What's Chinese Medicine
AN INTRODUCTION TO ACUPUNCTURE AND HOW IT WORKS
by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
There are two very different ways of looking at acupuncture: from the traditional Chinese perspective and from the modern international perspective. Each of these will be briefly described.
The understanding of how acupuncture works has evolved with its practice, but the descriptions set down a thousand years ago have largely been retained. The dominant function of acupuncture is to regulate the circulation of qi (vital energy) and blood. Approximately 2,000 years ago, the pre-eminent acupuncture text, Huangdi Neijing (Yellow Emperor's Classic on Internal Medicine), was written. In it, acupuncture was described as a means of letting out excess qi or blood by making holes in the body along certain pathways, called jingluo (meridians). For some of these meridians, it was advised to acupuncture in such a way as to let out the blood but not the qi; for others, to let out the qi, but not the blood. Many diseases were thought to enter the body through the skin, and then penetrate inward through muscle, internal organs, and, if not cured in timely fashion, to the marrow of the bone. By inserting a needle to the appropriate depth-to correspond with the degree of disease penetration-the disease could be let out.
Prior to the time when there were microscopes by which people could envision individual cells and before autopsies revealed the intricate structures within the body, doctors and scholars projected the internal workings of the body from what they could actually experience, which was the world outside the body. On this basis, the workings of the body were described in terms similar to those used to describe the visible world. One of the critical aspects of nature for humans living a thousand years ago, when Chinese civilization was well developed, was the system of water courses, which included tiny streams, huge rivers, man-made canals and irrigation systems, and the ocean. It was envisioned that the body had a similar system of moving, life-giving fluid. This fluid was the qi, and the pathways through which it flowed were the meridians.
Instead of discussing acupuncture in terms of letting something out of the body, physicians began describing it in terms of regulating something within the body. The flow of qi through the meridians, just like the flow of water through a stream, could be blocked off by an obstruction-a dam across the waterway. In the streams, this might be a fallen tree or a mud slide; in humans, it might be caused by something striking the body, the influence of bad weather, or ingestion of improper foods. When a stream is blocked, it floods above the blockage, and below the blockage it dries up. If one goes to the point of blockage and clears it away, then the stream can resume its natural course. In a like manner, if the qi in the meridian becomes blocked, the condition of the body becomes disordered like the flooding and dryness; if one could remove the blockage from the flow of qi within a meridian, the natural flow could be restored.
In a blocked stream, just cutting a small hole or crevice in the blockage will often clear the entire stream path, because the force of the water that penetrates the hole will widen it continuously until the normal course is restored. In the human body, inserting a small needle into the blocked meridian will have a similar effect. Just as a stream may have certain points more easily accessed (or more easily blocked), the meridians have certain points which, if treated by needling, will have a significant impact on the flow pattern. Many acupuncture points are named for geological structures: mountains, streams, ponds, and oceans.
Although this description of the basic acupuncture concept is somewhat simplified, it conveys the approach that is taught today to students of traditional acupuncture: locate the areas of disturbance, isolate the main blockage points, and clear the blockage. Of course, many layers of sophistication have been added to this model, so that the needling-which might be carried out in several different ways-can be seen to have subtle and differing effects depending upon the site(s) needled, the depth and direction of needling, and even the chemical composition of the needle (such as gold, silver, or steel). For example, some needling techniques are used for the primary purpose of increasing the flow of qi in a meridian without necessarily removing any blockage; other techniques reduce the flow of qi in the meridians. These tonifying and draining methods, as well as transference methods that help move qi from one meridian to another, are part of the more general aim of balancing the flow of qi in the body.
Ultimately, all the descriptions of acupuncture that are based on the traditional model involve rectifying a disturbance in the flow of qi. If the qi circulation is corrected, the body can eliminate most symptoms and eventually-with proper diet, exercise, and other habits-overcome virtually all disease.
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 1970s) 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 electrostimulation). 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.
TRADITIONAL AND MODERN VIEWS COEXISTING
The traditional and modern understandings of acupuncture arise from significantly different world views and from application of different levels of technology. It is difficult to directly correlate the two, though one can say that many of the traditional observations and ideas have partial explanations by modern mechanisms. Still, the modern practitioner can become aware of and trained in the application of both approaches to acupuncture. A person to be treated can be analyzed from both perspectives and the treatment strategy can be devised according to the conclusions derived from each perspective. Certain aspects of the case may be more amenable to traditional analysis and corresponding treatment, while other aspects are better suited to modern analysis and treatment approach.
