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HISTORY
Stone acupuncture needles dating back to 3000 B.C. have been found by archaeologists in Inner Mongolia, and acupuncture has been widely practiced in China for around 3,500 years. In the 17th century, physicians and missionaries brought acupuncture to Europe, where it slowly gained a foothold. In 1972, James Reston, a journalist for the New York Times, had an emergency appendectomy while in China. He gave acupuncture an enormous boost when he described how it had eased his post-operative pain. Spectacular examples of acupuncture as an alternative to conventional anesthesia during surgery were subsequently reported in the West.
Since the opening of China to the West after the 1970s, many Western physicians have studied acupuncture techniques and use "medical acupuncture", as the practice is known, to supplement conventional treatment in hospitals and pain clinics. In the West, traditionally trained practitioners who are not physicians tend to practice in private clinics. The use of acupuncture in anesthesia is mainly confined to China.
DESCRIPTION
Acupuncture is an element within the Traditional Chinese Medicine (TCM) health system, which also includes herbs, acupressure, exercise, and diet. Fundamental to TCM are the concepts of yin and yang, opposite but complementary forces whose perfect balance within the body is essential for well-being. Yin signifies cold, damp, darkness, stillness, and contraction; yang signifies heat, dryness, light, action, and expansion.
This ancient Chinese practice is based on the belief that health is determined by chi (qi or ch'i) pronounced "chee", the invisible vital life energy that flows through every living thing. Yin and yang are components of chi. This energy is thought to move through the body along pathways called meridians (channels), each of which is linked to a specific organ. There are 12 regular meridians running up and down the body in pairs (six on the left and six on the right). They are mostly named after the main internal organs through which they pass. Six are primarily yin, associated with "solid" yin organs, such as the liver, six are yang, linked to "hollow" yang organs, such as the stomach. Two more meridians, the Conception and Governing vessels, provide control of the 12 other meridians. If the flow of energy is balanced, evenly circulating around the body, the individual enjoys good health. If something interrupts this flow, disruption on a meridian can create illness at any point along it. Various problems, including pain, can result; for example, a disorder in the Stomach meridian (passing through the upper gums) could cause a toothache. There are 365 acupoints along the meridians at which chi is concentrated and can enter and leave the body. It is possible to affect the circulation of chi at these points. Acupuncture is used to restore proper energy flow by inserting needles to stimulate or suppress the flow, and, as a result, bring about good health.
In acupuncture treatment, the acupuncturist inserts thin needles at specific points in the body. Although slight discomfort may occasionally be felt upon insertion of the needle, the treatment is virtually painless. The needles may be left in place for anywhere from a few minutes to half an hour. To support the acupuncture therapy, the practitioner may recommend taking herbs in the form of teas and capsules, and may also suggest specific lifestyle changes and exercises. Relief may be experienced after only one treatment, or after a series of treatments.
Although used for a variety of health problems, including addictions, pain relief, anesthesia, musculoskeletal problems, arthritis, asthma, hay fever, mental disorders such as depression, anxiety, migraines, nausea and vomiting in pregnancy, high blood pressure, digestive disorders, women's health, and also promoting health. It can also be used for nausea associated with general anesthesia and chemotherapy.
In the United States acupuncture is perhaps most commonly used to relieve pain, including neck and lower back pain, post-surgical pain, and migraine headaches.
In the United Kingdom, midwives have used it to turn breech babies. The World Health Organization has identified over 40 conditions treatable with acupuncture.
Studies have indicated that acupuncture may stimulate the production of endorphins, the body's own "morphine-like" painkillers. It may also trigger nerve "gate control", in which pressure messages reach the brain faster than do messages of pain. Although attempts at relating the meridians' pattern of energy pathways to electrical current in the body have been unscientific and inconclusive, some evidence exists for acupoints having a lower electrical resistance than non-acupuncture sites. In a Spanish study in 1992, radioactive tracers injected at acupoints seemed to travel along similar pathways to meridians, leading to theories of information transmission linked to neurochemicals rather than to the circulatory or lymphatic system. Completely safe, acupuncture has no known side effects.
CONSULTING A PRACTITIONER
On your first visit, the practitioner will take notes on your lifestyle and medical history, and assess your condition using the "Four Examinations" of TCM - asking, observing, listening (and smelling), and finally touching, in which the most important test is taking the pulse. This is a skilled method of checking the rhythm and strength of all 12 meridian pulses (six on each wrist).
There are 28 descriptions, such as "wiry" or "choppy", to categorize the state of each pulse. To aid diagnosis, the practitioner may examine other parts of the body. She will then discuss treatment options, which, as well as acupuncture, often include advice on diet and lifestyle, and may involve herbs or acupressure. You will then be asked to lie on a treatment table, after removing any clothes covering needle sites (acupoints). The site depends on the disorder and whether the flow of chi is to be "warmed", reduced, or increased. Several acupoints may be used: those on the hands and feet are often treated, but sites on the back, abdomen, shoulders, and face are also widely used.
