A common question that an acupuncturist is asked is "How does acupuncture work?" To understand this it is essential to understand the philosophy and postulations on which acupuncture is based. The traditional Chinese explanation is given below while the modern scientific explanation is given in the next chapter.
The Chinese postulated that there is an energy flow in every living being that is responsible for life. They called this energy the Chi force. This energy is analogous to the Indian concept of 'prana' or life force and permeates all creation. The Chi (pronounced as kee) flows through the body in channels called acupuncture meridians. Every meridian influences an organ and there are different meridians for the heart, liver, lung, large intestine, stomach, kidney, urinary bladder etc.
Some acupuncture meridians are negative in orientation while others are positive in orientation. The Chinese call these the Yin and the Yang. Yin and Yang are relative terms in comparison with each other. Just as there is no darkness without light, no white without black there is no Yin without Yang and vice versa. Yin and Yang are also considered to be female and male respectively and both of these contain some amount of the opposite principal. This is illustrated in the diagram of the symbol of Yin and Yang given below.
The Yin meridians originate in hollow organs like the stomach, large intestine, small intestine, urinary bladder and the gall bladder. The Yang Meridians originate in solid organs like the heart, lung, liver, kidneys, and spleen.
In a person who is healthy, the Chi flows through all the channels smoothly and the Yin and Yang are in a state of dynamic equilibrium. This means that even though there are temporary fluctuations in the Yin and the Yang, the net energy is in balance. In a person who is sick, the energy flows are obstructed and unbalanced causing either an excess or a deficiency of Yin, or an excess or a deficiency of Yang. Acupuncture achieves its curative effect by clearing the obstruction in the flow of Chi and balancing the energy flow. Once the flow of energy is restored to normal, the person becomes and remains healthy.
An acupuncture meridian is a line of energy, which connects all the acupuncture points related to a particular organ. On every meridian there are acupuncture points, which increase or decrease the energy in the meridian to adjust the flow of Chi through it.
When a needle is inserted into an acupuncture point and manipulated strongly, pain is caused which radiates upwards or downwards along a definite route. This route passes through a series of acupuncture points, all of which are able to influence the same organ. The linking of these points established lines of related points from which the concept of acupuncture meridians and collaterals developed. The vertically distributed lines were designated as meridians while their branches were called collaterals. The names of these meridians indicated the relationship between certain sets of points and the internal organs.
According to traditional Chinese Acupuncture books, there are 12 main meridians, 15 collaterals and 8 extra ordinary meridians interwoven in a network which link the internal organs, the body surface, the head and the limbs into one integrated whole. This integration gives acupuncture tremendous flexibility in being able to treat an illness in any part of the body from any other part of the body. This concept of an integrated whole, which seems alien to many people, enables acupuncturists to treat a problem like a backache from points on the hand, ear, face, scalp, foot or back.
Each organ has two meridians one on each side of the body. This implies that the acupuncturist can treat a disease by inserting acupuncture needles on any side of the body. In localised problems like a pain in the knee acupuncture needles may be inserted on the opposite knee if the pain does not permit the insertion of needles in the required place. In a person suffering from herpes it is often unfeasible to place needles in the affected area so the opposite side is used to treat the herpes. Similarly, a person with a fractured leg in a cast can have his pain dramatically relieved and his recovery hastened by inserting needles in the other leg.
The following case will illustrate this principle clearly. Rajesh's leg had been amputated two years before he came to see me, yet he still had pain and itching in the amputated part of the leg. This type of pain is called phantom limb pain and is impossible to treat with Western medicine. It was impossible in this case to treat the patient with needles in the same leg, as he did not have one! So needles were placed in the opposite leg to relieve the pain and Rajesh felt much better.
Some acupuncturists say that about 60% of diseases can be cured by placing needles on the affected side, 30% can be cured by inserting needles on the opposite side, and 90% can be cured by putting needles on both sides. This is why acupuncturists insert needles either on the affected side, the opposite side, or on both sides depending on what he thinks will yield the best results.
An acupuncture point is a specific spot on the skin, which reflects disturbances in the internal organs. The same acupuncture point can also be used to treat disorders in that organ. The location of each point is specific and has certain definate therapeutic properties. Treatment at these points can prevent the development of diseases in the related organs. Most acupuncture points lie along acupuncture meridians. Each acupuncture point can be used to treat several diseases as it influences several organs both through the main meridians and their collaterals.
Acupuncture points were given descriptive names, which indicated their function and made them easy to remember. One point, for example is named "Zusanli" which means Godly serenity" and is used to treat stress, anxiety. insomnia and high blood pressure.
An acupuncture point can be detected by using a galvanometer to measure the electrical resistance of the skin. An acupuncture point, which requires treatment, is often tender and has a lower electrical resistance as compared to the surrounding skin. To detect an acupuncture point, the probe is passed over the skin and when a sensitive acupuncture point is located, the galvanometer shows deflection. This instrument is often used by less experienced acupuncturists to determine the exact location of an acupuncture point.
