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Acupuncture

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(Introduction)
(History)
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== History ==
== History ==
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=== Ancient Origins ===
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=== Chinese Origins ===
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Acupuncture is a form of healing that predates recorded history. It is deeply rooted in the Taoist philosophy which was created over 8,000 years ago.   
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The Chinese were the true pioneers of acupuncture. Although other civilizations had similar healing techniques, the Chinese developed the technique and formed the basis of modern acupuncture. It finds its origins in the Taoist philosophy created over 8,000 years ago. The philosophy, which focuses on the flow of energy within and without and the relationship between man and the universe. Inspired by the Taoist mindset, Fu Hsi, a legendary Chinese man from the Yellow River area of China created "I-Ching" or "Book of Change." The book dramatically influenced both the philosophy of the people and the foundations of Chinese medicine and subsequently acupuncture.
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The first official record of the practice of acupuncture can be found in the book "Nei Ching" or "The Yellow Emperor's Classic of Internal Medicine" that dates back to approximately 300 B.CIn the famous conversation, the emperor Huang Di and his physician Qi Bo discuss the Chinese Medical arts. The text of the conversation has since been declared the earliest book regarding Chinese medicine. The first part of the book, "Su Wen" or "Plain Questions," addresses human anatomy and physiology as well as the concepts of "Yin and Yang" and the "Five Elements." The second part of the book, "Ling Shu" or "Miraculous Pivot, Spiritual Axis" primarily addresses the practice of acupuncture. The book discusses the meridians of the body, the functions of the zang-fu organs, several different types of needles, the functions of the acupuncture points, techniques of using the needle, types of Qi (pronounced chi), and the location of 160 points on the body.
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  China was the foremost center for the development of acupuncture; there acupuncture truly flourished. In "Nei Ching" or "The Yellow Emperor's Classic of Internal Medicine" written in 300 B.C., the emperor addresses many medical topics including the importance of yin yang balance and the use of acupuncture. Furthermore the first known book of acupuncture, "Nei Ching Su Wen", dates back to 200 B.C. in China. Consisting of two parts, the Su Wen and Lin Shu, the book describes Chinese medical thinking that was geared to restore the disturbed balances and harmonies of the body. During the third century B.C., Chang Chi wrote two famous medical books which he entitled "Various Kinds of Fevers" and "Golden Shrine." In 700 A.D., 300 doctors were trained in acupuncture and massage at the first medical school in Salermo.[http://www.americanacupuncture.com/history.htm]
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  During the third century B.C., Chang Chi wrote two famous medical books which he entitled "Various Kinds of Fevers" and "Golden Shrine." In 700 A.D., 300 doctors were trained in acupuncture and massage at the first medical school in Salermo.[http://www.americanacupuncture.com/history.htm][http://www.acupuncturecare.com/acupunct.htm]
=== Recognition by Western Medicine ===
=== Recognition by Western Medicine ===
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In 1932, Chang Khi Check took control of China and ushered in an era of Western medicine to China. The development of acupuncture stopped during this timee as Chang Khi Check banned the practice in the cities In 1945, Mao Tse Tung took power of China and restored acupuncture as the method of healing while banning the practice of western medicine. When President Nixon opened the doors in to China in 1972, acupuncture gained world wide recognition as a form of medical treatment. More attention was called to acupuncture when American journalist James Reston had an emergency appendectomy in China with acupuncture used as the anesthetic. [http://www.americanacupuncture.com/history.htm]
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In 1932, Chang Khi Check took control of China and ushered in an era of Western medicine to China. The development of acupuncture stopped during this time as Chang Khi Check banned the practice in the cities In 1945, Mao Tse Tung took power of China and restored acupuncture as the method of healing while banning the practice of western medicine. When President Nixon opened the doors in to China in 1972, acupuncture gained world wide recognition as a form of medical treatment. More attention was called to acupuncture when American journalist James Reston had an emergency appendectomy in China with acupuncture used as the anesthetic. [http://www.americanacupuncture.com/history.htm]
Europe learned about acupuncture through the French Indochina (now Vietnam). Dr. Nogier was a French doctor whose research on ear acupuncture between 1951 and 1996 built the bridge between oriental acupuncture and Western medicine.[http://www.americanacupuncture.com/history.htm]
Europe learned about acupuncture through the French Indochina (now Vietnam). Dr. Nogier was a French doctor whose research on ear acupuncture between 1951 and 1996 built the bridge between oriental acupuncture and Western medicine.[http://www.americanacupuncture.com/history.htm]
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The philosophy is rooted in the Taoist tradition which goes
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back over 8000 years. The people of this time period would meditate
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and observe the flow of energy within and without.They also were keen
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to observe man's relations with nature and the universe.There were many
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sages of this period, but the most legendary was Fu Hsi, who lived in the
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Yellow River area of China approximately 8000 years ago.By observing 
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nature, he formulated the first two symbols, a broken line and unbroken line.
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These symbols represented the two major forces in the universe - creation
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and reception - and how their interaction forms life.This duality was
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named yin-yang and they represent the backbone of Chinese Medicine
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theory and application.Fu hsi then discovered that when yin-yang fuse,
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a creative action occurs, and this gives birth to a third aspect. Fu Hsi
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then pondered on how this triplicity occurs eight times and this led to
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the eight trigrams and then 64 hexagrams of the I-Ching (Book of Change).
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The I-Ching shaped the thinking for years to come and every influential
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book on Chinese Medicine is based upon its fundamental philosophy.
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The primitive society of China is divided into two time periods- The Old
 
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Stone Age(10,000 years ago and beyond) and the New Stone Age
 
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(10,000-4000 years ago).During the Old Stone Age knives were made
 
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of stone and were used  for certain medical procedures.During the New
 
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Stone Age, stones were refined into fine needles and served as
 
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instruments of healing. They were named bian stone - which means
 
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use of a sharp edged stone to treat disease.Many bian stone needles
 
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were excavated from ruins in China dating back to the New Stone Age.
 
The most significant milestone in the history of Acupuncture occurred
The most significant milestone in the history of Acupuncture occurred

Revision as of 05:55, 25 October 2009

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Contents

Introduction

File:Acupuncture needles.jpg File:Forehead acupuncture.jpg File:Acupuncture diagram doll.jpg File:Hua shou acupuncture diagram.jpg Acupuncture is an ancient form of healing that has become the newest craze in the medical world. The treatment involves the insertion of thin needles into the skin in an effort to eliminate pain tension in the body. Although the treatment is commonly associated with Chinese medicine, similar methods have been practiced in several different ancient civilizations. In the medical treatises called the Papyrus Ebera in 1550 B.C., the Egyptians discussed 12 meridians that were similar to those discussed by the Chinese. The Arabs cauterized their ears with extremely hot metal probes. The Eskimos employed sharp stones to perform simple acupuncture. Cannibals in Brazil shot tiny arrows using blow pipes to the diseased parts of their bodies. The primitive tools of these civilizations were eventually replaced by the thin metal needles commonly seen today.[1]

History

Chinese Origins

The Chinese were the true pioneers of acupuncture. Although other civilizations had similar healing techniques, the Chinese developed the technique and formed the basis of modern acupuncture. It finds its origins in the Taoist philosophy created over 8,000 years ago. The philosophy, which focuses on the flow of energy within and without and the relationship between man and the universe. Inspired by the Taoist mindset, Fu Hsi, a legendary Chinese man from the Yellow River area of China created "I-Ching" or "Book of Change." The book dramatically influenced both the philosophy of the people and the foundations of Chinese medicine and subsequently acupuncture.

