Acupuncture: principles, applications, and clinical effectiveness

Acupuncture is an ancient practice of the East with a long history, which has been incorporated into modern Western use, and has been met with mixed reviews by the public and scientific communities.

The History of Acupuncture

The Origins of Acupuncture

Early tools and methods

Early texts

Evolution of Acupuncture

Moxabustion

F. Development of schools and comprehensive Texts

Eastern Medicine Meets the Modern West

Medical Missionaries to China

Adoption of Western Practice

The Decline of Acupuncture

Communist Support for Acupuncture

Regrowth and new methods

Acupuncture in Use Today

FDA Approved Needles

Growing Popularity

Universities and Physicians

New variations on Acupuncture

E. Why Western Medicine Fails

Arguments Against Acupuncture

A. The skeptics

B. Risks

C. How to avoid Risks

Scientific Proof and Conclusion

A. Studies have varying conclusions

B. Remains widely used by prestigious medical institutions and private practitioners

C. Acupuncture makes people feel better, therefore it works

Acupuncture

Although there is a great deal of controversy surrounding alternative forms of healing today, many forms of natural or complimentary medical treatments seem to be more popular today than any time in recent centuries. There has been particular influence from the East invading the American medical system and changing the assumptions of many patients about where treatment and relief can be found. Chinese herbs and philosophy alike have become standard sale items at specialty shops, malls, and drug stores, and they have been used to lure in feeble minded consumers for the sake of a dollar, as well as providing real hope and sincere assistance to faithful users. Among the products and services developed from Eastern healing beliefs now available regularly in America is acupuncture. As one acupuncture practitioner states, " You've probably already seen acupuncture features on a television show or in a newspaper or magazine article. I'm encouraged to see it's even made it into the comic strips! It tells me that acupuncture has become part of our culture." (Sollars, 4) Acupuncture is an ancient system of diagnosis and treatment that could possibly be administered for almost any physical or mental ailment, because it is based on the theories about energy flow through the body. While the similar practice of acupressure is performed using a form of massage to clear the energy channels or meridians which may be "clogged" within the body at certain pressure points, acupuncture is met with a stronger resistance from many people because it is performed using needles. Needles are inserted into the skin at specific locations depending on the symptoms. While some people swear to the miracle of this system, others are more than skeptical of its medical benefits. Acupuncture is an ancient practice of the East with a long history, which has been incorporated into modern Western use, and has been met with mixed reviews by the public and scientific communities.

The term "acupuncture" itself is only a few hundred years old, but the practice is much older. Meaning "needle puncture," a Dutch physician in the seventeenth century coined the term for the medical practice he witnessed on a trip to Nagasaki, Japan. The Chinese, on the other hand, refer to this practice as "to prick with a needle," represented by the character Chen. (Lewith) It is clear from historical records that the practice of acupuncture is at least two thousand years old, having existed for the entirety of the Common Era, however many historians believe it has actually been a part of Chinese medicine for around four thousand years. In fact, other historians have found evidence that acupuncture may have been practiced even five thousand years ago, originating in Egypt and Saudi Arabia before spreading to China and elsewhere. Although Chinese acupuncture "purists" will adamantly argue that acupuncture originated within the Orient, not Egypt, no historians claim that any other culture has done more for the development of the practice of acupuncture over time, or so far as introducing it to the world.

The origins of acupuncture are probably the stone-age practice of using a knife made of a sharpened stone to puncture and drain abscesses. Most likely, it was developed the most during wartime. The sharp tools that would have been used for this purpose during the stone age are represented by the Chinese character Bian. "the Chinese character 'Bian' means the 'use of a sharp edged stone to treat disease', and the modern Chinese character 'Bi', representing a disease of pain, is almost certainly derived from the use of 'Bian stones' for the treatment of painful complaints." (Lewith) The earliest document regarding acupuncture that is known today is the Nei Ching Su Wen, also known as "The Yellow Emperor's Classic of Internal Medicine," or "The Canon of Medicine." The book had two sections, one for the simple questions, and one for the more complicated ones. The format of the book is reminiscent of that used by many philosophers, utilizing a dialogue between characters to present medical information and philosophical thought. The section of simple questions features the Yellow Emperor and two other characters. "The Nei Ching Su Wen is timeless and deals almost exclusively with philosophical concepts, many of which seem to be as important today as they were 2,000 years ago." (Lewith) The concepts of the Yin and Yang, certain numbers, and others are vital to Chinese medicine, but have no place in Western healing. The Warring States period is one during which a great deal of advancements in acupuncture were made in Chinese medicine, led by the philosophical movements of Taoism and Confucianism. Confucianism taught that the entire body is sacred and should remain intact, inhibiting the use of surgery. "Acupuncture and related methods were the logical answer to this constraint, as they were able to cure internal disease with external means." (Lewith) For Taoists, health is focused on balance, and therefore acupuncture, which is used to balance energy, was also logical.

Bian stones used for lancing evolved into needles made of stone, metal, and pottery. There are nine specific shapes which developed for the acupuncture needle. "The 'nine needles' comprised the arrowhead needle for superficial pricking, the round needle for massaging, the blunt needle for knocking or pressing, the three edged needle for puncturing a vein, the sword-like needle for draining abscesses, the sharp round needle for rapid pricking, the filliform needle, the long needle for thick muscles and the large needle for puncturing painful joints." (Lewith) Many of these needles have now evolved into other tools, such as the sword needle which has been replaced by the surgical scalpel. The original set of needles has been found intact in tombs of royalty from over 2100 years ago.

