Teoria neurologica traditionala in acupunctura

Teoria neurologica

intre suprafata pielii si organele interne exista numeroase relatii realizate de fibre nervoase. La nivelul trunchiului, intre suprafata cutanata si or­ganele corespunzatoare din profunzime sint usor de observat aceste relatii. Suferintele organelor in­terne produc modificari la periferie, metameric, cum ar fi: hiperestezie cutanata, condensari ale tesutului subcutanat, hipertonie musculara, tulbu­rari de vascularizatie si modificarea proprietatilor electrice cutanate. Afectiunile stomacului produc hiperestezie si hipertonie musculara, paravertebral stinga la nivel D₉-L_x si in jumatatea stinga a epi-gastrului; afectiunile hepatobiliare produc aceleasi modificari paravertebral dreapta la nivel D₇-D₁₂.

Tipul de relatie prezentat este viscero-somatic, iar modificarile amintite se realizeaza prin reflexe viscero-somatice. Aceste modificari sint de o deo­sebita utilitate diagnostica, desi in general sint pu­tin cunoscute. Pentru practicianul acupunctor prin interventia cu ace de acupunctura de argint, ele constituie elemente curente de diagnostic.

in experientele efectuate pe animale de labo­rator s-au constatat modificari in kinetica si vas-cularizatia tubului digestiv, corespunzator derma-tomului stimulat. Tipul de relatie este somato-vis-ceral, iar modificarile se realizeaza prin reflexe somato-viscerale. Ele se produc si la animalul decerebrat, de unde concluzia ca sint reflexe de tip segmentar sau intersegmental". Mecanismul de actiune al acupuncturii se bazeaza probabil pe acest tip de relatii.

Relatiile intre diferite teritorii ale organismului sint foarte complexe. Zone cutanate situate pe mem­bre au relatii care la prima vedere apar improbabile cu organele interne. Explicatia acestor relatii ar fi existenta unor proiectii comune Ia nivelul maduvei sau al creierului pentru zonele corelate. Cu ocazia unor interventii neurochirurgicale s-a putut dovedi existenta la nivelul creierului a unei arii comune de proiectie, pentru intestinul gros si suprafata cu­tanata pe care este situat punctul IG₄ (situat in un­ghiul format de metacarpienele I si II). Alta in­cercare de a explica diversele relatii observate in practica acupunctica are in vedere evolutia tesu­turilor si segmentelor corpului, in perioada dez­voltarii embrionare. Astfel, segmente foarte inde­partate topografic si aparent fara nici o relatie au fost vecine intr-o anumita faza a dezvoltarii em­brionare, fapt care ar fi determinat anumite le­gaturi.

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acupuncture needles Kidney

Kidney Shen

The kidney (Table 2.6) is said to be the root of life and it is responsible for storing the essence. Kidney yin is said to be the fundamental substance (structure) of birth and growth, while kidney yang is the motive force (function). The kidney therefore dominates both reproduc­tion and development. Kidney essence may be either congenital (from parents) or acquired (from essential substances transformed by the spleen and stomach). Essence is said to follow a seven year cycle for women, and an eight year cycle for men. Essence lourishes at age 14 in females and declines at age 49. In males it flourishes at 16 and declines at age 56 and is inally gone at age 64. Kidney yin is the foundation of all yin fluids in the body which moisten the Zang Fu organs. If kidney yin is deicient it will fail to control kidney yang and symptoms are heat in the chest, palms and soles, night sweats and seminal emission. If kidney yang is deicient, leading to a failure of warming and promoting, there will be coldness and pain in the lumbar region, and possibly impotence.

Table 2.6. Kidney Shen (the root of life).

Stores essence.

Dominates reproduction and development. Dominates water metabolism. Receives the qi. Dominates bone.

Manufactures marrow to fill the brain. Manifests in the hair. Opens to the ear.

Dominates anterior and posterior orifices.

The kidney is said to dominate water metabolism. Water is received by the stomach and then transmitted by the spleen to the lung, which disperses and descends it. Part of the luid reaches the kidney where it is divided into clear and turbid (unclean) portions. The clear portion goes to the lung to be circulated to the organs and tissues. The turbid portion goes to the bladder to form urine. If the kidney fails to open and close one of the results will be oedema and/or abnormal micturition.

