Chinese Medicine Demystified (Part VI): 5 ways acupuncture can help you where drugs and surgery can’t

yintang

Note: This is the sixth article in an ongoing series. If you haven’t read the first five, I recommend doing that before continuing:

Most people in the US don’t know much about acupuncture. They might have heard it’s good for pain, that it can treat infertility, or that it can help you relax. What most people don’t realize is that acupuncture is a more complete and effective method of healthcare than western medicine.

Here’s why.

#1: Acupuncture treats your whole body

Acupuncture isn’t directed toward a particular disease or condition. It works instead by activating the body’s self-healing ability. This is why acupuncture can address everything from irritable bowel syndrome to back pain to the side effects of chemotherapy.

When you get an acupuncture treatment for elbow pain, your elbow pain will go away but it’s also likely that you’ll see improvements in other areas. The headaches you’ve had for ten years will get better, you’ll have more energy, you’ll be better able to handle stress, and you’ll sleep better.

The reason acupuncture can do this is that it focuses on treating the root cause of your health problems. The ancient Chinese knew that symptoms don’t arise out of nowhere. Symptoms are manifestations of an underlying malfunction and disease process. The progression from malfunction > disease process > symptom can take many years. If you just address the symptom without addressing the malfunction or disease process, healing doesn’t occur.

The Chinese also knew that a malfunction or disease process can give rise to many different symptoms that may seem unrelated. For example, headaches, heartburn and skin rashes may all be expressions of the same underlying problem.

Western medicine, on the other hand, often mistakes symptoms for disease. Treatment is almost always directed at the symptom, not the disease. Western medicine is based on the Cartesian paradigm that has dominated both scientific and philosophical views of the body for the past three hundred years. This philosophy created the notion that the body is a machine composed of many separate parts, and that health can be achieved by simply addressing each part in isolation. There is no consideration for how the parts are connected and related.

This is why in western medicine we have doctors for every different part of our body. We’ve got cardiologists for our hearts, gastroenterologists for our guts, podiatrists for our feet, gynecologist for female reproductive organs, neurologists for our brains, etcetera. We’ve carved our body up into various parts and put different doctors in charge of taking care of each part. In a perfect medical system these doctors would be communicating frequently and sharing ideas about their patients. While this does happen in some cases, all too often it doesn’t. I don’t believe this is the fault of the doctors themselves. They are as much victims of the deficiencies of our healthcare system as patients are.

Acupuncturists have a different perspective, because Chinese medicine is based not on Cartesian dualism but on Chinese philosophy, which is inherently holistic. Acupuncturists look at the body as one interconnected whole. From this viewpoint it is impossible to consider a specific part (like the knee, or the heart) without considering it in relation to the whole. This is of course much more consistent with what we know about how ecological and biological systems (which the body is an example of) operate. And it explains why a single therapy like acupuncture can treat your entire body at the same time.

#2: Acupuncture cures disease

What is a cure? One definition is that a cure has been achieved when the treatment is removed and the dysfunction or illness doesn’t come back.

With the exception of antibiotics, chemotherapy and selective surgery, western medicine does not cure disease. It suppresses symptoms.

How do we know this? If you take a drug for a problem you generally have to take it for the rest of your life. The problem doesn’t go away – it’s being suppressed by the drug. The drug has just replaced a certain function of your body. But as soon as you stop taking that drug, the problem will come back. And often it will be worse than before.

Blood pressure medication is the perfect example of this. It will certainly lower your blood pressure, but it doesn’t do anything to fix whatever was causing your high blood pressure in the first place. People find this out the hard way when they try to stop taking their medication, and their blood pressure skyrockets to a level higher than it was before they started taking the drug.

Why does the problem get worse after taking a drug? Because drugs don’t only suppress symptoms. Drugs also suppress functions. Though drugs provide symptom relief in the short term, over time they may worsen the underlying condition because they interfere with our body’s self-healing mechanisms.

For example, many people take ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) to cope with arthritis and inflammatory conditions. While NSAIDs are effective in reducing pain and inflammation in the short-term, they are also known to reduce blood flow to cartilage. Since blood carries all of the nutrients and immune substance necessary for tissue repair, NSAIDs can actually worsen the original problem when taken chronically.

Drugs also have side effects. Drugs may correct a specific imbalance, but in the process they cause at least one other and often several other imbalances. When this happens in western medicine, other drugs are prescribed to address the side effects caused by the first drug – and so on until the patient ends up on a cocktail of drugs treating the side effects of drugs. (See my article Problem With Your Pill? Take Another Pill! for more on this phenomenon.)

There’s nothing wrong with symptom relief. Anyone who has suffered from a debilitating health condition can tell you that. I believe that symptom suppression with medication is necessary, and even life saving, in certain cases. The problem occurs when symptom suppression with drugs takes the place of other approaches (such as nutritional and lifestyle changes) that address the root of the condition.

Acupuncture, unlike most drugs, has the potential to cure disease. Why? Because as I mentioned above, acupuncture stimulates the body’s self-healing mechanisms. And the body’s ability to heal itself far surpasses anything western medicine has to offer.

The discovery of antibiotics is certainly one of the greatest achievements of medicine (though not without problems, as the recent phenomenon of antibiotic resistance indicates). However, these medications are like children’s toys compared with the extraordinary complexity of the immune system’s ability to heal disease.

The body is capable of spontaneously healing wounds, regenerating tissue, neutralizing toxins, and keeping cancer cells at bay – all while we catch the latest episode of Lost on TV or pick up the kids from soccer practice.

As evolutionary biologist Paul Ewald puts it:

Put bluntly, medicine’s success at vaccination and antibiotic treatment are trivial accomplishments relative to natural selection’s success at generating the immune system… We will probably obtain much better disease control by figuring out how to further tweak the immune system and capitalize on its vastly superior abilities than by relying on some human invention such as new antimicrobials (antibiotics, antivirals or antiprotozoal agents).1

Acupuncture does just that: it “tweaks” the immune system and capitalizes on the body’s vastly superior ability to heal itself. That is the strength of acupuncture. However, this strength can also be a limitation. Since acupuncture works by stimulating the body’s built-in healing capacity, if that capacity is impaired or damaged (by poor nutrition, excessive stress, etc.) then the healing power of acupuncture will be limited.

#3: Acupuncture prevents disease

The superior physician makes it his prerogative to treat disease when it has not yet structurally manifested, and prevents being in the position of having to treat disorders that have already progressed to the realm of the physical. The low level physician finds himself salvaging what has already manifested in physical form, and treating what is already ruined. 2

Amazingly enough, this quote comes from a medical text in China written 2,500 years ago! The idea of “preventative medicine” has received a lot of attention in the west during the past decade. But as the quote above indicates, the Chinese have been aware of the importance of preventative medicine for thousands of years.

Acupuncture and the other branches of Chinese medicine (nutrition, herbal medicine, tai qi, qi gong) restore homeostasis and keep the body functioning at an optimal level. When the body is functioning at an optimal level, we’re far less likely to get sick, and far more likely to recover quickly when we do get sick.

Another way to put it: acupuncture is an effective method of healthcare.

Healthcare, which may be defined as a method of promoting and maintaining health, is not the focus of our current medical system. A more accurate term for the focus of Western medicine would be disease management.

Disease management is important and we certainly need it in the modern world. Yet it’s a mistake to confuse disease management with healthcare. They aren’t the same thing at all.

Western medicine is focused on the treatment of serious disease. Many of the tests, for example, performed in western medicine will not be triggered as abnormal unless the person being tested is already very sick. If a person goes to see a doctor complaining of headaches, digestive problems, fatigue and insomnia, the doctor will run some tests. If the tests come back “normal”, the patient is told that there’s nothing wrong with them! But of course the patient knows that’s not true. They know it’s not normal to have all those problems, and they know that something is wrong.

In fact, until recently doctors thought serious health conditions such as irritable bowel syndrome and fibromyalgia, and physiological changes related to normal life stages like menopause, were “all in the patient’s head”.

Why is western medicine so oriented towards serious disease? Part of the reason is that there is no concept of health in western medicine. If you look in the index of any western medical textbook, you’re not going to find a definition of health. Doctors don’t study health, and what it takes to be healthy, in medical school. They study diseases and the drugs that are used to treat those diseases. This puts western medicine at a serious disadvantage when it comes to promoting health.

I want to emphasize that I am making generalizations here. There are surely many doctors (and I have seen quite a few of them myself) that are deeply committed to the health and well-being of their patients, recognize the interconnectedness of the body and mind, emphasize the importance of preventative care, and prescribe nutritional and lifestyle changes to their patients. In particular I see this with many younger doctors who have graduated from medical school in the past ten to fifteen years. They tend to be much more open-minded to alternatives to drugs and surgery, and more inclined to recommend these alternatives when appropriate. This is an encouraging trend in medicine.

#4: Acupuncture makes your life better

The goal of Chinese medicine is to improve your quality of life and keep you healthy right up until the end. This means you’re rock climbing, snowboarding, playing with your grandchildren, or doing whatever else you enjoy until you pass away in your sleep at a ripe old age.

Western medicine, on the other hand, is focused on the treatment of serious, life-threatening conditions. It is an unsurpassed intervention for trauma and acute emergencies. Doctors can achieve almost miraculous feats to keep people alive, including reattaching severed limbs and literally bringing people back from the dead. It’s also true that antibiotics have nearly eliminated the risk of dying from the infections that were the primary cause of death all the way up until the mid-20th century, and that medications like insulin for Type 1 Diabetes have made a normal life possible for people who otherwise would have died at an early age. These interventions have extended our average lifespan considerably, and their contributions to our quality of life shouldn’t be underestimated.

So I’m certainly not “against” Western medicine. Believe me, if I get in a car accident or someday have a heart attack, I’ll go straight to the hospital. However, if I were to develop type 2 diabetes, I would begin by changing my diet because in many cases type 2 diabetes can be completely controlled with diet alone. (Of course it’s very unlikely that I will ever get diabetes, because my diet and lifestyle make it virtually impossible for that kind of blood sugar dysregulation to occur.) These examples explain my guiding principle in making decisions about my health care: for any given condition, I will choose the treatment that does the most good and causes the least harm. In my experience, acupuncture and Chinese medicine fits this guiding principle far more often than drugs and surgery.

#5: Acupuncture won’t kill you or make you sick

Primum non nocere, or “first, do no harm” is one of the principal precepts of medical ethics that students are taught in medical school. Another way to state this principle is, “given an existing problem, it may be better to do nothing than to do something that risks causing more harm than good.”

Somewhere along the line this important precept got swept under the rug. While western medicine has made tremendous contributions to disease management, it has also proven to be dangerous to our health.

We may have the most advanced disease management system in the world, but the US is far behind most other industrialized countries when it comes to health. The U.S. ranks just 34th in the world in life expectancy and 29th for infant mortality. Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from bottom) for 16 available health indicators. 3

Even worse, a recent study (PDF) by Dr. Barbara Starfield published in 2000 in the prestigious Journal of the American Medical Association demonstrated that medical care is the 3rd leading cause of death in this country, causing more than 250,000 deaths per year. Only heart disease and cancer kill more people. Although this study was published in one of the most reputable medical journals in the world, it received little media attention and my guess is that few doctors have heard of it.

Dr. Starfield estimates that, each year, medical errors and adverse effects of the health care system are responsible for:

  • 116 million extra physician visits
  • 77 million extra prescriptions
  • 17 million emergency department visits
  • 8 million hospitalizations
  • 3 million long-term admissions
  • 199,000 additional deaths
  • $77 billion in extra costs

As grim as they are, these statistics are likely to be seriously underestimated as only about 5 to 20% of medical-care related incidents are even recorded. Analyses which have taken these oversights into consideration estimate that medical care is in fact the leading cause of death in the U.S. each year. 4

I ask you this: can a medical system that potentially kills more people each year than any other cause of death else be considered “healthcare”?

In contrast to western medicine, acupuncture is extremely safe and well-tolerated. A recent cumulative review published in the British Medical Journal examined the incidence of adverse effects with acupuncture in more than one million treatments.

According to the evidence from these studies, the risk of a serious adverse event with acupuncture is estimated to be 0.0005% per 10,000 treatments, and 0.0055% per 10,000 individual patients.

The authors conclude:

The risk of serious events occurring in association with acupuncture is very low, below that of many common medical treatments. The range of adverse events reported is wide and some events, specifically trauma and some episodes of infection, are likely to be avoidable.

The incidence of milder side effects during acupuncture is also relatively low. In a study of 230,000 patients who received an average of 10 treatments each, 8.6% reported experiencing at least one adverse effect and 2.2% reported one which required treatment. Common adverse effects were bleedings or hematoma (6.1% of patients, 58% of all adverse effects), pain (1.7%) and drowsiness (0.7%).

To put that in perspective, a review of more than a hundred phase I double-blind, placebo-controlled trials reported that 19% of those receiving placebo experienced side effects, with higher rates following repeated dosing and in the elderly. 5

This suggests that placebos (sugar pills) may cause more side effects than acupuncture.

