discuss the history and the current situation of acupuncture legislation in Virginia,and provides some insights for the related legislations in other states and at federal level.This study was based on author’s personal experience and an interview with Mr.Floyd Herdrich,former president of the Acupuncture Society of Virginia,who made the biggest contribution to this legislation.Led by the Acupuncture Society of Virginia,and supported by the School Tai Sophia Institute,Virginia acupuncture legislation began in 1988 and the law was implemented in 1994.Virginia is the 27th state in the United States to legalize acupuncture practice,and it has been 28 years since then.The author’s insights are:the first important factor is dedications as the persistent efforts in legislation usually take many years to materialize.The second factor is the strategy,that is,legislation through the executive or administrative system is probably a much easier route or shortcut.

Chinese herbal medicine for COVID-19: Current evidence with systematic review and meta-analysis

Background: There is currently no drug or therapy that cures COVID-19, a highly contagious and life-threatening disease.Objective: This systematic review and meta-analysis summarized contemporary studies that report the use of Chinese herbal medicine(CHM) to treat COVID-19.Search strategy: Six electronic databases(PubMed/MEDLINE, Cochrane Library, ScienceDirect, Google Scholar, Wanfang Data and China National Knowledge Infrastructure) were searched from their beginning to May 15, 2020 with the following search terms: traditional Chinese medicine, Chinese medicine,Chinese herbal medicine, COVID-19, new coronavirus pneumonia, SARS-CoV-2, and randomized controlled trial.Inclusion criteria: Randomized controlled trials(RCTs) from peer-reviewed journals and non-reviewed publications were included. Further, included RCTs had a control group that was given standard care(SC;such as conventional Western medicine treatments or routine medical care), and a treatment group that was given SC plus CHM.Data extraction and analysis: Two evaluators screened and collected literature independently;information on participants, study design, interventions, follow-up and adverse events were extracted, and risk of bias was assessed. The primary outcomes included scores that represented changes in symptoms and signs over the course of treatment. Secondary outcomes included the level of inflammatory markers, improvement of pneumonia confirmed by computed tomography(CT), and adverse events. Dichotomous data were expressed as risk ratio or hazard ratio with 95% confidence interval(CI);where time-to-event analysis was used, outcomes were expressed as odds ratio with 95% CI. Continuous data were expressed as difference in means(MD) with 95% CI, and standardized mean difference(SMD) was used when different outcome scales were pooled.Results: Seven original studies, comprising a total of 732 adults, were included in this meta-analysis.Compared to SC alone, CHM plus SC had a superior effect on the change of symptom and sign score(-1.30 by SMD, 95% CI [-2.43, -0.16];3 studies;n = 261, P = 0.03), on inflammatory marker C-reactive protein(CRP, mg/L;-11.82 by MD, 95% CI [-17.95, -5.69];5 studies;n = 325, P = 0.0002),on number of patients with improved lung CT scans(1.34 by risk ratio, 95% CI [1.19, 1.51];4 studies;n = 489, P < 0.00001). No significant adverse events were recorded in the included RCTs.Conclusion: Current evidence shows that CHM, as an adjunct treatment with standard care, helps to improve treatment outcomes in COVID-19 cases.

Dr. Ralph Coan: a hero in establishing acupuncture as a profession in the United States

1 Introduction Dr. Ralph Coan is not well known to the general public. Originally, we had wanted to interview him as he was the medical director of the first acupuncture center in the United States that opened in the early 1970s. We wanted to know more about that center＇s history. Prior to visiting Dr. Coan, we found an article written by Dr. Sherman Cohn that mentioned Dr. Coan. The article noted that Dr. Coan was the founder of the American Association of Acupuncture and Oriental Medicine, which is the national association of acupuncturists and Chinese medicine practitioners in the United States.

Dr.William Prensky:The birth of the acupuncture profession in the United States(1969–1979)——the Institute for Taoist Studies and the National Acupuncture Association

Acupuncture is one important part of traditional Chinese medicine （here after, the author will only use the term ＂acupuncture＂ to denote both acupuncture and Chinese medicine） and is a fast growing profession in recent years. Many patients have benefited from acupuncture therapy because acupuncture is a safe, effective and natural therapy. Several articles and interviews published in recent years have described the history of the establishment of acupuncture and Chinese medicine on the east and west coasts of the United States （U.S.） of America.

