Acupuncture (AP) in Traditional Chinese Medicine (TCM)
GENERAL CONCEPTS (7/7)
Szathmary_L (1996) Diagnostic Possibilities of Oral AP in Vet Med. Magy Allatorv Lapja Feb 51(2):75-79. L Szathmary, Allatkorhaz Gazdasagi Munkakozosseg, Ady E, U12, H-8200 Veszprem, Hungary. Oral AP points in humans become sensitive when disease develops in the related organs (inner hollow and compact organs, sinuses, organs of sense, lymphoid organs, vertebral segments and a determined skin area). From work with AP over many years, he recorded diagnostic aspects of certain oral signs of dogs. These points in the mouth not only become sensitive, but also show other changes (ulcer, inflammation, swelling of solitary salivary glands) when a disease occurs in the related organs. Thus, considering functional circuits, from the oral status, he diagnosed diseases of the organs belonging to the functional circuit. In some cases, this method can also help in differential diagnosis.
Walker_C (1995) TCM Training in Beijing. Summary of Paper to the BMAS autumn meeting at the Commonwealth Inst, London, October 1995. Adapted from WWW. The author was given extended study leave from his general practice in Merseyside to attend a 3-mo Diploma in AP Course at the International AP Training Centre in Beijing. The course involved 137 h of lectures, mainly on TCM, but covering EAP- analgesia, ear and scalp AP, plum-blossom needling, cupping and Qigong. The 168 h of classical training was in small groups at one of the 10 Beijing hospitals or at the centre's clinics. Having completed the course and found it a clinical experience difficult to rival, the author suggests that much of benefit has been lost from traditional AP in its westernisation.
Wang_LL7 (1996) Clinical Observation of the Effect of Health-preserving Moxibustion on Delaying Aging. Nanjing Coll of TCM, 210029, PRC. Adapted from WWW. Clinically moxibustion had a health-promoting effect in aged people without apparent organic diseases. It lessened aging symptoms and improved physiologic functions of the senile body. TCM holds that KI-Qi-Xu (Weakness) from middle-age is an important cause of senility; SP-Xu and Xue-Stasis also play a role. Health-preserving moxibustion of CV08 and ST36 warms the Yang, reinforces Qi and promotes blood circulation to Clear Stasis (obstruction) in the Channels. It is thus a method for protection of one's health.
Yang_JMc01 (1996) The Diagnosis and Treatment of Arthritis in TCM: Part01. Adapted from WWW (Acupuncture.com). [The author, Mr Jwing-Ming Yang, has translated TCM concepts into words and ideas that are better understood in the Western world. For more information on how arthritis is described in the terms that practitioners of TCM use, please see the article on "Bi Syndromes" among the Clinical Point Selections: WebMaster].
Bi means pain, and many of "Bi Syndromes" overlap with the differential diagnosis of arthritis in WM.
Although we understand how some forms of arthritis start, we do not understand other forms. This section summarizes the known possible causes and contributes some ideas from TCM and Qigong.
1. Weakness (Xu) of the Internal Organs: The condition of the internal organs is closely related to health. In TCM, the Five Zang (Yin Solid Organs: HT, LV, LU, KI, and SP) are considered the main ones for health and longevity. Illness, even death, can occur if any of these Zang fails to function properly. Also, all of the Five Zang are mutually interrelated. A problem with one always involves a problem with one or more of the others. For example, gouty arthritis is caused by the improper functioning of LV and KI.
2. Defective Genes: Some forms of arthritis are caused by defective genes, e.g. are inherited. In TCM, genetic inheritance is Yuanjing, the Source-, or Original-, or Ancestral- Essence. Jing-Essence controls the production of hormones, from which Qi is generated. When this Qi is fed to the brain, the Shen-Spirit is raised. When all of these conversion processes are functioning normally, the immune system is strong and sickness is less likely. One of the main goals of Qigong is learning how to convert Jing-Essence into Qi efficiently and lead it to the brain.
3. Weak Joints: Weak joints can come from heredity or from lack of exercise. The body is a living machine; the more you use it, the better its condition. TCM teaches that even if you have inherited a weak joint it is still possible to strengthen it through Qigong. Exercise brings Qi to the joint by the movement of the muscles and tendons. This nourishes the joint and rebuilds it.
4. Injury: In WM, some forms of arthritis are caused by injury to the joints. Although the injury may not be serious, it may have significant results. The injury can affect the muscles, tendons, ligaments, or even the cartilage and bone. In TCM, if any joint injury, even a minor one, is not treated, the normal smooth Qi circulation in the joint area will be affected. If the situation persists, the Qi imbalance can cause problems such as arthritis.
5. Aging: Aging has always been the cause of many sicknesses, including arthritis. In old age, the body Qi level is low. Since the system is being deprived of the required amount of Qi, it starts to degenerate. One of the main goals of Qigong practice is learning how to slow down the aging process by building up the Qi in the body.