The first official record of the practice of acupuncture can be found in the book "Nei Ching" or "The Yellow Emperor's Classic of Internal Medicine" that dates back to approximately 300 B.C. In the famous conversation, the emperor Huang Di and his physician Qi Bo discuss the Chinese Medical arts. The text of the conversation has since been declared the earliest book regarding Chinese medicine. The first part of the book, "Su Wen" or "Plain Questions," addresses human anatomy and physiology as well as the concepts of "Yin and Yang" and the "Five Elements." The second part of the book, "Ling Shu" or "Miraculous Pivot, Spiritual Axis" primarily addresses the practice of acupuncture. The book discusses the meridians of the body, the functions of the zang-fu organs, several different types of needles, the functions of the acupuncture points, techniques of using the needle, types of Qi (pronounced chi), and the location of 160 points on the body.


During the third century B.C., Chang Chi wrote two famous medical books which he entitled "Various Kinds of Fevers" and "Golden Shrine." In 700 A.D., 300 doctors were trained in acupuncture and massage at the first medical school in Salermo.[2][3]

Recognition by Western Medicine

In 1932, Chang Khi Check took control of China and ushered in an era of Western medicine to China. The development of acupuncture stopped during this time as Chang Khi Check banned the practice in the cities In 1945, Mao Tse Tung took power of China and restored acupuncture as the method of healing while banning the practice of western medicine. When President Nixon opened the doors in to China in 1972, acupuncture gained world wide recognition as a form of medical treatment. More attention was called to acupuncture when American journalist James Reston had an emergency appendectomy in China with acupuncture used as the anesthetic. [4]

Europe learned about acupuncture through the French Indochina (now Vietnam). Dr. Nogier was a French doctor whose research on ear acupuncture between 1951 and 1996 built the bridge between oriental acupuncture and Western medicine.[5]

Streamlined versions of the metal needles used by these peoples have since become the main tool in modern acupuncture. The needles are extremely fine and are often as thin as hair. They are placed at specific points of the body to relieve pain with very little discomfort.[6]




The most significant milestone in the history of Acupuncture occurred during the period of Huang Di -The Yellow Emperor (2697-2597). In a famous dialogue between Huang Di and his physician Qi Bo, they they discuss the whole spectrum of the Chinese Medical Arts. These conversations would later become the monumental text - The Nei Jing (The Yellow Emperors Classic of Internal Medicine). The Nei Jing is the earliest book written on Chinese Medicine. It was compiled around 305-204 B.C. and consists of two parts: 1. The Su Wen(Plain Questions) -9 volumes - 81 chapters The Su Wen introduces anatomy and physiology, etiology of disease, pathology, diagnosis, differentiation of syndromes, prevention, yin-yang, five elements, treatment, and man's relationship with nature and the cosmos. 2.: The Ling Shu (Miraculous Pivot,Spiritual Axis)- 81 Chapters The Ling Shu's focus is Acupuncture, description of the meridians, functions of the zang-fu organs, nine types of needles, functions of the acupuncture points, needling techniques, types of Qi, location of 160 points.

Approximately 1000 BC, during the Shang Dynasty, hieroglyphs showed evidence of Acupuncture and Moxibustion. Bronze needles were excavated from ruins, but the bian stones remained the main form of needle.

During the Warren States Era(421-221 B.C.) metal needles replaced the bian stones. Four gold needles and five silver needles were found in an ancient tomb dating back to 113B.C. The Miraculous Pivot names nine types of Acupuncture needles.The Historical Records notes many physicians practicing Acupuncture during this time. Another milestone for this period was the compilation of the Nan Jing (Book of Difficult Questions).The Nan Jing discusses five element theory, hara diagnosis, eight extra meridians, and other important topics.

From 260-265 A.D., the famous physician Huang Fu Mi, organized all of the ancient literature into his classic text -Systematic Classics of Acupuncture and Moxibustion. The text is twelve volumes and describes 349 Acupuncture points.It is organized according to the theory of: zang fu, Qi and blood, channels and colllaterals, acupuncture points, and clinical application. This book is noted to be one of the most influential text in the history of Chinese Medicine.

Acupuncture was very popular during the Jin, Northern,Southern, Dynasties (265-581A.D.). For generations the Xu Xi family were known as the experts in the art of Acupuncture.During this time period important texts and charts enhanced knowledge and application.

Acupuncture experienced great development during the Sui (581-618) and Tang (618-907) Dynasties.Upon request from the Tang Government (627-649A.D.), the famous physician Zhen Quan revised the important Acupuncture texts and charts. Another famous physician of the time, Sun Simio, wrote Prescription with a Thousand Gold for Emergencies (650-692). This text includes data on Acupuncture from various scholars. During this period Acupuncture became a special branch of of medicine and practitioners were named Acupuncturists. Acupuncture schools appeared, and Acupuncture education became part of the Imperial Medical Bureau.

During the Song Dynasty (960-1279),the famous physician Wang Weiyi wrote, The Illustrated Manual on Points for Acupuncture and Moxibustion. This book included the description of 657 points. He also casted two bronze statues on which meridians and points were engraved for teaching purposes.

The Ming Dynasty (1568-1644) was the enlightening period for the advancement of Acupuncture. Many new developments included: 1. revision of the classic texts 2.Refinement of Acupuncture techniques and manipulation 3.Development of Moxa sticks for indirect treatment 4.Development of extra points outside the main meridians 5.The encyclopedic work of 120 volumes- Principle and Practice of Medicine was written by the famous physician Wang Gendung 6.1601 - Yang Jizhou wrote Zhenjin Dacheng ( Principles of Acupuncture and Moxibustion. This great treatise on Acupuncture reinforced the principles of the Nei Jing and Nan Jing. This work was the foundation of the teachings of G.Soulie de Morant who introduced Acupuncture into Europe.

From the Qing Dynasty to the Opium Wars (1644-1840), herbal medicine became the main tool of physicians and Acupuncture was suppressed.

Following the Revolution of 1911, Western Medicine was introduced and Acupuncture and Chinese Herbology were suppressed. Due to the large population and need for medical care, Acupuncture and herbs remained popular among the folk people, and the "barefoot doctor" emerged.

Acupuncture was used exclusively during the Long March (1934-35) and despite harsh conditions it helped maintain the health of the army. This led Mao Zedong,the leader of the Communist Party, to see that Acupuncture remained an important element in China's medical system. In 1950 Chairman Mao officially united Traditional Chinese Medicine with Western Medicine, and acupuncture became established in many hospitals. In the same year Comrade Zhu De reinforced Traditional Chinese Medicine with his book New Acupuncture.

In the late 1950's to the 1960's Acupuncture research continued with - further study of the ancient texts, clinical effect on various diseases, acupuncture anesthesia, and acupuncture's effect on the internal organs.

From the 1970's to the present, Acupuncture continues to play an important role in China's medical system. China has taken the lead in researching all aspects of acupuncture's application and clinical effects. Although acupuncture has become modernized, it will never lose its connection to a philosophy established thousands of years ago.[7]

Acupuncture and moxabustion have been used in the Far East to restore, promote, and maintain good health for over 5000 years. The first acupuncture needles were made from stone, and then later from bronze, gold and silver. The first known medical account of acupuncture was The Yellow Emperor's Classic of Internal Medicine (Huang Di Nei Jing Su Wen), which dates from around 300 BC.

