The California business and professions code (Chapter 267, Article 3.5, Sections 2150 through 2525.17c) provides for the proper restoration of balance energy flow through the Leg Sunlight Yang Meridian.
Or the Arm Lesser Yang Meridian, which is also known as the Triple Warmer. Or the Governing Vessel, or the Conception Vessel. Anywhere the body suffers disruption of the life energy called Ch'i.
This is the language of acupuncuture, the ancient Chinese practice that the state of California now defines as "the stimulation of a certain point or points on or near the surface of the body by the insertion of needles to prevent or modify the perception of pain, or to normalize physiological functions, including pain control, for the treatment of certain diseases or dysfunctions of the body."
Many California acupuncturists say that is a rather stodgy and inadequate description of their profession ("old - fashioned" is the way one San Francisco acupuncturist described it recently), but there it is, written into the state law the cenerpiece of a burgoening culture clash here between eastern medicine and the western regulatory mind generating some of the more novel health care delimmas in recent local memory. For example:
A Korean acupuncturist (who does not speak English) is under investigation for injecting his patients with tiny gold silvers, removable only by surgery. The acupuncturists say this is a well - recognized procedure. A state health official describes the case and throws up his hands. "Where are you going to find experts?" he demands.
The law requires acupuncturists to treat patients only after diagnosis and referral by a medical doctors think acupuncture is, to put it kindly, experimental, and will not refer patients.
One acupuncturist requesting permission to practice under the "grandfather clause," which automatically grants licenses to those with five years' proven practice, says he has no proof because he learned his profession from an old masteer, now dead, in China. Another refuses to privide proof, because, as it develops, all his equipment was confiscated when he was arrested for illegally practing acupuncture.
Should an acupuncturist receive a title "doctor," without which most insurance companies will not pay for acupuncture treatment? Should accredited acupunture schools stress philosophy and history? Is it right that Western medical doctors are automatically allowed to practice acupuncture, regardless of their training?
Questions like these have been plaguing health officials here ever since the state legislature 2 1/2 years ago made it legal for licensed acupuncturists to practice in California. Thirteen other states have laws addressing acupuncture (some allow the practice only under the supervision of physicians), but California, with its large Asian population and its statewide interest in non - traditional health care, has now licensed more acupuncturists than any other state - 590, as of November.
It has been a complicated and often bewildering process, this tentative wedding of old Eastern practice and new Western law. A businessman sits in a seventh - floor Chinatown acupuncture office, his suit pants rolled to the knee and a dozen needles stuck in each leg, watching the evening news on the color television. A Chinese - American physician sits at her dining room table, Christmas music coming over the stereo, and begins explaining acupuncture by drawing the Yen - Yang symbol with a felt tip pen.
"It really is a confrontation," said Robert Rowland, executive director of the state's Board of Medical Quality Assurance, in a recent interview. "Everybody sort of makes a joke about it ... all the objective scientific thinkers, all the totally programmed Western thought people ... they don't want to have anything to do with it yet."
For a society raised on Darwin and astrophysics, the whole principle is a little hard to grasp. Acupuncture is based on the belief that balanced, constantly moving energy flows through the human body to maintain both physical health and harmony with the outside world. It flows, acupuncturists believe, along 14 "meridians," a concept that a Chinese - American physician, Dr. Jane F. Lee, boxed nicely into Western smile by comparing meridians to continuous internal subway tracks.
And when the energy flow is disrupted by congestion along the meridians, acupuncturists use the stimulation of needles at select points to restore it. "Like one stop that has too many people," said Dr. Lee, who practices acupuncture in San Francisco. "You have to shove some people into the train to send them on."
Health care through inner balances; through the opposition of yang and yin. The state is grappling with it as best it can. The Department of Consumer Affairs will send, upon request, an application for certified acupuncturists: Acupuncture experience? Description? Have you, in the past (5) years been convicted of, pled guilty or no contest to a crime other than minor traffic violation?
A man with a distinctly un - Aasian name of Aldo Avellino oversees the collection of these forms. When the applicants speak no English, he calls in translators. When the applicants arrive bearing nothing but the blessing of a long - dead acupuncture master, Avellino gropes for alternatives acceptable to both the old and new countries: Letters from peers, for example.
Each newly trained applicant - many schooled in England or China, since California currently has no state - certified acupuncture schools - sits through an oral examination, during which he must display his needles and perform acupuncture on himself. He might be asked to locate a certain numbered acupuncture point along the Leg Sunlight Yang Meridian, which is also called Stomach Meridian: "Find Stomach 36," the examiner might say (Stomach 36 is a little below the knee).
Five years ago, when acupuncture made its firs appearance in the United States following American visits to the People's Republic of China, the state was firm about nonphysicians who used needles for traditional Asian health care. It arrested them. A Japanese acupuncturist named Ted Hayashida was arrested three times for the illegal pracitice of medicine, by persons he refers to as "Western gestapo;" after each arrest, he paid a respectable fine and went back to work.
"I was breaking the law," said Hayashida, "but I was saving people too."
Now Hayashida, liked most of his assosciates, has stepped into the bureaucratic embrace of the state, and serves on the Acupuncture Advisory Committee, helping with recommendations on the proper administration of his profession. But even for Hayashida and the other newly welcomed acupuncturists working in California, it is still a fairly hostile word.
Many acupuncturists say there are too many of them, especially the non - English speaking acupuncturists whose particle is often restricted to the Asian community, and not enough patients. They are not accorded the title of doctor, which many consider a gesture of respect that their profession entitles them to.
More important, the law says acupuncturists must have a patient's diagnosis from a doctor, and doctors - who have not exactly rushed to embrace the concept of energy meridians - are often reluctant to send patients. The California Medical Association fought adoption of the acupuncture bill, and still officially views acupuncture as an unaproven technique which "may have potential value in the relief of pain."
So although California has confronted, licensed, and - with some uncertainty - begun trying to regulate acupuncture, it has not yet figured out how to weave the Asian practice into Western health care.
"There's a big basic difference," said Dr. Lee, who probably understands both worlds as well as anybody here, "that we can't bridge or accept at this point."