An individual who is suffering from a chronic pain syndrome might be analyzed in terms of which meridians are blocked: through treatment of appropriate points on the meridian, the pain might be alleviated. The same individual might be analyzed according to which muscle groups are involved in the painful area and might be treated by acupuncture at trigger points that specifically affect those muscles. An individual suffering from an autoimmune disorder might be analyzed according to which of the traditional organ systems are involved, with treatment of the associated meridians. The same individual might be analyzed in terms of the immune system disturbance and treated by stimulating points that have been recently identified as immune regulators.
Since the traditional acupuncture approach has been shown to be effective in clinical trials conducted in China (and elsewhere in Asia), one can rely on the traditional methods. However, many practitioners in the West, with little or no prior exposure to Oriental philosophy but with experience and training in Western modes of analysis, may feel uncomfortable turning partly or completely to the traditional Chinese view, and will, instead, focus on the modern understanding of this healing technique.
Traditional Chinese medicine is not a static system, but an evolving one. Thus, in Asia and in the West there are many doctors and researchers who are working on an integration of the earlier traditional approach and the modern understanding.
SD November 1996
Breast Thermography is a 15 minute safe & non-invasive test offering the earliest screening possible. It's role in breast cancer and breast disorders is to help in early detection and monitoring of abnormal physiology and the establishment of risk factors for the development or existence of cancer. This procedure empowers women to make decisions, with their health practitioners, at the earliest moment possible. They can then take a pro-active approach to their health through nutrition, hormone balancing and detoxification.
by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
Cupping refers to an ancient Chinese practice in which a cup is applied to the skin and the pressure in the cup is reduced (by using change in heat or by suctioning out air), so that the skin and superficial muscle layer is drawn into and held in the cup. In some cases, the cup may be moved while the suction of skin is active, causing a regional pulling of the skin and muscle (the technique is called gliding cupping).
This treatment has some relation to certain massage techniques, such as the rapid skin pinching along the back that is an important aspect of tuina (12). In that practice, the skin is pinched, sometimes at specific points (e.g., bladder meridian points), until a redness is generated. Cupping is applied by acupuncturists to certain acupuncture points, as well as to regions of the body that are affected by pain (where the pain is deeper than the tissues to be pulled). When the cups are moved along the surface of the skin, the treatment is somewhat like guasha (literally, sand scraping), a folk remedy of southeast Asia which is often carried out by scraping the skin with a coin or other object with the intention of breaking up stagnation. Movement of the cups is a gentler technique than guasha, as a lubricant allows the cup to slide without causing as much of the subcutaneous bruising that is an objective of guasha. Still, a certain amount of bruising is expected both from fixed position cupping (especially at the site of the cup rim) and with movement of the cups.
Traditional cupping, with use of heated cups, also has some similarity to moxibustion therapy. Heating of the cups was the method used to obtain suction: the hot air in the cups has a low density and, as the cups cool with the opening sealed by the skin, the pressure within the cups declines, sucking the skin into it.
Moxibustion is a traditional Chinese medicine technique that involves the burning of mugwort, a small, spongy herb, to facilitate healing. Moxibustion has been used throughout Asia for thousands of years; in fact, the actual Chinese character for acupuncture, translated literally, means "acupuncture-moxibustion."
A infrared heat lamp adds yang energy to the body to help fight diseases. When the infrared waves penetrate the body, they heat the cells and push the toxins from the cells and out through the pores of the skin. This treatment modality allows for expansion of capillaries, enhancing circulation. Far infrared lamps relaxes the tight muscles around a stiff neck or back. Many practitioners value their use for improving the health of the immune system. Infrared lamps are effective in treating medical conditions such as: back pain, arthritis pain, joint pain, chronic wounds, and skin conditions. The Far Infrared Lamp is ideal for chronic conditions. Toxins exit the body through the pores during exposure to the waves. Promoting circulation and relieving inflammation are the greatest benefits.
by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
HISTORY AND GENERAL PRINCIPLES
Electro-acupuncture, the application of a pulsating electrical current to acupuncture needles as a means of stimulating the acupoints, was developed in China as an extension of hand manipulation of acupuncture needles around 1934. It is described, though only briefly, in most comprehensive texts of acupuncture (1-4). The procedure for electro-acupuncture is to insert the acupuncture needle as would normally be done, attain the qi reaction by hand manipulation, and then attach an electrode to the needle to provide continued stimulation. The benefits of using electrical stimulation are:
- It substitutes for prolonged hand maneuvering. This helps assure that the patient gets the amount of stimulation needed, because the practitioner may otherwise pause due to fatigue. Electro-acupuncture may also help reduce total treatment time by providing the continued stimulus. During electro-acupuncture, the practitioner can attend to other patients.