I hope this article has helped you to understand the power of acupuncture and Chinese medicine and its relevance as a genuine system of healthcare. And I hope this series of articles has made clear that acupuncture is not a “woo-woo” energy therapy, but a complete system of medicine based on known anatomical and physiological principles.

I would love to hear your feedback on how these articles have affected your perception and understanding of acupuncture. Please leave a comment!

If you’d like to refer people to this series of posts in the future, I’ve created a special “acupuncture” page on the blog with an index of all of the articles in the series. It’s listed on the right hand side of the page, in the sidebar, under “Health Reports”.

  1. Ewald, P. Plague Time. p.64
  2. See chapter 2 of the Suwen, in Nanjing Zhongyi Xueyuan, ed., Huangdi neijing suwen yishi (An Annotated Text With Translation of the Yellow Emperor’s Classic of Medicine: Plain Questions) (Shanghai: Shanghai Kexue Jishu Chubanshe, 1991), p. 16;
  3. Starfield B. Primary Care: Balancing Health Needs, Services, and Technology. New York, NY: Oxford University Press; 1998.
  4. General Accounting Office study sheds light on nursing home abuse. July 17, 2003 . Available at: http://www.injuryboard.com/view.cfm/Article=3005. Accessed December 17, 2003
  5. Rosenzweig P, Brohier S, Zipfel A. The placebo effect in healthy volunteers: influence of experimental conditions on the adverse events profile during phase I studies. Clin Pharmacol Ther 1993;54:578-83.

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Comments Join the Conversation

  1. says

    Modern physics tells us matter and energy are interchangeable. Particle physics strongly suggests that what we call “matter” is “energy” in a stabilized form. We still don’t really know what that “energy” is, but we know something about the characteristics it may possess, and we give those characteristics names like: positive or negative charge, spin, and color. We talk about their orbital velocity. We note that they all are both particle and wave. We note that sub-atomic particles are not little billiard balls, but waves of potential that will temporarily collapse into solid-seeming objects when they interact with other particles. We talk about the Heisenberg Uncertainty Principle and the Pauli Exclusion Principle in our efforts to understand how the universe works. All are terms we made up to describe the behaviors we perceive.

    With that in mind, implying the belief that Qi is an “energy” (and putting “energy” in scoff quotes) is clearly an example of materialist reductionism. Every atom, every molecule, every biochemical substance you mention is also “energy”.

    Similarly, Yin and Yang are “energy”. The Five Elements are “energy”. Since these and other related concepts are significant concepts in Chinese Medicine… you expose both the shallowness of your understanding of Chinese Medicine and your ignorance of Quantum Theory. It is no particular flaw to be ignorant of these things, but it is preposterously presumptuous of you to explain Chinese Medicine to other people when you understand it so poorly yourself.

    If you did the same with other subjects (which you do not, as far as I can tell) your entire endeavor would be nothing more than one more bullshit, self-serving website offering stuff for sale and bad advice.

    I believe you add considerable value to people’s quest for good health and quality of life. That’s why I wrote this.

  2. Beth says

    Hi Chris,

    I work in sports medicine. I spent the better part of 13 years handing out Advil like candy. I took a few years off and am now returning.
    Standard practice for and initial injury such as an ankle sprain is RICE rest, ice, compression, and elevation. With that is usually a dosage of NSAIDs as well. During my time off I have turned my life to a more holistic approach. For chronic issues I know diet and fish oils are used to reduce systemic inflammation. Do you have any suggestions on alternatives for acute injuries? I just listened to your podcast regarding Asprin but that usually isn’t what is used in a sports med situation. Thank ou for your time! Cheers!
    Beth

  3. James says

    If the muscle pains were caused by sprain or strain, then we should look closely to and study the muscles. We know that a muscle was only made for contraction. It will return to its relaxed position after each contraction. If not, one will get a cramp.

    What happens if a muscle was stretched and not return to the relaxed position? Well, one will get a muscle pain. Instead of given a painkiller to get rid of the pain, one must find a way to relax the muscle. So, the muscle can be returned to its relaxed position.

    The body human has a reflexo-point for every area which has a pain. For that being said, there is a sore point for an area where a pain is taken place. Instead of treating the area in pain, the sore point is where the acupressure of acupuncture should be applied.

    This is my experience, I had a pain in my neck from knife throwing. I had the neck pain for two years, especially with a backpack on my back on the Great Wall of China. After I’ve come back to the US, I had decided to do something about.

    What I did was bought this book on acupuncture and moxibustion. There are few ways to stimulate the acupoints by acupuncture, acupressure, moxibustion and electrical stimulation. I had chose the acupressure method by using a acupressure hook applying pressure to some points on the shoulder blade and along the edge of the shoulder blade. What a miracle, my pain in the neck was almost gone immediately.

    If one has opened a book on the nervous system, one will find that the brachial plexus is connected to lots of nerves in the neck. By stimulating the sore points(reflexopoints) on the shoulder blade, it will definitely relax the muscles in the neck as in my case.

    There is another case, many many years ago, I had tried to remove the oil filter on my car and overstretched the nerves on my small back. It was impossible to return my back muscles to the relaxed position. So, what I have done was using a wide rubber band strapped around my waist to apply acupressure and use my body temperature which builds up around the band to act as moxibustion. With the acupressure and the moxibustion methods, they helped me to live like a normal person and able to lift weights with no problem. However, if I have removed the waist band, then I feel more pain and not able to lift heavy weights again.

    My wife has various occupational pains allover her body from time to time. I had applied acupressure, many times, on her to release her pains before bed. So, she could have a good night sleep without pain.

    If one have studied the books closely enough, then one will realize that the acupoints on the meridians are riding along on all the nerves in our nervous system. Thus when a needle was applied to an acupoint, actually, it was only a nerve has being stimulated. However, each meridian can be correlated to a nerve in our body is so desired. Indeed, it is no longer a mystery to all of us anymore.

  4. Mike says

    Wow! Those articles on acupuncture were awesome. I definitely want to try it for some problems I have. It just makes a lot of sense to me.

    How can I locate an acupuncture physician here in Brevard County Florida that has similar training and understanding that you have?

  5. Rose Mullen says

    Thank you so much for these articles. I have been an acupuncturist for over 10 years and I am also a nurse practitioner steeped in western medicine. I could never really get the why of its mechanisms and took it on faith.
    Sometimes I felt like a charlatan selling this magic.
    Now I am grounded. Thank you thank you thank you!!!!!!

  6. Mary-Ann says

    Well! This has been an extraordinary series of articles to stumble across as I was doing research for an essay. Studying ‘Human Anatomy and Physiology for Beauty and Complementary Therapy’ and the essay is supposed to be how a particular complementary therapy affects any of the body’s systems, e.g. Muscular, cardiovascular, lymphatic and so on.
    Most students in the past have simply chosen ‘massage’ as the therapy and, having seen several previous essays, all without fail have spouted this stuff about massage coming from China/Japan/India and talking about the meridians and chi/qi/prana……….I was about to go on my own merry way and copy them, my chosen therapy being acupressure; HowEVER,… having looked at numerous websites, read articles and books in the library all offering this as ‘gospel’, I have been comparing pictures of the ‘meridians’ and the tsubos/pressure points and was seeing correlations with things like the axial and linguinal nodes, and other elements of the lymphatic system, as well as other corresponding areas too numerous to go into here, and had started to wonder about the scepticism of some Western medical practitioners. I have been trawling sites for ages, trying to make sense of things and get more information…. and thank GOODness have happened upon YOURS!! It all makes so much sense! How typical that people just keep repeating and repeating some so-called facts, [and this info. as you say is taught on courses all over the place....] without checking and going back to the original source! Yes, well of course learning to read and understand Chinese/Japanese would take a while but….THank you so much for this de-bunking. I underwent acupuncture and thought ‘why was I sent HERE I’ve got a muscular complaint…’.(had sprained my groin and needed it all loosened up for a dance project)’ I need physio to move the muscle not all this needle stuff……’Ten sessions later I had complete and utter all round unimpeded movement. I was amazed but confused and now I know why. Why is this information not being trumpeted from the rooftops?! The world needs to know this, she declared from the top of her soapbox! Well Done, I certainly will spread the word. M-AC in Methven, Perthshire Scotland

  7. Daniel says

    Brilliant articles Chris. Truly amazing and inspiring to read about the complexity and science of acupuncture. Even before I read these articles, I knew there had to be something special with a modality that has shown to be successful for thousands of years. What are some other beneficial ways to improve health other than good nutrition, acupuncture, acupressure or herbal medicine? Do you have much familiarity with Qi Gong and its effects? I’ve also been tuned to visceral manipulation work, which I’m assuming is somewhat similar to the origins of Qi Gong (mobility and motility of the connective tissue of the internal organs). Thank you for the fascinating read. (Ha, random) but I just realized you are in the east bay too! Small world.

  8. Julie says

    Hi Chris,
    Great series of articles. I went to my first accupuncture appointment just last week and had the chinese medical physician explain the foundation of Chinese Medicine in much the same way you did and expressed just as much frustration at it being thought of as an “energy based” medicine.

    I was still skeptical about Chinese medicine’s effectiveness and wanted to do further research. i was very happy to find your detailed and very easy to digest explanation. You make a fantastic arguement for the benefits of this medical practice.

    I had always believed that acupuncture was just some silly voodoo, hocus pocus witch doctor nonsense that works largely on the power of suggestion as do many westerners. The only reason I tried TCM was because it was so highly recommended on so many fertility blogs.

    I’m still a bit skeptical, but while I went in for fertility treatments, I know the neck pain I’ve had for months is almost gone.

    So kudos to you for your fantastic article and efforts to educate the public.

    So here is a question for you: how does a superficial micro trauma to the leg or arm cause nutrient rich blood flow to be directed to a viceral organ like the heart?

  9. says

    Chris,
    I am thrilled to have come upon this series. I am an acupuncturist myself, and feel like such a cop-out when patients ask me how it works, and ask me to explain Qi. You are 100% right in saying that school teaches you all about energy and meridians. You have answered all my questions beautifully and I couldn’t have asked for anything more. I had a teacher in school who refused to converse with students about this topic, only saying, “Qi is not energy.” He came from a long lineage of Chinese Doctors, and I could feel his frustration in our understanding of the medicine. I have been fervently curious about the truth behind it all ever since. Again, wow, and thanks for taking the time to pull all this information together with concrete bibliographies. I will be passing your series along to patients and colleagues alike. Much appreciated!

  10. Jill says

    Chris, thank you for explaining acupunture so simply. Do you know how the qi system is related to Applied Kinesology (AK, or muscle testing)? When I have had health practitioners test the strength or weakness of my body with AK, they have explained that they are testing the energy flow through meridians. Are they actually testing low oxygen levels in painful areas of my body? Some supplements test weak? What would this mean according to your understanding?

  11. Dean McNash says

    Chris,

    I am going to acupuncture school in two years after I finish my term in the Coast Guard and help pay my Wife’s student loans from Chiropractic school. I am not a fan of debts. Anyways, I was curious where you go to school and if you know which acupuncture schools teach solid science. Or do you feel that all schools are relatively decent and that it is up to us to seek the best information? P.s. I like the Podcast you did with the BulletProof Exec.

  12. g says

    Hi there, I spend a fair bit of time reading medical literature and trying my best to figure out the best ways to proceed with my own health issue (autoimmune hypothyroidism). I have honestly had the best results with pure evidence based (rather than experiential based) medicine. Notice that I did not use the term western medicine as that term is in itself rather racist considering that this form of healthcare has had contributors from pretty much any nationality one could mention. Also as this composite form of healthcare progress’s it certainly does treat the patient as a whole, the big problem being crappy doctors rather than a crappy central concept.

    My question is about the efficacy of acupuncture. To my knowledge there has never been a conclusive trial showing acupuncture to be any more effective than a good massage or for efficacy in treating serious ailments. In addition I have read time and time again that there are no correlate physiological structures to be found at acupressure points.

    I do not wish to be argumentative. Perhaps I am reading the wrong materials or am missing something here?

    Thank you for your time and great blog!

  13. Brian says

    Interesting series, though it probably would have been better titled “Acupuncture Demystified.”

    When I think of Chinese medicine I tend to think more of herbs and remedies. Unfortunately I know little about this aspect other than the scenes you see in movies of people going to a Chinese medicine shop and being prescribed all sorts of exotic substances. Would be interesting to know more about the validity of that domain of CM.

  14. Christine says

    Thanks for a very informative and easy to understand article. I have been using acupuncture to manage stress and the annoying symptoms of menopause with great success. I wish I had known before I had my gall bladder removed, I would have liked to try diet change and acupuncture instead of surgery. The surgeon really scared me into getting it immediately.

    I do love the Zen feeling after acupuncture and have noticed that other things seem to improve such as headaches and I have found that I can concentrate and my occasional “brain fog” is no longer a concern.

    I have been using acupuncture for the past 2 years along with a real food diet (paleo) with great success. Next on my list is to be able to completely come off blood pressure medication.

    Thanks again for the great article in easy to understand terms. By the way, I LOVE the Meal Plan Generator!

