This essay is provided, with the permission of the student who submitted it for marking, to give you an example of an essay that scored Borderline for overall competence. I have annotated the text to emphasise some of the deficiencies and areas where it could be improved, and have attached a mark sheet that indicates how I would grade this essay. Julian Burton Phase 1a Director and Moderator of this SSC.
Please assess the student on the following criteria which are defined in more detail in the School s Outcome Objectives (see attached). Professional Behaviours should be considered separately from the generic and specific skills assessments. Please give written feedback to ALL students, and not just those with a Borderline or Unsatisfactory grade. PLEASE CIRCLE THE APPROPRIATE JUDGEMENT Generic Graduate Skills Excellent Good Satisfactory Borderline Unsatisfactory [Includes skills in written communication, information gathering, organisation and selfmanagement and IT literacy producing a word processed report, formatted appropriately doublejustified, double line spaced, appropriate font and font size, use of special characters]. Please provide FEEDBACK for all grades awarded Word count stated. A limited number of references cited, but within the 12-20 limit. Avoid using Wikipedia it is not a reliable information source. Some attempt at synthesis but no critical analysis of sources.. (Continue overleaf if necessary) Attachment Specific Skills History of Medicine Specific Skills Excellent Good Satisfactory Borderline Unsatisfactory [Understanding of the subject, able to write in the style of a scientific paper]. Please provide FEEDBACK for all grades awarded Your essay is at the same time detailed on unnecessary issues and superficial on information directly relating to the title. You do present a chronological account but your writing is somewhat colloquial and verbose. In a short essay you need to be concise. The body of the essay does not support the conclusions made. Text is correctly double-justified and double-line spaced but page numbers are not given and no special characters have been used. There are numerous typographic and grammatical errors which indicate the need for you to proof-read your work more carefully. These impair the readability and sense of your essay. (Continue overleaf if necessary) Overall Competence Overall performance on generic and specific skills for stage of training Excellent Good Satisfactory Borderline Unsatisfactory Professional Behaviours Satisfactory Borderline Unsatisfactory [Includes submission (hard copy) of work on time & submission of Probity form, ensuring an ethical approach, avoiding plagiarism, & completion as requested]. Please provide FEEDBACK for all grades awarded Some deficiencies in in-text citations but no apparent plagiarism. (Continue overleaf if necessary)
52. Acupuncture: from ancient Chinese medicine to modern day general practice Word Count: 1998 Registration number: XXXXXXXXX
Introduction: I aim to find out about the origins of acupuncture: when and where it was first practiced, the underlying traditional philosophies and its practice in medicine. I also want to Comment [JB1]: Embolden or underline headings and place them on a different line to the following text. investigate how it has evolved through the ages including key people in its development to present day clinical trials and the associated timeline of these events. Comment [JB2]: I think this paragraph is unnecessary. Acupuncture has existed before man recorded history. Incredibly finely shaped needles named bian stones have been excavated from Chinese ruins dating back from 8000BC until 2000BC. 1 The first classic of Chinese medicinal texts was named the I Ching and was written by Fu Hsi in approximately 3000BC. The title literally means the book of change and it is the oldest of the five Comment [JB3]: Doesn t make sense. One or more words missing? Comment [JB4]: Reference? sacred Chinese classics. The basis of this book is the idea of ying and yang, the two forces in the universe and how their interaction creates and shapes all things. Fu Hsi created symbols to represent this. Two lines, one solid to represent yang and the other broken to represent yin. 2 He then arranged these symbols into eight trigrams containing three lines arranged in a unique way. Each of these trigrams represents an aspect of nature and they are arranged in opposites. The trigrams are then arranged into the 64 hexagrams which represent a state or action e.g. Force. The I ching was used to predict the future by one of several methods that organise the lines into the hexagrams. This idea shows the concept of constant change in yin and yang and the equilibrium due to the system of duality and opposites in nature. 2 A decrease in yin means an increase in yang and vice versa. This imbalance causes an overall change that in the case of the human body can lead to in increase in disease causing Chi. This idea of change is fundamental to Chinese medicine. 3 The earliest text on traditional Chinese medicine is the Nei Jing. It is the first classic of Chinese medicine because the details are still relevant in present day medicine. It is accepted Comment [JB5]: All this information about the I Ching is interesting but is it directly relevant? Comment [JB6]: You ve just contradicted yourself earlier on this page you imply the I Ching was the earliest medical text in China. that Huang Di, Chinese emperor from 2697 2599 BC discussed all aspects of Chinese medicine