Acupuncture is rooted in the Daoist philosophy of change, growth, balance, and harmony. The Yellow Emperor's Classic outlines the principles of natural law and the phases of life - yin and yang, the five elements, the organ system and the meridian network along which the vital acupuncture points are located. These records also contain details of pathology and physiology, which some 2,000 years later provide the theoretical foundation for acupuncture today.

Although acupuncture is used far more extensively in China than in the West, the last few decades have seen huge growth in people seeking the benefits of this safe and highly effective treatment.[8]

The earliest written record of acupuncture is the Chinese text Shiji (史記, English: Records of the Grand Historian) with elaboration of its history in the second century BCE medical text Huangdi Neijing (黃帝內經, English: Yellow Emperor's Inner Canon).[8] Different types of acupuncture (Classical Chinese, Japanese, 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[9] but it remains controversial among conventional medical researchers and clinicians.[9] Due to the invasive nature of acupuncture treatments, it is difficult to create studies that use proper scientific controls.[10][9][11][12][13]:126 Some scholarly reviews have concluded that the effectiveness of acupuncture as a treatment can be explained largely through the placebo effect,[14][15] while other studies have suggested some efficacy in the treatment of specific conditions.[9][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] though this review has been criticized by several scientists for bias and a focus on studies with a poor methodology.[19][20] Reports from the National Center for Complementary and Alternative Medicine (NCCAM), 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.[9] Antiquity

Acupuncture's origins in China are uncertain. One explanation is that some soldiers wounded in battle by arrows were cured of chronic afflictions that were otherwise untreated,[24] and there are variations on this idea.[25] In China, the practice of acupuncture can perhaps be traced as far back as the Stone Age, with the Bian shi, or sharpened stones.[26] In 1963 a bian stone was found in Duolon County, Mongolia, pushing the origins of acupuncture into the Neolithic age.[27] Heiroglyphs and pictographs have been found dating from the Shang Dynasty (1600-1100 BCE) which suggest that acupuncture was practiced along with moxibustion.[28] Despite improvements in metallurgy over centuries, it was not until the 2nd century BCE during the Han Dynasty that stone and bone needles were replaced with metal.[27] The earliest records of acupuncture is in the Shiji (史記, in English, Records of the Grand Historian) with references in later medical texts that are equivocal, but could be interpreted as discussing acupuncture. The earliest Chinese medical text to describe acupuncture is the Huangdi Neijing, the legendary Yellow Emperor’s Classic of Internal Medicine (History of Acupuncture) which was compiled around 305–204 B.C. The Huangdi Neijing does not distinguish between acupuncture and moxibustion and gives the same indication for both treatments. The Mawangdui texts, which also date from the second century BC though antedating both the Shiji and Huangdi Neijing, mentions the use of pointed stones to open abscesses and moxibustion but not acupuncture, but by the second century BCE, acupuncture replaced moxibustion as the primary treatment of systemic conditions.[8]

In Europe, examinations of the 5,000-year-old mummified body of Ötzi the Iceman have identified 15 groups of tattoos on his body, some of which are located on what are now seen as contemporary acupuncture points. This has been cited as evidence that practices similar to acupuncture may have been practiced elsewhere in Eurasia during the early Bronze Age.[29] [edit] Middle history

Acupuncture spread from China to Korea, Japan and Vietnam and elsewhere in East Asia. Portuguese missionaries in the 16th century were among the first to bring reports of acupuncture to the West.[30] [edit] Modern era

In the 1970s, acupuncture became better known in the United States after an article appeared in The New York Times by James Reston, who underwent an emergency appendectomy while visiting China. While standard anesthesia was used for the actual surgery, Mr. Reston was treated with acupuncture for post-operative discomfort.[31] The National Acupuncture Association (NAA), the first national association of acupuncture in the US, introduced acupuncture to the West through seminars and research presentations. The NAA created and staffed the UCLA Acupuncture Pain clinic in 1972. This was the first legal clinic in a medical school setting in the US.[citation needed] The first acupuncture clinic in the United States is claimed to have been opened by Dr. Yao Wu Lee in Washington, D.C. on July 9, 1972.[32][unreliable source?] The Internal Revenue Service allowed acupuncture to be deducted as a medical expense beginning in 1973.[33]

In 2006, a BBC documentary Alternative Medicine filmed a patient undergoing open heart surgery allegedly under acupuncture-induced anaesthesia. It was later revealed that the patient had been given a cocktail of weak anaesthetics that in combination could have a much more powerful effect. The program was also criticised for its fanciful interpretation of the results of a brain scanning experiment.[10]


ACUPUNCTURE TODAY

China and Taiwan today play a leading role in developing traditional Chinese medicine. In these countries there are some 232,000 traditional Chinese medical doctors and 50 institutes producing 30,000 traditional Chinese medical doctors annually. Korea has developed very effective hand acupuncture which compliments other acupuncture modalities.Russia since the end of the cold war has revealed research done behind the iron curtain that has contributed to sonic and reflexolgy treatments today.

Japan has junior colleges of acupuncture. There are 8500 Japanese doctors in the Oriental Medical Association developing methodology in acupuncture to compliment western medicine.

In America there are about 8000 acupuncturists. 16 acupuncture schools, and 2 medical schools teaching acupuncture. UCLA medical school has been teaching acupuncture to physicians under the leadership of Dr.Joseph Helms. In 18 states, only doctors can perform acupuncture. Border states like Florida, California, and New York allow non physicians to perform acupuncture.All require licensing.

An organization the American Academy Of Medical Acupuncture (AAMA) based in California, has a membership of nearly 1000 physician members from the entire country. All physicians who are members must have been previously accredited by formal training and certification. About 25% of these physicians work in pain centers around America.

In Europe oriental medical research is very active and quite advanced. Spain has an acupuncture school called Golden Clover. Germany, Austria and Italy all have very strong and active acupuncture centers. England has no organized acupuncture medical activity but there is a British Medical Acupuncture society which is quite active. France has pioneered ear acupuncture through its famous center in Lyons under the leadership of Dr. Nogier (he recently died)

As you see, acupuncture is practiced worldwide. In the United States more and more practitioners are now developing knowledge and new skills in acupuncture. Many are incorporating all the modalities from the various countries, using hand, ear, Chinese, Japanese and scalp acupuncture along with Russian reflexology and adapting these techniques to the modern times with use of modern technology to produce what is now called American Acupuncture.

In 1996 in America, needles were removed from the "investigative" category to "accepted medical instruments". Being investigative, allowed insurance companies to deny payment for medical acupuncture treatment. There is a bill before congress with 12 sponsors to allow Medicare to pay for acupuncture treatments. The National Institute of Health for the first time has formed a department of Alternative Health care to provide needed research funding in alternative avenues of medical care. [11]

Traditional Method

The term "acupuncture" describes a family of procedures involving the stimulation of anatomical points on the body using a variety of techniques. The acupuncture technique that has been most often studied scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation.