  15. says

    Meridian Essence: Modern Thought
    JIANG Hui-ru (蒋会茹), CUI Xue-Jun (崔学军), and YU Zheng (于峥) Chin J Integr Med 2013 Jun;19(6):471-474 DOI: 10.1007/s11655-013-1322-5

    Abstract
    Meridian essence has been investigated through anatomy, electrophysiology, biophysics, and biochemistry. Various hypotheses of meridian essence exist, but no hypothesis can truly reflect the internal character of Chinese medicine (CM). The research of meridian essence requires a holistic viewpoint and innovative awareness. Initially, any hypothesis regarding meridian essence should begin with observation of the human body. Secondly, the research should arise from the meridians’ physical functions and pathological changes, so as to maintain the fundamental nature of the meridians themselves. Thirdly, the research should be based upon the theory of CM, yet coupled with the integration of modern techniques to deepen our understanding of the scientific contents of meridians. Fourthly, theoretical research should be combined closely with clinical practice, in order to test the achievements in actual conditions. Lastly, more attention should be given to negative results in studies to more accurately discover the real essence of meridians.
    KEYWORDS: acupuncture, meridian, acupoints

    Meridian theory is a core component of Chinese medicine (CM). The concept of meridian was derived from meridian phenomena by ancient Chinese doctors through long and arduous clinical practice. Among these meridian phenomena, propagated needle sensation (PNS) is perhaps most significant. The phenomenon of PNS includes subjective feelings of numbness, soreness, distention or heaviness (experienced by the patient), that travels along lines of the body once certain points are stimulated with acupuncture. PNS has been verified by many researchers, since the principal was founded by a Japanese researcher in 1950s.(1) Meridian theory has guided acupuncture treatment in the clinic for thousands of years. Therefore, defining meridian essence is a key scientific issue. Thus meridian essence has been investigated via the study of anatomy, electrophysiology, biophysics, and biochemistry.

    Anatomy
    Regarding the anatomical structure of meridians, various hypotheses have been introduced. The most popular belief is that meridians are composed primarily of the nervous system, and further supplemented by both the vascular and lymphatic systems.(1) Around most of acupoints and meridians, there are nerve trunks or large nerve branches. For instance, the Lung (Fei) meridian at the upper limb distributes along the musculocutaneous nerve and lateralcutaneous nerve of the forearm, while the Ren channel, Kidney (Shen) meridian and Stomach (Wei) meridian at the chest and abdomen spread along intercostal nerves and cutaneous branches of the thoracic nerve.(2) Nerve segments contribute to the meridian system. Nerve segments connect Back-shu acupoints and Front-mu acupoints with corresponding Zang-fu organs. The therapeutic effects of acupoints could be attributed to the innervation of nerve segments. Needling Pangguangshu (BL28), Ciliao (BL32), and Qugu (RN2) could enhance the intravesical pressure. Nerves deep to these acupoints belong to nerve segments controlled by the vesical center. The circulatory system is also related to parts of meridians. It has been found that 286 of 309 acupoints, when inserted with needles, are surrounded by arterial and venous trunks.(2) The courses of the three foot yin meridians and the three hand yang meridians are in accord with the flow of the lymphatic system.

    Electrophysiology
    Acupoints usually display low impedance; namely, the current intensity is stronger at acupointssthan at other points. Meanwhile, the strongest intensity is found in acupoints on the head, while the weakest is at the ends of limbs. Among acupoints on the back, acupoints have lower impedance at the upper back than those at the lumbosacral portion.(3,4)

    High electrical potential is the other electrophy- siological characteristic of acupoints. The electrical potential of acupoints is higher than at other areas.(5) The electrical potential of acupoints is similar to the characteristic of low impedance. Acupoints on the head have the highest potential, and at the four limbs the lowest potential. The electricalpotential decreases in Jing (well), Xing (brook), Shu (stream), and Jing (river) acupoints in turn, and increases in He (sea) acupoints. The electrical potential of acupoints is affected by the physical and pathological status of the body, and by many other factors. The lowest potential is detected at the midnight. Food intake and excretion could influence the potential of acupoints. For instance, after eating, the electrical potential of most acupoints on the Stomach (Wei) meridian are enhanced, especially the Zusanli (ST36), while Zhiyin (BL67), and Jinggu (BL64) of the Bladder (Dan) meridian are reduced. Micturition increases the potential of Kunlun (BL60) and Weizhong (BL40), whereas defecation lowers the potential of the Large Intestine (Dachang) meridian. In healthy young volunteers, the electrodermal activity in a pre- exercise resting state was stable and similar amongst 8 different tested points, while during exercise a significant increase of current (from 1000–2000 to 4000–8000 nA) was observed, with the maximal values related to the point located on the ulnar side of the little finger, at the base of the nail, corresponding to the Shaochong (HT9) of the Heart meridian.(6) Normally, bilateral acupoints have balanced potential. However, unbalanced potential is detected in a diseased state. The potential of Ganshu (BL18), and Xingjian (LR2) were unbalanced in Liver (Gan) diseases, as were Zhongfu (LU1), and Feishu (BL13) in Lung (Fei) diseases.

    The extremely low-frequency electrical energy is transported somewhat more efficiently through the Large Intestine meridian when compared with a non-meridian control. The results were not dramatic, with some participants giving greater values to the control channel, but they were statistically significant.(7) There was a trend for the Bladder meridian acupoints to have larger numbers of neurofilaments than the reference points, and that trend seemed to be directly proportional to the difference involtage between the points. Bladder meridian acupoints on the back in rats exhibited specific electrical and histological characteristics. Therefore, those acupoints may be utilized to investigate the efficacy of acupuncture with laboratory animals.(8)

    Biophysics
    Meridians possess the biophysical property of high emission of light. A markedly low luminance appeared on the Du channel in animals with experimental syndrome of yang deficiency induced by hydrocortisone; while in animals with experimental syndrome of blood deficiency caused by bleeding, an apparently low luminance occurred on the Ren channel. The intensity of the emitted light on both the Du and Ren channels increased after acupuncture treatment.(9) Electro-acupuncture could affect the light intensity. Sparse-dense wave stimulates light emission of needled acupoints and the distal acupoints of the meridian.(10)

    The skin temperature at acupoints is higher than that at non-acupoints. There are lines and points with higher temperatures on the chest and the abdomen, where temperatures are 0.5–1 ℃ higher than surrounding areas.(1) These point characteristics are consistent regardless of seasonal, physical or pathological conditions. Most of the points correspond to Front-mu acupoints. The temperature changes of acupoints could reflect the pathological changes of corresponding Zang-fu organs. In patients with coronary heart disease, for example, the temperature of related acupoints is lower than that of those seen in healthy people.(1) In patients with chronic gastritis, gastric ulcer, and gastric cancer, the temperature difference at bilateral Chengman (ST20), and Liangmen (ST21) is higher than that of healthy patients.(11)

    In contrast to the central nervous system activation by sham acupoints, Taichong (LR3), Zhongdu (LR6), Zusanli (ST36) and Xiangu (ST43) had the common effect of activating two specific areas of the brain: the bilateral primary somatosensory area and the ipsilateral cerebellum. Acupuncture stimulation of both acupoints Taichong (LR3) and Zhongdu (LR6) evoked activation at the ipsilateralsuperior parietal lobe (BA7). Acupuncture stimulation of both acupoints Zusanli (ST36) and Xiangu (ST43) evoked activation at the ipsilateral middle frontal gyrus (BA10). These results suggest that different acupoints on the same meridian may activate certain similar areas of the brain.(12)

    Biochemistry
    Ion concentration is special in acupoints and meridians. There is a high concentration of calcium (Ca2+), and potassium ions (K+), and a low concentration of sodium (Na+).(13) Stimulating the acupoints on the meridian could cause the Ca2+ concentration to increase in other points of the same meridian but to reduce in the control points (lateral to the meridian points). The results indicate that Ca2+ maybe involved in the activities of the meridians.(14) When acupoints are needled, the concentrations of K+ and Na+ change contrarily. The increased concentration of K+ is accompanied by decreased Na+, vice versa, indicating acupuncture may strengthen the sodium (potassium) pump. Acupuncture also reduces pH values in the acupoints.(15)
    Vigorous metabolism can be detected in acupoints and meridians. Transcutaneous CO2 emission is an important index for the metabolizing level. CO2 emission is more from acupoints than that from non-acupoints. (16) The distribution of transcutaneous CO2 emission is highly related to the position on the body. Transcutaneous CO2 emission is significantly higher at Daling (PC7) and Quze (PC3) than the control points beside them.(17) Needling acupoints adds to the CO2 emission and oxygen consumption.(18) It has also been discovered that oxygen partial pressure is higher in acupoints than that in non-acupoints. Electro-acupuncture at Hegu (LI4) and Neiguan (PC6) depresses the oxygen partial pressure, and the oxygen partial pressure recovers gradually after removal of electroacupuncture.(19) Mechanical pressure could block the induction of acupuncture treatment on oxygenpartial pressure.(20)

    Current Thought
    All of these studies prove the objective existence of meridians in the human body, and meridians could regulate physical functions. However, any hypothesis has limitations in explaining meridian phenomena and can not truly reflect the internal character of CM. One hypothesis usually illuminates partial meaning. Among these hypotheses, some experimental results are mutually contradictory. Meanwhile, no negative result or counter view regarding the existence of meridians was reported. There were rather, many arguments in documented studies to prove their existence.(21-23) We need to maintain a holistic viewpoint and support innovative ideas. Firstly, it is most important that any hypothesis about meridian essence should originate from observation of the human body, as meridian theory was born in medical practice to treat diseases in numerous patients. Animal experiments, therefore, can not truly reflect meridian phenomena in the human body. Secondly, research of meridian essence should begin with the meridians’ physical functions and pathological changes in order to maintain the fundamental nature of meridians. Thirdly, the research should be based upon the theory of CM, yet coupled with the integration of modern techniques to further examine the scientific contents of meridians. Fourthly, the theoretical research should be done in combination with clinical practice to test the achievements in actual conditions. Fifthly, more attention should be given to negative results in studies in order to more accurately discover the real essence of meridians, and thus avoid being blinded by superfluous information. Research of meridian essence is a pivotal aspect of Chinese academia, and continued debate will further drive the development of medical science.

    Acknowledgement
    We gratefully thank the assistance of Michael R. Berger, M.S. Medicine-Acupuncture, Tuina, in revising the manuscript.

    REFERENCES
    1. Sun GJ, ed. Acupuncture science. 2nd ed. Beijing: People’s Medical Publishing House; 2011:88.
    2. Jiang KC, Li D. Anatomical observation of the twelve meridians and body structure. Acta Univ Tradit Med Sin Pharmacol Shanghai (Chin) 1960;1:57.
    3. Hu XL, Wu BH, LI WF, LI BJ. Preliminary study on plotting out the channel course with skin impedance as index. Acupunct Res (Chin) 1987;(Suppl):9-15,8.
    4. Zhu ZX, Yu SZ, Zhang RX, Zheng MX, Yang FS, Liu YM, et al. A study on the skin electrical conductance of the line of latent propagated sensation along channel. Acupunct Res (Chin) 1980;5:308-310.
    5. Wang BX, ed. Abroad studies of meridians. 1st ed. Beijing: People’s Medical Publishing House;1984:29.
    6. Pontarollo F, Rapacioli G, Bellavite P. Increase of electrodermal activity of heart meridian during physical exercise: the significance of electrical values in acupuncture and diagnostic importance. Complement Ther Clin Pract 2010;16:149-153.
    7. Keith S, Kent C. The transport of extremely low-frequency electrical signals through an acupuncture meridian compared to non-meridian tissue. J Altern Complement Med 2011;7:127-132.
    8 Han HJ, Park SJ, Soh KS, Myoung HS, Lee KJ, Ogay V, et al. Electrical characterization of proposed transpositional acupoints on the urinary bladder meridian in a rat model. Evid Based Complement Alternat Med 2011;295475
    9. Yan ZQ, Chi YR, Zhu XR, Cheng J, Wang PJ. Applications of surface ultra-weak luminescence law in the study of Chinese medicine syndromes, needling sensation and acupoints characteristics. Beijing J Tradit Chin Med (Chin) 1993;12:51-53.
    10. Sun KX, Yang WY, Ni XD, Zhang HM, Su L. Effects of electroacupuncture stimulation with different parameters on light emission of body acupoints. China J Basic Med Tradit Chin Med (Chin) 1998;4(3):52-54.
    11. Sun KX, Yang WY, Ni XD, Zhang HM, Su L. Effects of electroacupuncture stimulation with different parameters on light emission of body acupoints. China J Basic Med Tradit Chin Med (Chin) 1998;4(3):52-54.
    12. Li L, Liu H, Li YZ, Xu JY, Shan BC, Gong D, et al. The human brain response to acupuncture on same-meridian acupoints: evidence from an fMRI study. J Altern Complement Med 2008;14:673-678.
    13. Guo Y, Xu TP, Chen JS, Zhang CX, Jiang P. Speciality of concentration of calcium in acupoints of rabbits. Acupunct Res (Chin) 1991;16:66-68.
    14. Guo Y, Xu TP, Chen JS, Zhang CX, Jiang P. Experimental study of the acupuncture effects on calcium ion concentration in rabbits’ acupoints. World J Acupunct Moxibust 1992;2:51-55.
    15. Jiang HZ, Wang Q, Zhang MM, Gong P, Huang GY. Effect of acupuncture on pH values of acupoints in the goat. Chin Acupunct Moxibust (Chin) 2006;26:732-734.
    16. Huang T, Wang RH, Zhang WB, Han B, Huang X, Tian YY, et al. Relationship between needle sensation and periphery transcutaneous CO2 emission. China J Basic Med Tradit Chin Med (Chin) 2009;15:615-616,618.
    17. Zhang WB, Tian YY, Zhu ZX, Xu RM. The distribution of transcutaneous CO2 emission and correlation with the points along the pericardium meridian. J Acupunct Meridian Stud 2009;2:197-201
    18. Zhang WB, Li H, Xu RM. Effects of needling meridian on transcutaneous CO2 emission. China Acupunct Moxibust (Chin) 1996;16:39-42.
    19. Chen M, Hu XL, Wu ZX. Observation on changes of oxygen partial pressure in the deep tissues along the Large intestine meridian during acupuncture in healthy subjects. Acupunct Res (Chin) 2010;35:213-216.
    20. Xu XY, Hu XL, Wu BH. The influence of mechanical pressing on partial pressure of oxygen in three points along the Large Intestine meridian during acupuncture. Acupunct Res (Chin) 2000;25:276-279.
    21. Wang FC, Li T. Channels and collaterals are “doctrine” or “theory”. China Acupunct Moxibust (Chin) 2006;26:446-450. He XH, Zhang J, Jia MH. Doubt on conception of meridian. J Ningxia Med Coll (Chin) 2006;28:359-361.
    22. He XH, Zhang J, Jia MH. Doubt on conception of meridian. J Ningxia Med Coll (Chin) 2006;28:359-361
    23. Zhang WB. Traditional meridian concepts and modern meridian research. China J Basic Med Tradit Chin Med (Chin) 2003;9:924-929.