with his main physician Qi Bo and the dialogue was published in roughly 300 BC. 1 The Nei Jing is composed of two individual books. The Su Wen covers all the aspects of Chinese medicine from disease to diagnosis to treatment. The second book is the Ling Shu and is commonly known as Huang Di s canon of acupuncture. Whereas Su Wen deals with the theories behind the practise of medicine such as yin and yang, Ling Shu deals with the clinical application of the ideas involved in acupuncture, the main treatment at this time. Ling Shu details the concept of Chi which is the name the Chinese know the concept of a life Comment [JB7]: Reference? Comment [JB8]: By which? force. It is what western scientists would label the original energy which created mass in the big bang theory and remains all around us. Chi can transform into different forms but can never be destroyed. 3 Ling Shu says human beings have chi in our bodies that flows through specific channels in our bodies known as meridians. 3 There are 12 main meridians and also many which branch off from these. All meridians accommodate the circulation of chi and blood which they Comment [JB9]: Correct tense? You are talking about the past. Comment [JB10]: Small numbers are best written out in words. distribute all over the body. There are also 12 muscle meridians and the skin regions. These represent the fixed positions of the main meridians because they are connected directly by the branch meridians. The main meridians supply the organs of the body with chi and blood. 3 The 12 organs are split into Fu and Tsang, the meridians are also either yin or yang. There are 6 great Yin meridians that serve the Tsang organs and 6 great yang meridians that serve the Fu organs. Each Fu organ is connected to a corresponding Tsang organ through the meridians connecting the whole body. According to Ling Shu, abnormality in the equilibrium occurs due to disease causing chi which can affect a specific meridian or a corresponding organ to the meridian. 4 There are different causes and the chi enters the body differently. For example the disease causing chi of coldness enters the body by the head and then circulates through the meridians. This suppresses the nourishing chi that naturally circulates through the meridians and causes damage linked to the specific meridian the chi entered or associated organ. 4 Therefore even at this time diagnosis of Comment [JB11]: Which time?
the infected meridian, organ and the nature of the chi imbalance was thorough. The art of acupuncture is to either re-enforce or reduce the chi in the meridian. If the nourishing Chi is deficient, then a needle is applied to the meridian slowly and pulled out quickly to increase the flow of chi and vice versa for excessive disease causing chi in the meridian. 5 There were nine needles at this time of different shapes to treat different symptoms. 5 These needles were inserted Comment [JB12]: Do you mean for disease causing excessive chi? into specific acupuncture points along the skin region meridians where the chi can enter and escape to the environment. The skin in these points has a small palpable cleft and electromagnetic property. 6 Acupuncture continued to be widely practiced in the following dynasties. Metal medical needles replaced the bian stones in the warring states era (421 221BC). In the Three kingdoms era, Huang Fu Mi gathered the classics into one piece, The Systematic classics of acupuncture and moxibustion which added new detail to Ling Shu including correcting mistakes made in the diagnostic procedures. Several generations of Xu Xi s family developed into experts in the field and charts detailing the meridians and acupuncture points were enhanced making practice more accurate. 7 During the Tang dynasty which was 618 907 AD, acupuncture schools were set up and it was separated from other traditional Chinese medicines to become its own branch of medicine. The Comment [JB13]: Unnecessary just put the dates into parentheses. tang government ordered the revision of acupuncture texts and Prescriptions worth a Thousand Gold for Emergencies was composed in roughly 650 AD which included many practitioners of acupuncture s clinical experience. Also more acupuncture points were identified totaling 650 points. 7 In the song dynasty (960 1279 AD) Wang Weiyi revised the location of acupuncture points on the meridians due to the advanced research and clinical experience accumulated in the previous dynasties. This revision of texts and primitive clinical trials into the effectiveness upon Comment [JB14]: Shouldn t this be capitalized? Comment [JB15]: Reference? various problems continued until the Opium War (1644 1840 AD). However in this era
acupuncture declined in popularity as herbal medicine became the main treatment in China. Western medicine was introduced after the revolution in 1911 and became the main source of treatment by medical practitioners. 1 Traditional Chinese medicine declined rapidly and acupuncture only continued to be practiced by barefoot doctors. They continued to practice and attempted to explain the reasoning behind acupunctures using western principles of science to bring credibility back to the ancient art. This worked and many controlled clinical trials were conducted on the effectiveness of acupuncture by practitioners of western medicine. Acupuncture Comment [JB16]: Reference? was also included in a modern hospital in its own wing in 1945 and began to be taught again. This continued in the 1950 s with many acupuncture clinics set up in hospitals all over china and since then the focus has been on investigating acupunctures clinical effectiveness. 