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History of Acupuncture
Acupuncture originated in China over 2000 years ago
as one discipline in a complex tradition of Chinese medicine. The earliest
major source on acupuncture, Huang Di Nei Jing (Yellow Emperor's Inner
Classic), was compiled between 206 B.C.E. and 220 A.D. Acupuncture became
widely known in the United States in 1971. New York Times reporter James
Reston, in Beijing reporting on a Ping-Pong tournament between China and
the United States, suffered an acute appendicitis. Reston wrote a front-page
article describing how three acupuncture needles alleviated his postoperative
appendectomy pain. Since that time, public and scientific interest in
Acupuncture has gradually grown.
Acupuncture Principles
Traditional Chinese medicine theorizes that the 2,000+ acupuncture points
on the body connect to form 12 main and 8 accessory pathways called meridians.
The meridians are conduits for circulating Qi (chi) or life energy. Qi
regulates the functions and essence of the body, mind and spirit. Qi follows
the principles of Yin and Yang-the philosophy of opposites in balance.
If the Qi in the body becomes blocked or unbalanced, then pain, illness
and disease manifest. The acupuncture needles, when properly placed, unblock
obstructions and restore a proper balance in the flow of Qi.
Western science has yet to conclusively identify any
Qi or meridians. However, several mechanisms of action have been demonstrated
with the proper placement of an acupuncture needle. An acupuncture needle
is made of a stainless steel shaft with a copper or steel handle. Three
physical phenomena occur with this construction:
- The thermoelectric effect-An electrical potential gradient is generated
along the temperature gradient generated when a needle is placed into
a warm body (Seebeck effect). The tip of the needle generates a positive
charge, the handle becomes negatively charged.
- The bimetallic effect-An electromagnetic effect from the second metal
spiraled around the shaft of the needle, reinforcing the charges generated
by the thermoelectric effect.
- The electron transfer effect-Electrons are transferred from one metal
to the other as the needle temperature varies (Peltier effect).
This needle charge generates a current of 2 to 3 micro-amperes.
The current can be increased manipulating the needle, altering the temperature
of the handle. Heating the handle results in a polarity flip, with the
tip becoming negative and the handle positive. The charge not only affects
the bodies nervous, vascular and lymphatic systems, but also affects muscle
and fascia (and Qi of course).
Electro-Acupuncture
Since 1958, electricity has been used in China for prolonged needle stimulation
during surgeries. It is now widely used for management of pain problems
with acupuncture. Two effects can be seen with electrical stimulation
of the acupuncture needle. A low-frequency/high-intensity stimulation
(2 to 4 Hz at 10 or more milli-amperes) affects the opioid/endorphin system.
This produces a generalized analgesia that continues for some time after
the stimulation has ended. A high-frequency/low-intensity stimulation
(70 Hz at less than 10 milli-amps) affects the monoamine transmitters
serotonin, norepinephrine, and dynorphin. This produces a segmental analgesia
that lasts only as long as the needles are stimulated.
Conditions Treated with Acupuncture
Acupuncture is used to treat an array of injuries, painful conditions,
and diseases. A few examples of conditions treated with Acupuncture include:
- Musculoskeletal pain
- Menstrual disorders
- Perioperative pain
- Perioperative nausea
- Nausea associated with chemotherapy
- Functional bowel disorders
- Dental pain
- Arthritis
- Headaches
- Asthma
- Tinnitus
- Depression
- Chemical addiction
- Fatigue
- Fibromyalgia
Research
Acupuncture research was minimal until it was brought into the Western
world. Over the last 30 years, research has grown in quantity and quality.
While it is difficult to design a gold-standard double blind, placebo
controlled study due to the nature of acupuncture, significant basic science
and clinical outcome research has been produced. The National Institutes
of Health (NIH) issued a consensus statement in 1997 indicating acupuncture
was an effective treatment for nausea due to chemotherapy and surgical
anesthesia. They also found that acupuncture may be useful for treating
addiction, headaches, Fibromyalgia, low back pain and carpal tunnel syndrome.
Most acupuncture research is directed toward pain control. Some recent
clinical trials have shown:
- Giles and Muller reported in Spine 2003 (28(14):1490-1502) that acupuncture
was beneficial for chronic spinal pain.
- Meng, et al. reported in Rheumatology 2003 (42(12):1508-17) that acupuncture
was safe and effective adjunctive treatment for chronic low back pain.
- Melchart, et al. reported in the Journal of Internal Medicine that
acupuncture was effective for migraine headaches compared to placebo.
It was as effective as sumatriptan for prevention of migraine attacks,
but its effectiveness was less than sumatriptan for migraines in progress.
Training
Many acupuncturists in America are trained in Traditional Chinese Medical
schools, which emphasize herbal treatments with acupuncture also incorporated.
Physicians training can be variable-from a few weekend seminars to intensive
training courses. One of the best-organized and most respected physician
acupuncture training programs is offered through the University of California,
Los Angeles and the Helms Medical Institute.
The Medical Acupuncture for Physicians course has trained over 5,000 physician
acupuncturists.
The American Academy of Medical Acupuncture
provides board certification in medical acupuncture for physicians. The
AAMA also provides information resources for physicians and patients as
well as continuing medical education for physicians.
You can also learn more about acupuncture at www.Acupuncture.com
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