Acupuncture : a Traditional Approach having Scientific Explanation

 

MK Sastry lecture series. From previous lectures posted in different classes. 

I have no copyright. distribute in the manner it is felt as deem fit and proper. 

Acupuncture is very wide concept, it's among the widest concept to be ever studied , challenging the most stubborn and arrogant opinions.   For example in case of PIVD ( prolapse of the intervertebral disc)  with secondary cannel stenosis, operate ,  do disectomy  or laminectomy, and  spine fixation is the most scientific approach.  In my career of as Acupunctuist practise, I have recovered number of cases  , I saw patient treated by surgery had lot of complication , in a post operative stage than treated by us. Many of my patients have  almost recovered and are leaving  more than a normal life  having a laborious working day , that also Indian life. So more important is to mixup the approach , integrate them and produce the finest results, with the highest traditions laid down in the medical science . 

Every Science is a logic , else it would have not survived,  only it's our ego , and it's our manifestation that we compare , else we can produce the highest results if we can recover from dogmas within ourselves. 

Recover a case , nerve by nerve , muscle by muscle, organ by organ , channel by channel, area by area , overcome the situation of a varied nature  in the most simplest manner. (Mk Sastry) 

 

TRADITIONAL VIEW

The understanding of how acupuncture works has evolved with its practice, having a glorious  and descriptive explanation which even today with most advance technologies we are unable to produce results and also explain the underlying principles and  pathologies . Even the involvement of nanotechnologies such as gold nano particles with dendrimers unable to explain the real nature of acupuncture.    and  and so we call acupuncture has placebo. , because we are unable to support with our logic. Acupuncture set down a centuries  years ago have largely been retained. In India it was largely practised during the era of Lord Rama , than Lord Krishna, very much of its description has laid down in our religious texts, called Vedas, yajurva Veda. Since channelising the power of charkras from (suksham nadis) channels of energy called the power of kundalini ad epi center , creating internal harmony. Rather disease is nothing started with a small change in the internal pathology called a underlying cause if addressed properly in a true manner , to the point , the symptoms automatically disappear. Treating the leaves one by one with variety of medicines, leaving the cause unaddressed is our most scientific way of treatment, relapse of tumour after its treatment most suitable and advance manner is the biggest defeat  we are facing today. 

  Approximately 3,000 years ago, the pre-eminence of acupuncture was established , our Vedas ie religious text of Hindus   including Huangdi  Nanzing ie yellow emperor book of internal medicine . There  it has been very well explained that disease is nothing but a symptom, not the cause , so to realise the cause,take the pathway of the disease, to reach the underlying cause .    In it, acupuncture is described as to treat a disease with  very fine adopted methodologies, to the symptoms and correct the circuit involved to recover and cure the word cure had been mentioned because the cause has been addressed at the root level.  Diseases may be created  in the body trying to adopt with the external environment leading to its adoption  through muscle, internal organs, and, if not cured in timely fashion, to the marrow of the bone. By inserting a needle to the appropriate depth-to correspond with the degree of disease penetration-the disease could be let out.

Prior to the time when there were microscopes and instruments and equipments  by which people could envision individual cells and before autopsies revealed the intricate structures within the body, doctors and scholars projected the internal workings of the body from what they could actually experience, and involved the underlying with deep level of meditation on the disease, they realised that body resembles the cosmos . It is believed that   On this basis, the workings of the body were described in terms similar to those used to describe the visible world. One of the critical aspects of nature for humans living a thousand years ago, when Indian as well Chinese, here we should not compare which was more civilized and scientific.  civilization was well developed, was the system of water courses, which included tiny streams, huge rivers, man-made canals and irrigation systems, and the ocean. It was envisioned that the body had a similar system of fluid dynamics. There is a energy which moves everything called qi and the pathways through which it flowed were the meridians connected to zang and fu organ, branched into 12 , 2 vessel channels. 

Instead of discussing acupuncture in terms of letting something out of the body, physicians began describing it in terms of regulating something within the body. The flow of qi through the meridians, just like the flow of water through a stream, could be blocked off by an obstruction-a dam across the waterway. In the streams, this might be a fallen tree or a mud slide; in humans, it might be caused by something striking the body, the influence of bad weather, or ingestion of improper foods. When a stream is blocked, it floods above the blockage, and below the blockage it dries up. If one goes to the point of blockage and clears it away, then the stream can resume its natural course. In a like manner, if the qi in the meridian becomes blocked, the condition of the body becomes disordered like the flooding and dryness; if one could remove the blockage from the flow of qi within a meridian, the natural flow could be restored.

In a blocked stream, just cutting a small hole or crevice in the blockage will often clear the entire stream path, because the force of the water that penetrates the hole will widen it continuously until the normal course is restored. In the human body, inserting a small needle into the blocked meridian will have a similar effect. Just as a stream may have certain points more easily accessed (or more easily blocked), the meridians have certain points which, if treated by needling, will have a significant impact on the flow pattern. Many acupuncture points are named for geological structures: mountains, streams, ponds, and oceans.

