ACUPUNCTURE: WHAT IS IT? 

Acupuncture is a method of encouraging the body to promote natural healing and to improve functioning. The intent of acupuncture therapy is to promote health and alleviate pain and suffering.  This is done by inserting needles and applying heat or electrical stimulation at very precise acupuncture points  

WHAT IS MEDICAL ACUPUNCTURE? IS IT DIFFERENT FROM ORDINARY ACUPUNCTURE? 

 Acupuncture is a very old medical art, and there are many approaches to learning and practicing it. Medical acupuncture is the term used to describe acupuncture performed by a doctor trained and licensed in Western medicine who has also had thorough training in acupuncture as a specialty practice. Such a doctor can use one or the other approach, or a combination of both as the need arises, to treat an illness.

WHAT IS THE SCOPE OF MEDICAL ACUPUNCTURE?

Medical acupuncture is a system which can influence three areas of health care:

Acupuncture is particularly useful in resolving physical problems related to tension and stress and emotional conditions. 

Acupuncture has been practiced in China for more than 2,000 years (though some think it has been around for 4,000 years). Today, the needles are twirled, heated, or even stimulated with weak electrical current, ultrasound, or certain wavelengths of light. But no matter how it is done, scientific research can never demonstrate that unblocking chi by acupuncture or any other means is effective against any disease. Chi is defined as being undetectable by the methods of empirical science.  

The perspective from which an acupuncturist views health and sickness hinges on concepts of "vital energy," "energetic balance" and "energetic imbalance." Just as the Western medical doctor monitors the blood flowing through blood vessels and the messages traveling via the nervous system, the acupuncturist assesses the flow and distribution of this "vital energy" within its pathways, known as "meridians and channels".   

The acupuncturist is able to influence health and sickness by stimulating certain areas along these "meridians". Traditionally these areas or "acupoints" were stimulated by fine, slender needles. Today, many additional forms of stimulation are incorporated, including herbs, electricity, magnets and lasers. Still, the aim remains the same - adjust the "vital energy" so the proper amount reaches the proper place at the proper time. This helps your body heal itself   

A variation of traditional acupuncture is called auriculotherapy or ear acupuncture. It is a  method of diagnosis and treatment based on the unsubstantiated belief that the ear is the map of the bodily organs. For example, a problem with an organ such as the liver is to be treated by sticking a needle into a certain point on the ear that is supposed to be the corresponding point for that organ. (Similar notions about a part of the body being an organ map are held by those who practice iridology [the iris is the map of the body] and reflexology [the foot is the map of the body].) Staplepuncture, a variation of auriculotherapy, puts staples at key points on the ear hoping to do such things as help people stop smoking.

 HOW DOES ACUPUNCTURE WORK?

 The classical Chinese explanation is that channels of energy run in regular patterns through the body and over its surface. These energy channels, called meridians, are like rivers flowing through the body to irrigate and nourish the tissues. An obstruction in the movement of these energy rivers is like a dam that backs up in others. For millennia, the acupuncturist has been engaging subtle human energies, otherwise known as "Qi". According to time-tested principles unique to Oriental Medicine, the acupuncturist would assess and adjust the flow and distribution of "Qi" in order to promote health and healing. Acupuncture is a traditional Chinese medical technique for unblocking chi (ch'i or qi) by inserting needles at particular points on the body to balance the opposing forces of yin and yang. Chi is an energy that allegedly permeates all things. It is believed to flow through the body along 14 main pathways called meridians.  When yin and yang are in harmony, chi flows freely within the body and a person is healthy. When a person is sick, diseased, or injured, there is an obstruction of chi along one of the meridians. Traditional Chinese medicine has identified some 500 specific points where needles are to be inserted for specific effects. 

The meridians can be influenced by needling the acupuncture points; the acupuncture needles unblock the obstructions at the dams, and reestablish the regular flow through the meridians. Acupuncture treatments can therefore help the body's internal organs to correct imbalances in their digestion, absorption, and energy production activities, and in the circulation of their energy through the meridians.

 The modern scientific explanation is that needling the acupuncture points stimulates the nervous system to release chemicals in the muscles, spinal cord, and brain. These chemicals will either change the experience of pain, or they will trigger the release of other chemicals and hormones which influence the body's own internal regulating system.

 The improved energy and biochemical balance produced by acupuncture results in stimulating the body's natural healing abilities, and in promoting physical and emotional well-being.

 So far, modern research has described various physiological shifts following acupuncture, such as beneficial changes in the body's own natural painkillers, anti-inflammatory agents, immune system functions and hormonal activity.

 Despite the powerful technology available today, even the modern physicists cannot explain exactly how this ancient healing therapy works. Perhaps in the near future, the actual chemical and electromagnetic events that occur during acupuncture will be described.

 HOW MANY TREATMENTS WILL I NEED?

 The number of treatments needed differs from person to person. For complex or long-standing conditions, one or two treatments a week for several months may be recommended. For acute problems, usually fewer visits are required, and for health  

Proposed Mechanisms of Action

The following mechanisms have been proposed to explain acupuncture's presumed action on pain:

Scientific Status

The World Health Organization has listed forty conditions for which claims of effectiveness have been made.  They include acute and chronic pain, rheumatoid and osteoarthritis, muscle and nerve "difficulties," depression, smoking, eating disorders, drug "behavior problems," migraine, acne, ulcers, cancer, and constipation.  Some chiropractors and psychologists have made unsubstantiated claims to improve dyslexia and learning disorders by acupressure.  However, scientific evidence supporting these claims is either inadequate or nonexistent.

 The Principles of Disease

 Diseases fall into two main groups, diseases of the channels and collaterals, and diseases of the zang and fu organs.

