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Acupuncture Facts
Acupuncture Modern Views
When the human body was finally described in terms of cells, biochemicals, and
specific structures (most of this accomplished less than 150 years ago), the
Chinese method of acupuncture and its underlying concepts were evaluated in
these new terms. As a first effort, researchers sought out physical pathways
that might correspond to the meridians, and even a fluid substance that might
correspond to qi. Neither of these were found. Nonetheless, the action of
performing acupuncture was shown to have effects on the body that required some
detailed explanation.
From the modern perspective, diseases and injuries are resolved by a complex set
of responses; the responses are coordinated by several signaling systems. The
signaling systems mainly involve peptides and other small biochemicals that are
released at one site, travel to other sites, interact with cells, and stimulate
various biologically programmed responses. Rather than blockages of circulation
described in the old Chinese dogma, diseases are understood to be caused by
microorganisms, metabolic failures, changes in DNA structure or signaling, or
breakdown of the immune system. Some of these disorders are resolved by the
cellular functions that are designed for healing, while others become chronic
diseases because the pathological factors involved have either defeated the
body’s normalizing mechanisms or because something else has weakened the body’s
responses to the point that they are ineffective. For example, poor nutrition,
unhealthy habits, and high stress can weaken the responses to disease.
Modern studies have revealed that acupuncture stimulates one or more of the
signaling systems, which can, under certain circumstances, increase the rate of
healing response. This may be sufficient to cure a disease, or it might only
reduce its impact (alleviate some symptoms). These findings can explain most of
the clinical effects of acupuncture therapy.
According to current understanding, the primary signaling system affected by
acupuncture is the nervous system, which not only transmits signals along the
nerves that comprise it, but also emits a variety of biochemicals that influence
other cells of the body. The nervous system, with over 30 peptides involved in
transmitting signals, is connected to the hormonal system via the adrenal gland,
and it makes connections to every cell and system of the body.
In a review article, Acupuncture and the Nervous System (American Journal of
Chinese Medicine 1992; 20(3–4): 331–337), Cai Wuying at the Department of
Neurology, Loyola University of Chicago, describes some of the studies that
implicate nervous system involvement. According to a report of the Shanghai
Medical University, cranial nerves, spinal nerves, and their terminals were
dispersed in the area surrounding the acupuncture points for about 5
millimeters. They also found that the nervous distribution of the Bladder
Meridian points (which run along the spine) was in the same area of the spine as
that of the corresponding viscera. In Japanese research, it was reported that
when acupuncture points were needled, certain neurotransmitters appeared at the
site. In laboratory-animal acupuncture studies, it was reported that two such
transmitters, substance P and calcitonin gene-related peptide, were released
from primary sensory neurons. Acupuncture analgesia appears to be mediated by
release of enkephalin and beta-endorphins, with regulation of prostaglandin
synthesis: all these have an effect on pain perception. One of the dominant
areas of research into acupuncture mechanisms has been its effect on endorphins.
Endorphins are one of several neuropeptides; these have been shown to alleviate
pain, and have been described as the body’s own “opiates.” One reason for the
focus on these biochemicals is that they were identified in 1977, just as
acupuncture was becoming popular in the West, and they are involved in two areas
that have been the focus of acupuncture therapy in the West: treatment of
chronic pain and treatment of drug addiction.
According to traditional Chinese doctors, one of the key elements of a
successful acupuncture treatment is having the person who is being treated
experience what is called the “needling sensation.” This sensation may vary with
the treatment, but it has been described as a numbness, tingling, warmth, or
other experience that is not simple pain (pain is not an expected or desired
response to acupuncture treatment, though it is recognized that needling certain
points may involve a painful response). Sometimes the needling sensation is
experienced as propagating from the point of needling to another part of the
body. The acupuncturist, while handling the needle should experience a response
called “getting qi.” In this case, the needle seems to get pulled by the body,
and this may be understood in modern terms as the result of muscle responses
secondary to the local nervous system interaction.
According to this interpretation, acupuncture is seen as a stimulus directed to
certain responsive parts of the nervous system, producing the needling sensation
and setting off a biochemical cascade which enhances healing. Some acupuncture
points are very frequently used and their applications are quite varied:
needling at these points may stimulate a “global” healing response that can
affect many diseases. Other points have only limited applications; needling at
those points may affect only one of the signaling systems. It is common for
acupuncturists to combine the broad-spectrum points and the specific points for
each treatment. Some acupuncturists come to rely on a few of these
broad-spectrum points as treatments for virtually all common ailments.
This modern explanation of how acupuncture works does not explain why the
acupuncture points are arrayed along the traditional meridian lines. At this
time, no one has identified—from the modern viewpoint—a clear series of neural
connections that would correspond to the meridians. However, acupuncturists have
identified other sets of points, such as those in the outer ear, which seem to
be mapped to the whole body. The description, in the case of the ear, is of a
layout of the body in the form of a “homunculus” (a miniature humanoid form).
Such patterns might be understood more easily than the meridian lines, because
the brain, which is adjacent to the ear, also has a homunculus pattern of
neurological stimulus that has been identified by modern research. Similarly,
acupuncturists have identified zones of treatment (for example, on the scalp or
on the hand) that correspond to large areas of the body, and this may also be
more easily explained because there are connections from the spinal column to
various parts of the body which might have secondary branches elsewhere. In
fact, acupuncture by zones, homunculi, “ashi” points (places on the body that
are tender and indicate a blockage of qi circulation), and “trigger” points
(spots that are associated with muscle groups) is becoming a dominant theme, as
the emphasis on treating meridians fades (for some practitioners). The new focus
is on finding effective points for various disorders and for getting biochemical
responses (rather than regulating qi, though there is no doubt some overlap
between the two concepts).
During this modern period (since the 1970’s) an increasing number of ways to
stimulate the healing response at various body points have been advocated,
confirming that needling is not a unique method (the idea that the needle would
produce a hole through which pathogenic forces could escape has long been
fading). In the past, the main procedures for affecting acupuncture points were
needling and application of heat (moxibustion). Now, there is increasing
reliance on electrical stimulation (with or without needling), and laser
stimulation. Since the basic idea of acupuncture therapy is gaining popularity
throughout the world while the practice of needling is restricted to certain
health professions and is not always convenient, other methods are also becoming
widely used. Lay persons and practitioners with limited training are applying
finger pressure (acupressure), tiny metal balls held to the to the skin by tape,
magnets (with or without tiny needles attached), piezoelectric stimulus (a brief
electric discharge), and low energy electrical pulsing (such as the TENS unit
provides with electrical stimulus applied to the skin surface by taped
electrodes). Some of these methods may have limited effectiveness, but it
appears that if an appropriate body site is stimulated properly, then the
healing response is generated.
For many nervous system functions, timing is very important, and this is the
case for acupuncture. The duration of therapy usually needs to be kept within
certain limits (too short and no effect, too long and the person may feel
exhausted), and the stimulation of the point is often carried out with a
repetitive activity (maintained for a minute or two by manual
stimulation—usually slight thrusting, slight withdrawing, or twirling—or
throughout treatment with electro-stimulation). It has been shown in laboratory
experiments that certain frequencies of stimulus work better than others: this
might be expected for nervous system responses, but is not expected for simple
chemical release from other cells.
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