6. Qi-Xu: Qi-Xu causes many problems. It can be caused by emotional depression and sadness, which can lead the Qi inward and make the body Yin. This deprives the outer body of Qi. When this happens, you will generally feel Cold. If the problem persists for a long time, the muscles and tendons will be affected by the lack of Qi, and the joints will be weakened. Qi-Xu can have other causes, such as the weather. For example, body Qi is weaker (Xu) in the winter, and therefore, arthritis can be more serious then. Qi-Xu also can be caused by working for long periods in a Damp area, or by exposing joints to the Cold.
7. Tension: Tension includes both mental tension and physical tension, which are related and cannot be separated. Constant mental and physical tension can increase the pressure on the joints. For example, some people are very tense and grind their teeth in their sleep, which can cause arthritis in the jaw. A lot of body tension is caused by the emotional disturbance which is related to your mental reaction to stressful events. For this reason, learning how to regulate your mind is an important part of the treatment of arthritis.
8. Other Possible Means of Preventing or Curing Arthritis
As well as those already discussed, other methods can prevent or cure arthritis. Although many of them are still awaiting scientific confirmation, they may be worth your consideration. However, you must understand that everybody has his or her own unique characteristics, and his or her own unique inheritance. As well as the habits and lifestyle that each person has developed, everyone's mental and physical structure is different. For example, some people are affected by allergies while others are not. What this means is that you cannot necessarily use the same method to treat different people, even when they have the same disease. Even modern WM has found that the same treatment will not work equally well on all patients. Therefore, do not automatically brush off some of the treatment methods we will discuss. After all, WM is only in its infancy, and it may come to understand and accept these alternative remedies.
1. Diet: In Qigong, food has a significant influence on the condition of the Qi in the body. For this reason, diet is one of the main concerns of TCM. "You are what you eat." Improper diet is one of the main causes of gouty arthritis. The Chinese have found many different herbs that can ease the pain and reduce the swelling of arthritis. It has recently been discovered that protein, calories, and fats can reduce the inflammation of arthritis. Certain fish oils may interfere with the process of inflammation and therefore reduce the symptoms of rheumatoid arthritis(5,6).
2. Change of Residence: Since environmental Qi can affect the Qi of the body, arthritis sufferers should give serious consideration to this method. If the local climate is too Damp or too Cold, it may exaggerate arthritis. Body Qi can be significantly affected by the electromagnetic fields generated by modern technology; adverse EMFs can cause many disorders, including some forms of cancer. People who live near high tension power lines tend to get cancer more often than those who do not. Perhaps similar environmental effects on arthritis will be found.
3. Change of Lifestyle: Lifestyle affects how the Qi circulates in the body. If one often feels ill, especially mentally, one might need to change lifestyle. How one thinks and coordinates the Qi pattern in the body with the natural Qi is very important for health. Whenever Qi circulation is against the "Dao" (nature), one will be sick. Walking for an hour, or doing Qigong exercises every morning, improves Qi circulation.
4. Clothing: What you wear also affects the Qi in your body. In the winter you must stay warm, and especially protect your joints. Joints that are left unprotected can loose Qi very quickly. It has been discovered that many man-made fibres can adversely affect the Qi distribution and circulation in the body. For example, polyester causes Qi-Stasis and prevents the body's Qi from exchanging with the environmental Qi.
Yang_JMc02 (1996) The Diagnosis and Treatment of Arthritis in TCM: Part02. Yin are the feminine qualities in the universe; Yang are the masculine qualities.
| Yin | Yang. |
| passive | active. |
| dark | light. |
| inside | outside. |
| Yin | Yang. |
| Anatomy | Physiology. |
| Yin | Yang. |
| Xue (Blood). | Qi (Energy). |
When applied to Med in general, WM acts upon the Yin of the body, the substance of the body, the cells and chemicals. TCM works more on the Qi that animates those cells.
What WM tends to diagnose and treat is the effect that the disease state has on the body itself. The TCM Practitioner diagnoses and acts upon the Qi that creates the disease state.
In ancient Greece, where Western civilization was born, the Med of the day mimicked Oriental Med in that they looked at the body with analogies to nature in much the same way that Oriental Med still does. However, with the invention of the microscope and the discovery of the cell, WM became very materialistic in its approach to the human body.
When I say materialistic, I'm not talking about an unhealthy attachment to money, but the sense that only the material of the body is real, nothing else. If you can't touch it, see it under a microscope or conceive of it in chemical equations then it doesn't exist. It is a discipline that is based on the philosophy that only what exists in the physical realm is real. This is materialism. This is Yin in TCM.
TCM acts upon the Yang of the body, on its vital energies (Qi). Yin-Yang are always connected. Acting on the Yin affects the Yang, and visa-versa. TCM states that: "Xue is the mother of Qi and Qi rules the Xue." That statement is true if we regard Jin-Ye Fluids such as Xue as Yin (material, visible) and Qi as the Yang (immaterial, invisible).
By acting upon the Qi, pathology involving the Xue is rectified. In TCM, it is a deeper, more causal approach to Med than WM. It is this difference between acting upon the body's Qi (Energy) and acting upon the body's Shui (Substance) that makes up the most significant difference between these 2 major Med disciplines.