Another element, other than needles, which has been used in acupuncture therapy throughout time is moxibustion, the burning of the herb moxa on the skin in the same pressure points used for needle insertion. This term means "to scar with a burning object" although no scarring is involved. This actually developed separately from acupuncture, but over time it has become entwined with acupuncture therapy to the degree that it is important to mention. "Moxa can be used in a variety of ways. Loose moxa is made into a cone and burnt on the skin, the cone then being removed when it is half burnt, to avoid blistering. It may also be burnt on ginger or garlic so that the skin is isolated from extreme heat, or a moxa stick may be used and burnt a centimeter or two away from the skin." (Lewith)

Originally, acupuncture was performed without predetermined locations for application, but as it developed, the most effective areas were identified and recorded. The energy flow systems were mapped out and different points for different ailments discovered. When the first medical college was formed in China, during the Sui dynasty (561-618 AD), a number of texts and a great deal of knowledge was already established about acupuncture. Formal training was provided in acupuncture, as well as needle craftsmanship, and other herbal and medical arts. Training was done in a master-to-apprentice style, unlike formal medical colleges today. Later, during the Tang dynasty, acupuncture would continue to flourish and the Thousand Golden Remedies, another important text on acupuncture, was written with color charts and great detail about where the acupuncture points are. Books were also being printed in limited quantities during this time, using carved stone for printing blocks. However, many texts were being copied by hand by calligraphers rather than those who were medically trained, so there is a lot of confusion from some of the medical texts of this time. In the eleventh century, a somewhat comprehensive text was finally compiled by Wei-yi, including text and illustrations. He also had models of the human body made for practicing acupuncture. These were both incredible teaching tools. Acupuncture was encouraged to continue during the industrial revolution of the Ming dynasty, and Li Shih-chen wrote a treatise on the Eight Extra Channels, and Kao Wu released a summary of all previous writings on acupuncture and moxibustion. 'Yang Chi-chou edited the Compendium of Acupuncture and Moxibustion during this period. Kao Wu's books were really short summaries for acupuncture students, but the Compendium was a complete collection of all the available material on this subject. It is copiously annotated and integrates the herbal remedies used with acupuncture and moxibustion." (Lewith)

It was during the Ming dynasty, around 1504, that contact with Europe was established, and Europeans began to settle there. It was largely through the priests sent to convert the non-Christians of the Orient that acupuncture information first filtered out to Europe. "The Jesuits were particularly active in collecting and disseminating this information in Europe, but the process was far from one-sided as the Jesuits also introduced Western science to China." (Lewith) Europeans translated anatomy and medical books into Chinese, but they were banned a majority of the time because there were ideas that contradicted Eastern teachings. However, the Ching dynasty, influenced by war and Europeans, led to acupuncture being are moved from Chinese medical college curriculum in 1822. Medical missionaries from the West introduced surgical practice, and the art of acupuncture continued to decline. By 1929, acupuncture was actually outlawed in China.

In the 1940's, the Communist party of China gained power and increased support for traditional Chinese medicine. New research and resources were thrown at acupuncture as a healing method, and many new forms of practice emerged. One of these new ideas is ear acupuncture, which was adopted by the French as well as a therapy, and acupuncture began use as a form of anesthesia for use with other medical procedures. Homunuculus, or acupuncture of the hand to affect the entire body, was also growing. Western medicine influenced injection acupuncture, and electro-acupuncture too.

Today, acupuncture is used extensively in pain relief, addiction relief, and other common problems. Several years ago, the American Food and Drug Administration decided that acupuncture needles are a respectable medical tool. "The... ruling stopped short of suggesting that acupuncture works for specific ailments; FDA officials said they needed more proof. But that may come soon. As research proceeds at many U.S. medical centers, the evidence is piling up that people with a variety of problems -- from asthma and arthritis to migraines and strokes -- can truly be helped by the ancient healing art." (Podolsky) The popularity of acupuncture is growing; in 1997 there were more than 5 million acupuncture visits in the United States alone. (Schultz) Acupuncture has been in use in America since the 1930s, but today new developments are underway that are revolutionizing the place it has in our medical system. "American doctors have tolerated acupuncture practitioners in their midst since the 1930s, mostly with suspicion. But recent developments have opened more than a few eyes - and minds." (Findlay et al.) About four thousand physicians have training in acupuncture in America, and large universities such as the University of California at Los Angeles medical school have training programs. (Carroll) Doctors in the fields of iridology, which studies the iris as the map of the entire human body, and reflexology, where the foot is seen as the map of the body, both incorporate many elements from acupuncture. Even staplepuncture, which puts staples in key points in the ear, has emerged from traditional acupuncture. (Carroll)

With the advancements of Western medicine, many people wonder what the advantages of using an ancient method of healing would be. It is because acupuncture is based on an entirely different set of teachings and philosophy than Western medicine that it can be so beneficial. "There are some patients whom doctors find it very difficult to treat because, although they are clearly unwell, all the tests are normal and a diagnosis cannot be made. For these patients acupuncture (like many other complementary therapies) is perfectly suitable. It does not require a diagnosis in Western terms for the patient to be treated successfully." (Kidson, 4) New York City has even put millions of dollars into acupuncture treatment programs in an attempt to alleviate things like drug addiction. (Findlay et al.)

Skeptics dismiss acupuncture as ignorant and useless. The NCAHF, for example, believes that acupuncture is entirely unproved, and that "Its theory and practice are based on primitive and fanciful concepts of health and disease that bear no relationship to present scientific knowledge." (NCAHF) They point to research which they believe has failed to prove acupuncture to be effective, and suggest that it is merely the power of suggestion and placebo that create any perceived difference for patients who undergo acupuncture treatment. In fact, groups such as this one would like to restrict use of acupuncture, and prevent insurance companies from covering this as a medical treatment, as well as making it impossible for non-physicians to become licensed in acupuncture.