Acupuncture (3) -theory
Theory
The general theory of acupuncture is based on the premise that bodily functions are regulated by an energy called qi which flows through the body; disruptions of this flow are believed to be responsible for disease. Acupuncture describes a family of procedures aiming to correct imbalances in the flow of qi by stimulation of anatomical locations on or under the skin (usually called acupuncture points or acupoints), by a variety of techniques. The most common mechanism of stimulation of acupuncture points employs penetration of the skin by thin metal needles, which are manipulated manually or by electrical stimulation.
A parallel theory is offered by C. Chan Gunn, MD. Gunn uses a technique in which he take advantage of acupuncture needle to insertion into tight bands. These bands have a overlapping pattern to the meridian of TCM. He called his technique Intramuscular Stimulation or IMS. He stated in his textbook the differences in IMS and traditional acupuncture as: 1. IMS requires a medical diagnosis. 2. A medical examination is imperative. 3. The placement of the needles is indicated by the examination. 4. Knowledge of modern anatomy is essential. 5. An immediate positive change in the subjective and objective finding is expected.
Qi, meridians and acupuncture points
Traditional Chinese medicine distinguishes not only one but several different kinds of qi (姘?. In a general sense, qi is something that is defined by five "cardinal functions":
- Actuation (鎺ㄥ嫊, tu墨d貌ng) 鈥?of all physical processes in the body, especially the circulation of all body fluids such as blood in their vessels. This includes actuation of the functions of the zang-fu organs and meridians.
- Warming (婧叇, pinyin: w膿nx霉) 鈥?the body, especially the limbs.
- Defense (闃插尽, pinyin: f谩ngy霉) 鈥?against Exogenous Pathogenic Factors
- Containment (鍥烘敐, pinyin: g霉sh猫) 鈥?of body fluids, i.e. keeping blood, sweat, urine, semen etc. from leakage or excessive emission.
- Transformation (姘ｅ寲, pinyin: q矛hu脿) 鈥?of food, drink, and breath into qi, xue (blood), and jinye ("fluids"), and/or transformation of all of the latter into each other.
To fulfill its functions, qi has to steadily flow from the inside of the body (where the zang-fu organs are located) to the "superficial" body tissues of the skin, muscles, tendons, bones, and joints. It is assisted in its flow by "channels" referred to as meridians (缁忕粶, pinyin: j墨ng-lu貌). TCM identifies 12 "regular" and 8 "extraordinary" meridians; the Chinese terms being 鍗佷簩缁忚剦 (pinyin: sh铆-猫r j墨ngm脿i, lit. "the Twelve Vessels") and 濂囩粡鍏剦 (pinyin: q铆 j墨ng b膩 m脿i) respectively. There's also a number of less customary channels branching off from the "regular" meridians. Contemporary research has not supported the existence of qi or meridians. The meridians are believed to connect to the bodily organs, of which those considered hollow organs (such as the stomach and intestines) were also considered yang while those considered solid (such as the liver and lungs) were considered yin. They were also symbolically linked to the rivers found in ancient China, such as the Yangtze, Wei and Yellow Rivers.
Acupuncture points are mainly (but not always) found at specified locations along the meridians. There also is a number of acupuncture points with specified locations outside of the meridians; these are called "extraordinary" points and often credited with special therapeutic properties. A third category of acupuncture points called "A-shi" points have no fixed location but represent tender or reflexive points appearing in the course of pain syndromes. The actual number of points have varied considerably over time, initially they were considered to number 365, symbolically aligning with the number of days in the year (and in Han times, the number of bones thought to be in the body). The Huangdi Neijing mentioned only 160 and a further 135 could be deduced giving a total of 295. The modern total was once considered 670 but subsequently expanded due to more recent interest in auricular (ear) acupuncture and the treatment of further conditions. In addition, it is considered likely that some points used historically have since ceased being used.
TCM concept of disease
In TCM, disease is generally perceived as a disharmony (or imbalance) in the functions or interactions of yin, yang, qi, xu臅, z脿ng-f菙, meridians etc. and/or of the interaction between the human body and the environment. Therapy is based on which "pattern of disharmony" can be identified. In the case of the meridians, typical disease patterns are invasions with wind, cold and damp Excesses.
In order to determine which pattern is at hand, practitioners will examine things like the color and shape of the tongue, the relative strength of pulse-points, the smell of the breath, the quality of breathing or the sound of the voice.
TCM and its concept of disease do not strongly differentiate between cause and effect. In theory, however, endogenous, exogenous and miscellaneous causes of disease are recognized.
Traditional diagnosis
The acupuncturist decides which points to treat by observing and questioning the patient in order to make a diagnosis according to the tradition which he or she utilizes. In TCM, there are four diagnostic methods: inspection, auscultation and olfaction, inquiring, and palpation.
- Inspection focuses on the face and particularly on the tongue, including analysis of the tongue size, shape, tension, color and coating, and the absence or presence of teeth marks around the edge.
- Auscultation and olfaction refer, respectively, to listening for particular sounds (such as wheezing) and attending to body odor.
- Inquiring focuses on the "seven inquiries", which are: chills and fever; perspiration; appetite, thirst and taste; defecation and urination; pain; sleep; and menses and leukorrhea.
- Palpation includes feeling the body for tender A-shi points, and palpation of the left and right radial pulses .
Tongue and pulse
Examination of the tongue and the pulse are among the principal diagnostic methods in TCM. Certain sectors of the tongue's surface are believed to correspond to the z脿ng-f怒. For example, teeth marks on one part of the tongue might indicate a problem with the Heart, while teeth marks on another part of the tongue might indicate a problem with the Liver.
Pulse palpation involves measuring the pulse both at a superficial and at a deep level at three different locations on the radial artery (Cun, Guan, Chi, located two fingerbreadths from the wrist crease, one fingerbreadth from the wrist crease, and right at the wrist crease, respectively, usually palpated with the index, middle and ring finger) of each arm, for a total of twelve pulses, all of which are thought to correspond with certain z脿ng-f怒. The pulse is examined for several characteristics including rhythm, strength and volume, and described with qualities like "floating, slippery, bolstering-like, feeble, thready and quick"; each of these qualities indicate certain disease patterns. Learning TCM pulse diagnosis can take several years.