    Meridian Essence: Modern Thought
    JIANG Hui-ru (蒋会茹), CUI Xue-Jun (崔学军), and YU Zheng (于峥) Chin J Integr Med 2013 Jun;19(6):471-474 DOI: 10.1007/s11655-013-1322-5

    Abstract
    Meridian essence has been investigated through anatomy, electrophysiology, biophysics, and biochemistry. Various hypotheses of meridian essence exist, but no hypothesis can truly reflect the internal character of Chinese medicine (CM). The research of meridian essence requires a holistic viewpoint and innovative awareness. Initially, any hypothesis regarding meridian essence should begin with observation of the human body. Secondly, the research should arise from the meridians’ physical functions and pathological changes, so as to maintain the fundamental nature of the meridians themselves. Thirdly, the research should be based upon the theory of CM, yet coupled with the integration of modern techniques to deepen our understanding of the scientific contents of meridians. Fourthly, theoretical research should be combined closely with clinical practice, in order to test the achievements in actual conditions. Lastly, more attention should be given to negative results in studies to more accurately discover the real essence of meridians.
    KEYWORDS: acupuncture, meridian, acupoints

    Meridian theory is a core component of Chinese medicine (CM). The concept of meridian was derived from meridian phenomena by ancient Chinese doctors through long and arduous clinical practice. Among these meridian phenomena, propagated needle sensation (PNS) is perhaps most significant. The phenomenon of PNS includes subjective feelings of numbness, soreness, distention or heaviness (experienced by the patient), that travels along lines of the body once certain points are stimulated with acupuncture. PNS has been verified by many researchers, since the principal was founded by a Japanese researcher in 1950s.(1) Meridian theory has guided acupuncture treatment in the clinic for thousands of years. Therefore, defining meridian essence is a key scientific issue. Thus meridian essence has been investigated via the study of anatomy, electrophysiology, biophysics, and biochemistry.

    Anatomy
    Regarding the anatomical structure of meridians, various hypotheses have been introduced. The most popular belief is that meridians are composed primarily of the nervous system, and further supplemented by both the vascular and lymphatic systems.(1) Around most of acupoints and meridians, there are nerve trunks or large nerve branches. For instance, the Lung (Fei) meridian at the upper limb distributes along the musculocutaneous nerve and lateralcutaneous nerve of the forearm, while the Ren channel, Kidney (Shen) meridian and Stomach (Wei) meridian at the chest and abdomen spread along intercostal nerves and cutaneous branches of the thoracic nerve.(2) Nerve segments contribute to the meridian system. Nerve segments connect Back-shu acupoints and Front-mu acupoints with corresponding Zang-fu organs. The therapeutic effects of acupoints could be attributed to the innervation of nerve segments. Needling Pangguangshu (BL28), Ciliao (BL32), and Qugu (RN2) could enhance the intravesical pressure. Nerves deep to these acupoints belong to nerve segments controlled by the vesical center. The circulatory system is also related to parts of meridians. It has been found that 286 of 309 acupoints, when inserted with needles, are surrounded by arterial and venous trunks.(2) The courses of the three foot yin meridians and the three hand yang meridians are in accord with the flow of the lymphatic system.

    Electrophysiology
    Acupoints usually display low impedance; namely, the current intensity is stronger at acupointssthan at other points. Meanwhile, the strongest intensity is found in acupoints on the head, while the weakest is at the ends of limbs. Among acupoints on the back, acupoints have lower impedance at the upper back than those at the lumbosacral portion.(3,4)

    High electrical potential is the other electrophy- siological characteristic of acupoints. The electrical potential of acupoints is higher than at other areas.(5) The electrical potential of acupoints is similar to the characteristic of low impedance. Acupoints on the head have the highest potential, and at the four limbs the lowest potential. The electricalpotential decreases in Jing (well), Xing (brook), Shu (stream), and Jing (river) acupoints in turn, and increases in He (sea) acupoints. The electrical potential of acupoints is affected by the physical and pathological status of the body, and by many other factors. The lowest potential is detected at the midnight. Food intake and excretion could influence the potential of acupoints. For instance, after eating, the electrical potential of most acupoints on the Stomach (Wei) meridian are enhanced, especially the Zusanli (ST36), while Zhiyin (BL67), and Jinggu (BL64) of the Bladder (Dan) meridian are reduced. Micturition increases the potential of Kunlun (BL60) and Weizhong (BL40), whereas defecation lowers the potential of the Large Intestine (Dachang) meridian. In healthy young volunteers, the electrodermal activity in a pre- exercise resting state was stable and similar amongst 8 different tested points, while during exercise a significant increase of current (from 1000–2000 to 4000–8000 nA) was observed, with the maximal values related to the point located on the ulnar side of the little finger, at the base of the nail, corresponding to the Shaochong (HT9) of the Heart meridian.(6) Normally, bilateral acupoints have balanced potential. However, unbalanced potential is detected in a diseased state. The potential of Ganshu (BL18), and Xingjian (LR2) were unbalanced in Liver (Gan) diseases, as were Zhongfu (LU1), and Feishu (BL13) in Lung (Fei) diseases.

    The extremely low-frequency electrical energy is transported somewhat more efficiently through the Large Intestine meridian when compared with a non-meridian control. The results were not dramatic, with some participants giving greater values to the control channel, but they were statistically significant.(7) There was a trend for the Bladder meridian acupoints to have larger numbers of neurofilaments than the reference points, and that trend seemed to be directly proportional to the difference involtage between the points. Bladder meridian acupoints on the back in rats exhibited specific electrical and histological characteristics. Therefore, those acupoints may be utilized to investigate the efficacy of acupuncture with laboratory animals.(8)

    Biophysics
    Meridians possess the biophysical property of high emission of light. A markedly low luminance appeared on the Du channel in animals with experimental syndrome of yang deficiency induced by hydrocortisone; while in animals with experimental syndrome of blood deficiency caused by bleeding, an apparently low luminance occurred on the Ren channel. The intensity of the emitted light on both the Du and Ren channels increased after acupuncture treatment.(9) Electro-acupuncture could affect the light intensity. Sparse-dense wave stimulates light emission of needled acupoints and the distal acupoints of the meridian.(10)

    The skin temperature at acupoints is higher than that at non-acupoints. There are lines and points with higher temperatures on the chest and the abdomen, where temperatures are 0.5–1 ℃ higher than surrounding areas.(1) These point characteristics are consistent regardless of seasonal, physical or pathological conditions. Most of the points correspond to Front-mu acupoints. The temperature changes of acupoints could reflect the pathological changes of corresponding Zang-fu organs. In patients with coronary heart disease, for example, the temperature of related acupoints is lower than that of those seen in healthy people.(1) In patients with chronic gastritis, gastric ulcer, and gastric cancer, the temperature difference at bilateral Chengman (ST20), and Liangmen (ST21) is higher than that of healthy patients.(11)

    In contrast to the central nervous system activation by sham acupoints, Taichong (LR3), Zhongdu (LR6), Zusanli (ST36) and Xiangu (ST43) had the common effect of activating two specific areas of the brain: the bilateral primary somatosensory area and the ipsilateral cerebellum. Acupuncture stimulation of both acupoints Taichong (LR3) and Zhongdu (LR6) evoked activation at the ipsilateralsuperior parietal lobe (BA7). Acupuncture stimulation of both acupoints Zusanli (ST36) and Xiangu (ST43) evoked activation at the ipsilateral middle frontal gyrus (BA10). These results suggest that different acupoints on the same meridian may activate certain similar areas of the brain.(12)

    Biochemistry
    Ion concentration is special in acupoints and meridians. There is a high concentration of calcium (Ca2+), and potassium ions (K+), and a low concentration of sodium (Na+).(13) Stimulating the acupoints on the meridian could cause the Ca2+ concentration to increase in other points of the same meridian but to reduce in the control points (lateral to the meridian points). The results indicate that Ca2+ maybe involved in the activities of the meridians.(14) When acupoints are needled, the concentrations of K+ and Na+ change contrarily. The increased concentration of K+ is accompanied by decreased Na+, vice versa, indicating acupuncture may strengthen the sodium (potassium) pump. Acupuncture also reduces pH values in the acupoints.(15)
    Vigorous metabolism can be detected in acupoints and meridians. Transcutaneous CO2 emission is an important index for the metabolizing level. CO2 emission is more from acupoints than that from non-acupoints. (16) The distribution of transcutaneous CO2 emission is highly related to the position on the body. Transcutaneous CO2 emission is significantly higher at Daling (PC7) and Quze (PC3) than the control points beside them.(17) Needling acupoints adds to the CO2 emission and oxygen consumption.(18) It has also been discovered that oxygen partial pressure is higher in acupoints than that in non-acupoints. Electro-acupuncture at Hegu (LI4) and Neiguan (PC6) depresses the oxygen partial pressure, and the oxygen partial pressure recovers gradually after removal of electroacupuncture.(19) Mechanical pressure could block the induction of acupuncture treatment on oxygenpartial pressure.(20)

    Current Thought
    All of these studies prove the objective existence of meridians in the human body, and meridians could regulate physical functions. However, any hypothesis has limitations in explaining meridian phenomena and can not truly reflect the internal character of CM. One hypothesis usually illuminates partial meaning. Among these hypotheses, some experimental results are mutually contradictory. Meanwhile, no negative result or counter view regarding the existence of meridians was reported. There were rather, many arguments in documented studies to prove their existence.(21-23) We need to maintain a holistic viewpoint and support innovative ideas. Firstly, it is most important that any hypothesis about meridian essence should originate from observation of the human body, as meridian theory was born in medical practice to treat diseases in numerous patients. Animal experiments, therefore, can not truly reflect meridian phenomena in the human body. Secondly, research of meridian essence should begin with the meridians’ physical functions and pathological changes in order to maintain the fundamental nature of meridians. Thirdly, the research should be based upon the theory of CM, yet coupled with the integration of modern techniques to further examine the scientific contents of meridians. Fourthly, the theoretical research should be done in combination with clinical practice to test the achievements in actual conditions. Fifthly, more attention should be given to negative results in studies in order to more accurately discover the real essence of meridians, and thus avoid being blinded by superfluous information. Research of meridian essence is a pivotal aspect of Chinese academia, and continued debate will further drive the development of medical science.

    Acknowledgement
    We gratefully thank the assistance of Michael R. Berger, M.S. Medicine-Acupuncture, Tuina, in revising the manuscript.