The kidney is said to receive the qi, and works with the lung in this function. It is said that 'the lung is the governor of qi and the kidney is the root of qi'. The lung receives the clear qi from the air and passes it down to the kidney which holds it. Kidney qi must be strong for the passage of qi to be free and for respiration to be smooth. If kidney qi is weak (deficient), the root of qi is not firm and the kidney will fail to hold the qi, giving shortness of breath especially on exertion. This is often seen in chronic asthma (also called deiciency-type asthma in TCM), for example, where lung points (LU-9 or BL-13, back shu point of the lung) and kidney points (KI-3) may be combined in order to treat with acupuncture needles .

Case history

An elderly, frail patient presented with long-standing asthma.She had a slightly stooped appearance with a flattened anterior chest suggesting a history of breathing difficulties.Her tongue examination revealed a nor­mal tongue body with a thin white coating.The tongue was larger than normal giving the appearance of filling the mouth, and there were a number of lateral cracks on either side of the tongue.The patient de­scribed dryness of her throat with a desire to drink, especially during the evening and at night.The patient woke two or three times at night to go to the toilet.The urine was clear with no recent change in volume.The patient's sleep was disturbed by palpitations, and she was breathless on exertion.

To palpation, the chest was quite rigid with poor expansion.Breathing was isolated to the upper regions.Pulse examination showed a deep slippery pulse with the lung level weak and the kidney level moderately weak.

This clinical picture shows deficiency.The history and pulse suggest de­ficiency in the lung and kidney.The aim of treatment is to tonify the lung and kidney with acupuncture needles, and release the tightness in the chest.

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acupuncture - conditions, the six patogens

Deficiency and excess

Deiciency and excess are terms used to describe the relationship between the strength of a pathogen and the proportional strength of anti-pathogenic qi. An excess condition exists when a pathogenic factor is hyperactive compared to normal anti-pathogenic qi. In contrast deficiency is present when anti-pathogenic qi is being consumed. Treatment will aim at either promoting anti-pathogenic qi in the case of deiciency,or eliminating the pathogenic factor in the case of excess.

Deiciency may be of either yin,yang,blood,or qi. Deiciency of yin gives heat symptoms while deiciency of yang gives cold symptoms. Deficiency of qi is seen after a long illness especially and shows as general lassitude. There may be spontaneous sweating due to the inability of qi to control the pores. Deiciency of blood is normally due to weakness in the spleen and stomach. Because blood is unable to reach the head the patient often experiences dizziness,and lack of blood to the heart may give palpitations.

General signs of deficiency include lassitude and weight loss,weak breathing,pallor,and night sweats. Where pain is present it is alleviated by pressure (see Chapter 4). The tongue is dry with little coating. Excess shows as agitation,rapid breathing,distension and fullness in the chest. Where pain is present it is aggravated by pressure. The tongue coating is thick and sticky.

The six pathogens

The six pathogens are wind,cold,summer heat,damp,dryness and ire (representing warmth and heat). Under normal circumstances these climatic changes do not pose a threat and are seen simply as six types of qi found in the natural environment (Xinnong,1999). However,if the factors are particularly strong,or the change from one factor to another is sudden and unexpected,or if the body's ability to produce anti-pathogenic qi to combat the factors is weak,the pathogens can invade the body and cause harm. Each of the factors invades the exterior of the body (skin,mouth and nose) and may act in isolation or combination. In the case of musculoskeletal pain,the factors produce the bi syndromes (see page 54).

Wind is the main pathogen,as all the other pathogens depend on it for transport into the body. It is yang in nature and has two important characteristics in TCM. Firstly,wind is characterised by 'upward and outward dispersion' and is therefore likely to invade the upper part of the body and the external surface. Wind therefore attacks the head and face,and the lungs and skin. Secondly,wind by nature 'moves'. Conditions resulting from wind therefore show movement as part of their symptoms. Pains which change position,skin marking which appears and disappears,convulsions, spasms and tremors are all wind signs. Points such as GB-20 (wind pool), GV-16 (palace of wind),and BL-12 (wind gate) are used to treat wind-related conditions by needeling with Acupuncture needles

Cold is yin in nature,and is characterised by contraction and stagnation. Exposure to cold after sweating or when wearing thin clothing allows the cold to invade the body. Cold will consume the yang qi of the body and the warming function of the body is therefore impaired. Symptoms are cold limbs,stiffness,cold pain and contractions. There is a dislike of cold and lack of sweating. Treatment often involves moxibustion and warm needling,and reinforcing techniques.

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acupuncture needles

Diagnosis in TCM takes many factors into consideration, not least of


which are the Pathogens. These are classified as either External or Internal.