EQUIPMENT
INSERTING THE NEEDLES
The practitioner generally inserts the acupuncture needles to a depth of 1/8 - 1 inch (4-25 mm) depending on the position of the acupoint being treated, although in some cases, practitioners may insert needles to a deeper level. Treatment often involves a combination of acupoints; usually 6 to 12 needles are used, varying according to the type of acupuncture and the condition of the individual patient. Acupuncture needles may be left in position for a few minutes, as little as a few seconds (especially along the back), or as long as an hour. At the end of the session they are withdrawn swiftly and gently, usually painlessly, without bleeding and leaving no trace on the skin.
MOXIBUSTION
For some conditions, especially those due to chi or yang deficiency, such as low back pain, the practitioner burns the herb moxa, generating heat to stimulate acupoints.
CUPPING
Glass cups are placed on Kidney acupoints. The practitioner creates a vacuum in the cup by burning an alcohol soaked cotton ball in it and placing it on the skin. When the cotton has burned the oxygen, the skin lifts into the vacuum.
ELECTRO-ACUPUNCTURE
A variation on traditional acupuncture, electro-acupuncture was developed in China in the 1950s. Practitioners apply a low-intensity pulsating electrical current to the needles, which is then conducted through to the acupoint to stimulate it. Electro-acupuncture reaches a large number of acupoints simultaneously, and is especially useful as an anesthetic during surgery, avoiding the need for many acupuncturists to work on the patient at the same time.
Laser acupuncture, another variation, directs a fine, low-energy laser beam onto the acupoint. It is particularly useful for patients who have an aversion to needles.
The practitioner uses electro-acupuncture to ease the pain of a frozen shoulder. She attaches electrodes, connected to an electro-acupuncture machine, to needles inserted at selected acupoints along a meridian - in this case, the Large Intestine meridian, which runs down the arm. When the machine is switched on, a light electric current is transmitted into the acupoints for a few minutes.
AURICULAR ACUPUNCTURE
According to Chinese medical theory, there are over 120 acupoints on each ear relating to specific parts of the body. The traditional therapy of auricular, or ear, acupuncture has been adapted by modern practitioners, who now stimulate ear acupoints using needles, laser treatment, and electrical currents.
The ear has traditionally been considered an area of great significance in TCM, since it is thought to be crossed by all the major meridians. Practitioners study the ears in detail, observing their color as well as the condition of the skin.
A French physician, Dr. Paul Nogier, made a study of auricular acupuncture in the late 1950s, based on his observation of the work of a local healer in the town of Lyons. Dr. Nogier developed a theory that the ear corresponded to an inverted fetus, and identified 30 basic points that appeared to have a reflex response in an associated area of the body. He later carried out research in China, where acupunctures adopted his theories, and he developed a method of pulse diagnosis. Dr. Nogier is now regarded as the father of modern acupuncture.
In auricular acupuncture (sometimes known as auriculotherapy or ear acupuncture), diagnosis is based not only on the traditional Four Examinations of Traditional Chinese Medicine, but also on a detailed examination of the ear itself. The practitioner will note any signs on the ears, such as flaking skin or blisters, that may point to disharmony in your system as a whole (dry skin, for example, is said to be a common feature of kidney disorders). Treatment is designed to stimulate the acupoints on the ear, over 120 of which have now been suggested. The practitioner may apply gentle pressure to the acupoints with her hands or use tiny acupuncture needles, a mild electrical current, or laser or infrared light, to stimulate the relevant points. In some cases, needles resembling thumb tacks, with tips about 1/16 inch (1.5 mm) long, are left in place for several days, in order to transmit chi to the relevant organ or body part.
Ear acupuncture is used for pain relief, anesthesia, addictions, sports injuries, acute pain including sciatica, headaches, digestive disorders such as indigestion and nausea, and kidney disorders.
QUESTIONS & ANSWERS
Q. How long does a treatment session last?
A. Treatment times vary greatly, from 30 to 90 minutes, depending on how long the needles are left in position. The initial consultation will probably be the longest.
Q. How many sessions will I need?
A. You will usually require between 10 and 20 sessions, depending on your age and on how long you have suffered from the condition. You should expect some improvement after 5 lessons.
Q. Will it be uncomfortable?
A. An ache or tingle known as the "needle sensation", is often felt.
Q. Will there be any aftereffects?
A. Some people feel tired after treatment and need to rest, or find that their pain worsens for a few hours before getting better. Others may feel rejuvenated.
FOR MORE INFORMATION
For more information on acupuncture and a list of practitioners in your area, you can contact the following organizations:
American Association of Oriental Medicine
433 Front Street
Catasauqua, PA 18032
610-433-2448 (phone)
Or
5530 Wisconsin Avenue, Suite 1210
Chevy Chase, MD 20815
301-941-1064 (phone)
888-500-7999 (toll-free)
301-986-9313 (fax)
www.aaom.org
NEW ENGLAND PRACTITIONERS:
Massachusetts Practitioners
Sitike Counseling Center
1211 Old Mission Road
San Francisco, CA 94080
415-589-9305 Or
306 Spruce Avenue
South San Francisco, CA 94080
650-689-9305 (phone)
650-589-9330 (fax)
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