7 The introduction of acupuncture to the rest of the world has been a very gradual process. Chinese scholars trained in china, gradually spread there ideas to neighboring countries such as Korea from as early as 500 AD and much later to Europe in the sixteenth century. A key figure in the Comment [JB17]: China Comment [JB18]: their progress of acupuncture in Europe, George Soulie de Morant studied in China but published his findings and experience in French articles and taught the practice of acupuncture directly in France. He also composed the book L'Acuponcture Chinoise which was published in 1975 and Comment [JB19]: Reference? was the first non translated book showing understanding of acupuncture points, the meridians and the concept of chi. 8 However, another scholar of Chinese acupuncture was Dr Felix Mann. He learned to read traditional Chinese texts on acupuncture from 1958 but soon disagreed with the traditional philosophies instead adapting acupuncture to explain its success in terms of the autonomous nervous system. This was detailed in Reinventing Acupuncture published in 1992. Comment [JB20]: Reference? His system uses neurophysiology to investigate pain in a certain area. Scientific acupuncture only uses several short needle pricks and requires fewer consultations with the practitioner. His
lengthy work in the field helped him to achieve the title of President of the British Society of Acupuncture which still exists and trains people today. 9 However as acupuncture spread to Europe it was criticized by skeptics. Clinical trials were held and the results published by The World Health Organization. The clinical trials were compared to Comment [JB21]: References? Dates? a control of a placebo of an unnecessary or incorrect form of acupuncture. The effect of acupuncture on a massive variety of diseases and clinical problems were investigated. The results were very promising. For example 55 80 % of people sampled with chronic pain communicated relief from the pain as opposed to 70% on morphine treatment and a mere 30 35% on the placebo. 10 However there are also controlled clinical trials that did not show positive results. In a study in America, subjects were treated for 9 weeks using the traditional oriental acupuncture points and compared to other points not associated with weight loss. No significant weight loss was reported under a 95% confidence interval. 11 This may be due to an incorrect application of traditional methods but there are many trials which have reported similar results for different conditions. This suggests to me that much more research needs to be done and the practitioner must be medically trained to acquire a good knowledge of the body. As Felix Mann said one needs an incredible sensitive touch to properly feel the differences in pulse associated with disease causing chi. 12 Conclusion: It is clear from these studies that some conditions are more appropriately treated through acupuncture but also many are not and surgical involvement is required. Acupuncture has many benefits in that it is quicker and a lot cheaper than modern day western medicine but is still experimental to an extent. More trials are continuing all the time for instance in the case of Comment [JB22]: I don t think you have presented sufficient evidence to support this conclusion. Comment [JB23]: Examples? References?
anesthesia acupuncture is still very promising. However in many conditions, the medicine practiced most widely in Europe is far more advanced and proven to work. I believe that there is promise for acupuncture in medicine and it may well be more effective in some conditions than western medicine. Nowadays there are acupuncture clinics all over England using many forms of acupuncture from more traditional forms such as moxibustion to electro-acupuncture and the scientific acupuncture method. The treatment mainly depends on the belief of the practitioner. The exact reason acupuncture is successful has not been identified. Its roots lay deep in Comment [JB24]: Reference to support this claim? philosophies created over 4000 and although its theories have been questioned, it has and will continue to heal people for a long time to come. Comment [JB25]: How do you know that this is true? References 1) http://www.acupuncturecare.com/acupunct.htm (accessed 3rd November) 2) http://en.wikipedia.org/wiki/i_ching (accessed 3rd November) Comment [JB26]: Wikipedia is not a reliable information source and is best avoided. 3) Ki Sunu. Introduction: The canon of acupuncture. Los Angeles. Yuin university press: 1985: 14-25 4) Ki Sunu. Ch4 The Conditions of Diseases of Tsang and Fu Organs Caused by the Diseasecausing Chi: The canon of acupuncture. Los Angeles. Yuin university press: 1985: 62-65
5) Ki Sunu. Ch1 The Nine Needles and the Twelve Source Points: The canon of acupuncture. Los Angeles. Yuin university press: 1985: 31-36 6) http://www.tuberose.com/meridians.html (accessed 5th November) 7) http://www.china.org.cn/english/material/185663.htm 8) http://www.itmonline.org/arts/italy.htm (accessed 10th November 9) http://www.felixmann.co.uk/page1.html (10th November) 10) WHO Library. Acupuncture review and analysis of reports on controlled clinical trials Clinical trials. WHO Library cataloguing-in-publication Data: 2002. ISBN 9241545437 11) American Journal of Clinical Nutrition, Vol 29, pg832-835 by The American Society for Clinical Nutrition, Inc. http://www.tuberose.com/meridians.html (accessed 11th November) Comment [JB27]: Author(s) and title of the article? Incomplete reference. Note that this reference counts as paper-based. 12) Brian Inglis. Acupuncture: Fringe Medicine. London. Faber and Faber ltd: 1964: 124-127