Acupuncture is the procedure of inserting and manipulating fine filiform needles into specific points on the body to relieve pain or for therapeutic purposes.[3] The word acupuncture comes from the Latin acus, "needle", and pungere, "to prick". In Standard Mandarin, 針砭 (zhēn biān) (a related word, 針灸 (zhēn jiǔ), refers to acupuncture together with moxibustion).[4]
According to traditional Chinese medical theory, acupuncture points are situated on meridians along which qi, the vital energy, flows. There is no known anatomical or histological basis for the existence of acupuncture points or meridians.[5][6] Modern acupuncture texts present them as ideas that are useful in clinical practice.[7][8] According to the NIH consensus statement on acupuncture, these traditional Chinese medical concepts "are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture."[6]
The earliest written record that is available about acupuncture is Huangdi Neijing (黃帝內經 or Yellow Emperor's Inner Canon), which suggests acupuncture originated in China and would explain why it is most commonly associated with traditional Chinese medicine (TCM).[9] Different types of acupuncture (Classical Chinese, Japanese, Tibetan, Vietnamese and Korean acupuncture) are practiced and taught throughout the world.
Acupuncture has been the subject of active scientific research since the late 20th century[10] but it remains controversial among conventional medical researchers and clinicians.[10] Due to the invasive nature of acupuncture treatments, it is difficult to create studies that use proper scientific controls.[6][10][11][12][13]:126 Some scholarly reviews have concluded that the effectiveness of acupuncture as a treatment can be explained primarily through the placebo effect,[14][15] while other studies have suggested some efficacy in the treatment of specific conditions.[10][16][17] The World Health Organization published a review of controlled trials using acupuncture and concluded it was effective for the treatment of 28 conditions and there was evidence to suggest it may be effective for several dozen more.[18] Additionally, the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH), the American Medical Association (AMA) and various government reports have studied and commented on the efficacy (or lack thereof) of acupuncture. There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles, and that further research is appropriate.[6][19][20][21]
Acupuncture points and meridians
Needles being inserted into a patient's skin.
Most of the main acupuncture points are found on the "twelve main meridians" and two of the "eight extra meridians" (Du Mai and Ren Mai) a total of "fourteen channels", which are described in classical and traditional Chinese medical texts, as pathways through which Qi and "Blood" flow. There also exist "extra points" not belonging to any channel. Other tender points (known as "ashi points") may also be needled as they are believed to be where stagnation has gathered.
Treatment of acupuncture points may be performed along several layers of pathways, most commonly the twelve primary channels, or mai, located throughout the body. The first twelve channels correspond to systems of function: Lung, Large Intestine, Stomach, Spleen, Heart, Small Intestine, Bladder, Kidney, Pericardium, San Jiao (an intangible, also known as Triple Burner), Gall Bladder, and Liver. Other pathways include the Eight Extraordinary Pathways (Qi Jing Ba Mai), the Luo Vessels, the Divergents and the Sinew Channels. Ashi (tender) points are generally used for treatment of local pain.
Of the eight extraordinary pathways, only two have acupuncture points of their own: the Ren Mai and Du Mai, which are situated on the midline of the anterior and posterior aspects of the trunk and head respectively. The other six meridians are "activated" by using a master and couple point technique which involves needling the acupuncture points located on the twelve main meridians that correspond to the particular extraordinary pathway.
The twelve primary pathways run vertically, bilaterally, and symmetrically and every channel corresponds to and connects internally with one of the twelve Zang Fu ("organs"). This means that there are six yin and six yang channels. There are three yin and three yang channels on each arm, and three yin and three yang on each leg.
- The three yin channels of the hand (Lung, Pericardium, and Heart) begin on the chest and travel along the inner surface (mostly the anterior portion) of the arm to the hand.
- The three yang channels of the hand (Large intestine, San Jiao, and Small intestine) begin on the hand and travel along the outer surface (mostly the posterior portion) of the arm to the head.
- The three yin channels of the foot (Spleen, Liver, and Kidney) begin on the foot and travel along the inner surface (mostly posterior and medial portion) of the leg to the chest or flank.
- The three yang channels of the foot (Stomach, Gallbladder, and Urinary Bladder) begin on the face, in the region of the eye, and travel down the body and along the outer surface (mostly the anterior and lateral portion) of the leg to the foot.
The movement of Qi through each of the twelve channels comprises an internal and an external pathway. The external pathway is what is normally shown on an acupuncture chart and is relatively superficial. All of the acupuncture points of a channel lie on its external pathway. The internal pathways are the deep course of the channel where it enters the body cavities and related Zang Fu organs. The superficial pathways of the twelve channels describe three complete circuits of the body, chest to hands, hands to head, head to feet, feet to chest, etc.
The distribution of Qi through the pathways is said to be as follows (the based on the demarcations in TCM's Chinese Clock): Lung channel of hand taiyin to Large Intestine channel of hand yangming to Stomach channel of foot yangming to Spleen channel of foot taiyin to Heart channel of hand shaoyin to Small Intestine channel of hand taiyang to Bladder channel of foot taiyang to Kidney channel of foot shaoyin to Pericardium channel of hand jueyin to San Jiao channel of hand shaoyang to Gallbladder channel of foot shaoyang to Liver channel of foot jueyin then back to the Lung channel of hand taiyin. According to the "Chinese clock", each channel occupies two hours, beginning with the Lung, 3AM-5AM, and coming full circle with the Liver 1AM-3AM.
A standard teaching text comments on the nature and relationship of meridians (or channels) and the Zang Fu organs:
- "The theory of the channels is interrelated with the theory of the Organs. Traditionally, the internal Organs have never been regarded as independent anatomical entities. Rather, attention has centered upon the functional and pathological interrelationships between the channel network and the Organs. So close is this identification that each of the twelve traditional Primary channels bears the name of one or another of the vital Organs.
- "In the clinic, the entire framework of diagnostics, therapeutics and point selection is based upon the theoretical framework of the channels. "It is because of the twelve Primary channels that people live, that disease is formed, that people are treated and disease arises." [(Spiritual Axis, chapter 12)]. From the beginning, however, we should recognize that, like other aspects of traditional medicine, channel theory reflects the limitations in the level of scientific development at the time of its formation, and is therefore tainted with the philosophical idealism and metaphysics of its day. That which has continuing clinical value needs to be reexamined through practice and research to determine its true nature.[7]
|
