Medicine

A pricking feud over the right to needle

Merilyn Read October 13 1980
Medicine

A pricking feud over the right to needle

Merilyn Read October 13 1980

A pricking feud over the right to needle

Medicine

Merilyn Read

The walls and shelves of Pierre Gaulin’s Ottawa clinic are lined with Chinese slogans, posters and medicinal herbs imported from Hong Kong—just the right touches to complement his work as a lay acupuncturist. The small waiting room in the basement of his home, which is strewn with dirty ashtrays, dated newspapers and magazines, accommodates only a few of his weekly load of 500 to 800 patients. Every two or three minutes—in the middle of all the clutter—Gaulin, a diminutive, chain-smoking volcano of energy, slips quickly from the side of one of the eight curtained beds to another, “needling” his patients.

Until recently his livelihood has been threatened, for his activities are considered illegal by the Ontario medical associations. In August, provincial court Judge Jean-Pierre Beaulne acquitted Gaulin on a charge of practising medicine without a licence. He ruled that acupuncture is not a medical procedure and thus is outside the jurisdiction of the Ontario Health Disciplines Act. But Gaulin’s victory may be short-lived. If an appeal launched by the health ministry and the College of Physicians and Surgeons is successful (it is due to be heard this winter), the college will crack down on an estimated 100 lay acupuncturists who have been operating without professional approval. That would force Gaulin and his colleagues to meet college standards or go underground, as well as threatening the livelihood of some 300 others who work discreetly in Chinatowns and clinics across the country. In the meantime, the case has highlighted a continuing controversy over who is best qualified to practise this 5,000-year-old Oriental art.

The problem became apparent in 1974 when an increased number of nonmedical acupuncturists began practising in Canada. A fear of quacks setting up business led the Ontario College of Physicians and Surgeons, along with every other province in the country except Quebec (where lay acupuncturists have operated legally since 1977), to rule that

lay acupuncturists can practise only under direct medical supervision. As well, the Ontario college has established examinations to determine which laymen are qualified to practise under supervision. But the college has been unsuccessful in its aim, since only 27 acupuncturists have even bothered to take the exams.

“How can you supervise something you don’t know anything about?” asks Gaulin. Dr. Joseph Wong, medical director of rehabilitation at Laurentian Hospital in Sudbury and one of the

country’s recognized medical acupuncturists, agrees. “The doctor is there not so much to supervise the acupuncturist as to supervise the safety of the body.” But, he adds, “If you go through the skin you have to have a knowledge of what’s under it.”

The ancient art of acupuncture is based on the principle that there are channels of energy called meridians running through the body. Needles from one to 10 cm in length are inserted at specific points along the meridians to massage and stimulate the nervous system. Throughout its long history, acupuncture has been used to treat problems ranging from migraines and arthritis to obesity and smoking. It is also used as a pain reliever. Although the Athabascan Indians are said to have used a form of acupuncture in Canada as early as 1836, it wasn’t until about 1972 that it became popular.

That’s the year that Pierre Gaulin hung up his shingle in Ottawa. His training includes three years of classical acupuncture in China and doctorates from the British Acupuncture Association and the International Society of Acupuncture in Paris. He is also a member of the World Union of Acupuncture

Associations. His patients, who he says are referred by more than 500 local doctors, range from three to 97 years of age and include members of the Ottawa Rough Riders football team. But even with all this business—up to 800 patients a week at $20 a head—Gaulin says he isn’t getting rich. Many of his patients are on welfare and pay only what they can afford.

The division in philosophy between lay and medical practitioners is wide. While doctors are eager to control the practice, lay acupuncturists are quick to

criticize the qualifications of the medical profession to judge them. “There is not a single medical doctor qualified to practise acupuncture in Canada,” says Oscar Wexu, president of the Acupuncture Association of Quebec. Gaulin agrees: “Doctors don’t know anything about acupuncture themselves. They ask a lot of questions about anatomy and physiology, which have nothing to do with acupuncture.”

The Ontario College of Physicians and Surgeons admits that its exams are more to ensure that a person has a basic knowledge of anatomy and hygiene than to test his skills as an expert needier. “We have no way to judge a qualified acupuncturist,” says Dr. Wolfgang Spoerel, professor of anesthesia at the University of Western Ontario and one of the four doctors who set the provincial exam. “There is no standard of acupuncture that is universally recognized.” But he, like college registrar Dr. Michael Dixon, believes it is in the public interest that acupuncture be regulated by the medical profession, especially since serious mistakes have been made, such as accidentally puncturing a lung. Still, even doctors make mistakes. Three years ago, 26-year-old Donna Carlin commuted between Ot-

tawa and Montreal to a physician acupuncturist for treatment of a stomach ulcer. A needle implanted in her ear was supposed to stop the flow of acid to her stomach and allow the ulcer to heal naturally. The pain went away as long as the needle was in her ear, but when Carlin was forced to have it removed because she developed an ear infection, the pain returned, intensified, and she was hospitalized. Comments Dr. Brian Bailey, an Ottawa physician and acupuncturist: “This use of acupuncture as an ongoing anesthetic is unusual and out of the mainstream.”

Despite the controversy over who should be administering acupuncture, doctors, dentists and veterinarians have been incorporating it into their practices for the past six years. Dr. Linda Rapson, a Toronto acupuncture specialist and former president of the Acupuncture Foundation of Canada, says about 800 doctors have taken fiveday introductory courses offered by the foundation since 1974. So far, about 300 are using it to some degree in their practices. Rapson, who has been employing the method for six years, says that a doctor could effectively use acupuncture in a limited way after the basic course.

Dr. Herbert Adirim, a Toronto dentist and graduate of one of the foundation’s first sessions, uses acupuncture as a pain-killer. Instead of the standard injection of Novocain, he applies needles to various parts of the body. “I had one patient who had to be hospitalized for simple fillings because he couldn’t control his gagging,” he says. “After he was referred to me I spent five hours trying out a system of needles to help him. Now that I’ve worked it out, it takes me less time to apply acupuncture than it takes to give a hypodermic.”

A further area of debate is whether acupuncture is an effective treatment of addictions and habits. Bailey says he has used it successfully to help patients quit smoking. Bailey, who counsels an average of 50 patients a week and charges from $25 to $30 a visit, says that while the patient must have the willpower to stop smoking, acupuncture acts in “dulling the withdrawal symptoms of excessive appetite, anxiety and the desire to smoke.”

Eventually, Gaulin would like to see the art categorized under the jurisdiction of the Drugless Practitioner’s Act, which already covers nonmedical professionals such as chiropractors and physiotherapists. As he awaits a decision on his future, he takes comfort in history: “Acupuncture has been prosecuted and persecuted for thousands of years by different Chinese emperors. It has survived. I’m only part of the flow.”