Practiced in China and other Asian countries for thousands of years, acupuncture is one of the key components of traditional Chinese medicine. In TCM, the body is seen as a delicate balance of two opposing and inseparable forces: yin and yangThe concept of two opposing yet complementary forces described in traditional Chinese medicine. Yin represents cold, slow, or passive aspects of the person, while yang represents hot, excited, or active aspects. A major theory is that health is achieved through balancing yin and yang and disease is caused by an imbalance leading to a blockage in the flow of qi.. Yin represents the cold, slow, or passive principle, while yang represents the hot, excited, or active principle. According to TCM, health is achieved by maintaining the body in a "balanced state"; disease is due to an internal imbalance of yin and yang. This imbalance leads to blockage in the flow of qiIn traditional Chinese medicine, the vital energy or life force proposed to regulate a person's spiritual, emotional, mental, and physical health and to be influenced by the opposing forces of yin and yang. (vital energy) along pathways known as meridians. Qi can be unblocked, according to TCM, by using acupuncture at certain points on the body that connect with these meridians. Sources vary on the number of meridians, with numbers ranging from 14 to 20. One commonly cited source describes meridians as 14 main channels "connecting the body in a weblike interconnecting matrix" of at least 2,000 acupuncture points.

Acupuncture became better known in the United States in 1971, when New York Times reporter James Reston wrote about how doctors in China used needles to ease his pain after surgery. American practices of acupuncture incorporate medical traditions from China, Japan, Korea, and other countries.[12]

In this paper I will be dealing with the ancient medical art of Acupuncture. Today in most western cultures it is considered a "new alternative" medicine. In reality Acupuncture (and its related Moxibustion) are practiced medical treatments that are over 5,000 years old. Very basically, Acupuncture is the insertion of very fine needles, (sometimes in conjunction with electrical stimulus), on the body's surface, in order to influence physiological functioning of the body.

Acupuncture can also be used in conjunction with heat produced by burning specific herbs, this is called Moxibustion. In addition, a non-invasive method of massage therapy, called Acupressure, can also be effective.

The first record of Acupuncture is found in the 4,700 year old Huang Di Nei Jing (Yellow Emperor's Classic of Internal Medicine). This is said to be the oldest medical textbook in the world. It is said to have been written down from even earlier theories by Shen Nung, the father of Chinese Medicine. Shen Nung documented theories about circulation, pulse, and the heart over 4,000 years before European medicine had any concept about them.

As the basis of Acupuncture, Shen Nung theorized that the body had an energy force running throughout it. This energy force is known as Qi (roughly pronounced Chee). The Qi consists of all essential life activities which include the spiritual, emotional, mental and the physical aspects of life. A person's health is influenced by the flow of Qi in the body, in combination with the universal forces of Yin and Yang . (I will discuss Yin and Yang a little later). If the flow of Qi is insufficient, unbalanced or interrupted, Yin and Yang become unbalanced, and illness may occur. Qi travels throughout the body along "Meridians" or special pathways. The Meridians, (or Channels), are the same on both sides of the body (paired). There are fourteen main meridians running vertically up and down the surface of the body. Out of these, there are twelve organ Meridians in each half of the body (remember they are in pairs). There are also two unpaired midline Meridians. There will be a diagram of Acupuncture points for treating diseases of the Meridians at the end of the digestive system paper. (See Appendix 1). The acupuncture points are specific locations where the Meridians come to the surface of the skin, and are easily accessible by "needling," Moxibustion, and Acupressure. The connections between them ensure that there is an even circulation of Qi, a balance between Yin and Yang.

Energy constantly flows up and down these pathways. When pathways become obstructed, deficient, excessive, or just unbalanced, Yin and Yang are said to be thrown out of balance. This causes illness. Acupuncture is said to restore the balance.

Yin and Yang is an important theory in the discussion of Acupuncture treatment, in relation to the Chinese theory of body systems. As stated earlier Qi is an energy force that runs throughout the body. In addition, Qi is also prevalent throughout nature as well. Qi is comprised of two parts, Yin and Yang. Yin and Yang are opposite forces, that when balanced, work together. Any upset in the balance will result in natural calamities, in nature; and disease in humans. Yin is signified by female attributes, passive, dark, cold, moist, that which moves medially, and deficient of Yang. Yang is signified by male attributes, light, active, warm, dry, that which moves laterally, and deficient of Yin. Nothing is completely Yin or Yang. The most striking example of this is man himself. A man is the combination of his mother (Yin) and and his father (Yang). He contains qualities of both: This is the universal symbol describing the constant flow of yin and yang forces. You'll notice that within yin, there is Yang, and within Yang, there is the genesis of Yin. Whether or not you believe in Taoist philosophy, (which all this is based on), one thing is indisputable: Acupuncture works.

Acupuncturists can use as many as nine types of Acupuncture needles, though only six are commonly used today. These needles vary in length, width of shaft, and shape of head. Today, most needles are disposible. They are used once and disgarded in accordance with medical biohazard regulations and guidlines. There are a few different precise methods by which Acupuncturists insert needles. Points can be needled anywhere in the range of 15 degrees to 90 degrees relative to the skin surface, depending on the treatment called for. In most cases, a sensation, felt by the patient, is desired. This sensation, which is not pain, is called deqi (pronounced dah-chee). The following techniques are some which may be used by an Acupuncturist immediately following insertion: Raising and Thrusting, Twirling or Rotation, Combination of Raising/Thrusting and Rotation, Plucking, Scraping (vibrations sent through the needle), and Trembling (another vibration technique). Once again, techniques are carefully chosen based on the ailment.

There are a few related procedures that fall into the range of Acupuncture treatments. The first is Electro-Acupuncture. This is the using of very small electrical impulses through the Acupuncture needles. This method is generally used for analgesia (pain relief or prevention). The amount of power used is only a few micro amperes, but the frequency of the current can vary from 5 to 2,000 Hz. The higher frequencies are generally used for surgery (usually abdominal), and the lower frequencies for general pain relief. The first reported successful use of Electro-Acupuncture was in 1958 in China for a tonsillectomy. Today, it is a common method of surgical analgesia used in China. Other methods for stimulating Acupuncture points have used Lasers and sound waves (Sonopuncture). A very commonly used treatment in the United States is Auriculotherapy or Ear Acupuncture. The theory is that since the ear has a rich nerve and blood supply, it would have connections all over the body. For this reason, the ear has many Acupuncture points which correspond to many parts and organs of the body. Auricular Acupuncture has been successful in treating problems ranging from obesity to alcoholism, to drug addiction. There are numerous studies either completed, or currently going on which affirms Auricular Acupuncture's effectiveness. (These will be mentioned in detail later on in the paper.)

Another popular treatment method is Moxibustion, which is the treatment of diseases by applying heat to Acupuncture points. Acupuncture and Moxibustion are considered complimentary forms of treatment, and are commonly used together. Moxibustion is used for ailments such as bronchial asthma, bronchitis, certain types of paralysis, and arthritic disorders.

Cupping is another type of treatment. This is a method of stimulating Acupuncture points by applying suction through a metal, wood or glass jar, in which a partial vacuum has been created. This technique produces blood congestion at the site, and therefore stimulates it. Cupping is used for low backache, sprains, soft tissue injuries, and helping relieve fluid from the lungs in chronic bronchitis.

One of the most popular alternatives to Acupuncture is Acupressure. This is simply Acupuncture without needles. Stimulation of the Acupuncture points is performed with the fingers or an instrument with a hard ball shaped head. Another variation of Acupressure is Reflexology (also called Zone Therapy). This is where the soles of the feet and the posterio-inferior regions of the ankle joints are stimulated. Many diseases of the internal organs can be treated in this manner.