The External Pathogens are really based on climatic influences: Wind,


Cold, Damp and Heat. These are considered to be capable of entering the


body to cause disease. When present in excess, a body with deficient


defences, or Wei Qi, will be susceptible to invasion by them. Thus, External


Pathogens can become internalized, moving deeper from the meridians


into the organ systems where they can cause considerable damage to


the delicate energy balances. Each type of pathogenic invasion produces


distinctive symptoms, allowing the Pathogen to be recognized. Cold tends


to produce a deep pain, generally static in nature with loss of joint movement


- 'freezing' in effect. Damp is associated with excess fluid, oedema,


heaviness, swelling of the lower limbs and a dull pain, often a headache.


Wind is characterized by a volatile or mobile symptomatology. Joint pain


caused by Wind will not have a constant focus but is likely to move from


joint to joint. Heat is relatively straightforward, causing an increase in


internal heat, shown by a rise in body temperature or drying of body fluids


and a burning type of pain.


More than one Pathogen can invade at the same time; if a patient is suffering


from influenza, there will be a fever and also muscular aches that


wander all over the body. This is defined as an invasion of the Pathogens


Wind and Heat.We treat this using acupuncture needles.


Internal Pathogens are those arising from within the body itself and are


thought to be excess emotions. These emotions are a normal part of life,


and normal emotional activity does not lead to illness. Illness results from


emotions only when the emotional pressure is too strong, or the patient is


highly sensitive for some other health reason. Anger, fear or worry taken to


excess can lead to pathogenic damage to the energy systems within the


body. Particular emotions are said to affect specific body organs (Table 1.4);


for example, the Liver is particularly susceptible to damage by anger and


the Lungs by grief.

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SPECIFIC ACUPUNCTURE POINTS in acupuncture

SPECIFIC ACUPUNCTURE POINTS

As mentioned above, among the acupuncture points of the fourteen channels, a num­ber have specific properties. They are grouped together under special names as follows:

1. Five Shu Acupuncture points

Along each of the twelve regular channels, below the elbow or knee, lie five specific acupuncture points , namely, Jing-Well, Ying-Spring, Shu-Stream, Jing-River and He-Sea. They are arranged in the above order from the distal ends of the limbs to the elbow or knee. These names image the flow of qi along the channels as the movement of water. Jing-Well is the place where the qi of the channel starts to bubble. Ying-Spring is where the qi of the channel starts to flourish. Shu-Stream is where the qi of the channel flourishes. Jing-River is where the qi of the channel increases in abundance. Finally, He-Sea represents the confluence of rivers in the sea, where the qi of the channel is the most flourishing.

The therapeutic properties of the Five Shu Acupuncture points are as follows: Jing-Well Acupuncture points are indicated in mental illness and a stifling sensation in the chest, Ying-Spring Acupuncture points in febrile diseases, Shu-Stream Acupuncture points in bi syndrome (painful joints) caused by pathogenic wind and damp, Jing-River Acupuncture points in asthma, cough and throat disorders, and He-Sea Acupuncture points in dis­orders of the intestines, stomach and the other fu organs. (Each of the six fu organs has a He-Sea Point in the three yang channels of foot respec­tively, known as the Inferior He-Sea Point.)

2. Yuan (Source) Acupuncture points

Each of the twelve regular channels has a Yuan (Source) Point in the extremities where the original qi is retained. In the yin channels, the Yuan (Source) Acupuncture points coincide with the Shu-Stream Acupuncture points of the Five Shu Acupuncture points . The Yuan (Source) Acupuncture points are of great significance in diagnosis and treatment of diseases of channels and zang-fu organs.

3. Luo (Connecting) Acupuncture points

Each of the twelve regular channels has a collateral in the extremities connecting a definite pair of yin and yang channels which are externally-internally related. In the trunk, there are the collaterals of the Ren and Du Channels and the major collateral of the spleen distributed respec­tively in the posterior, anterior and lateral aspects of the body. Each of the collaterals has a Luo (Connecting) Point, making 15 in all. A Luo (Con­necting) Point is used to treat diseases which involve the two externally-internally related channels and also diseases in the area supplied by the two channels.

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Description of acupuncture

Acupuncture is the practice of inserting a acupuncture needle or needles into certain

points in the body for therapeutic purposes. Needles used for acupuncture

in the United States are most commonly made of sterilized stainless steel

and designed for single use. The needles may be stimulated further after

insertion by manual movement, heat, or electricity.

