Acupuncture is one of the main forms of treatment in
traditional Chinese medicine. It involves the use of sharp,
thin needles that are inserted in the body at very specific
points. This process is believed to adjust and alter the
body’s energy flow into healthier patterns, and is used to
treat a wide variety of illnesses and health conditions.
Origins
The original text of Chinese medicine is the Nei
Ching, The Yellow Emperor’s Classic of Internal Medicine,
which is estimated to be at least 2,500 years old.
Thousands of books since then have been written on the
subject of Chinese healing, and its basic philosophies
spread long ago to other Asian civilizations. Nearly all of
the forms of Oriental medicine which are used in the
West today, including acupuncture, shiatsu, acupressure
massage, and macrobiotics, are part of or have their roots
in Chinese medicine. Legend has it that acupuncture developed
when early Chinese physicians observed unpredicted
effects of puncture wounds in Chinese warriors.
The oldest known text on acupuncture, the Systematic
Classic of Acupuncture, dates back to 282 A.D. Although
acupuncture is its best known technique, Chinese medicine
traditionally utilizes herbal remedies, dietary therapy,
lifestyle changes and other means to treat patients.
In the early 1900s, only a few Western physicians
who had visited China were fascinated by acupuncture,
but outside of Asian-American communities it remained
virtually unknown until the 1970s, when Richard Nixon
became the first U.S. president to visit China. On Nixon’s
trip, journalists were amazed to observe major operations
being performed on patients without the use of anesthetics.
Instead, wide-awake patients were being operated on
with only acupuncture needles inserted into them to control
pain. During that time, a famous columnist for the
New York Times, James Reston, had to undergo surgery
and elected to use acupuncture instead of pain medication,
and he wrote some convincing stories on its effectiveness.
Today acupuncture is being practiced in all 50 states
by more than 9,000 practitioners, with about 4,000 MDs
including it in their practices. Acupuncture has shown notable
success in treating many conditions, and more than
15 million Americans have used it as a therapy. Acupuncture,
however, remains largely unsupported by the medical
establishment. The American Medical Association
has been resistant to researching it, as it is based on concepts
very different from the Western scientific model.
Several forms of acupuncture are being used today
in America. Japanese acupuncture uses extremely thin
needles and does not incorporate herbal medicine in its
practice. Auricular acupuncture uses acupuncture points
only on the ear, which are believed to stimulate and balance
internal organs. In France, where acupuncture is
very popular and more accepted by the medical establishment,
neurologist Paul Nogier developed a system of
acupuncture based on neuroendocrine theory rather than
on traditional Chinese concepts, which is gaining some
use in America.
Benefits
The World Health Organization (WHO) recommends
acupuncture as an effective treatment for over
forty medical problems, including allergies, respiratory
conditions, gastrointestinal disorders, gynecological
problems, nervous conditions, and disorders of the eyes,
nose and throat, and childhood illnesses, among others.
Acupuncture has been used in the treatment of alcoholism
and substance abuse. In 2002, a center in Maine
received a unique grant to study acupuncture treatment
for substance abuse. Although recognizing that acupuncture
had been used before for helping those with abuse,
this study sought to show that ear acupuncture’s effects
on relaxation response helped those abusing drugs and
alcohol better deal with the anxiety and life circumstances
thought to lead them to substance abuse.
Acupuncture is an effective and low-cost treatment
for headaches and chronic pain, associated with problems
like back injuries and arthritis. It has also been used
to supplement invasive Western treatments like
chemotherapy and surgery. Acupuncture is generally
most effective when used as prevention or before a
health condition becomes acute, but it has been used to
help patients suffering from cancer and AIDS. In 2002,
the National Institutes of health announced that pain
from certain musculoskeletal conditions like fibromyalgia
could be helped by acupuncture. Acupuncture is limited
in treating conditions or traumas that require surgery
or emergency care (such as for broken bones).
Description
Basic ideas of Chinese medicine
Chinese medicine views the body as a small part of the
universe, and subject to universal laws and principles of harmony
and balance. Chinese medicine does not draw a sharp
line, as Western medicine does, between mind and body.
The Chinese system believes that emotions and mental states
are every bit as influential on disease as purely physical
mechanisms, and considers factors like work, environment,
lifestyle, and relationships as fundamental to the overall picture
of a patient’s health. Chinese medicine also uses very
different symbols and ideas to discuss the body and health.