- It can produce a stronger stimulation, if desired, without causing tissue damage associated with twirling and lifting and thrusting the needle. Strong stimulation may be needed for difficult cases of neuralgia or paralysis.
- It is easier to control the frequency of the stimulus and the amount of stimulus than with hand manipulation of the needles.
The main disadvantage of electrical stimulation of acupuncture needles is the lack of direct practitioner participation in this aspect of acupuncture therapy and the associated limited opportunity for the practitioner to respond to changes that are taking place during treatment. However, for practitioners who, after inserting and initially stimulating the needles, normally leave the patient to rest undisturbed without performing prolonged needle manipulation, electro-acupuncture can provide a significant benefit: replacing the missing stimulus that is recommended by most experienced acupuncturists in China.
Although electro-acupuncture may be used as a component of nearly all acupuncture treatments that require manipulation of the needles, according to the Chinese literature, especially good results are expected from electro-acupuncture treatment of neurological diseases, including chronic pain, spasm, and paralysis. In patients with serious cardiac diseases, however, the method should be used with caution. It is generally recommended to avoid placing electrodes near the heart, as the heart can respond adversely to electrical impulses, and the path between any two electrodes should not cross the heart area, despite the low current that is used. Some have suggested avoiding placing electrodes to needles on both sides of the spinal cord (e.g., for Hua Tuo or bladder meridian points), because of the possible effect of the electrical stimulus on the nervous system. Points are generally selected in pairs for electrical pulse stimulation, with 1-3 pairs at one time, and the pairs are usually on the same side of the body.
Gua sha is a traditional Chinese medical treatment in which the skin is scraped to produce light petechiae. Practitioners use gua sha to release unhealthy bodily matter from blood stasis within sore, tired, stiff or injured muscle areas to stimulate new oxygenated blood flow to the treated areas, thus promoting metabolic cell repair, regeneration, healing and recovery. Gua sha is sometimes referred to as "scraping", "spooning" or "coining" by English speakers, it has also been given the descriptive French name, tribo-effleurage.
Neuro-muscular re-education is a therapeutic technique that is used to improve balance, coordination, posture, kinesthetic sense and proprioception. There is no precise description of what neuromuscular reeducation entails. Treatment may include balance exercises such as one-legged standing and the progressive use of a wobble board. Tandem exercises along with a postural challenge may be utilized to evaluate stability. The individual receiving treatment is encouraged to feel the correct position of joints and to perceive the direction of movement of the body extremities.
Other areas of neuromuscular reeducation involve constraint-induced movement therapy for limbs. This technique involves restraint of a non-involved limb and extensive movement practice with the involved limb.
Separation of joint surfaces by a therapist to stimulate nutrition to flow around joints and encourage the extension of the surrounding conective tissues.
What is NET? The brief answer:
Trauma can become a psychosomatic/somatopsychic stress to the being.
NET is a reduction intervention aimed at emotional and physical health improvement.
NET is neuro-emotional intervention for mind/body health.
NET is a tool for mind/body practitioners who are seeking to restore health in their patient population.
Chinese Herbal Medicine is one of the great herbal systems of the world, with an unbroken tradition going back to the 3rd century BC.
Yet throughout its history, it has continually developed in response to changing clinical conditions and has been sustained by research into every aspect of its use. This process continues today with the development of modern medical diagnostic techniques and knowledge.
Because of its systematic approach and clinical effectiveness it has for centuries had a very great influence on the theory and practice of medicine in the East and more recently has grown rapidly in popularity in the West. It still forms a major part of healthcare provision in China and is provided in state hospitals alongside western medicine. Chinese medicine includes all Asian traditions emerging from Southeast Asia that have their origins in China.
Practitioners may work within a tradition that comes from Japan, Vietnam, Taiwan or Korea. It is a complete medical system that is capable of treating a very wide range of conditions. It includes herbal therapy, acupuncture, dietary therapy, and exercises in breathing and movement (tai chi and qi gong). Some or several of these may be employed in the course of treatment.
Chinese Herbal Medicine, along with the other components of Chinese medicine, is based on the concepts of Yin and Yang. It aims to understand and treat the many ways in which the fundamental balance and harmony between the two may be undermined and the ways in which a person's Qi or vitality may be depleted or blocked. Clinical strategies are based upon diagnosis of patterns of signs and symptoms that reflect an imbalance.
However, the tradition as a whole places great emphasis on lifestyle management in order to prevent disease before it occurs. Chinese medicine recognises that health is more than just the absence of disease and it has a unique capacity to maintain and enhance our capacity for well being and happiness.
Originally from: rchm.co.uk/what-is-chinese-herbal-medicine/
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