Basic Science Matters

In the United States, the first 2 years of medical school are traditionally the occasion for learning the “basic medical sciences.” It has been almost 40 years in my case, and things have certainly changed, but students of today still study anatomy, histology, microbiology, biochemistry, pathology, and pharmacology. These subjects, along with others, such as human genetics and molecular biology, form a foundation for understanding the principles of every branch of clinical medicine and surgery.

Medical acupuncture is a part of medicine and is being validated, increasingly, as an effective treatment for a wide range of conditions. ¹ However, for the most part, we are missing the foundation, the basic science piece. This is a deficiency which, in my view, we must correct. Understanding acupuncture in the same manner that we understand the mechanism of action and pharmacokinetics of a particular drug will, similarly, enable us to match treatments better with conditions. The net effect will be improved outcomes.

How does one define “basic science” in the field of acupuncture? There are traditional paradigms that many of us use every day in treating patients, and then there are views that are informed by those subjects we studied in medical school. So far, efforts to “connect the dots” have not been completely successful. However, progress is being made, and once that goal is achieved, the sharp lines of demarcation between Western and Oriental medicine will disappear.

For this special issue, we encouraged the submission of exemplary studies or comprehensive review articles dealing with research methodologies, physical properties of points and channels, signaling mechanisms, and mechanisms of acupuncture effects.

You will read about how research methodologies must take into account even the most basic principles, such as the reliability of acupuncture point location. You will also see how the application of highly advanced technologies, such as functional magnetic resonance imaging and transcontinental data sharing, are opening new frontiers. Among the articles in this issue is convincing evidence for unique bioelectric properties of points and channels; the report of a surprising result obtained when minimum De Qi needling depth at GB 34 is measured by ultrasound; indications that modulation of the posterior default mode network is the basis for the antidepressant effect of laser acupuncture; and the findings of a well-planned study of the effects of electroacupuncture at HT 7 and PC 6 on the cardiac sympathetic afferent reflex in an animal model. A study is included that demonstrates that degree of pain sensitivity is a predictor of sham-acupuncture response and that specific excitatory neurotransmitters also correlate with low versus high pain sensitivity. Finally, there is a very detailed review of what is known about the mechanisms of cardiovascular effects of acupuncture.

The authors of the articles in this special issue are from all over the world, and this diversity is important. You will also notice that there have been collaborative efforts across borders, a model from which researchers in Western medicine might draw some lessons.

In the United States, the Society for Acupuncture Research (SAR) is the vanguard in acupuncture research. The members of the Society are involved in both basic science and clinical realms. This organization also periodically sponsors an international conference.

Thanks to all researchers who continue the process of validation and of deepening our understanding of what actually happens when it is just our patient, the needle, and us.