The question arises, how does Acupuncture work? Scientists have no real answer to this; as you know many of the workings of the body are still a mystery. There are a few prevailing theories.

  1. By some unknown process, Acupuncture raises levels of triglycerides, specific hormones, prostaglandins, white blood counts, gamma globulins, opsonins, and overall anti-body levels. This is called the "Augmentation of Immunity" Theory.
  2. The "Endorphin" Theory states that Acupuncture stimulates the secretions of endorphins in the body (specifically Enkaphalins).
  3. The "Neurotransmitter" Theory states that certain neurotransmitter levels (such as Seratonin and Noradrenaline) are affected by Acupuncture.
  4. "Circulatory" Theory: this states that Acupuncture has the effect of constricting or dilating blood vessels. This may be caused by the body's release of Vasodilaters (such as Histamine), in response to Acupuncture.
  5. One of the most popular theories is the "Gate Control" Theory. According to this theory, the perception of pain is controlled by a part of the nervous system which 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 first gates to close would be the ones that are the smallest. The nerve fibers that carry the impulses of pain are rather small nerve fibers called "C" fibers. These are the gates that close during Acupuncture.
     In the related "Motor Gate" Theory, some forms of paralysis can be overcome by Acupuncture. This is done by reopening a "stuck" gate, which is connected to an Anterior Horn cell. The gate, when closed by a disease, stops motor impulses from reaching muscles. This theory was first stated by Professor Jayasuriya in 1977. In it he goes on to say:
     "...one of the factors contributing to motor recovery is almost certainly the activation of spindle cells. They are stimulated by Gamma motor neurons. If Acupuncture stimulates the Gamma motor neurons, the discharge causes the contraction of Intrafusal Muscle fibers. This activates the Spindle cells, in the same way as muscle stretching. This will bring about muscle contraction."

There are many diseases that can be treated successfully by Acupuncture or its related treatments. The most common ailments currently being treated are: lower backache, Cervical Spondylosis, Condylitis, Arthritic Conditions, Headaches of all kinds (including migraine), Allergic Reactions, general and specific use for Analgesia (including surgery) and relief of muscles spasms. There have also been clinical trials in the use of Acupuncture in treating anxiety disorders and depression. Likewise, very high success rates have been found in treating addictions to alcohol, tobacco (nicotine) and "hard' drugs. Acupuncture can rid the body of the physical dependency, but can not rid the mind of the habit (psychological dependency). For this reason, Acupuncture treatment of addictions has not been fully successful.[13]

How Acupuncture Works

The ancient Chinese believed that there is a universal life energy, called Chi, present in all things ranging from infinitely tiny molecules to living breathing human beings.

This Chi is said to circulate throughout the body along specific pathways or meridians. As long as this energy flows freely throughout the meridians, health is maintained, but once the flow of energy is blocked, the homeostatic system is disrupted resulting in pain or illness.

Visualize if you will, rivers that flood and cause disasters or an electrical grid short-circuiting that causes blackouts etc. This is what happens to our somatic and spiritual landscapes when our Chi is not flowing harmoniously. The insertion of needles into specific points on these “channels” allows for the manipulation and harmonization of ones Chi, which results in improved health, and thus, increased fertility.[14]

TCM is based on a pre-scientific paradigm of medicine that developed over several thousand years and involves concepts that have no counterpart within contemporary medicine.[10] In TCM, the body is treated as a whole that is comprised of several "systems of function" known as the zang-fu (脏腑). These systems are named after specific organs, though the systems and organs are not directly associated. The zang systems are associated with the solid, yin organs such as the liver while the fu systems are associated with the hollow yang organs such as the intestines. Health is explained as a state of balance between the yin and yang, with disease ascribed to either of these forces being unbalanced, blocked or stagnant. The yang force is the immaterial qi, a concept that is roughly translated as "vital energy". The yin counterpart is Blood, which is linked to but not identical with physical blood, and capitalized to distinguish the two. TCM uses a variety of interventions, including pressure, heat and acupuncture applied to the body's acupuncture points (in Chinese 穴 or xue meaning "cavities") to modify the activity of the zang-fu. [edit] Acupuncture points and meridians Needles being inserted into a patient's skin. See also: Acupuncture point and Meridian (Chinese medicine)

Classical texts describe most[dubious – discuss] of the main acupuncture points as existing on the twelve main and two of eight extra meridians (also referred to as mai) for a total of fourteen "channels" through which qi and Blood flow. Other points not on the fourteen channels are also needled. Local pain is treated by needling the tender "ashi" points where qi or Blood is believed to have stagnated. The zang-fu of the twelve main channels are Lung, Large Intestine, Stomach, Spleen, Heart, Small Intestine, Bladder, Kidney, Pericardium, Gall Bladder, Liver and the intangible San Jiao. The eight other pathways, referred to collectively as the qi jing ba mai, include the the Luo Vessels, Divergents, Sinew Channels, ren mai and du mai though only the latter two (corresponding to the anterior and posterior sagittal plane of the torso respectively) are needled. The remaining six qi jing ba mai are manipulated by needling points on the twelve main meridians.

Normally qi is described as flowing through each channel in a continuous circuit. In addition, each channel has a specific aspect and occupies two hours of the "Chinese clock". Flow of qi through the meridians Zang-fu Aspect Hours Lung taiyin 0300-0500 Large Intestine yangming 0500-0700 Stomach yangming 0700-0900 Spleen taiyin 0900-1100 Heart shaoyin 1100-1300 Small Intestine taiyang 1300-1500 Bladder taiyang 1500-1700 Kidney shaoyin 1700-1900 Pericardium jueyin 1900-2100 San Jiao shaoyang 2100-2300 Gallbladder shaoyang 2300-0100 Liver jueyin 0100-0300 Lung (repeats cycle)

The zang-fu are divided into yin and yang channels, with three of each type located on each limb. Qi is believed to move in a circuit through the body, travelling both superficially and deeply. The external pathways correspond to the acupuncture points shown on an acupuncture chart while the deep pathways correspond to where a channel enters the bodily cavity related to each organ. The three yin channels of the hand (Lung, Pericardium, and Heart) begin on the chest and travel along the inner surface 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 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 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 of the leg to the foot. Each channel is also associated with a yin or yang aspect, either "absolute" (jue-), "lesser" (shao-), "greater" (tai-) or "brightness" (-ming).