The galvanometer is also used by experienced acupuncturists on the fingers, the feet and the ears, to make a precise diagnosis of the cause of the patients illness This is an exceedingly accurate method of diagnosis, which can predict an illness much before it actually occurs. However this form of diagnosis requires a great deal of skill and experience, as it is prone to many errors. The results are affected by the amount of moisture on the skin, the salinity of the skin and the pressure applied on the skin. Too much pressure on the probe can cause a deflection on the galvanometer while too little pressure may fail to detect a sensitive point.
Acupuncture points can also be detected by a technique, which was developed almost sixty years ago by Semyon Kirlian in the Soviet Union. He accidentally placed his hand between a photographic plate and a high tension electric Spark, and found a picture on developing the plate. The picture was unusual in that it showed an aura as well as several bright spots on the skin. This discovery gave rise to the science of Kirlian photography.
Kirlian repeated this experiment and found that similar points were present on other parts of the body, as well as in plants and animals. Kirlian saw that these points appeared to be arranged in straight lines. One day, a chance visitor to his laboratory who was familiar with Chinese medicine suggested that perhaps he had managed to visualise the acupuncture points and meridians. When he compared his photographs with Chinese charts of acupuncture points, he found that his points and the acupuncture points were identical. Colour photographs taken with this technique may show a series of green dots, blue dots, or red dots arranged in lines which correlate well with charts of traditional acupuncture points.
This technique has been used in Hungary as a method of early diagnosis. The patient is stripped and made to lie on a photographic plate of the same size as his body and a high speed Kirlian photograph is taken The presence of any bright spots on the photographic plate can help to diagnose illnesses which the patient has and can even help to predict illnesses which he may develop in future.
As the internal organs are not easily accessible for treatment with acupuncture, they are treated by using meridians, which pass through or influence the organ. For example, lung diseases like asthma and chronic bronchitis can be treated using points on the meridians, which pass through the lung. The large intestine meridian is used to treat disorders in the lung as it passes through the lungs on the way to the intestine.
The large intestine meridian starts near the nail of the index finger and travels up the finger on the side of the thumb over the outer aspect of the arm. It passes through the shoulder over the throat to the nose. After passing through the nose, the meridian plunges inwards and passes down through the throat and the lungs to the large intestine. The meridian has a total of twenty points along its course on the skin. These superficial points are used for treatment required for any of the organs which lie along the path of the meridian
A disruption of the energy flow through this meridian may cause bleeding from the nose, colds, sore throats, or pain in the arm, shoulder, elbow or wrist. Because of its internal linkage with the large intestine, it may cause abdominal pain or diarrhoea. An excess of energy in the large intestine meridian can cause pain along its course. It may also cause stiffness of the shoulder, dizziness, distention of the abdomen and constipation, while a deficiency of Chi in this meridian may cause diarrhoea, shivering and a dry mouth. All the above mentioned conditions can be treated using points on the large intestine meridian.
The Chi flows through each organ at different times as illustrated in the diagram of the biological clock given on the next page. Each organ is prone to suffer problems at the time when the Chi is flowing through it. For example, The flow of Chi through the large intestine meridian is maximum between five a.m. and seven a.m. which is why most of us pass stools early in the morning. The flow of Chi in the lung meridian is maximum between three a.m. and five a.m. so patients with asthma often suffer attacks at this hour. This concept of a biological clock has been confirmed by research in the last thirty years, which shows that the functioning of all organisms synchronises with an internal clock.
The expertise of the acupuncturist is put to test in deciding exactly which acupuncture points need to be stimulated or sedated to achieve a particular effect in each patient. The efficacy of acupuncture treatment depends on the selection of the correct acupuncture points for each patient and the accuracy with which the needles are placed. This is particularly important because each patient requires individualised treatment depending on the cause of the problem which will differ from patient to patient even though their symptoms may be the same.
It is possible for a particular set of symptoms to be created by different mechanisms in different individuals. The skill of the acupuncturist lies in identifying the true cause of an illness and the appropriate acupuncture points to be used for its treatment. For example a person with a stomach-ache may have a disorder which originates in any one of a dozen organs and may be due to an excess or deficiency of either Yin or Yang. Asthma may be caused not only by a disorder in the lung but also by an obstruction in the energy flow in the liver and lung meridians which precede and follow the lung meridian. Similarly the urinary bladder or kidney meridian may be used to treat asthma especially when the patient is treated in the afternoon.
There are a total of eight hundred and twenty-six classical acupuncture points available for treatment. In addition there are one hundred and thirty six acupuncture points in the ear. In the last few years acupuncturists have discovered over a hundred new acupuncture points in the scalp, ear, nose, face, hand and foot. Therefore the acupuncturist has over a thousand acupuncture points to choose from while treating a patient.
A good acupuncturist is able to assess each patient and decide which acupuncture points will be effective in curing the disease in the shortest possible time. The efficacy of treatment with acupuncture is thus directly proportional to the skill and expertise of the practitioner. An expert acupuncturist may use a few needles for this purpose while a novice may require thirty to forty needles and still be unable to achieve the desired effect. Often patients consult an inexperienced acupuncturist who relies on set formulas to treat diseases irrespective of the cause. Naturally in these cases the results are unsatisfactory.