Acupuncture Introduction

"It matters not if medicine is old or new

so long as it can cure.

It matters not if theories come from East or West

so long as they be true."

Jen-Hsou Lin, Taipei

Acupuncture has probably been practised in China for some 3,500 years, but the exact date of its origin is difficult to determine. The first medical textbook on acupuncture is called the Nei Ching Su Wen; this literally means the 'Yellow Emperor's Classical Internal Medicine' and it dates from about 400 BC. Acupuncture has been known to Western doctors since the Jesuits first went to China in the 17th century, and was used extensively by physicians in this country in the early part of the 19th century. The first edition of the Lancet in 1823 carried a detailed report of the use of acupuncture in timpany and rheumatism, extolling the virtues of this technique. The author, John Elliotson, was a consultant physician at St Thomas's Hospital in central London.

Traditional Chinese medicine

The first recorded therapeutic success with acupuncture occurs in the 'historial records' of some 2,000 years ago. Pein Chueh, a physician, used acupuncture to revive a dying patient already in a coma. The practice of acupuncture was progressively developed and refined throughout Chinese history until the Ching dynasty (1644-1911 AD). During this period acupuncture fell into disrepute and was discouraged in favour of Western medicine, but since the Communist revolution of 1948 has been revitalized and is now widely used in China.

Acupuncture is one of the therapeutic techniques used in Traditional Chinese Medicine (TCM), which has its own complete system of anatomy, physiology and diagnosis: the main tenets are described in detail in the Nei Ching Su Wen. The traditional Chinese viewed the human body as a balance between two opposing forces, yin and yang: yin represents placidity or water, while yang represents activity or fire. If yin or yang are deficient or in gross excess, the balance between them is distorted and disease results. The Chinese concept of health can best be defined as a normal fluctuating balance between yin and yang; their system of diagnosis and therapy is designed to particularise the imbalance of yin and yang and correct it, thereby restoring the body to a health state. In order to effect this change, the Chinese insert needles into acupuncture points. The majority of the important acupuncture points are on 14 channels running over the body, each representing an internal organ. Qi, or vital energy, is said to flow through these channels. In disease the flow of qi is altered and the insertion of an acupuncture needle into an appropriate point is said to correct the flow of vital energy, thereby restoring the body to health.

The Chinese also developed a very sophisticated idea of physiology, and specific functions were defined for each of the 12 main organs. The Nei Ching Su Wen states that 'the heart fills the pulse with blood…. And the force of the pulse flows into the arteries, and the force of the arteries ascends into the lungs'. This describes the double circulation of blood some 2,000 years before William Harvey. The anatomy (acupuncture points and channels) and physiology of traditional Chinese medicine, along with a detailed examination of the pulse and tongue, provides the basis for TCM. A set of empirical rules are then followed in order to select the appropriate acupuncture points to treat disease and dispel the pathogens causing these imbalances. For instance, there are particular acupuncture points that can be used to disperse the pathogen damp that may be affecting the spleen.

However, not all acupuncturists use a traditional Chinese approach; some just treat the tender points that arise in a variety of musculoskeletal diseases. A number of clinical trials have shown that the treatment of tender trigger points for painful diseases produces a defined and significantly useful clinical result. In the treatment of pain it is not yet clear which approach is the best - the traditional Chinese diagnosis or simply treating tender trigger points. However, in non-painful diseases, such as asthma or bowel disease, trigger points do not always occur and so, in order to perform effective acupuncture, a traditional diagnosis must be made and the points selected within the context of TCM.