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.[5]

The meridians are part of the controversy in the efforts to reconcile acupuncture with conventional medicine. The National Institutes of Health 1997 consensus development statement on acupuncture stated that acupuncture points, Qi, the meridian system and related theories play an important role in the use of acupuncture, but are difficult to relate to a contemporary understanding of the body.[10] Chinese medicine forbade dissection, and as a result the understanding of how the body functioned was based on a system that related to the world around the body rather than its internal structures. The 365 "divisions" of the body were based on the number of days in a year, and the twelve meridians proposed in the TCM system are thought to be based on the twelve major rivers that run through China. However, these ancient traditions of Qi and meridians have no counterpart in modern studies of chemistry, biology and physics and to date scientists have been unable to find evidence that supports their existence.[7] A 2008 review of electrical impedance studies concluded that although results were suggestive, the studies available were of poor quality with significant limitations, and because of this there was no clear evidence to demonstrate the existence of acupuncture points or meridians.[37] [edit] Traditional diagnosis

The acupuncturist decides which points to treat by observing and questioning the patient in order to make a diagnosis according to the tradition which he or she utilizes. In TCM, there are four diagnostic methods: inspection, auscultation and olfaction, inquiring, and palpation.[38]

   * Inspection focuses on the face and particularly on the tongue, including analysis of the tongue size, shape, tension, color and coating, and the absence or presence of teeth marks around the edge.
   * Auscultation and olfaction refer, respectively, to listening for particular sounds (such as wheezing) and attending to body odor.
   * Inquiring focuses on the "seven inquiries", which are: chills and fever; perspiration; appetite, thirst and taste; defecation and urination; pain; sleep; and menses and leukorrhea.
   * Palpation includes feeling the body for tender "ashi" points, and palpation of the left and right radial pulses at two levels of pressure (superficial and deep) and three positions Cun, Guan, Chi (immediately proximal to the wrist crease, and one and two fingers' breadth proximally, usually palpated with the index, middle and ring fingers).

Other forms of acupuncture employ additional diagnostic techniques. In many forms of classical Chinese acupuncture, as well as Japanese acupuncture, palpation of the muscles and the hara (abdomen) are central to diagnosis. [edit] Traditional Chinese medicine perspective

Although TCM is based on the treatment of "patterns of disharmony" rather than biomedical diagnoses, practitioners familiar with both systems have commented on relationships between the two. A given TCM pattern of disharmony may be reflected in a certain range of biomedical diagnoses: thus, the pattern called Deficiency of Spleen Qi could manifest as chronic fatigue, diarrhea or uterine prolapse. Likewise, a population of patients with a given biomedical diagnosis may have varying TCM patterns. These observations are encapsulated in the TCM aphorism "One disease, many patterns; one pattern, many diseases". (Kaptchuk, 1982)

Classically, in clinical practice, acupuncture treatment is typically highly individualized and based on philosophical constructs as well as subjective and intuitive impressions, and not on controlled scientific research.[39] [edit] Criticism of traditional Chinese medicine theory

Felix Mann, founder and past-president of the Medical Acupuncture Society (1959–1980), the first president of the British Medical Acupuncture Society[40] (1980), and the author of the first comprehensive English language acupuncture textbook Acupuncture: The Ancient Chinese Art of Healing first published in 1962, has stated in his book Reinventing Acupuncture: A New Concept of Ancient Medicine:

   "The traditional acupuncture points are no more real than the black spots a drunkard sees in front of his eyes." (p. 14)

and...

   "The meridians of acupuncture are no more real than the meridians of geography. If someone were to get a spade and tried to dig up the Greenwich meridian, he might end up in a lunatic asylum. Perhaps the same fate should await those doctors who believe in [acupuncture] meridians." (p. 31)[41]

Felix Mann tried to join up his medical knowledge with that of Chinese theory. In spite of his protestations about the illogicality of the theory he was fascinated by it and trained many people in the west with the parts of it he borrowed. He also wrote many books on this subject. His legacy is that there is now a college in London and a system of needling that is known as "Medical Acupuncture". Today this college trains Doctors and western medical professionals only.

Medical acupuncture has caused much controversy amongst traditional practitioners; the British Acupuncture Council wished for it to be called 'treatment using needles', and removing from it the title 'Acupuncture', as it is so different to traditional methods but have had to retract this after pressure from the medical profession. Mann proposed that the acupuncture points related to the nerve endings and he reassigned the points different uses. He altered the theory so that the treatments given are no longer individual to each client, a central premise of traditional theory. Traditionally the needle combinations differ according to the age of the client, the length of time they had had the condition, the type of pain they experience and their health history. In medical acupuncture none of this is addressed and the presenting symptom is treated using a set group of points.

A report for CSICOP on pseudoscience in China written by Wallace Sampson and Barry Beyerstein said:

   "A few Chinese scientists we met maintained that although Qi is merely a metaphor, it is still a useful physiological abstraction (e.g., that the related concepts of Yin and Yang parallel modern scientific notions of endocrinologic and metabolic feedback mechanisms). They see this as a useful way to unite Eastern and Western medicine. Their more hard-nosed colleagues quietly dismissed Qi as only a philosophy, bearing no tangible relationship to modern physiology and medicine."[42]

George A. Ulett, MD, PhD, Clinical Professor of Psychiatry, University of Missouri School of Medicine states:

   "Devoid of metaphysical thinking, acupuncture becomes a rather simple technique that can be useful as a nondrug method of pain control." He believes that the traditional Chinese variety is primarily a placebo treatment, but electrical stimulation of about 80 acupuncture points has been proven useful for pain control."[43]

Ted J. Kaptchuk,[44] author of The Web That Has No Weaver, refers to acupuncture as "prescientific." Regarding TCM theory, Kaptchuk states:

   "These ideas are cultural and speculative constructs that provide orientation and direction for the practical patient situation. There are few secrets of Oriental wisdom buried here. When presented outside the context of Chinese civilization, or of practical diagnosis and therapeutics, these ideas are fragmented and without great significance. The "truth" of these ideas lies in the way the physician can use them to treat real people with real complaints." (1983, pp. 34-35)[45]

According to the 1997 NIH consensus statement on acupuncture:

   "Despite considerable efforts to understand the anatomy and physiology of the "acupuncture points", the definition and characterization of these points remains controversial. Even more elusive is the basis of some of the key traditional Eastern medical concepts such as the circulation of Qi, the meridian system, and the five phases theory, which 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."[10]

At least one study found that acupuncture "seems to alleviate pain just barely better than sticking needles into nonspecified parts of the body"[46] and concluded that some of acupuncture's effects may be due to the placebo effect. [15]

Clinical Method

Finding a Qualified Practitioner

Health care providers can be a resource for referral to acupuncturists, and some conventional medical practitioners—including physicians and dentists—practice acupuncture. In addition, national acupuncture organizations (which can be found through libraries or Web search engines) may provide referrals to acupuncturists.

   * Check a practitioner's credentials. Most states require a license to practice acupuncture; however, education and training standards and requirements for obtaining a license to practice vary from state to state. Although a license does not ensure quality of care, it does indicate that the practitioner meets certain standards regarding the knowledge and use of acupuncture.
   * Do not rely on a diagnosis of disease by an acupuncture practitioner who does not have substantial conventional medical training. If you have received a diagnosis from a doctor, you may wish to ask your doctor whether acupuncture might help.

Top What To Expect from Acupuncture Visits

During your first office visit, the practitioner may ask you at length about your health condition, lifestyle, and behavior. The practitioner will want to obtain a complete picture of your treatment needs and behaviors that may contribute to your condition. Inform the acupuncturist about all treatments or medications you are taking and all medical conditions you have.

Acupuncture needles are metallic, solid, and hair-thin. People experience acupuncture differently, but most feel no or minimal pain as the needles are inserted. Some people feel energized by treatment, while others feel relaxed. Improper needle placement, movement of the patient, or a defect in the needle can cause soreness and pain during treatment. This is why it is important to seek treatment from a qualified acupuncture practitioner.

Treatment may take place over a period of several weeks or more.

Top Treatment Costs

Ask the practitioner about the estimated number of treatments needed and how much each treatment will cost. Some insurance companies may cover the costs of acupuncture, while others may not. It is important to check with your insurer before you start treatment to see whether acupuncture is covered for your condition and, if so, to what extent. (For more information, see NCCAM's fact sheet Paying for CAM Treatment.)