While Western medicine typically describes health in terms
of measurable physical processes made up of chemical reactions,
the Chinese use ideas like yin and yang, chi, the organ
system, and the five elements to describe health and the
body. To understand the ideas behind acupuncture, it is
worthwhile to introduce some of these basic terms.
YIN AND YANG. According to Chinese philosophy,
the universe and the body can be described by two separate
but complementary principles, that of yin and yang.
For example, in temperature, yin is cold and yang is hot.
In gender, yin is female and yang is male. In activity, yin
is passive and yang is active. In light, yin is dark and
yang is bright; in direction yin is inward and downward
and yang is outward and up, and so on. Nothing is ever
completely yin or yang, but a combination of the two.
These two principles are always interacting, opposing,
and influencing each other. The goal of Chinese medicine
is not to eliminate either yin or yang, but to allow
the two to balance each other and exist harmoniously together.
For instance, if a person suffers from symptoms
of high blood pressure, the Chinese system would say
that the heart organ might have too much yang, and
would recommend methods either to reduce the yang or
to increase the yin of the heart, depending on the other
symptoms and organs in the body. Thus, acupuncture
therapies seek to either increase or reduce yang, or increase
or reduce yin in particular regions of the body.
CHI. Another fundamental concept of Chinese medicine
is that of chi (pronounced chee, also spelled qi). Chi
is the fundamental life energy of the universe. It is invisible
and is found in the environment in the air, water, food
and sunlight. In the body, it is the invisible vital force that
creates and animates life. We are all born with inherited
amounts of chi, and we also get acquired chi from the
food we eat and the air we breathe. The level and quality
of a person’s chi also depends on the state of physical,
mental and emotional balance. Chi travels through the
body along channels called meridians.
THE ORGAN SYSTEM. In the Chinese system, there
are twelve main organs: the lung, large intestine, stomach,
spleen, heart, small intestine, urinary bladder, kidney,
liver, gallbladder, pericardium, and the “triple
warmer,” which represents the entire torso region. Each
organ has chi energy associated with it, and each organ
interacts with particular emotions on the mental level. As
there are twelve organs, there are twelve types of chi
which can move through the body, and these move
through twelve main channels or meridians. Chinese
doctors connect symptoms to organs. That is, symptoms
are caused by yin/yang imbalances in one or more organs,
or by an unhealthy flow of chi to or from one organ
to another. Each organ has a different profile of symptoms
it can manifest.
THE FIVE ELEMENTS. Another basis of Chinese theory
is that the world and body are made up of five main
elements: wood, fire, earth, metal, and water. These elements
are all interconnected, and each element either
generates or controls another element. For instance,
water controls fire and earth generates metal. Each organ
is associated with one of the five elements. The Chinese
system uses elements and organs to describe and treat
conditions. For instance, the kidney is associated with
water and the heart is associated with fire, and the two
organs are related as water and fire are related. If the kidney
is weak, then there might be a corresponding fire
problem in the heart, so treatment might be made by
acupuncture or herbs to cool the heart system and/or increase
energy in the kidney system.
The Chinese have developed an intricate system of
how organs and elements are related to physical and mental
symptoms, and the above example is a very simple one.
Although this system sounds suspect to Western scientists,
some interesting parallels have been observed. For instance,
Western medicine has observed that with severe
heart problems, kidney failure often follows, but it still
does not know exactly why. In Chinese medicine, this connection
between the two organs has long been established.
MEDICAL PROBLEMS AND ACUPUNCTURE. In Chinese
medicine, disease as seen as imbalances in the
organ system or chi meridians, and the goal of any remedy
or treatment is to assist the body in reestablishing its
innate harmony. Disease can be caused by internal factors
like emotions, external factors like the environment
and weather, and other factors like injuries, trauma, diet,
and germs. However, infection is seen not as primarily a
problem with germs and viruses, but as a weakness in
the energy of the body that is allowing a sickness to
occur. In Chinese medicine, no two illnesses are ever the
same, as each body has its own characteristics of symptoms
and balance. Acupuncture is used to open or adjust
the flow of chi throughout the organ system, which will
strengthen the body and prompt it to heal itself.
A VISIT TO THE ACUPUNCTURIST. The first thing an
acupuncturist will do is get a thorough idea of a patient’s
medical history and symptoms, both physical and emotional.
This is done with a long questionnaire and interview.