    REFERENCES
    1. Sun GJ, ed. Acupuncture science. 2nd ed. Beijing: People’s Medical Publishing House; 2011:88.
    2. Jiang KC, Li D. Anatomical observation of the twelve meridians and body structure. Acta Univ Tradit Med Sin Pharmacol Shanghai (Chin) 1960;1:57.
    3. Hu XL, Wu BH, LI WF, LI BJ. Preliminary study on plotting out the channel course with skin impedance as index. Acupunct Res (Chin) 1987;(Suppl):9-15,8.
    4. Zhu ZX, Yu SZ, Zhang RX, Zheng MX, Yang FS, Liu YM, et al. A study on the skin electrical conductance of the line of latent propagated sensation along channel. Acupunct Res (Chin) 1980;5:308-310.
    5. Wang BX, ed. Abroad studies of meridians. 1st ed. Beijing: People’s Medical Publishing House;1984:29.
    6. Pontarollo F, Rapacioli G, Bellavite P. Increase of electrodermal activity of heart meridian during physical exercise: the significance of electrical values in acupuncture and diagnostic importance. Complement Ther Clin Pract 2010;16:149-153.
    7. Keith S, Kent C. The transport of extremely low-frequency electrical signals through an acupuncture meridian compared to non-meridian tissue. J Altern Complement Med 2011;7:127-132.
    8 Han HJ, Park SJ, Soh KS, Myoung HS, Lee KJ, Ogay V, et al. Electrical characterization of proposed transpositional acupoints on the urinary bladder meridian in a rat model. Evid Based Complement Alternat Med 2011;295475
    9. Yan ZQ, Chi YR, Zhu XR, Cheng J, Wang PJ. Applications of surface ultra-weak luminescence law in the study of Chinese medicine syndromes, needling sensation and acupoints characteristics. Beijing J Tradit Chin Med (Chin) 1993;12:51-53.
    10. Sun KX, Yang WY, Ni XD, Zhang HM, Su L. Effects of electroacupuncture stimulation with different parameters on light emission of body acupoints. China J Basic Med Tradit Chin Med (Chin) 1998;4(3):52-54.
    11. Sun KX, Yang WY, Ni XD, Zhang HM, Su L. Effects of electroacupuncture stimulation with different parameters on light emission of body acupoints. China J Basic Med Tradit Chin Med (Chin) 1998;4(3):52-54.
    12. Li L, Liu H, Li YZ, Xu JY, Shan BC, Gong D, et al. The human brain response to acupuncture on same-meridian acupoints: evidence from an fMRI study. J Altern Complement Med 2008;14:673-678.
    13. Guo Y, Xu TP, Chen JS, Zhang CX, Jiang P. Speciality of concentration of calcium in acupoints of rabbits. Acupunct Res (Chin) 1991;16:66-68.
    14. Guo Y, Xu TP, Chen JS, Zhang CX, Jiang P. Experimental study of the acupuncture effects on calcium ion concentration in rabbits’ acupoints. World J Acupunct Moxibust 1992;2:51-55.
    15. Jiang HZ, Wang Q, Zhang MM, Gong P, Huang GY. Effect of acupuncture on pH values of acupoints in the goat. Chin Acupunct Moxibust (Chin) 2006;26:732-734.
    16. Huang T, Wang RH, Zhang WB, Han B, Huang X, Tian YY, et al. Relationship between needle sensation and periphery transcutaneous CO2 emission. China J Basic Med Tradit Chin Med (Chin) 2009;15:615-616,618.
    17. Zhang WB, Tian YY, Zhu ZX, Xu RM. The distribution of transcutaneous CO2 emission and correlation with the points along the pericardium meridian. J Acupunct Meridian Stud 2009;2:197-201
    18. Zhang WB, Li H, Xu RM. Effects of needling meridian on transcutaneous CO2 emission. China Acupunct Moxibust (Chin) 1996;16:39-42.
    19. Chen M, Hu XL, Wu ZX. Observation on changes of oxygen partial pressure in the deep tissues along the Large intestine meridian during acupuncture in healthy subjects. Acupunct Res (Chin) 2010;35:213-216.
    20. Xu XY, Hu XL, Wu BH. The influence of mechanical pressing on partial pressure of oxygen in three points along the Large Intestine meridian during acupuncture. Acupunct Res (Chin) 2000;25:276-279.
    21. Wang FC, Li T. Channels and collaterals are “doctrine” or “theory”. China Acupunct Moxibust (Chin) 2006;26:446-450. He XH, Zhang J, Jia MH. Doubt on conception of meridian. J Ningxia Med Coll (Chin) 2006;28:359-361.
    22. He XH, Zhang J, Jia MH. Doubt on conception of meridian. J Ningxia Med Coll (Chin) 2006;28:359-361
    23. Zhang WB. Traditional meridian concepts and modern meridian research. China J Basic Med Tradit Chin Med (Chin) 2003;9:924-929.

    Meridian Essence: Modern Thought
    JIANG Hui-ru (蒋会茹), CUI Xue-Jun (崔学军), and YU Zheng (于峥) Chin J Integr Med 2013 Jun;19(6):471-474 DOI: 10.1007/s11655-013-1322-5

    Abstract
    Meridian essence has been investigated through anatomy, electrophysiology, biophysics, and biochemistry. Various hypotheses of meridian essence exist, but no hypothesis can truly reflect the internal character of Chinese medicine (CM). The research of meridian essence requires a holistic viewpoint and innovative awareness. Initially, any hypothesis regarding meridian essence should begin with observation of the human body. Secondly, the research should arise from the meridians’ physical functions and pathological changes, so as to maintain the fundamental nature of the meridians themselves. Thirdly, the research should be based upon the theory of CM, yet coupled with the integration of modern techniques to deepen our understanding of the scientific contents of meridians. Fourthly, theoretical research should be combined closely with clinical practice, in order to test the achievements in actual conditions. Lastly, more attention should be given to negative results in studies to more accurately discover the real essence of meridians.
    KEYWORDS: acupuncture, meridian, acupoints

    Meridian theory is a core component of Chinese medicine (CM). The concept of meridian was derived from meridian phenomena by ancient Chinese doctors through long and arduous clinical practice. Among these meridian phenomena, propagated needle sensation (PNS) is perhaps most significant. The phenomenon of PNS includes subjective feelings of numbness, soreness, distention or heaviness (experienced by the patient), that travels along lines of the body once certain points are stimulated with acupuncture. PNS has been verified by many researchers, since the principal was founded by a Japanese researcher in 1950s.(1) Meridian theory has guided acupuncture treatment in the clinic for thousands of years. Therefore, defining meridian essence is a key scientific issue. Thus meridian essence has been investigated via the study of anatomy, electrophysiology, biophysics, and biochemistry.

    Anatomy
    Regarding the anatomical structure of meridians, various hypotheses have been introduced. The most popular belief is that meridians are composed primarily of the nervous system, and further supplemented by both the vascular and lymphatic systems.(1) Around most of acupoints and meridians, there are nerve trunks or large nerve branches. For instance, the Lung (Fei) meridian at the upper limb distributes along the musculocutaneous nerve and lateralcutaneous nerve of the forearm, while the Ren channel, Kidney (Shen) meridian and Stomach (Wei) meridian at the chest and abdomen spread along intercostal nerves and cutaneous branches of the thoracic nerve.(2) Nerve segments contribute to the meridian system. Nerve segments connect Back-shu acupoints and Front-mu acupoints with corresponding Zang-fu organs. The therapeutic effects of acupoints could be attributed to the innervation of nerve segments. Needling Pangguangshu (BL28), Ciliao (BL32), and Qugu (RN2) could enhance the intravesical pressure. Nerves deep to these acupoints belong to nerve segments controlled by the vesical center. The circulatory system is also related to parts of meridians. It has been found that 286 of 309 acupoints, when inserted with needles, are surrounded by arterial and venous trunks.(2) The courses of the three foot yin meridians and the three hand yang meridians are in accord with the flow of the lymphatic system.

    Electrophysiology
    Acupoints usually display low impedance; namely, the current intensity is stronger at acupointssthan at other points. Meanwhile, the strongest intensity is found in acupoints on the head, while the weakest is at the ends of limbs. Among acupoints on the back, acupoints have lower impedance at the upper back than those at the lumbosacral portion.(3,4)

    High electrical potential is the other electrophy- siological characteristic of acupoints. The electrical potential of acupoints is higher than at other areas.(5) The electrical potential of acupoints is similar to the characteristic of low impedance. Acupoints on the head have the highest potential, and at the four limbs the lowest potential. The electricalpotential decreases in Jing (well), Xing (brook), Shu (stream), and Jing (river) acupoints in turn, and increases in He (sea) acupoints. The electrical potential of acupoints is affected by the physical and pathological status of the body, and by many other factors. The lowest potential is detected at the midnight. Food intake and excretion could influence the potential of acupoints. For instance, after eating, the electrical potential of most acupoints on the Stomach (Wei) meridian are enhanced, especially the Zusanli (ST36), while Zhiyin (BL67), and Jinggu (BL64) of the Bladder (Dan) meridian are reduced. Micturition increases the potential of Kunlun (BL60) and Weizhong (BL40), whereas defecation lowers the potential of the Large Intestine (Dachang) meridian. In healthy young volunteers, the electrodermal activity in a pre- exercise resting state was stable and similar amongst 8 different tested points, while during exercise a significant increase of current (from 1000–2000 to 4000–8000 nA) was observed, with the maximal values related to the point located on the ulnar side of the little finger, at the base of the nail, corresponding to the Shaochong (HT9) of the Heart meridian.(6) Normally, bilateral acupoints have balanced potential. However, unbalanced potential is detected in a diseased state. The potential of Ganshu (BL18), and Xingjian (LR2) were unbalanced in Liver (Gan) diseases, as were Zhongfu (LU1), and Feishu (BL13) in Lung (Fei) diseases.

    The extremely low-frequency electrical energy is transported somewhat more efficiently through the Large Intestine meridian when compared with a non-meridian control. The results were not dramatic, with some participants giving greater values to the control channel, but they were statistically significant.(7) There was a trend for the Bladder meridian acupoints to have larger numbers of neurofilaments than the reference points, and that trend seemed to be directly proportional to the difference involtage between the points. Bladder meridian acupoints on the back in rats exhibited specific electrical and histological characteristics. Therefore, those acupoints may be utilized to investigate the efficacy of acupuncture with laboratory animals.(8)

    Biophysics
    Meridians possess the biophysical property of high emission of light. A markedly low luminance appeared on the Du channel in animals with experimental syndrome of yang deficiency induced by hydrocortisone; while in animals with experimental syndrome of blood deficiency caused by bleeding, an apparently low luminance occurred on the Ren channel. The intensity of the emitted light on both the Du and Ren channels increased after acupuncture treatment.(9) Electro-acupuncture could affect the light intensity. Sparse-dense wave stimulates light emission of needled acupoints and the distal acupoints of the meridian.(10)

    The skin temperature at acupoints is higher than that at non-acupoints. There are lines and points with higher temperatures on the chest and the abdomen, where temperatures are 0.5–1 ℃ higher than surrounding areas.(1) These point characteristics are consistent regardless of seasonal, physical or pathological conditions. Most of the points correspond to Front-mu acupoints. The temperature changes of acupoints could reflect the pathological changes of corresponding Zang-fu organs. In patients with coronary heart disease, for example, the temperature of related acupoints is lower than that of those seen in healthy people.(1) In patients with chronic gastritis, gastric ulcer, and gastric cancer, the temperature difference at bilateral Chengman (ST20), and Liangmen (ST21) is higher than that of healthy patients.(11)

    In contrast to the central nervous system activation by sham acupoints, Taichong (LR3), Zhongdu (LR6), Zusanli (ST36) and Xiangu (ST43) had the common effect of activating two specific areas of the brain: the bilateral primary somatosensory area and the ipsilateral cerebellum. Acupuncture stimulation of both acupoints Taichong (LR3) and Zhongdu (LR6) evoked activation at the ipsilateralsuperior parietal lobe (BA7). Acupuncture stimulation of both acupoints Zusanli (ST36) and Xiangu (ST43) evoked activation at the ipsilateral middle frontal gyrus (BA10). These results suggest that different acupoints on the same meridian may activate certain similar areas of the brain.(12)

    Biochemistry
    Ion concentration is special in acupoints and meridians. There is a high concentration of calcium (Ca2+), and potassium ions (K+), and a low concentration of sodium (Na+).(13) Stimulating the acupoints on the meridian could cause the Ca2+ concentration to increase in other points of the same meridian but to reduce in the control points (lateral to the meridian points). The results indicate that Ca2+ maybe involved in the activities of the meridians.(14) When acupoints are needled, the concentrations of K+ and Na+ change contrarily. The increased concentration of K+ is accompanied by decreased Na+, vice versa, indicating acupuncture may strengthen the sodium (potassium) pump. Acupuncture also reduces pH values in the acupoints.(15)
    Vigorous metabolism can be detected in acupoints and meridians. Transcutaneous CO2 emission is an important index for the metabolizing level. CO2 emission is more from acupoints than that from non-acupoints. (16) The distribution of transcutaneous CO2 emission is highly related to the position on the body. Transcutaneous CO2 emission is significantly higher at Daling (PC7) and Quze (PC3) than the control points beside them.(17) Needling acupoints adds to the CO2 emission and oxygen consumption.(18) It has also been discovered that oxygen partial pressure is higher in acupoints than that in non-acupoints. Electro-acupuncture at Hegu (LI4) and Neiguan (PC6) depresses the oxygen partial pressure, and the oxygen partial pressure recovers gradually after removal of electroacupuncture.(19) Mechanical pressure could block the induction of acupuncture treatment on oxygenpartial pressure.(20)

    Current Thought
    All of these studies prove the objective existence of meridians in the human body, and meridians could regulate physical functions. However, any hypothesis has limitations in explaining meridian phenomena and can not truly reflect the internal character of CM. One hypothesis usually illuminates partial meaning. Among these hypotheses, some experimental results are mutually contradictory. Meanwhile, no negative result or counter view regarding the existence of meridians was reported. There were rather, many arguments in documented studies to prove their existence.(21-23) We need to maintain a holistic viewpoint and support innovative ideas.
    Firstly, it is most important that any hypothesis about meridian essence should originate from observation of the human body, as meridian theory was born in medical practice to treat diseases in numerous patients. Animal experiments, therefore, cannot truly reflect meridian phenomena in the human body.
    Secondly, research of meridian essence should begin with the meridians’ physical functions and pathological changes in order to maintain the fundamental nature of meridians.
    Thirdly, the research should be based upon the theory of CM, yet coupled with the integration of modern techniques to further examine the scientific contents of meridians.
    Fourthly, the theoretical research should be done in combination with clinical practice to test the achievements in actual conditions.
    Fifthly, more attention should be given to negative results in studies in order to more accurately discover the real essence of meridians, and thus avoid being blinded by superfluous information. Research of meridian essence is a pivotal aspect of Chinese academia, and continued debate will further drive the development of medical science.