Currently, in the West, much research is being done on the effects of AP, TCM herbs and even disciplines such as Qigong. It is the opinion of the author that much of this research is presenting false results due to one simple fact, and that is that it only measures the body's reaction to TCM from the materialistic Yin standpoint. To record this and call it knowledge is OK, but to limit the understanding of TCM to what is discovered in research is misguided.
I've seen many people research TCM to determine not how the herb or AP treatment works from the Oriental perspective, but from how it "really" works, which is to say how it works from the Western perspective.
If we give an AP treatment that is designed solely to activate the Qi in the body, many unusual aches and pains within the patient will be abated. When modern Western research attempts to determine what happened to take away the pain they'll look toward endorphin release in the nervous system, the body's natural pain killers. They may even find a higher prevalence of these pain killers in the blood stream which confirms that this is what AP "really" does, but this is only the body's response to what "really" happened from the Oriental viewpoint. This is the law of Yang controlling Yin. What "really" happened is the Qi that wasn't moving well, was activated to move better. However, this is never understood, nor researched. And I believe that this is truly unfortunate.
It is because of this materialistic approach to Med that so many alternative treatments are written off to the placebo effect, or the end of symptoms because the patient believes that they are supposed to end.
And it is this same approach that so many very real diseases avoid understanding by WM. Chronic Fatigue Syndrome, Irritable Bowel Syndrome (IBS), Fibromyalgia are but a few common conditions that WM considers "idiopathic" which means that the cause is unknown. In TCM, the cause is quite simply a Stasis of the flow of Qi due to a small variety of factors.
The fact is, the cause is not physical, however the symptoms are. WM can see and measure certain changes in the body's chemistry and functional activities with these conditions, but cannot act upon these changes for lack of understanding of their cause. The symptoms are too divergent and unrelated from a materialistic standpoint. But when you factor in Qi and its properties, all these conditions make perfect sense.
When reading research on TCM, readers should keep in mind that research measures only the body's physical response to changes induced by the changes in the flow of Qi in the body. Research gives only half the story; the other half is what Acupuncture.com is all about.
Finally, I applaud practitioners of WM who are sincere enough about their patients' treatment that they are beginning to use AP. I caution these practitioners, and patients who seek their assistance, to understand that sticking needles into muscles that hurt to take away the pain is among the most superficial applications of TCM available. We're glad that MDs can help you in this manner, but we're also peeved that some MDs will poo-poo TCM for any internal or idiopathic problems.
TCM has a great deal to offer the Western discipline of Internal Med, perhaps more than the "pain control" applications that are finally being accepted in WM. 10 yr ago, using AP for muscular pain control too, was considered quite silly. In another 10 yr, I hope that we'll see a greater acceptance of TCM's true genius, and this is in the area of Internal Med.
For patients who live in areas where acupuncturists are not allowed to practice, then only MDs will be available for AP treatments. MDs with a scanty 200 h education in AP will probably be successful at taking away your muscular pain; that is easy. But for other problems, it is a good idea to find a practitioner who has been trained in TCM theory. Many MDs have been; they may be able to help the Yang in your body as well as the Yin.
If you can not find an acupuncturist, seek out a school of Chinese martial arts such as Gongfu, Taiqi and others. They often know of practitioners of TCM who practice "underground." There are certain legal problems with this, but sometimes pain can motivate one to seek out help wherever it can be found. Perhaps someday AP and TCM will be accepted better everywhere and practitioners will be able to practice legally. Until then, we have the WWW (Acupuncture.com).
Yang_JMc03 (1996) The Diagnosis and Treatment of Arthritis in TCM: Part03. Clothing made of polyester can accumulate a considerable charge of static electricity in the winter. This builds up an electromagnetic field and affects the Qi circulation in your body. Many other ways can improve the arthritic condition. For example, sexual activity can stimulate the adrenal glands to produce more corticosteroid, a hormone that reduces joint inflammation and pain. It is believed that sexual activity may also trigger the release of endorphins, a naturally occurring painkilling substance(7).
References
1."Med for the Layman - Arthritis," Clinical Centre Office of Clinical Reports & Inquiries, Building 10B, Room 1C255, Bethesda, Maryland, 20892. 2."The Complete Med Guide," Benjamin F Miller MD, Simon and Schuster, New York, 1978. 3."Arthritis, Rheumatic Diseases, and Related Disorders," USDH and Human Services, Public Health Service, NIH. 4."An Overview of Arthritis and Related Disorders," Caring, January 1989. 5."Arthritis and Diet," Arthritis Foundation, 1314 Spring Street, NW, Atlanta, GA 30309. 6."Can Diet Relieve Arthritis," Univ of California, Berkeley, Wellness Letter 6(8). 7."Arthritis and Your Love Life," 8, Mens' Health, 1989.
From the book entitled "Qigong for Arthritis", YMAA Publication Centre, Jamaica Plain.