The need for practical courses in anatomy for acupuncturists

Since 1965 publications have repeatedly reported life-threatening incidents in connection with acupuncture treatment. Several publications have collated a list of complications affected by and associated with acupuncture. The most frequently reported injury caused by the acupuncture needles is pneumothorax. This chiefly occurs when the needles are placed parasternally or supraclavicularly. However, also paravertebral and infraclavicular acupuncture and that in the lateral thorax region often cause injuries to the pleura and lungs. In most of these cases it has to be implied that the therapists did not have a clear understanding of the actual position and borders of the pleura and lungs or had insufficient knowledge of the thickness of the soft tissue covering. Injuries to the heart and the pericardium are less frequent. The responsibility for such injuries lies, amongst other things, in the lack of knowledge regarding a relatively frequent variation of the so-called “foramen sternale”. The causes for the life-threatening incidents almost always lie in the therapist’s rudimentary knowledge of normal and pathological anatomy. An exact analysis of the case studies found in the publications shows this ignorance as the main cause of life-threatening complications. Especially the exact topographical relationship of the thoracic viscera to each other and in projection to the thorax wall, as well as its anomaly and dependence on the patient’s constitution and previous illnesses do not appear to be familiar to many therapists. For this reason we consider it essential to include practical courses in anatomy into medical acupuncture training programmes.