    Acknowledgement
    We gratefully thank the assistance of Michael R. Berger, M.S. Medicine-Acupuncture, Tuina, in revising the manuscript.

    REFERENCES
    1. Sun GJ, ed. Acupuncture science. 2nd ed. Beijing: People’s Medical Publishing House; 2011:88.
    2. Jiang KC, Li D. Anatomical observation of the twelve meridians and body structure. Acta Univ Tradit Med Sin Pharmacol Shanghai (Chin) 1960;1:57.
    3. Hu XL, Wu BH, LI WF, LI BJ. Preliminary study on plotting out the channel course with skin impedance as index. Acupunct Res (Chin) 1987;(Suppl):9-15,8.
    4. Zhu ZX, Yu SZ, Zhang RX, Zheng MX, Yang FS, Liu YM, et al. A study on the skin electrical conductance of the line of latent propagated sensation along channel. Acupunct Res (Chin) 1980;5:308-310.
    5. Wang BX, ed. Abroad studies of meridians. 1st ed. Beijing: People’s Medical Publishing House;1984:29.
    6. Pontarollo F, Rapacioli G, Bellavite P. Increase of electrodermal activity of heart meridian during physical exercise: the significance of electrical values in acupuncture and diagnostic importance. Complement Ther Clin Pract 2010;16:149-153.
    7. Keith S, Kent C. The transport of extremely low-frequency electrical signals through an acupuncture meridian compared to non-meridian tissue. J Altern Complement Med 2011;7:127-132.
    8 Han HJ, Park SJ, Soh KS, Myoung HS, Lee KJ, Ogay V, et al. Electrical characterization of proposed transpositional acupoints on the urinary bladder meridian in a rat model. Evid Based Complement Alternat Med 2011;295475
    9. Yan ZQ, Chi YR, Zhu XR, Cheng J, Wang PJ. Applications of surface ultra-weak luminescence law in the study of Chinese medicine syndromes, needling sensation and acupoints characteristics. Beijing J Tradit Chin Med (Chin) 1993;12:51-53.
    10. Sun KX, Yang WY, Ni XD, Zhang HM, Su L. Effects of electroacupuncture stimulation with different parameters on light emission of body acupoints. China J Basic Med Tradit Chin Med (Chin) 1998;4(3):52-54.
    11. Sun KX, Yang WY, Ni XD, Zhang HM, Su L. Effects of electroacupuncture stimulation with different parameters on light emission of body acupoints. China J Basic Med Tradit Chin Med (Chin) 1998;4(3):52-54.
    12. Li L, Liu H, Li YZ, Xu JY, Shan BC, Gong D, et al. The human brain response to acupuncture on same-meridian acupoints: evidence from an fMRI study. J Altern Complement Med 2008;14:673-678.
    13. Guo Y, Xu TP, Chen JS, Zhang CX, Jiang P. Speciality of concentration of calcium in acupoints of rabbits. Acupunct Res (Chin) 1991;16:66-68.
    14. Guo Y, Xu TP, Chen JS, Zhang CX, Jiang P. Experimental study of the acupuncture effects on calcium ion concentration in rabbits’ acupoints. World J Acupunct Moxibust 1992;2:51-55.
    15. Jiang HZ, Wang Q, Zhang MM, Gong P, Huang GY. Effect of acupuncture on pH values of acupoints in the goat. Chin Acupunct Moxibust (Chin) 2006;26:732-734.
    16. Huang T, Wang RH, Zhang WB, Han B, Huang X, Tian YY, et al. Relationship between needle sensation and periphery transcutaneous CO2 emission. China J Basic Med Tradit Chin Med (Chin) 2009;15:615-616,618.
    17. Zhang WB, Tian YY, Zhu ZX, Xu RM. The distribution of transcutaneous CO2 emission and correlation with the points along the pericardium meridian. J Acupunct Meridian Stud 2009;2:197-201
    18. Zhang WB, Li H, Xu RM. Effects of needling meridian on transcutaneous CO2 emission. China Acupunct Moxibust (Chin) 1996;16:39-42.
    19. Chen M, Hu XL, Wu ZX. Observation on changes of oxygen partial pressure in the deep tissues along the Large intestine meridian during acupuncture in healthy subjects. Acupunct Res (Chin) 2010;35:213-216.
    20. Xu XY, Hu XL, Wu BH. The influence of mechanical pressing on partial pressure of oxygen in three points along the Large Intestine meridian during acupuncture. Acupunct Res (Chin) 2000;25:276-279.
    21. Wang FC, Li T. Channels and collaterals are “doctrine” or “theory”. China Acupunct Moxibust (Chin) 2006;26:446-450. He XH, Zhang J, Jia MH. Doubt on conception of meridian. J Ningxia Med Coll (Chin) 2006;28:359-361.
    22. He XH, Zhang J, Jia MH. Doubt on conception of meridian. J Ningxia Med Coll (Chin) 2006;28:359-361
    23. Zhang WB. Traditional meridian concepts and modern meridian research. China J Basic Med Tradit Chin Med (Chin) 2003;9:924-929.

  16. Rachel says

    This was fascinating and very helpful. I will refer my skeptical relatives here next time I get acupuncture! Thank you.

  17. Paige says

    I had a stroke 7 years ago at the age of 21. A year later it seemed like I had made an almost complete recovery. I have since then had three children and struggle daily with chronic fatigue. We have tried everthing we can to determine the root cause and have come to the conclusion that it must be a result of the stroke. Do you think acupuncture could be helpful to treat post-stroke fatigue?

  18. Katania says

    Chris, I follow all your health podcasts, etc. And love it all. As an acupuncturist, I LOVED this explanation. I have used the “micro-trauma” explanation, but not to this depth. Thanks!!!!

  19. Rei says

    Thanks for your article! I’ve suffered PCOS, Hypothyroidism and Adrenal Fatigue for the past year, and what cured me are moderate exercise, processed- and gluten-free diet, natural supplements and ACUPUNCTURE! It was like the needed “key” for me to get better, faster.

    I swear by it and I could never forget that chance encounter with the Korean acupuncturist in our town. :)

  20. Luimon says

    Nice series. I am currently searching for an accupuncture practitioner and am wondering if accupuncture will still work if the practitioner is all into “energy meridians” instead of concerned with physiology?

  21. Chris C says

    Also, you cannot cure blood deficiency by adding more blood, or qi deficiency by adding oxygen, or Jing deficiency by adding harmones. Western medicine has tried that and it does not work, and their patients are made to take the pills continuously and endure the side effects and further imbalance the drugs cause.

    The body must return to balance itself, through the persuasion methods utilized in Chinese medicine and similar intuitive practices. The lack of a substance is not the concern, but is the symptom. The imbalance is the concern, and this has to do with yin and yang, which are unidentifiable, relative terms and are the chief target of the Chinese doctor’s medical inquiry. Once western medicine identified vitamins, they assumed they could extract them and use them by themselves to nourish a patient, as they did when they discovered fat, carbohydrates, and protein as the primary constituents of food. They were wrong, and discovered there was a unique balance of various substances within each food, an yin yang balance that allowed that food to live and grow. They still do not understand this balance, just as they do not understand the balance within the body, believing you can separate it into parts to be addressed individually. This is their folly, which was not made the basis of Chinese medicine thousands of years ago, when they developed a medicine based on universal principles understood by wise men who lived healthy lives (not scientists unconcerned with understanding the true nature of the universe in totality, but wished to examine its parts).

    Chinese medicine cannot be influenced by western science if it is to preserve its true meaning and influence western thought. If it is, the true meaning will be discarded to make room for scientific, fragmented understanding, and we will have taken a mighty step backwards in our ability to understand the larger processes in the universe.

  22. Chris C says

    Thanks for the fantastic article series! Concerning the significance of such translational science, while it works to bridge the gap with western science a little, it still ignores the classical cultural perspective. For instance, oxygen and harmones are easily dismissed as simply chemicals in modern thinking, but qi and jing are very precious in classical china with even severe moral concerns associated with them. It’s like you lose respect for something when you stare at it and label it dismissively, considering yourself/your culture to have “conquered its mystery”.  You are “above” it instead of “of” it. This is why I don’t believe they’re accurate translations, because they don’t translate the cultural significance of the concepts. There’s also a concern I have that the classical understanding has a subjectivity that is important to understanding the concepts clinically, which can be lost with excessive objectivity.

  23. says

    Greetings,
    I’m a Licensed Massage Therapist, & Shiatsu Practitioner. I have a true love for Chinese medicine. Thanks so much for bridging the paradigm gap between East and West. Much appreciated! I would like very much for my circle of contacts to be better aware of this information. Mind if I quote you on some items? I’ll give a link to your site and due credit. I’m seriously considering becoming an acupuncturist. Thanks for taking some of the mystery out of the Art of Chinese medicine. Here is a sample of my newsletter. Feel free to subscribe if you like. Thanks again! Pamela
    http://conta.cc/pEPwIb via #constantcontact

  24. John N says

    While the design of acupuncture studies has been improving, it is still not sufficient in isolating the ‘placebo effect’ and other variables responsible for the inconsistent positive effects that have been seen in past studies. There is still quite a few biases that are not included in any of these studies. It is evident that there’s still a need for a better designed ‘double blind tests’ between receiving acupuncture and not receiving acupuncture at all.

    Here is a suggestion by Dr. Steven Novella.” We need to develop an experimental acupuncture needle that is housed in an opaque rigid sheath. This has been done with glass sheaths in some studies because when pressing the sheath against the skin the subject cannot tell if a needle is inserted or not (because of limitations in what we call two-point discrimination – the nerves cannot separate the stimuli). This is a good idea to blind the subject, but now we must take it a step further to blind the acupuncturist. Modify this setup so that a plunger is depressed that either will or will not insert a needle into the subject, in a way so that the subject and the acupuncturist cannot know if a needle was inserted. What this will accomplish is to truly isolate the variable of needle insertion.”

    So far what we have seen in the acupuncture literature amounts to “noise”. After reading all 6 parts, I would say it is more than obvious that we don’t yet fully understand how placebo works.

  25. Michelle says

    This series was very informative to me! It was great to hear a more balanced, scientific perspective of TCM. Now I am left wondering: is there a big difference in outcome between acupuncture and acupressure? Is the latter as effective? Aren’t the mechanisms similar?

  26. Steph says

    Hi, Thankyou so much for this article I’m fresh out of school and very much bewildered. If there are no meridians how do I determine point functions? (we used peter deadman at school), In addition to your answer it would be super if you could refer me to some articles/books on this topic
    Thankyou
    Steph

  27. Bethany says

    Chris,

    I enjoyed this article very much. I’ve had great results with acupuncture but frustration around understanding what the mechanisms are and getting thrown with whackadoodle/woo woo talk. Do you know much or have an understanding of chiropractic philosophy & methodology? Specifically the Gonstead technique? You may notice that many wellness, paleo physicians network members are chiropractors. I find that a combination of chiropractic, acupuncture, nutrition, exercise and stress management solves most aliments. Even one that completely puzzled the medical community. I’d love to know your thoughts on chiropractic. I believe it is in some cases as misunderstood as acupuncture, and that the paleo community, especially crossfitters would benefit from it greatly.

    Thanks for everything you’re doing here!

    Bethany

  28. MIKE B says

    CHRIS, really enjoyed this series and I am convinced that I should seek some acupuncture treatments for a some digestive disorders that I suspect are linked to the PNS. Is there a source that is available that can be used to locate practitioners who have a similar east meets west philosophy to yours?

  29. says

    Hi Chris, a very late comment but I wanted to thank you for your articles, which, as a teacher of acupuncture and research, and a practising acupuncturist, I find most useful in many ways. I wish you would publish a book!

    Just a quick further thought on the meaning of ‘qi’ (Birch and Felt, in ‘Understanding Acupuncture’ by the way have an excellent section on this. One suggestion – from memory – is that it could be called ‘the signals that stop, start or moderate a process’):

    My thoughts (and I am not a sinologist) about the character for qi: it consists of two parts: one part is the sign for steam, and inside this is the sign for rice: boiling rice, the basic nutrition for all of East Asia. The body can only digest rice if it is boiled, and then it is the main source of nutrition in East Asia.
     