Then the acupuncturist will examine the patient to
find further symptoms, looking closely at the tongue, the
pulse at various points in the body, the complexion, general
behavior, and other signs like coughs or pains. From
this, the practitioner will be able to determine patterns of
symptoms which indicate which organs and areas are
imbalanced. Depending on the problem, the acupuncturist
will insert needles to manipulate chi on one or more
of the twelve organ meridians. On these twelve meridians,
there are nearly 2,000 points that can be used in
acupuncture, with around 200 points being most frequently
used by traditional acupuncturists. During an individual
treatment, one to 20 needles may be used, depending
on which meridian points are chosen.
Acupuncture needles are always sterilized and
acupuncture is a very safe procedure. The depth of insertion
of needles varies, depending on which chi channels
are being treated. Some points barely go beyond superficial
layers of skin, while some acupuncture points require
a depth of 1-3 in (2.5-7.5 cm) of needle. The needles
generally do not cause pain. Patients sometimes report
pinching sensations and often pleasant sensations,
as the body experiences healing. Depending on the problem,
the acupuncturist might spin or move the needles,
or even pass a slight electrical current through some of
them. Moxibustion may be sometimes used, in which an
herbal mixture (moxa or mugwort) is either burned like
incense on the acupuncture point or on the end of the
needle, which is believed to stimulate chi in a particular
way. Also, acupuncturists sometimes use cupping, during
which small suction cups are placed on meridian
points to stimulate them.
How long the needles are inserted also varies. Some
patients only require a quick in and out insertion to clear
problems and provide tonification (strengthening of
health), while some other conditions might require needles
inserted up to an hour or more. The average visit to
an acupuncturist takes about 30 minutes. The number of
visits to the acupuncturist varies as well, with some conditions
improved in one or two sessions and others requiring
a series of six or more visits over the course of
weeks or months.
Costs for acupuncture can vary, depending on
whether the practitioner is an MD. Initial visits with non-
MD acupuncturists can run from $50-$100, with followup
visits usually costing less. Insurance reimbursement
also varies widely, depending on the company and state.
Regulations have been changing often. Some states authorize
Medicaid to cover acupuncture for certain conditions,
and some states have mandated that general coverage
pay for acupuncture. Consumers should be aware of
the provisions for acupuncture in their individual policies.
Precautions
Acupuncture is generally a very safe procedure. If a
patient is in doubt about a medical condition, more than
one physician should be consulted. Also, a patient should
always feel comfortable and confident that their
acupuncturist is knowledgable and properly trained.
Research & general acceptance
Mainstream medicine has been slow to accept
acupuncture; although more MDs are using the technique,
the American Medical Association does not recognize it as
a specialty. The reason for this is that the mechanism of
acupuncture is difficult to scientifically understand or
measure, such as the invisible energy of chi in the body.
Western medicine, admitting that acupuncture works in
many cases, has theorized that the energy meridians are
actually part of the nervous system and that acupuncture
relieves pain by releasing endorphins, or natural pain
killers, into the bloodstream. Despite the ambiguity in the
biochemistry involved, acupuncture continues to show effectiveness
in clinical tests, from reducing pain to alleviating
the symptoms of chronic illnesses, and research in
acupuncture is currently growing. The Office of Alternative
Medicine of the National Institute of Health is currently
funding research in the use of acupuncture for treating
depression and attention-deficit disorder.
Training & certification
Medical acupuncture has evolved in America which
uses traditional methods mainly as surgical techniques
and pain management, and not as part of Chinese medicine
overall. Medical acupuncture is performed by an
MD or an osteopathic physician (DO). Currently 23
states allow only this type of acupuncture. Practitioners
get their training as part of conventional medical school
programs. As any MD can legally perform acupuncture,
The American Academy of Medical Acupuncture
(AAMA) was chartered in 1987 to support the education
and correct practice of physician-trained acupuncturists.
Its members must be either MDs or DOs who have completed
proper study of acupuncture techniques. Address:
5820 Wilshire Blvd., Suite 500, Los Angeles, CA 90036,
(323) 937-5514, http://medicalcupuntcture.org
For traditional acupuncturists, The National Commission
for Certification of Acupuncturists (NCCA) conducts
certification exams, promotes national standards,
and registers members. Most states that license acupuncturists
use the NCCA standards as certification. Address:
11 Canal Center Plaza, Ste. 300, Alexandra, VA 22314,
(703) 548-9004, http://www.nccaim.org.
The American Association of Acupuncture and Oriental
Medicine (AAAOM) is the largest organization for
practitioners, with more than 1,600 members. Address:
1925 W. County Rd B2, Roseville, MN 55113, (651) 631-
0204, http://www.aaaom.org.
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