[16]

Most modern acupuncturists use disposable stainless steel needles of fine diameter (0.007 to 0.020 in (0.18 to 0.51 mm)), sterilized with ethylene oxide or by autoclave. These needles are far smaller in diameter (and therefore less painful) than hypodermic injection needles since they do not have to be hollow for purposes of injection. The upper third of these needles is wound with a thicker wire (typically bronze), or covered in plastic, to stiffen the needle and provide a handle for the acupuncturist to grasp while inserting. The size and type of needle used, and the depth of insertion, depend on the acupuncture style being practiced.

Warming an acupuncture point, typically by moxibustion (the burning of a combination of herbs, primarily mugwort), is a different treatment than acupuncture itself and is often, but not exclusively, used as a supplemental treatment. The Chinese term zhēn jǐu (針灸), commonly used to refer to acupuncture, comes from zhen meaning "needle", and jiu meaning "moxibustion". Moxibustion is used to varying degrees among current schools of oriental medicine. For example, one well-known technique is to insert the needle at the desired acupuncture point, attach dried moxa to the external end of an acupuncture needle, and then ignite it. The moxa will then smolder for several minutes (depending on the amount adhered to the needle) and conduct heat through the needle to the tissue surrounding the needle in the patient's body. Another common technique is to hold a large glowing stick of moxa over the needles. Moxa is also sometimes burned at the skin surface, usually by applying an ointment to the skin to protect from burns, though burning of the skin is general practice in China. [edit] An example of acupuncture treatment

In Western medicine, vascular headaches (the kind that are accompanied by throbbing veins in the temples) are typically treated with analgesics such as aspirin and/or by the use of agents such as niacin that dilate the affected blood vessels in the scalp, but in acupuncture a common treatment for such headaches is to stimulate the sensitive points that are located roughly in the centers of the webs between the thumbs and the palms of the patient's hands, the hé gǔ points. These points are described by acupuncture theory as "targeting the face and head" and are considered to be the most important points when treating disorders affecting the face and head. The patient reclines, and the points on each hand are first sterilized with alcohol, and then thin, disposable needles are inserted to a depth of approximately 3–5 mm until a characteristic "twinge" is felt by the patient, often accompanied by a slight twitching of the area between the thumb and hand..

In the clinical practice of acupuncturists, patients frequently report one or more of certain kinds of sensation that are associated with this treatment:

  1. Extreme sensitivity to pain at the points in the webs of the thumbs.
  2. In bad headaches, a feeling of nausea that persists for roughly the same period as the stimulation being administered to the webs of the thumbs.
  3. Simultaneous relief of the headache.[47]

[edit] Indications according to acupuncturists in the West

The American Academy of Medical Acupuncture (2004) states: "In the United States, acupuncture has its greatest success and acceptance in the treatment of musculoskeletal pain.".[48] They say that acupuncture may be considered as a complementary therapy for the conditions in the list below, noting: "Most of these indications are supported by textbooks or at least 1 journal article. However, definitive conclusions based on research findings are rare because the state of acupuncture research is poor but improving."[48]

   * Abdominal distention/flatulence
   * Acute and chronic pain control
   * Allergic sinusitis
   * Anesthesia for high-risk patients or patients with previous adverse responses to anesthetics
   * Anorexia
   * Anxiety, fright, panic
   * Arthritis/arthrosis
   * Atypical chest pain (negative workup)
   * Bursitis, tendinitis, carpal tunnel syndrome
   * Certain functional gastrointestinal disorders (nausea and vomiting, esophageal spasm, hyperacidity, irritable bowel) *
   * Cervical and lumbar spine syndromes
   * Constipation, diarrhea


   * Cough with contraindications for narcotics
   * Drug detoxification is suggested[49] but evidence is poor[50][51][52]
   * Dysmenorrhea, pelvic pain
   * Frozen shoulder
   * Headache (migraine and tension-type), vertigo (Meniere disease), tinnitus
   * Idiopathic palpitations, sinus tachycardia
   * In fractures, assisting in pain control, edema, and enhancing healing process
   * Muscle spasms, tremors, tics, contractures
   * Neuralgias (trigeminal, herpes zoster, postherpetic pain, other)
   * Paresthesias
   * Persistent hiccups
   * Phantom pain


   * Plantar fasciitis
   * Post-traumatic and post-operative ileus
   * Selected dermatoses (urticaria, pruritus, eczema, psoriasis)
   * Sequelae of stroke syndrome (aphasia, hemiplegia)
   * Seventh nerve palsy
   * Severe hyperthermia
   * Sprains and contusions
   * Temporo-mandibular joint derangement, bruxism
   * Urinary incontinence, retention (neurogenic, spastic, adverse drug effect)
   * Weight Loss

[17]

Effectiveness

Acupuncture Use in the United States

The report from a Consensus Development Conference on Acupuncture held at the National Institutes of Health (NIH) in 1997 stated that acupuncture is being "widely" practiced—by thousands of physicians, dentists, acupuncturists, and other practitioners—for relief or prevention of pain and for various other health conditions. According to the 2007 National Health Interview Survey, which included a comprehensive survey of CAM use by Americans, an estimated 3.1 million U.S. adults and 150,000 children had used acupuncture in the previous year. Between the 2002 and 2007 NHIS, acupuncture use among adults increased by three-tenths of 1 percent (approximately 1 million people). Acupuncture Side Effects and Risks

The U.S. Food and Drug Administration (FDA) regulates acupuncture needles for use by licensed practitioners, requiring that needles be manufactured and labeled according to certain standards. For example, the FDA requires that needles be sterile, nontoxic, and labeled for single use by qualified practitioners only.

Relatively few complications from the use of acupuncture have been reported to the FDA, in light of the millions of people treated each year and the number of acupuncture needles used. Still, complications have resulted from inadequate sterilization of needles and from improper delivery of treatments. Practitioners should use a new set of disposable needles taken from a sealed package for each patient and should swab treatment sites with alcohol or another disinfectant before inserting needles. When not delivered properly, acupuncture can cause serious adverse effects, including infections and punctured organs.

Top Status of Acupuncture Research

There have been many studies on acupuncture's potential health benefits for a wide range of conditions. Summarizing earlier research, the 1997 NIH Consensus Statement on Acupuncture found that, overall, results were hard to interpret because of problems with the size and design of the studies.

In the years since the Consensus Statement was issued, the National Center for Complementary and Alternative Medicine (NCCAM) has funded extensive research to advance scientific understanding of acupuncture. Some recent NCCAM-supported studies have looked at:

   * Whether acupuncture works for specific health conditions such as chronic low-back pain, headache, and osteoarthritis of the knee
   * How acupuncture might work, such as what happens in the brain during acupuncture treatment
   * Ways to better identify and understand the potential neurological properties of meridians and acupuncture points
   * Methods and instruments for improving the quality of acupuncture research

Top Finding a Qualified Practitioner

Health care providers can be a resource for referral to acupuncturists, and some conventional medical practitioners—including physicians and dentists—practice acupuncture. In addition, national acupuncture organizations (which can be found through libraries or Web search engines) may provide referrals to acupuncturists.