    When qi is written without the sign for rice, then it simply means air. So the complete pictogram describes the transformation of vital essences (food, air) to support life.
     
    Transformation takes place on a spectrum from energy to matter or vice versa. As we know from basic physics, the addition of heat to solid water (ice) causes increased movement of molecules and a change to the liquid state. Further addition of heat, and the liquid changes to steam (gas). The only difference between states of matter is the amount of energy (or heat) in each state. So this ‘potential’ to transform states is maybe what is meant by qi.
     
    In a study of Qi in classical texts, Rochat de la Vallee (2006) explains:
    When we speak of qi in general or of qi being everything, we cannot perceive it because it is just a kind of potential. But when some of that potential is realised then there is form, and we can see what kind of qi is acting by the transformation enacted through the form. That is the basis of medical theory. By observing qi through the forms it takes, by knowing what kind of qi is at work, whether all the necessary transformations are proceeding well at each level of the physiology and even the psychology, and by reading signs shown by the form or body, we can know what kind of qi is disturbed.
     
    Acupuncture treatment according to traditional principles is about regulating transformative processes – or ‘tuning’ qi, as you might with a piano, to make it more harmonious.

    How eternally interesting Chinese medicine is!

    Best wishes to you Chris, and all contributors.

    Julie

  30. says

    As a Bowen therapist, I am very interested in all forms of holistic healthcare and I found your series of articles very interesting and informative. I am glad to now understand what chi and meridians really refer to. No talk of the fascia though. My understanding of acupunture was that it worked by stimulating the superficial fascia in a similar way to the Bowen technique which I practice. Do you know anything of that?

  31. says

    Really loved this series Chris! I never truly understood Chinese medicine or acupuncture or the mechanisms behind it. Now I have to say that I might give it a try for some “chronic pain” in my lower back! I’ll let you know how it goes once I get the chance.

  32. Julien says

    Thanks Chris for the articles. I have been considering going back to school to learn acupuncture/TCM but after buying an introductory book, I was somewhat put off and discouraged by the esotericism and lack of scientific frame of reference. I now think I will go for it (and read the sources you provided before I jump!)

    Julien

  33. Dave says

    Hi Clark, I once heard a quote by a Chinese TCM professor. He told the Western Students that most of them are more likely to be more precise than him in terms of locating the points according the anatomy landmarks. However, he is more likely to be successful in resulting the desirable effects, even if he is missing the point locations by a few mm according the standard texts. The main points I am trying to share is that a skilled practitioners can feel the points by scanning the skin surface, while the talented ones can effect the desirable results even though the needle is off by a few mm. The best analogy is to watch the star war episode IV, instead of relying on computer to guide the missiles, Luke is advised to trust the “Force”. So, close your eyes and train the point localization.  Therefore you are right to state that the physical variation can slightly modify the point locations. I just happened to find this blog and I would like to congratulate Chris for putting up this nice sharing platform.

  34. Dave says

    Hi Chris, I once heard a quote by a Chinese TCM professor. He told the Western Students that most of them are more likely to be more precise than him in terms of locating the points according the anatomy landmarks. However, he is more likely to be successful in resulting the desirable effects, even if he is missing the point locations by a few mm according the standard texts. The main points I am trying to share is that a skilled practitioners can feel the points by scanning the skin surface, while the talented ones can effect the desirable results even though the needle is off by a few mm. The best analogy is to watch the star war episode IV, instead of relying on computer to guide the missiles, Luke is advised to trust the “Force”. So, close your eyes and train the point localization.  Therefore you are right to state that the physical variation can slightly modify the point locations. I just happened to find this blog and I would like to congratulate Chris for putting up this nice sharing platform.

  35. Clark says

    Chris,
    I’m a first year acupuncture student, and have found your six part series on chinese medicine very interesting and informative.  I appreciate you sharing your thoughts and insights.
    Reading your material has generated a few questions:
    – People can have a fair amount of anatomical variation, including the precise location of veins, arteries, nerves etc.  Have you found that acupuncture points and meridians vary significantly person to person as well?  Are there methods you use to locate points other than tranditional surface anatomy landmarks and cun measurements?
    – Some studies have shown that practitioner to patient interaction, expectations, and confidence are key, but that the point locations chosen may not be as critical.  Do you have thoughts on the criticality or importance of point selection?  What do your insights on meridians suggest about point selection?

  36. Mark says

    Chris, Thanks a lot for these articles. A friend of mine put me in contact with your blog. I have a decision to make. I’m 60 yrs old and was recently diagnosed with a number of heart related ailments (atrial fibrillation, high blood pressure and a malfunctioning contraction of the heart – I forgot the medical term). My cardiologist told me a pacemaker is a certainty and the usual drug treatment will follow. I’m considering trying accupuncture first – depending on cost. My questions are: (1) Is there an accupuncture treatment that can correct a heart that’s malfunctioning in so many ways? (2) Is there a point at which a malfunctioning heart becomes too serious for accupuncture treatment?

    • Chris Kresser says

      Mark: acupuncture can help with high blood pressure and overall cardiovascular health by improving blood flow, reducing inflammation and reducing stress. However, I’m not aware of any particular effect acupuncture would have on reversing atrial fibrillation or a malfunction in the contraction of the heart. I think in your case acupuncture would be best used as a complementary therapy alongside what your doctor recommends.

  37. Fredo says

    The Chinese description of chi is very analogous to electromagnetism.

    The importance of electromagnetic energy and the human body was brilliantly shown by Dr. Robert Becker who using energy (electricity) was among other things able to regrow animal limbs. Documented in his book- The Body Electric: Electromagnetism and the Foundation of Life

    His research in the electro-conductivity of collagen in bone marrow give evidence of how advanced chi-kungs such as bone marrow washing work as well as I-Chuan, Yogic stretching, and importance of correct posture to keep bones and tendon in both electrical and structural connection.  This also begins to explain what internal martial arts describe as tendon and bone power (tendon is made from collagen) and why minimal muscle is used.

    Dr. Mae Won Ho further connects the electromagnetic nature of the human body to acupuncture in her paper, “The Acupuncture System and The Liquid Crystalline Collagen Fibres of the Connective Tissues”, in which she states, “Bound water layers on the collagen fibres provide proton conduction pathways for rapid intercommunication throughout the body, enabling the organism to function as a coherent whole.” In another paper she states, “Aligned collagen fibres in connective tissues provide oriented channels for electrical intercommunication, and are strongly reminiscent of acupuncture meridians in traditional Chinese medicine.”  (note an acupuncture needle is a conductive material)

    Collagen, Collagen, Collagen, a triple helix, a beautiful spiral encompassing water, a liquid crystal, sensitive to light, pressure, vibration, and electromagnetism. Is it a coincidence that its spiraling extension is like the movement of Chinese internal martial arts.

    Lastly I am electrical engineer and have also practiced internal martial arts / qi-gong for many years. With the research of the above and others, good teachers, and discipline (almost daily practice) have all helped me to actually experience stronger chi. Among other experiences, it feels as though the electromagnetic field of my body has increased and unified my body. Its hard to describe. This in turn has transformed my tai-chi and bagua movements, making my entire body float effortlessly. Its quite beautiful.

    I have also taken medical chi-kung for several years which uses the same meridian system as acupuncture yet there is no touch necessary to help heal someones body. One uses ones own field (which has been strengthened through chi-kung) and intent to get energy moving through a patients meridians.

    The science described above has only just begun to explain some of how chinese medicine works in terms of western concepts.  The science done by Dr. Robert Becker is relatively new and no doubt much is still unknown about the energetic nature of the human body.

  38. Jennifer says

    Hello all,
    At the age of 23 I all of a sudden started having grand mal seizures out of nowhere, with no history of epilepsy in my family. I have been on Lamictal for nearly 5 years, and since I’ve been on it, I have had no problems. But I did go off briefly for 3 days and the seizures came back. Does acupuncture heal seizures? is there any record of it healing epilepsy?

  39. says

    Hi Chris,
    Late comment, but I’ve really enjoyed reading this 5-part analysis of how acupuncture works.  It’s put a lot of research that I’ve encountered in one place, in a very systematic presentation.  De-mystifying is key to the acceptance of our medicine by people that are alienated by things outside of the western/objective approach to healthcare, and your efforts are really commendable.
    While I agree that translating the word “qi” as “energy” is not really adequate, I respectfully disagree that thinking of it as oxygen or neural activation is much better, except in the context of communicating to people in a strictly conventional medical paradigm.  As a fellow practitioner of Nei Jia Quan (in fact, I believe we share some of the same teachers), there is something about the subjective nature of qi sensations that is unique, and worth keeping in our description of this phenomenon.
    In my qi gong classes, I’ve come around to the clumsy description of qi as “feeling-awareness.”  It is that feeling of blood-flow, the tingling in your hands after a palm-change, the invisible, almost magnetic feeling in the whole body after a good session of Tai Ji or Qi Gong.  It is something that we can consciously experience, doing any activity that makes us feel more alive, and the Chinese just happen to realize that there were places in our bodies (the dan tians and channels) where this aliveness is more likely to aggregate.  I forgive the woo-woo people for calling this “energy,” because that is what it feels like sometimes.  I also understand that the scientifically minded people will hate this, because there is no room in science for this messy, unmeasurable subjective feeling stuff, and they like to think of  energy is something we can store, convert, and measure.
    This, in the end, is where Chinese Medicine and nei gong practices actually will lose something if we define them exclusively in terms of the western-rational paradigm:  these arts (and they are arts, as well as sciences) engage the person on the subjective level, and that just doesn’t boil down into objective models.  To say that “channels are X” and “qi is Y” will miss this part of the equation:  that we can experience these things directly ourselves, and they lose something when we try and pluck them out of this context.  The Tao that can be spoken etc etc.
    Great work in any case!  I look forward to further posts!

    • Chris Kresser says

      Thanks for your comment, Joseph.

      I think we’re mostly in agreement, but here’s where we might differ. I’ve experienced the sensations you describe, but I don’t believe we need non-western terminology or concepts to describe them. The fact that organizing my body, breathing and moving in a certain way can produce the experience I have when doing internal martial arts is no less magical when I understand it in terms of neurovascular mechanisms than it is if I explain it in terms of energy.

      There are many other movement oriented practices that are western in origin and produce similar sensations. For example, my wife is a Feldenkrais practitioner. She experiences something very similar to what you describe in her practice of Feldenkrais. Yet she is able to explain it without any concept of meridians or energy.

      I understand your concern that explaining this phenomenon in western scientific terms is reductionistic. But that’s only true if we take a reductionist view of western science. Unfortunately, many docs and researchers are stuck in that reductionist paradigm. But there is another, emerging paradigm within the western scientific community that acknowledges the wholeness and interconnectedness of all life (via quantum physics) and the influence of non-material phenomena on physiological processes (via psychoneuroimmunology, with placebo effect being a prime example).

      This is the paradigm I’m speaking from and identifying with. It’s what makes sense to me, it’s verifiable using contemporary scientific methods, and it’s no less wondrous than anything I’ve read about in Western translations of Chinese texts.

  40. luke says

    Great article! It is nearly impossible to unwind peoples perceptions of TCM when you use terms like QI and meridians, I usually just say “go find out if it works for you” and step back from explaining it.
    I’ve gone from skeptical (having never tried it but still judging it)  to using it as my primary healthcare.
    With TCM you leave feeling good. No drugs, no side effects. try it.

  41. Jonah says

    Chris,
    Thanks for your explanation.  And I appreciate your acknowledgment that some of these things remain a mystery.  The nervous system is highly complex and there is still oodles to be understood by “modern” science.  My own sense is that microsystems, and 6 channel theory in acupuncture illustrate the holographic nature of the body (and everything for that matter).  I believe that quantum mechanics touches on this idea.  Where it really becomes interesting is in mirroring and then reverse mirroring!  How can the body know that the hand can be the head or the foot?  I’m wondering what your take is on that.

    • Chris Kresser says

      I really have no idea, Jonah.

      As you say, the nervous system is vastly complex. There are obviously sophisticated links between every part of our body. Without them, proprioception would be impossible. My completely rough and inadequate guess is that mirroring has something to do with that proprioceptive network.

  42. Jonah says

    Chris,
    Awesome articles.  As a student of Chinese Medicine myself, I’m always looking for explanations that patients can understand.  You did a great job with these articles.  Thanks for doing the work for me!  I wonder how you would explain microsystems (such as Master Tung, or auricular), or balance method therapeutics in Acupunture?

    • Chris Kresser says

      Hi Jonah,

      I’ve thought about your question quite a bit, because I use Balance Method and Tung’s style exclusively. (In fact, I started the Balance Method Acupuncture Forum with a friend. Check it out if you’re not already aware of it.)

      There are a few modern neurological concepts that can at least partly explain Tan and Tung’s style. The first is reciprocal innervation, which is associated with the notion of paired muscular activity. Skeletal muscles exist as pairs, which work “against” one another in order to reach optimum efficiency. Reciprocal innervation occurs so that the contraction of a muscle results in the simultaneous relaxation of the corresponding other. This explains System 3, where balancing the paired meridian stimulates changes in the effected meridian. For example, the Lung channel runs along the biceps (flexor) muscle, and the Large Intestine runs along the triceps (extensor) muscle.