 Diseases of the Channels and Collaterals
These are the diseases of the superficial channels of the body—arthritis and acute strains are examples of this type of disease. The internal yin and yang balance is normal but the flow of qi and blood through the channels is disrupted. This usually presents with pain and is called a disease of 'bi' or blockage of the channels. If the flow of qi and blood is restored then the pain will go. This is the main therapeutic principle that is applied for this type of disease.

 Diseases of the Zang and Fu Organs
These are the diseases of the internal organs of the body where there is an imbalance of the yin and yang within the body. Neurasthenia and asthma are clear examples of this type of disease. To treat these problems it is essential to be able to make a clear traditional diagnosis and to know the rules of point selection.

Diseases that Combine Zang and Fu, and Channel Disorders
A disease of pain, such as migraine, may combine these two ideas. Migraine is usually a disorder of the gan-liver but there is also a blockage of the flow of qi and blood in the channels around the temple, resulting in pain. The channels and collaterals, and the zang fu, will therefore both require treatment in this disease.

 Principles of Point Selection

 Diseases of the Channels and Collaterals   

The principle of treatment for these diseases is to select the local points (Ah shi points or acupuncture points), and also a distal point on the channel that crosses the painful area. The local painful points are quite simple to find when the patient is examined, but the distal points are a matter of experience. There are no rules for the selection of these distal points, they have just been handed on to us as a product of empirical experience.

 Local points
The local points are outlined in the discussion on each disease. There are common painful points in each type of disease and these are included in the prescriptions. The disease may not be typical, and the local points may vary a little, so do not follow the prescription blindly but examine the painful area and use the points that seem most relevant. The tender point, or the Ah shi point (both mean the same thing) also has a part to play in this type of disease. If you find a very tender area that does not seem to be an acupuncture point then use it as well as the local acupuncture points. The tender point is often an acupuncture point that you have not learnt.

 Distal points
These are part of the basic grammar of acupuncture and they just have to be learnt. The easiest way to do this is to give a list of the most important distal points, with their uses.

Houxi (SI 3) This point may be used for pain over the small intestine channel, especially pain from cervical syndrome that is referred to the scapular area.   

Hegu (LI 4) This point may be used for pain over the large intestine channel and it is also a very important point for facial pain, headache and sinusitis. 

Quchi (LI 11) This is often used as a distal point for referred pain from the shoulder or neck.

Waiguan (SJ 5) This is the most important distal point in the upper limb. If there is pain in the upper limb that is not on a channel then this point may be used. It is also used when there is pain over the Sanjiao channel.

Weizhong (UB 40) This point is used for low back pain, or any pain over the lower part of the urinary bladder channel.

Kunlun (UB 60) This point is used for upper thoracic, cervical pain or headache, i.e. pain over the upper part of the urinary bladder channel.

Yanglingquan (GB 34) This may be used for any pain over the gall bladder channel, such as migraine.

Neiting (St 44) This is used for pain over the stomach channel such as facial pain, abdominal pain or hip pain radiating down the front of the leg.

These are the most important distal points. For some diseases of 'hi' no distal points are used, and the common diseases where these exceptions apply are knee pain, ankle pain, wrist pain, hand pain and foot pain. In these diseases use only the local points as outlined in the prescriptions. Sometimes the local acupuncture points may not be tender until they are carefully examined.

Diseases of the Zang and Fu Organs
On the basis of traditional diagnosis the acupuncturist will be able to decide what organ is diseased and what pathogen is causing that disease. He will then know which channel to use to correct the problem, and whether to sedate or tonify a particular organ. He must also dispel the pathogen, for instance, in cases of cold, he will need to warm with moxa or cupping or both.

 There are many different rules that can be applied in order to select a point for a particular disease, but an experienced acupuncturist will often select only a few points. Initially this will be very confusing to a beginner, but as more clinical experience is obtained then it will slowly become clear that experience is the basis of many prescriptions. There are no dogmatic rules governing point selection for the zang fu diseases but there are several groups of special points that represent each organ. The most therapeutically useful groups are discussed and listed.

 Back shu and front mu points
These points represent the surface points of the organs, the mu points are on the front and the shu points are on the back. If the zang organs are diseased (yin organs) then the back shu points are particularly effective, and if the fu organs are diseased (yang organs) then the front mu points are useful.

 The shu points can be alternated with points on the ventral surface of the body, as outlined in some of the prescriptions. The back shu points are particularly useful in treating a zang disorder when it is associated with back pain, primarily because the position of the patient for acupuncture is much simpler.

 The back shu points are prefixed by the Chinese name for the organ, for instance pi means spleen and pishu is the back shu point for the spleen; wei means stomach and weishu is the back shu point for the stomach.

 Table I

 Lung
Feishu (UB 13)
Zhongfu (Lu 1)

 

 

 

Pericardium
Jueyinshu (UB 14)
Shanzhong (Ren 17)

 Heart
Xinshu (UB 15)
Jujue (Ren 14)

 Liver
Ganshu (UB 18)
Qimen (Liv 14)

 Gall Bladder
Danshu (UB 19)
Riyue (GB 24)

 Spleen
Pishu (UB 20)
Zhangmen (Liv 13)

 Stomach
Weishu (UB 21)
Zhongwan (Ren 12)

 Sanjiao
Sanjiaoshu (UB 22)
Shimen (Ren 5)

 Kidney
Shensh (UB 23)
Jingmen (GB 25)

 Large intestine
Dachangshu (UB 25)
Tianshu (St 25)

 Small intestine
Xiaochangshu (UB 27)
Guanyuan (Ren 4)

 Urinary bladder
Pangguangshu (UB 28)
Zhongji (Ren 3)