美国“针灸热”的“第一束火焰”——采访“华盛顿针灸中心”李耀武医师(英文)

Forty years ago,President Nixon＇s visit to China was a sign of the start of the normalization of Sino-American relations.Before and after President Nixon＇s journey,the Chinese government＇s ＂acupuncture diplomacy＂ was very effective.

The legendary life of Dr.Gim Shek Ju, the founding father of the education of acupuncture and Chinese medicine in the United States

Several stories of various pioneers establishing acupuncture and Chinese medicine （ACM） practices in the United States （U.S.） have been documented. However, the establishment of schools for ACM signaled the establishment of ACM as an established profession in the U.S. One of the first persons who wanted to set-up a school for Chinese medicine in the U.S. was Dr. Tom Foo Yuen （谭富园, August 7, 1858 - July 10, 1947） during the late 1800s in Los Angeles （LA）, California. However, it was not until 1969 or 1970 that the first informal ACM school was actually established in the U.S. This school was called the Institute for Taoist Study, and was located in LA. However, this school was not registered with the local government and Dr. Gim Shek Ju was the sole teacher at that time.

Recovery of a patient with severe COVID-19 by acupuncture and Chinese herbal medicine adjuvant to standard care

There is currently no drug or therapy that can cure the coronavirus disease 2019(COVID-19), which is highly contagious and can be life-threatening in severe cases. Therefore, seeking potential effective therapies is an urgent task. An older female at the Leishenshan Hospital in Wuhan, China, with a severe case of COVID-19 with significant shortness of breath and decrease in peripheral oxygen saturation(SpO_(2)),was treated using manual acupuncture and Chinese herbal medicine granule formula Fuzheng Rescue Lung with Xuebijing Injection in addition to standard care. The patient’s breath rate, SpO_(2), heart rate,ratio of neutrophil/lymphocyte(NLR), ratio of monocyte/lymphocyte(MLR), C-reactive protein(CRP),and chest computed tomography were monitored. Acupuncture significantly improved the patient’s breathing function, increased SpO_(2), and decreased her heart rate. Chinese herbal medicine might make the effect of acupuncture more stable;the use of herbal medicine also seemed to accelerate the absorption of lung infection lesions when its dosage was increased. The combination of acupuncture and herbs decreased NLR from 14.14 to 5.83, MLR from 1.15 to 0.33 and CRP from 15.25 to 6.01 mg/L. These results indicate that acupuncture and Chinese herbal medicine, as adjuvants to standard care, might achieve better results in treating severe cases of COVID-19.

Controversial conclusions from two randomized controlled trials for acupuncture’s effects on polycystic ovary syndrome or in vitro fertilization support

Two reports of trials investigating the potential effect of acupuncture in increasing live birth rate(LBR) in women with polycystic ovary syndrome(PCOS) or those undergoing in vitro fertilization(IVF) were published by Journal of American Medical Association in 2017 and 2018 respectively. The trial investigators did not recommend acupuncture for the women with PCOS or IVF based on their findings. This paper raises the concern that the findings that acupuncture did not increase LBR for women with PCOS or undergoing IVF may be the result of methodological flaws in the studies and unintended bias such as use of an invalid control intervention and underestimation of the true acupuncture effect. Therefore, their findings may not be a valid reflection of acupuncture’s effect in improving LBR in women with these clinical conditions.

Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems,levels and targets and is not limited to“driving the vagus-adrenal axis”

In October 2021,an international collaborative study on the use of electroacupuncture(EA)to treat inflammation was published in the journal Nature by Dr.Qiufu Ma’s team.Based on the results of EA on inflammation in the mouse model of lipopolysaccharide inflammatory storm,the study showed that the distal effect of acupuncture can be achieved by“driving the vagus-adrenal axis(through the adrenal medulla,by releasing catecholamines).”PROKR2Cre-marked sensory neurons,which innervate the deep hindlimb fascia but not the abdominal fascia,are crucial for driving this axis.The study suggests the existence of specificity distribution of acupoints,that different EA stimulation intensities or different needle penetration depths have different therapeutic effects,that photosensitive stimulation may be a substitute for needle acupuncture,and that massage,stretching and body movements may also activate PROKR2Cremarkable dorsal root ganglion sensory neurons and elicit anti-inflammatory effects.However,results of some other studies are contrary to the conclusions of Ma’s team.For examples:low-intensity EA at GB30 point significantly reduced the inflammation in the rat model of persistent inflammation,which is more relevant to the real daily acupuncture practice,and this effect was partly related to the adrenal cortex and associated with the stimulation of corticosterone and adrenocorticotropic hormone;manual acupuncture(similar to the low-intensity EA)at KI3,Zhichuan point(an extra point),etc.was effective in a severe COVID-19 patient with sepsis;stimulating ST25 with low-intensity EA or manual acupuncture was effective against gastrointestinal inflammations;the above mentioned points are not in an area enriched with PROKR2Cre-marked sensory nerve endings.Evidence shows that the mechanism of EA against inflammation includes modulating multi-systems,multi-levels and multi-targets,which does not limit to“driving the vagus-adrenal axis.”

Discussions on real-world acupuncture treatments for chroni clow-back pain in older adults

Chronic low-back pain(CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP in older adults. Clinical acupuncture experts in the American Traditional Chinese Medicine Association(ATCMA) were interested in the recent grant on CLBP research announced by the National Center for Complementary and Integrative Health. The ATCMA experts held an online discussion on the subject of real-world acupuncture treatments for CLBP in older adults. Seven participants, each with more than 20 years of acupuncture practice, discussed their own unique clinical experience while another participant talked about the potential mechanism of acupuncture in pain management. As a result of the discussion, a picture of a similar treatment strategy emerged across the participants for CLBP in older adults. This discussion shows that acupuncture may have complicated mechanisms in pain management, yet it is effective for the treatment of chronic pain involving maladaptive neuroplasticity;therefore, it should be effective for CLBP in older adults.

“Obamacare” covers fifty-four million Americans for acupuncture as Essential Healthcare Benefit

＂Obamacare＂ is the informal and most-used term for The Patient Protection known as the Affordable and Affordable Care Act, also Care Act （ACA）, and is a United States federal statute signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act, the ACA represents the most significant regulatory overhaul of the United States healthcare system since the passage of Medicare and Medicaid in 1965Cq. This healthcare reform has already begun, with the open enrollment for the first year of the ACA＇s healthcare exchange marketplace ending on March 31, 2014.

The methodology flaws in Hinman's acupuncture clinical trial, Part Ⅱ: Zelen design and effectiveness dilutions

In the October 2014 publication of JAMA, Dr. Hinman and colleagues published the study “Acupuncture for Chronic Knee Pain： A Randomized Clinical Trial,” which concluded that in patients older than 50 years with moderate or severe chronic knee pain, neither laser nor needle acupuncture conferred benefit over sham for pain or function. Our findings do not support acupuncture for these patients.

Dr. Gene Bruno: The beginning of the acupuncture profession in the United States(1969–1979) — acupuncture, medical acupuncture and animal acupuncture

Acupuncture was practiced by both Western medical doctorst and Chinese medicine doctorst in the United States （U.S.） in the 19th century; however, after 1910, it seems that people seldom heard about it until it was re-introduced during the 1960s-1970s. Acupuncture legislation, acupuncture practice and the start of acupuncture education were some of the events that marked the re-introduction of acupuncture in the U.S..

Dr.Miriam Lee:a heroine for the start of acupuncture as a profession in the State of California

1 Introduction The first legal acupuncture center established in the United States （US） of America was on the east coast in Washington, D.C. in 1972[1-4]. However, the most important state in the acupuncture profession is on the west coast - in the state of California, which has the longest Iristory of acupuncture practice[5,6] and the largest number of licensed acupuncturists in the US[7].