Although this description of the basic acupuncture concept is somewhat simplified, it conveys the approach that is taught today to students of traditional acupuncture: locate the areas of disturbance, isolate the main blockage points, and clear the blockage. Of course, many layers of sophistication have been added to this model, so that the needling-which might be carried out in several different ways-can be seen to have subtle and differing effects depending upon the site(s) needled, the depth and direction of needling, and even the chemical composition of the needle (such as gold, silver, or steel). For example, some needling techniques are used for the primary purpose of increasing the flow of qi in a meridian without necessarily removing any blockage; other techniques reduce the flow of qi in the meridians. These tonifying and draining methods, as well as transference methods that help move qi from one meridian to another, are part of the more general aim of balancing the flow of qi in the body.

Ultimately, all the descriptions of acupuncture that are based on the traditional model involve rectifying a disturbance in the flow of qi. If the qi circulation is corrected, the body can eliminate most symptoms and eventually-with proper diet, exercise, and other habits-overcome virtually all disease.

MODERN VIEWS

When the human body was finally described in terms of cells, biochemicals, and specific structures (most of this accomplished less than 150 years ago), the Chinese method of acupuncture and its underlying concepts were evaluated in these new terms. As a first effort, researchers sought out physical pathways that might correspond to the meridians, and even a fluid substance that might correspond to qi. Neither of these were found. Nonetheless, the action of performing acupuncture was shown to have effects on the body that required some detailed explanation.

From the modern perspective, diseases and injuries are resolved by a complex set of responses; the responses are coordinated by several signaling systems. The signaling systems mainly involve peptides and other small biochemicals that are released at one site, travel to other sites, interact with cells, and stimulate various biologically programmed responses. Rather than blockages of circulation described in the old Chinese dogma, diseases are understood to be caused by microorganisms, metabolic failures, changes in DNA structure or signaling, or breakdown of the immune system. Some of these disorders are resolved by the cellular functions that are designed for healing, while others become chronic diseases because the pathological factors involved have either defeated the body's normalizing mechanisms or because something else has weakened the body's responses to the point that they are ineffective. For example, poor nutrition, unhealthy habits, and high stress can weaken the responses to disease.

Modern studies have revealed that acupuncture stimulates one or more of the signaling systems, which can, under certain circumstances, increase the rate of healing response. This may be sufficient to cure a disease, or it might only reduce its impact (alleviate some symptoms). These findings can explain most of the clinical effects of acupuncture therapy.

According to current understanding, the primary signaling system affected by acupuncture is the nervous system, which not only transmits signals along the nerves that comprise it, but also emits a variety of biochemicals that influence other cells of the body. The nervous system, with over 30 peptides involved in transmitting signals, is connected to the hormonal system via the adrenal gland, and it makes connections to every cell and system of the body.

In a review article, Acupuncture and the Nervous System (American Journal of Chinese Medicine 1992; 20(3-4): 331-337), Cai Wuying at the Department of Neurology, Loyola University of Chicago, describes some of the studies that implicate nervous system involvement. According to a report of the Shanghai Medical University, cranial nerves, spinal nerves, and their terminals were dispersed in the area surrounding the acupuncture points for about 5 millimeters. They also found that the nervous distribution of the Bladder Meridian points (which run along the spine) was in the same area of the spine as that of the corresponding viscera. In Japanese research, it was reported that when acupuncture points were needled, certain neurotransmitters appeared at the site. In laboratory-animal acupuncture studies, it was reported that two such transmitters, substance P and calcitonin gene-related peptide, were released from primary sensory neurons. Acupuncture analgesia appears to be mediated by release of enkephalin and beta-endorphins, with regulation of prostaglandin synthesis: all these have an effect on pain perception. One of the dominant areas of research into acupuncture mechanisms has been its effect on endorphins. Endorphins are one of several neuropeptides; these have been shown to alleviate pain, and have been described as the body's own "opiates." One reason for the focus on these biochemicals is that they were identified in 1977, just as acupuncture was becoming popular in the West, and they are involved in two areas that have been the focus of acupuncture therapy in the West: treatment of chronic pain and treatment of drug addiction.

According to traditional Chinese doctors, one of the key elements of a successful acupuncture treatment is having the person who is being treated experience what is called the "needling sensation." This sensation may vary with the treatment, but it has been described as a numbness, tingling, warmth, or other experience that is not simple pain (pain is not an expected or desired response to acupuncture treatment, though it is recognized that needling certain points may involve a painful response). Sometimes the needling sensation is experienced as propagating from the point of needling to another part of the body. The acupuncturist, while handling the needle should experience a response called "getting qi." In this case, the needle seems to get pulled by the body, and this may be understood in modern terms as the result of muscle responses secondary to the local nervous system interaction.

