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Acupuncture in Depth

A Brief History

Acupuncture is probably the oldest of the Tradition Chinese Medical Treatments still in use today.  It originated in China (depending on the source you read) between 3,000 and 5,000 years ago and its use was first documented in print in the Huangdi Nei Jing  or Yellow emperers (sic) Classic of Medicine which was compiled in 475-221 BC. This work describes the use of acupuncture and moxibustion, pathology of the perceived channels of energy, acupuncture points.  At that time, acupuncture was a large part of the Chinese medical knowledge at that time. 

Acupuncture was banned in China during the Manchurian Qing Dynasty (1644-1911) because the rulers felt that it was inferior to the western medicine coming from the Western cultures.  However, the ban was unsuccessful because people already strongly believed that it worked, and it continued to be used widely among both the poor and the wealthy of China. 

The practice began to find its way into other cultures, and by the 1900s it had spread to Japan and other nearby countries as well as Arabian and European Countries who traded with China. 

Acupuncture was again fully embraced by the Chinese Government established under Mao Tsetung who advocated the use of both Chinese and western treatments. This East-West approach led to the development of acupuncture Anesthesia which is now widely recognized in the West. 

Acceptance of Acupuncture as a valid medical protocol in the U.S. did not really begin until the 1970s. Because acupuncture is based on Daoist (Taoist) theories like yin and yang, and the 5 elements a Chinese diagnosis may seem crude and unprofessional to Western physicians.  There is much anecdotal evidence that acupuncture and acupressure are effective on some illnesses, however, Western science has never been able to understand how it works.  Because they can show that in some instances it does works, but because they cannot explain how it works, many western physicians and researchers remain skeptical. 

Acupuncture (and Traditional Chinese Medicines in general) are not considered folk medicine by many.  They consider it to be a highly developed, and researched form of medicine.  It has been accepted more easily by the lay-persons than by scientists because the lay-person does not have to understand how it works, just that it works [for some people].           

What is acupuncture?

One of the primary precepts of acupuncture is that the Vital Substances flow through channels or Meridians in the body.  There are 12 channels or meridians in the body, and a network of smaller channels branching off the main channel.  Each of the 12 main meridians is connected to one of the 12 organs and travels along its own route in the body.  Unlike the blood circulatory system, the meridians are not visible to the naked eye. The acupuncture points lie along these meridians.

When the vital substances do not flow smoothly, disease occurs.  By stimulating specific acupuncture points, blockages can be removed and the body returned to its natural state.  

In Chinese medicine, the vital substances are:

Qi (vital energy)  This term is literally translated as air and is the vital energy of any living organism.  Deficiencies or blocked qui can result in an inability to properly process and transform our food and drink, and are believed to cause a lack of resistance to diseases and chronic fatigue

Xue (blood)  The blood circulates through the body and also houses the shen or spirit and aids in the development of clear and stable thought processes. It is believed that blood deficiencies typically lead to a pale complexion dry skin and dizziness.   

Jing (essence) (also known as prenatal Qi) .  This is the essential energy that we get from our parents and from food and air.  This element is believed to govern growth, reproduction and development, promotes kidney Qi and works with Ai to help protect the body from external factors. A deficiency in Jing is believed to influence infertility, poor memory and promote a chronic tendency to viral and bacterial influences.  

Jin Ye (body fluids)  The functional secretions of the body including tears, sweat, saliva, milk, mucous and vaginal secretions.  Jin are lighter fluids which moisten and nourish the skin and muscles. Ye are the denser fluids from the spleen to nourish the internal organs.  A deficiency in body fluids  are believed to lead to forms of dehydration shuch as dry skin and constipation.

Meridians These are the channels through which the vital fluids flow. When the vital substances fail to flow freely disease occurs.  By stimulating an acupuncture point, any blockages are released and the body returns to its natural state.

In essence acupuncture is the insertion of very fine needles on the body surface to influence the physiological functioning of the body.  It can be used in combination with heat  provided by burning specific herbs (Moxibustion).    There also a less invasive variety of the practice known as acupressure (no needles are used) .

How does acupuncture work? 

Unfortunately there is no real answer to why it works for some people.  Some of the workings of the body are still a mystery to scientists.  However as biogenetics progresses, maybe this question can be answered.  Currently there are several prevailing theories about how acupuncture works. 

• By some unknown process, Acupuncture raises the level of triglycerides, specific hormones, prostaglandins, white blood counts, gamma gobulins, opsonins and overall anti-body levels.  This is called the Augmentation of Immunity theory.

• The Endorphin theory states that Acupuncture stimulates the secretions  of endorphins in the body (specifically Enkaphalins)

• The Neurotransmitter theory states that certain neurotransmitter levels  (such as seratonin and Noradrenaline) are affected.

• The Circulatory theory states that Acupuncture has the effect of constricting or dilating blood vessels.  This may be caused by the bodys  release of vasodilaters (such as histamine),  in response to the Acupuncture.