Distribution of licensed acupuncturists and educational institutions in the United States in early 2015

In recent decades, acupuncture has been used more widely and extensively in the United States （U.S.）. However, there have been no national surveys or analyses reported in academic journals on the number of practicing or licensed acupuncturists, This study was conducted to identify the approximate number of licensed acupuncturists active in 2015. The Board of Acupuncture or Board of Medicine in each state or U.S. territory was contacted to collect data, Online license information searching was also performed in order to get accurate numbers of licensed acupuncturists for those states in which a board was unable to be contacted. The study found that the number of licensed acupuncturists in 2015 in the U,S, was 34,481. Of this, more than 50% were licensed in three states alone： California （32.39%）, New York （11,89%） and Florida （7.06%）. The number of licensed acupuncturists increased 23.30% and 52.09%, compared to the year 2009 （n = 27,965） and 2004 （n = 22,671）, respectively; increasing about 1,266 per year. There were 62 and 10 accredited acupuncture institutions providing master and doctoral degrees, respectively. The West Coast comprised 51.39% of degree granting programs, while the East Coast comprised 29.17%; together the coastal states housed more than 80% of all programs, with the remainder sprinkled across the southern （9.72%）, northern （8.33%）, and the middle/central states （1.39%）. Forty-four states and the District of Columbia regulated acupuncture practice by law at the time of data collection. Acupuncture continues to be a quickly growing profession in the U.S,

Effectiveness of two different acupuncture strategies in patients with vulvodynia Study protocol for a pilot pragmatic controlled trial

Background： Vulvodynia, or vulvar pain, is a common condition in women; however, there are few evidence-based clinical trials evaluating nonpharmacological therapies for this condition. Acupuncture is one complementary and integrative medicine therapy used by some patients with vulvodynia. This study evaluates two different acupuncture strategies for the treatment of vulvodynia and aims to evalu- ate whether either of the acupuncture protocols reduces vulvar pain, pain duration or pain with inter- course. The study also examines how long the effect of acupuncture lasts in women with vulvodynia. Methods/design： The study is designed as a randomized controlled trial, focused on two acupuncture protocols. Fifty-one patients who have had vulvodynia for more than 3 months will be recruited. Among them, 34 patients will be randomized into Groups la and 1b; those who are unwilling to receive acupuncture will be recruited into the standard care group （Group 2）. Patients in Group la will have acupuncture focused on the points in the pudendal nerve distribution area, while patients in Group lb will receive acupuncture focused on traditional （distal） meridian points. Patients in Group 2 will receive routine conventional treatments, such as using pain medications, local injections and physical therapies or other nonsurgical procedures. Acupuncture will last 45 min per session, once or twice a week for 6 weeks. The primary outcome measurement will be objective pain intensity, using the cotton swab test. The secondary outcome measurement will be subjective patient self-reported pain intensity, which will be conducted before cotton swab test. Pain intensities will be measured by an 11-point Numeric Pain Rating Scale. Pain duration and pain score during intercourse are recorded. Local muscle tension, tender- ness and trigger points （Ashi points） are also recorded. All measurements will be recorded at baseline （before the treatment）, at the end of each week during treatment and at the end of the 6weeks. Follow-up will be done 6 weeks following the last treatment. Discussion： Results of this trial will provide preliminary data on whether acupuncture provides better outcomes than nonacupuncture treatments, i.e., standard care, and whether acupuncture focused on the points in pudendal nerve distribution, near the pain area, has better results than traditional acupunc- ture focused on distal meridian points for vulvodynia.

The methodology flaws in Hinman's acupuncture clinical trial, Part Ⅲ: Sample size calculation

In the October 2014 publication of JAMA,Dr.Hinman and colleagues published the study＂Acupuncture for Chronic Knee Pain：A Randomized Clinical Trial,＂in which the authors concluded that＂in patients older than50 years with moderate or severe chronic knee pain,neither laser nor needle acupuncture conferred benefi t over sham for pain or function.Our fi ndings do not support acupuncture[1]