According to this interpretation, acupuncture is seen as a stimulus directed to certain responsive parts of the nervous system, producing the needling sensation and setting off a biochemical cascade which enhances healing. Some acupuncture points are very frequently used and their applications are quite varied: needling at these points may stimulate a "global" healing response that can affect many diseases. Other points have only limited applications; needling at those points may affect only one of the signaling systems. It is common for acupuncturists to combine the broad-spectrum points and the specific points for each treatment. Some acupuncturists come to rely on a few of these broad-spectrum points as treatments for virtually all common ailments.

This modern explanation of how acupuncture works does not explain why the acupuncture points are arrayed along the traditional meridian lines. At this time, no one has identified-from the modern viewpoint-a clear series of neural connections that would correspond to the meridians. However, acupuncturists have identified other sets of points, such as those in the outer ear, which seem to be mapped to the whole body. The description, in the case of the ear, is of a layout of the body in the form of a "homunculus" (a miniature humanoid form). Such patterns might be understood more easily than the meridian lines, because the brain, which is adjacent to the ear, also has a homunculus pattern of neurological stimulus that has been identified by modern research. Similarly, acupuncturists have identified zones of treatment (for example, on the scalp or on the hand) that correspond to large areas of the body, and this may also be more easily explained because there are connections from the spinal column to various parts of the body which might have secondary branches elsewhere. In fact, acupuncture by zones, homunculi, "ashi" points (places on the body that are tender and indicate a blockage of qi circulation), and "trigger" points (spots that are associated with muscle groups) is becoming a dominant theme, as the emphasis on treating meridians fades (for some practitioners). The new focus is on finding effective points for various disorders and for getting biochemical responses (rather than regulating qi, though there is no doubt some overlap between the two concepts).

During this modern period (since the 1970s) an increasing number of ways to stimulate the healing response at various body points have been advocated, confirming that needling is not a unique method (the idea that the needle would produce a hole through which pathogenic forces could escape has long been fading). In the past, the main procedures for affecting acupuncture points were needling and application of heat (moxibustion). Now, there is increasing reliance on electrical stimulation (with or without needling), and laser stimulation. Since the basic idea of acupuncture therapy is gaining popularity throughout the world while the practice of needling is restricted to certain health professions and is not always convenient, other methods are also becoming widely used. Lay persons and practitioners with limited training are applying finger pressure (acupressure), tiny metal balls held to the to the skin by tape, magnets (with or without tiny needles attached), piezoelectric stimulus (a brief electric discharge), and low energy electrical pulsing (such as the TENS unit provides with electrical stimulus applied to the skin surface by taped electrodes). Some of these methods may have limited effectiveness, but it appears that if an appropriate body site is stimulated properly, then the healing response is generated.

For many nervous system functions, timing is very important, and this is the case for acupuncture. The duration of therapy usually needs to be kept within certain limits (too short and no effect, too long and the person may feel exhausted), and the stimulation of the point is often carried out with a repetitive activity (maintained for a minute or two by manual stimulation-usually slight thrusting, slight withdrawing, or twirling-or throughout treatment with electrostimulation). It has been shown in laboratory experiments that certain frequencies of stimulus work better than others: this might be expected for nervous system responses, but is not expected for simple chemical release from other cells.

ADITIONAL AND MODERN VIEWS COEXISTING

The traditional and modern understandings of acupuncture arise from significantly different world views and from application of different levels of technology. It is difficult to directly correlate the two, though one can say that many of the traditional observations and ideas have partial explanations by modern mechanisms. Still, the modern practitioner can become aware of and trained in the application of both approaches to acupuncture. A person to be treated can be analyzed from both perspectives and the treatment strategy can be devised according to the conclusions derived from each perspective. Certain aspects of the case may be more amenable to traditional analysis and corresponding treatment, while other aspects are better suited to modern analysis and treatment approach.

An individual who is suffering from a chronic pain syndrome might be analyzed in terms of which meridians are blocked: through treatment of appropriate points on the meridian, the pain might be alleviated. The same individual might be analyzed according to which muscle groups are involved in the painful area and might be treated by acupuncture at trigger points that specifically affect those muscles. An individual suffering from an autoimmune disorder might be analyzed according to which of the traditional organ systems are involved, with treatment of the associated meridians. The same individual might be analyzed in terms of the immune system disturbance and treated by stimulating points that have been recently identified as immune regulators.

Since the traditional acupuncture approach has been shown to be effective in clinical trials conducted in China (and elsewhere in the Orient), one can rely on the traditional methods. However, many practitioners in the West, with little or no prior exposure to Oriental philosophy but with experience and training in Western modes of analysis, may feel uncomfortable turning partly or completely to the traditional Chinese view, and will, instead, focus on the modern understanding of this healing technique.

Traditional Chinese medicine is not a static system, but an evolving one. Thus, in the Orient and in the West there are many doctors and researchers who are working on an integration of the earlier traditional approach and the modern understanding1q

With a warm thanks to mk shastri sir 

Hr. deepak raj mirdha
yog teacher , Acupressure therapist and blogger
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