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Japanese Acupuncture and Moxibustion (Online)

JAM  2007;Vol.3:1-3

Current State of Acupuncture Treatment in Italy

CASANOVA Emanuela 1), CTAKEUCHI Yoshiomi 2)
1) Maggiore Hospital, Rehabilitation Ward, Bologna, Italy
2) Keizan Clinic of Acupuncture, Kyoto, Japan

Abstract

Every year 4% of Italians receive a treatment of acupuncture and the doctors, who are practicing as acupuncturists, are approximately 15,000. From a legal point of view, only medical doctors can practice acupuncture in Italy. The formal education in East Asian traditional medicine consists of a 4-year postgraduate course and there are 13 schools of acupuncture in the major cities of Italy. Acupuncture is practiced in approximately 122 public pain centers, and the national health insurance system covers acupuncture treatment in those centers. The most common conditions treated by acupuncture are rheumatic and musculoskeletal symptoms.

I. Introduction

In Europe acupuncture is often assimilated into a large and heterogeneous category of treatments, the gso-calledh complementary and alternative medicine (CAM) or unconventional therapeutic methods 1). The reviewed information indicates that the rapid growth in the popularity of acupuncture and CAM in the last 15 years is a common denominator in European countries. According to the latest data, 9 million of Italians have experienced CAM. In detail, they have been submitted to homeopathy (5.8), massage (20.5%), herb therapy (10.5%) and acupuncture (5.8%).
Main indications for these therapies are musculoskeletal problems, allergic diseases, respiratory and gynecological conditions, neurological disorders (migraine, facial palsy and trigeminal neuralgia), psychological symptoms and stress 2). As revealed by a statistical survey of 1999, in the previous 1-2 years the percentage of Italian people who underwent to acupuncture has been 2.9%. Besides, between 1991 (2.1%) and 1999 (2.9%) a 0.8% increase of this percentage has been reached 3).
Nowadays every year 4% of Italians receive acupuncture. Medical doctors who are using acupuncture as one of the therapeutic method are approximately 15,000 and acupuncture is practiced in approximately 122 public pain centers, where the national health insurance system covers the expense of the treatment.

II. The diffusion of acupuncture

Acupuncture gradually spread from China to the rest of the world over the course of several centuries. Reports of acupuncture were first brought back to the west by Jesuit missionaries in the sixteenth century. Acupuncture was practiced widely by French physicians by the late nineteenth century, and the scholar-diplomat Soulier De Morant published an influential treatise on the subject. A great surge of interest in acupuncture followed President Nixonfs visit to China in 1971, when a member of the presidentfs press corps was treated by acupuncture for appendicitis 4).
During the last 20-30 years in Europe, as in all western countries, Oriental Medicine has been getting more and more popular and widespread, and in the 90fs took root. An exchange between the French school and Italian practitioners of acupuncture and oriental medicine was established and allowed a diffusion of these therapies in Italy, too. In fact, France has been essential to the development of acupuncture in Europe because of the linkage to Vietnam as a former colony. In the 70fs the first schools of oriental medicine were opened and in the 80fs academic cooperation with Chinese Universities and other European schools, like the British ones, were established.
Only doctors can practice acupuncture and in the last years the medical practitioners who are enrolled in school of oriental medicine have been notably increased. Besides, the Government and the Ministry of Health have gradually recognized and enacted the education and the practice of acupuncture. Consequently acupuncture center located in public health services has multiplied and post-graduate master courses have established in the Universities.

III. The education in acupuncture

In Italy there are two types of post-graduate courses of oriental medicine; 1) Western reflex-based school and 2) Traditional method-based school. The schools of acupuncture instituted in the 70fs or in the 80fs lasted in 3 years, but nowadays in Italy, like in the other European countries, the courses continue for 4 years. The Italian schools of acupuncture are included mostly in FISA (Federazione Italiana delle Societa di Agopuntura, Italian Federation of Acupuncture Societies) and are spread all over the country (Bologna, Bari, Catania, Genova, Milano, Padova, Palermo, Roma, Salerno e Torino).
The courses of Oriental Medicine have the following characteristics: Four-years-duration and at least 360 hours for theoretical and practical lectures lessons aiming to the traditional concepts of oriental medicine and to the recent acquisitions of acupuncture, a final test at the end of every year and a thesis for the degree examination.
Furthermore, in the middle of the 80fs even the Universities of Medicine perceived the necessity to deepen the knowledge of oriental medicine and master courses for medical doctors were instituted in some of the more important universities (Chieti, Ancona, Pavia, Brescia, gStataleh of Milano and gLa Sapienzah di Roma). Besides, sometime local departments of the National Health system (ASL) organize short courses of oriental medicine.
The private schools of oriental medicine located in Bari, Bologna, Milano, Napoli and Roma have recently established 2-years-course of Traditional Medicine-based herb therapy, rehabilitation, massage, Taichi and other methods of physical training.
In Italy there are a lot of organizations of acupuncture practitioners, but an official society doesnft exist.

IV. The practice of acupuncture

According to a survey conducted by FISA in 2000, there is a relative significant difference between North and South of Italy in the amount of acupuncture treatments provided in public hospital and in private centres 5).
Patients started to receive acupuncture without charge of the expenses in many national hospitals from the 90fs, but in some public centres the oriental medical therapies begun to be provided even in the 70fs (Civitanova Marche, Ravenna, the Orthopaedic Institute of Naples and Forlanini Hospital of Roma). As stated by this survey, the percentage of patients who receive acupuncture in local departments of the National Health System is 5%.
The public and private centres where acupuncture is provided have been estimated as 122. The doctors who are practicing in these centres have been rated as 261.
The data collected between 1995 and 1997 in the public centre of Civitanova Marche showed that symptoms treated by acupuncture were: rheumatism (48%), respiratory and otolaryngological diseases (34%), psychiatric and neurological disorders (32%), diseases of the digestive system (32%), cardiovascular diseases (27%) and urologic (19%), dermatologic (16%), gynecological disorders (14%).

V. Conclusions

We can conclude that during the last ten years the popularity of acupuncture has been growing quickly in Europe and in other western countries. In Italy, 4% of the population underwent to acupuncture every year. Between 1991 and 1999, 0.8% increase of this percentage has been reached. The practitioners are approximately 15,000 and the public and private centres where acupuncture is provided are about 122. The most treated diseases are rheumatism, respiratory and otolaryngological diseases, psychiatric and neurological disorders, diseases of the digestive system, cardiovascular diseases and urologic, dermatologic gynecological disorders.

(This paper is republished from the Journal of Japan Society of Acupuncture and Moxibustion (JJSAM), 56 (4), 2006. It is modified and translated.)

References

1) White AR, Resch K-L, Ernst E. Complementary medicine: use and attitude among GPs. Fam. Pract. 1997; 14 (4): 302-6.
2) Casanova E, Eto F, Yamashita H, Tsukayama H, Takeuchi Y. Current State of Acupuncture Treatment in Europe. The Japanese Journal of Rehabilitation Medicine. 2005; 41(12): 846-8.
3) Menniti-Ippolito F et al. Use of unconventional medicine in Italy: a nation-wide survey. Eur J Clin Pharmacol. 2002; 58 (1): 61-4.
4) Ernst E, White A. Acupuncture: a scientific appraisal.Butterworth-Heinemann, Professional Complementary Medicine. UK. 1999.
5) FISA. Agopuntura, evidenze cliniche e sperimentali. Casa Editrice Ambrosiana, luglio 2000.

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