Acupuncture originated in ancient China, where it was believed that all

illness could be traced to the imbalance of an animating energy flow

known as Qi (pronounced ''chi'') that ran in meridians (or channels) within

the body. According to acupuncture theory, the insertion of needles in

discrete locations or acupuncture points along these meridians in various

combinations and patterns results in the restoration of orderly energy flow

and a subsequent return to health [1]. The World Health Organization

standard acupuncture nomenclature recognizes 20 meridians and approximately

400 acupuncture points [2]. Only recently has acupuncture been

studied rigorously enough to draw scientific conclusions about its efficacy

or lack thereof.

History of acupuncture

The first comprehensive reference to acupuncture as a medical treatment

is found in an ancient Chinese medical textbook dating approximately to the

first century

BC. It is very likely, however, that acupuncture existed for a considerable

time before this textbook. A practice highly reminiscent of acupuncture

that used red-hot irons rather than needles to cauterize the skin

was known to the pre-Islamic Arabs and ancient Egyptians [3].

European missionaries who observed the therapy and its apparently

miraculous effects transmitted the first reports of acupuncture to the West

300 years ago. A period of practice and experimentation ensued in Europe

before the practice gradually declined. During the past 30 years, there has

been resurgence in popularity of the technique. Currently, acupuncture is

practiced widely in the United States by increasing numbers of physicians,

dentists, veterinarians, and lay acupuncturists. It is available in all states,

and its use by the public is growing [4]. As new research and more sophisticated

models of the physiology of pain and disease make the principles

behind its effectiveness more comprehensible, its use is likely to increase.

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the benefit of acupuncture

Before we begin a discussion about the benefits of acupuncture, let's talk about the origins of acupuncture. It was first used in China over 2000 years ago, and is one of the oldest medical procedures in the world. It is a family of procedures that stimulates the anatomy of the body and helps to balance the energy flow throughout the body. It is this kind of acupuncture that is practiced in the United Sates today, through the use of tiny, metallic needles placed in affected areas and manipulated by hand or by electrical stimulation.

Acupuncture is the basic foundation for Traditional Chinese Medicine and is based on the belief that there are two opposing and inseparable forces within our body. They are known as the Yin and Yang of the entire person. The Yin is representative of the cold, slow, or passive principle, and yang represents the hot, excited or active principle. A healthy state is achieved by maintaining a balance state of the yin and yang.

This is done through vital pathways or meridians that allow for the flow of qi, or vital energy. The vital energy flow occurs along pathways known as meridians. These meridians connect over 2,000 acupuncture points along the body. There are 12 main meridians, and 8 secondary meridians. Although traditional western medicine does not completely understand how acupuncture works, the proof that it does work has been shown in several studies conducted by western medical facilities.

Now, let's move to the question of does it work? According to the National Institute of Health, the answer would be yes. Acupuncture has been shown to be effective in many areas of health care. Areas such as postoperative nausea, chemotherapy side effects, osteoarthritis, low-back pain, headache, menstrual cramps, addiction, carpal tunnel syndrome, and asthma, just to name a few. The study revealed that acupuncture was able to provide pain relief, improve function and mobility of joints due to arthritis inflammation, and served to complement standard care.

Although there are many who would doubt the effectiveness of acupuncture, once they are a patient, they are believers. It has been proposed that acupuncture works and produces its effects through regulating the nervous system. The theory proposes that since acupuncture produces its effect through regulation of the nervous system, it induces the release of endorphins and immune system cells at specific sites on the body. So , when we use acupuncture needles we modify those aspects. There is also the theory that acupuncture alters the brain chemistry by the changing the neurotransmitters in the brain.

Without doubt acupuncture was a benefit in the study, and as a patient myself, I can vouch for the wonderful effect it has had on my back. Although acupuncture is classified as an alternative medicine therapy, and there is still much to be understood about the way it works, it is a proven aid in maintaining optimal health. But what about the well individual, can acupuncture provide a benefit to them? Absolutely. Because acupuncture works off the belief that we must maintain balance of our vital energy flow in order to remain healthy, acupuncture serves as the tool for realignment. Our vital energy flow can be out of balance, and we still feel and appear quite healthy. It is in this capacity that acupuncture serves as a sort of preventive medicine. Checking and balancing the flow of energy on the meridian points in your body is like your car receiving a tune-up before it is in need of a repair.

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