• In the Gate Control theory the perception of pain is controlled by a part of the nervous system whick regulates the impulse, which will later be interpreted as pain. This part of the nervous system is called the Gate.  If the gate is hit with too many impulses it becomes overwhelmed and it closes. This prevents some of the impulses from getting through. The nerve fibers that carry the pain impulse are rather small nerve fibers called C fibers.  These are the gates that close during Acupuncture.

The National Center for Complementary and Alternative Medicine (NCCAM) at the National Institute of health has proposed several process to explain acupunctures effect, primarily those on pain. Acupuncture points are believed to stimulate the central nervous system  (brain and spinal cord) to release chemicals into muscles, spinal cord and brain.  These chemicals either change the experience of pain or release other chemicals such as hormones, that influence the bodys  self-regulating systems. The biochemical changes may stimulate the bodys natural healing abilities and promote physical and emotional well-being.  There are three main mechanisms:

Conduction of electromagnetic signals: Western scientists have found evidence that acupuncture points are strategic conductors of electromagnetic signals.  Stimulating points along these pathways through acupuncture enables electromagnetic signals to be relayed at a greater rate than under normal conditions.  These signals may start the flow of painkilling biochemicals such as endorphins and of immune system cells to specific sites that are injured or vulnerable to disease.

Activation of the opiod systems:  Research has found that several types of opioids may be released into the central nervous system during acupuncture treatment, thereby reducing pain.

Changes in brain chemistry sensation and involuntary body functions:  studies have shown that acupuncture may alter brain chemistry by changing the release of neurotransmitters and neurohormones in a good way.  Acupuncture also has been documented to affect the parts of the central nervous system related to sensation and involuntary body functions, such as immune reactions and processes whereby a persons blood pressure, blood flow and body temperature are regulated.

Acupuncture and You:  The NCCAM is cautious in recommending acupuncture as a sole treatment.  The NCAAM states that The use of acupuncture, like many other complementary and alternative treatments, has produced a good deal of anecdotal evidence.  Much of this evidence comes from people who report their own successful use of the treatment.  If a treatment appears to be save and patients report recovery from their illness or condition after using it, others may decide to use the treatment.   However, scientific research may not substantiate the anecdotal reports.

The NCCAM continues its analysis with the fact that Lifestyle and age, philosophy, and other factors combine to make every person different.  A treatment that works for one person may not work for another who has the very same condition.  You, as a health care consumer (especially if you had a pre-existing medical condition), should discuss acupuncture with your doctor.  Do not rely on a diagnosis of disease by an acupuncturist that does not have substantial medical training.  If you have received a diagnosis from a doctor and have had little or no success using conventional medicine, you may wish to ask your doctor whether acupuncture may help.

You as a consumer are responsible for checking the practitioners credentials and being comfortable that you are working with a trained professional.  Today, many Doctors have established practices that encompass both the Traditional Chinese Medicine and Western Medical practices.  Many States have now established training standards for certification to practice acupuncture. If you are inclined to try this protocol, a list of doctors who practice acupuncture can be obtained from the American Academy of medical acupuncture.

In researching for this article, I found that the divide between endorsing and denying the effects to be about even. There is evidence that acupuncture works for some people and evidence that it doesnt for others. If you are interested in the topic, there is a plethora of information available on the Internet.  As with any other subject, check your resources for validity and discuss any changes you may want to make with your doctor.

Resource Materials:

Internet:

http://www.medicalacupuncture.org/general.htm     Public Information,  Whats Acupuncture all about
http://www.americanwholehealth.com/library/acupuncture/tcm.htm
http://www.acupuncture.com   Traditional Chinese Medicinal Therapies
http://www.acupuncture.com/StateLaws/StateLaws.htm   United States Acupuncture Laws by State  
http://www.acupuncture.com/TCMSchools/dom.htm   The ACAOM Doctoral Program Standards Adopted May 24, 2000
http://www.americanacupuncture.com/history.html  The History of Accupuncture
http://www.people.virginia.edu/~pjb3s/Acupuncture.html  Dr. Bowers Complementary and alternative Medicine Home Page
http://www.medicinechinese.com/  Chinese Medicine and acupuncture in Canada
http://nccam.nih.gov/nccam/fcp/factsheets/acupuncture/acupuncture.htm

Printed Materials:
Helms JM. Acupuncture Energetics: A Clinical Approach for Physicians. Berkeley, Calif: Medical Acupuncture Publishers: 1995.
Stux G. Pomeranz B. Acupuncture: Textbook and Atlas. Berlin, Germany Springer-Verlag: 1987; 1-26.
Norheim AJ. Adverse effects of acupuncture: a study of the literature for the years 1981-1994. J Altern Complement Med. 1996; 2(2) 291-297.
Culliton PD, Kiresuk TJ. Overview of substance abuse acupuncture treatment research. J Altern Complement Med. 1996; 2(1): 149-159.
Helms JM. Report on the World Health Organization's consultation on acupuncture. Med Acupunct. 1997; 9(1): 44-46. Birch, Stephen J., and Robert L. Felt. Understanding Acupuncture. Brookline, Massachusetts: Paradigm Publications, 1999.
Firebrace, Peter. Acupuncture: Restoring the Body's Natural Healing Energy. New York, New 

Ron Griffin
Page last updated on February 13, 2001