   * Check a practitioner's credentials. Most states require a license to practice acupuncture; however, education and training standards and requirements for obtaining a license to practice vary from state to state. Although a license does not ensure quality of care, it does indicate that the practitioner meets certain standards regarding the knowledge and use of acupuncture.
   * Do not rely on a diagnosis of disease by an acupuncture practitioner who does not have substantial conventional medical training. If you have received a diagnosis from a doctor, you may wish to ask your doctor whether acupuncture might help.[18]

Gate-control theory of pain

The "gate control theory of pain" (developed by Ronald Melzack and Patrick Wall in 1962[54] and in 1965[55]) proposed that pain perception is not simply a direct result of activating pain fibers, but modulated by interplay between excitation and inhibition of the pain pathways. According to the theory, the "gating of pain" is controlled by the inhibitory action on the pain pathways. That is, the perception of pain can be altered (gated on or off) by a number of means physiologically, psychologically and pharmacologically. The gate-control theory was developed in neuroscience independent of acupuncture, which later was proposed as a mechanism to account for the hypothesized analgesic action of acupuncture in the brainstem reticular formation by a German neuroscientist in 1976.[56]

This leads to the theory of central control of pain gating, i.e., pain blockade at the brain (i.e., central to the brain rather than at the spinal cord or periphery) via the release of endogenous opioid (natural pain killers in the brain) neurohormones, such as endorphins and enkephalins (naturally occurring morphines). [edit] Neurohormonal theory Modern acupuncture model.

Pain transmission can also be modulated at many other levels in the brain along the pain pathways, including the periaqueductal gray, thalamus, and the feedback pathways from the cerebral cortex back to the thalamus. Pain blockade at these brain locations is often mediated by neurohormones, especially those that bind to the opioid receptors (pain-blockade site).

Some studies suggest that the analgesic (pain-killing) action of acupuncture is associated with the release of natural endorphins in the brain. This effect can be inferred by blocking the action of endorphins (or morphine) using a drug called naloxone. When naloxone is administered to the patient, the analgesic effects of morphine can be reversed, causing the patient to feel pain again. When naloxone is administered to an acupunctured patient, the analgesic effect of acupuncture can also be reversed, causing the patient to report an increased level of pain.[57][58][59][60] It should be noted, however, that studies using similar procedures, including the administration of naloxone, have suggested a role of endogenous opioids in the placebo response, demonstrating that this response is not unique to acupuncture.[61]

One study performed on monkeys by recording the neural activity directly in the thalamus of the brain indicated that acupuncture's analgesic effect lasted more than an hour.[62] Furthermore, there is a large overlap between the nervous system and acupuncture trigger points (points of maximum tenderness) in myofascial pain syndrome.[63]

Evidence suggests that the sites of action of analgesia associated with acupuncture include the thalamus using fMRI (functional magnetic resonance imaging)[64] and PET (positron emission tomography)[65] brain imaging techniques,[66] and via the feedback pathway from the cerebral cortex using electrophysiological recording of the nerve impulses of neurons directly in the cortex, which shows inhibitory action when acupuncture stimulus is applied.[67] Similar effects have been observed in association with the placebo response. One study using fMRI found that placebo analgesia was associated with decreased activity in the thalamus, insula and anterior cingulate cortex.[68]

Recently, acupuncture has been shown to increase the nitric oxide levels in treated regions, resulting in increased local blood circulation.[69][70] Effects on local inflammation and ischemia have also been reported.[71][19]


Acupuncture and Chinese medicine can be used in combination with conventional reproductive medical care or as a primary treatment approach. Acupuncture can be effective for women taking fertility drugs or reproductive technology techniques (such as IVF or IUI). Acupuncture and traditional Chinese medicine can also be effective as a stand-alone approach to treat infertility for those not undergoing conventional medical treatment. Acupuncture helps to regulate hormonal activity, thus regulating menstruation, ovulation, and pregnancy. A recent study from the British Medical Journal found that among women who received acupuncture and IVF, the pregnancy rates were 65% higher and the rates of live births were nearly twice as high than among women who received IVF with sham acupuncture or no acupuncture.

Acupuncture helps to reduce stress and decrease the hypersympathetic nervous system response. Studies have shown that high stress levels decrease the likelihood of conceiving. Acupuncture has been shown to stimulate chemical changes within the uterine lining, thickening the endometrium, and preparing the uterus for implantation.

In men, acupuncture can improve sperm motility, volume and concentration as well as increase libido. From the perspective of Chinese medicine, optimum fertility enhancement would involve a course of treatments with the aim of nourishing the Kidney Essence and regulating the menstrual cycle as well as clearing any pathogens that may be interfering with the natural process of conception.[20]

 Case Studies

Obviously, especially for a paper such as this, my research would not be complete without backing it up with some case studies. Here they are.

The National Institute on Drug Abuse (NIDA) has sponsored three studies examining the effectiveness of Acupuncture for the treatment of substance abuse.

The first was at the Lincoln Medical Medical Center in Bronx, NYC, New York. It was headed by Dr. Douglas Lipton, and completed in 1991. This study used Auricular Acupuncture on Crack Cocaine users. The study was split into groups, one getting the correct Acupuncture treatments, the other getting "placebo" Acupuncture (needles placed in the "wrong" spots). Urinalysis results showed that the subjects receiving the correct treatments had lowered their use of the drug, in as little as two weeks. This was verified by testing for cocaine metabolite levels. However, the reduction was not as significant as had been anticipated. *Note that no other type of treatment, such as counseling as given.

In two other studies currently going on, (the first by Dr. Janet Konefal of Miami School of Medicine; and the other by Dr. Milton Bullock at the Hennepin County Medical Center in Minneapolis), counseling combined with acupuncture is being tested. The preliminary results have been quite promising.

Additional studies, too numerous to mention here have proven the effectiveness of Acupuncture therapy in Nicotine addiction, (look in Bibliography for some case citings).

Between 1971 and and 1972 a series of doctors (Frank Z. Warren: New York University Medical Center; Pang L. Man and Calvin H. Chen: Northville State Hospital, Northville, Michigan), conducted seven surgeries at both Northville State Hospital and at Albert Einstein Medical Center. they used both standard Acupuncture and Electro-Acupunture techniques. They found that in all cases of surgery (six invasive and one dental) these Acupuncture treatments were successful in stopping the pain of surgery without additional anesthetics. In only one case (a repair of an inguinal hernia) did the patient complain of "discomfort;" and only in one additional case did a patient (the same one) complain of post-operative pain.

In conclusion, I feel that Acupuncture should be considered a valid form of treatment alongside, not only other "alternative" forms of treatment, but also along side mainstream medicine. More and more insurance companies are discovering the cost effectiveness of Acupuncture. Unfortunately, many insurance companies still do not cover Acupuncture therapy, with the exception of Drug Addiction treatments; and then only if other therapies have been unsuccessful, or as part of another program. Part of the reason for this is that as of the writing of this paper, the Food and drug Administration classifies Acupuncture needles as "investigational" devices. However, since this paper was written, the FDA has reclassified acupuncture needles and so, now, one great block to insurance coverage has been removed.

Acupuncture Doctors are licensed independently in most states while some states require you to be a Medical Doctor to practice Acupuncture.

Acupuncture schools are federally accredited by the ACAOM (Accreditation Commission for Acupuncture and Oriental Medicine). This accreditation allows the school to offer federal guaranteed student loans.[21]

References

External links

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