      Second, crossed extensor responses dictate that the axons of associated neurons within a particular limb also cross the midline of the spinal cord to stimulate motor neurons of the opposing extremity. This explains how contralateral needling, which is basic to both Tan and Tung systems, is effective.

      For more on reciprocal innervation and crossed extensor reflexes, check out this article.

      Finally, the peripheral nerve response I described in this article explains why distal needling has such a potent effect.

      Beyond that, it’s still a bit of a mystery.

  43. Hap says

    The TCM doc I see once told me that if a person is skeptical about Chinese Medicine, then it won’t work for them. Ironic, then, that the “healthy skepticism” here may actually help to improve the results of TCM patients (or prospective patients) who read the series. (I don’t suppose it would hurt practitioners either!) I recently referred a friend to this series and she came back very interested. Seems the Western mind’s gotta get some respect. (Thank you, Rodney D.)
     
    In two visits to my doc since I read this series myself, I feel more comfortable and confident with TCM. Does this amount to a placebo? Does it improve one’s outcomes? I don’t know. But I do believe in the value of fictions, especially the practical ones.
     
    I’m passing along this info to a woman who runs a TCM/massage studio in Petaluma, CA. I’ve suggested to her that for Westerners this kind of explanation might make a very effective educational/marketing tool.

    • Chris Kresser says

      These days I prefer the terms “meaning response” or “contextual healing” to placebo, because they capture the essence of its significance much more accurately. Placebo is nothing short of self-healing, the body’s ability to repair itself and restore homeostasis. We know that 30-80% (or more) of the therapeutic benefit of any treatment is due to this meaning response, which is highly dependent upon the context in which the treatment is offered. Thus sugar pills can stimulate real physiological changes, but only when they are prescribed and taken in a setting that reflects all of the patient’s expectations about the medical encounter and its results.

      Placebo research suggests there are two components necessary to obtain the effect: a belief in the efficacy of the treatment, and hope that it will work (positive attitude). Explaining Chinese medicine and acupuncture in terms the patient can understand contributes to both of these components. If she grasps that the principles guiding her treatment are the same as those agreed upon by the authorities in her culture, whom she has been conditioned to respect and believe in (whether she consciously does or not), her respect for Chinese medicine will deepen and her faith that it will help her will grow.

      I think only good can come of this.

  44. Hap says

    Chris –

    Thanks for writing. Interesting that your wife is a Feldenkrais teacher. I graduated from the ‘Somathematics’ Feldenkrais teacher training (taught by Dennis Leri and Elizabeth Beringer) back in 1991, but I’ve not made it into a career. Still, I’m grateful that Moshe’s way of thinking is a part of my life.

    While I was living in Boston years ago I learned a Yang-style tai chi form from Master Yang in Jamaica Plain. I still practice that on my own here in Berkeley. What I especially enjoy is incorporating some sense — even if minimal — of the martial applications of the tai chi movements. (Thanks to Master Yang’s DVD for that.) Once a movement is “informed” with a specific purpose in relation to an imagined enemy, the feeling is quite different — just as the experience of a person’s touch varies with the intent of the one touching. Any “movement” of body/mind (martial and touch in this example) are informed by Moshe’s notion of “function,” an orientation to intent which distinguishes his approach from many others. (One masseuse friend told me they were taught to imagine they are touching a membrane full of water. That’s useful, and very different from a Feldenkrais teacher’s inclusion of skin, muscle, and especially, bone in their intent.) Anyhow, interesting stuff.

    I also especially appreciate Feldenkrais’ conversational model (as opposed to subject-object) which can inform any kind of relationship (with oneself or others) where the function is learning. Thus, for example, the power of the blog.

    They say older guys become more conservative with age. Maybe so. I just came across this: “[A neoconservative] is a liberal who has been mugged by reality.” – Irving Kristol. So, here’s to more “nuts-and-bolts” explanations!

    P.S. It would make for easier-on-the-eyes comment reading if carriage returns got displayed as paragraph breaks, not just line breaks. I’ve done double-ones here, hoping to create a blank line between paragraphs. I hope it hasn’t made a mess.

  45. Hap says

    A fascinating series and discussion. Now that you’ve begun to bring TCM back into the realm of Western understanding, I wonder if you’ll tackle a related subject.
    The Israeli genius Moshe Feldenkrais (founder of the body-mind discipline of the same name) seemed to think that “chi” was a mystifying, unnecessarily confusing concept. He believed (as has been stated here) that a martial artist’s power came from very fine skeletal organization, not from muscular strength or some woo-woo force. (Some claim he did mellow on the notion of “energy” late in his life.)
    Now, do you have a take on stuff like the “microcosmic orbit,” i.e. the small and large circulations? It seems to me that those of us trying to “find” such things may be looking for something that isn’t there; or if it is are tying ourselves in knots in the looking.
    Or are they nothing more than some kind of kinematic sequencing of skeletal movement? That is, something that really can be felt, if one senses in the right way, or one holds a particular intention which happens to be functional at a given point?
    I enjoy practicing tai chi, but so far haven’t a clue about any “circulations.”
    Will be interested in any comments on this subject from other readers here.
     

    • Chris Kresser says

      Hap,

      My wife is a Feldenkrais practitioner, so I’m very much aware of his work. I don’t have much to say about the microcosmic orbit concept. I’ve been involved in various internal martial arts (bagua, taiji, qi gong) for fifteen years, but I do not utilize those concepts in my practice. I suppose you could say I take a more “Feldenkrais” approach. Incidentally, so does my teacher, who is one of the most highly regarded bagua teachers in the world. I believe that internal power and strength come from proper skeletal organization and breath. There’s nothing magic about that in theory, but in practice it is quite difficult to attain so the results can feel and look that way.

  46. Chris Kresser says

    Markus,

    It’s true that “hit medicine”, as it’s referred to in the martial arts community, can produce results that sometimes seem miraculous.  I’ve experienced that first hand, as a martial artist who has had my share of injuries.  I don’t think much research has been done on using plasters, liniments and poultices of Chinese herbs for these purposes in the West, but there is certainly a long tradition of using them successfully in China.

  47. Markus says

    Some years ago, I saw a documentary about Chinese medicine. There was a man, not sure if he was a western doctor, who studied Chinese medicine in China. When he broke his leg, he decided to employ Chinese medicine for treatment. His leg was oiled and massaged for about 48 hours if I remember correctly. Shortly afterwards, maybe about two weeks, he went hiking. He emphasized that if he had used western medicine, he would have been plastered for maybe six weeks and afterwards had to work a long time to regain his muscles.
    His “explanation” was that Chinese medicine had been used to treat martial arts injuries for hundreds or thousands of years and that it would be silly to think they had not found ways to quickly cure broken arms or legs.
    Fact or fiction?
    Thanks for this refreshing series about acupuncture!
    Markus

  48. Darren Austin Hall says

    Chris,
    This is truly a great work on your part to bridge the gap between Chinese and Western Medicine. Indeed, many Chinese Medical practitioners take the “woo hoo” root you broach as the attraction of mystifying knowledge is a due vulnerable of a spiritual egoist. However, I would like to posit that there is another perspective of Chinese Medicine also steeped in the classical texts that makes Chinese Medicine even more remarkable. This is what has been coined “the inner tradition” by Chinese Medical luminary, Lonny Jarrett, and harkened by Heiner Fruehauf, Founding Professor of the School of Classical Chinese Medicine, who attributes to Chinese Medicine the notion of it being “virtue therapy”. These perspectives draw much on the Five Element Tradition put forth by J.R. Worseley and focus on Chinese understandings of Shen (with a capital S) as the spirit housed in the Heart as amalgamation of the 5 shen of the Yin Organs. In the inner tradition, this spirit is the focus of all treatment, guided by the development of the virtues of each particular organ’s or official’s shen, which is radiated when the organ/official is functioning harmoniously with the “sheng” or generating cycle of the elements. Although I came out of a more basic TCM approach to the medicine, it is this inner tradition that I am now studying and find deeply captivating in potent. Indeed, your work is a gift unto the world as it is a great step forward in the work of integrating Western and Eastern medical perspectives but there is a wealth of other wisdom also to be looked into in Chinese Medicine and, ultimately, bringing the Chinese concept of spirit into the health-care may be the final frontier of truly bridging the gap. As you I’m sure are familiar the West is still mightily fortified in materialist views of reality, making there science a study of quantity, while Chinese science is much more interested in the quality of things, which can be just as gross as material things, but also can be far more subtler. It’s telling that the ancient Chinese character for nerves is “shen jing” literally “wires that conduct spirit”.
    Great work, Chris! To the revolution-evolution of integrated health-care. I shall share your work with many and hope more do the same. This will definitely aid in many conversations between medical traditions. You have done a great service!

    • Chris Kresser says

      Darren,

      Thanks so much for your feedback and support. I’m familiar with Jarrett and Fruehauf’s work and enjoy them both. We might both agree that acupuncture, as powerful as it is, is the “physical therapy” of Chinese medicine, which taken as a while is a complete system that integrates spiritual, psychological, emotional and physiological health. Nevertheless, acupuncture is the doorway to Chinese medicine for most people, so I feel that it’s important to find a way to talk about it that most folks can understand and relate to. Once they walk through that doorway, a whole new universe awaits!

  49. Chris Kresser says

    Ha.  That’s hilarious.  The super new-age mumbo jumbo puts me off too – and I’m studying to be an acupuncturist!  I’m glad this series helped open your mind to acupuncture again, because it’s a remarkable therapeutic modality.

  50. Forty2 says

    Whoa, thanks for this series. I’d always associated acupuncture with the one time I tried it where this guy thwapped a buncha needles into my legs and ass for back pain, then dimmed the lights and put on some Enya for 30 minutes while mumbling some new-agey nonsense and leaving me to stew in my reactive juices or something. That experience put me off all Chinese medicine until reading your series.
    Look, naturopaths; explain this to me in non-woo-woo terms and we’ll be OK. I’ve known for years that allopaths are for the most part only interested in treating symptoms, not causes, but I’ve run into too many naturopaths who follow the woo-woo train which is a complete turn-off to rationalists.

  51. admin says

    Chris,

    I don’t think it’s unfair to suggest that western medicine ignores root causes in general.  As I explained, the only drugs that cure disease rather than simply suppressing symptoms are antibiotics and chemotherapy.  Some would argue that antibiotics and chemo don’t cure disease, because they ignore the “terrain” that allowed the infection or cancer to prosper in the first place.

    Certainly there are individual doctors who have a “holistic” view.  I’ve seen quite a few myself over the years.  But they do not acquire this view in medical school, nor is it encouraged within their professional organizations or within the scientific literature.  Nutritional training in medical school is woefully inadequate, as any doctor will tell you.

    Part of the problem is that western medicine is based on a Cartesian, dualistic view of the body which assumes that the parts are not connected to each other or the whole.  If someone goes to a general practitioner with a thyroid issue, constipation, depression, and fibroids, they could very well end up being treated by four different specialists (endocrinologist, gastroenterologist, psychiatrist and OB/GYN specialist) and taking four or more medications for each of those conditions.

    What distinguishes Chinese medicine and other holistic approaches is that they recognize the interconnectedness of the systems of the body, and diagnose and treat accordingly.  So, with the example above, rather than four separate doctors and treatments the patient may see a single practitioner and do a single treatment that improves all of her symptoms at once.

    The recent trend of “functional medicine” that has been embraced by some doctors will hopefully change the way medicine is practiced in the future.  For now, though, I think it’s not at all inaccurate to say western medicine in general is overwhelmingly focused on disease/symptom management.

    • Matt says

      Dear Chris,

      I don’t think that your negative polarisation between western and eastern doctors is much helpful, nor is it correct. Western doctors and western medicine is not that stupid, like you point it out. And western doctors don’t think that the human body is a machine, nor do they treat people only on lab results or nice radiographic pictures.

      In #2 you mentioned that western medicine supresses symptoms and only treats symptoms. That is such an unbelievable nonsense! There are not just specialists, there are also general practioners, that know a lot more about healthcare than you I think. You mentioned that bloodpressure drugs would make the blood pressure even more worse after stopping them. That’s incorrect. After stopping an ACE or AT-2-Blocker you can have a lowered blood pressure for the next 3-4 Werks, after that it will increase on its previous level, but not higher. Its also not correct that this medication does nothing for prevention, it does a lot. If you don’t lower it early, than there is the danger of structural fixation of the blood pressure, so the arterial walls get more stiff, the rens get damaged and then your chance to get that blood pressure cured is gone forever. So in early cases of raising blood pressure, a period of medication, lowering body weight and diet can lead to a cure and normalisation of the blood pressure in its initial state. If you wait to long, this chance is gone. If you can lower the blood pressure below 130/80 in a person who has Diabetes that’ s fine. But you have to do this constantly for months, for lifetime, and not for a short visit in the acupuncture clinic. If you can do that, then there’s no problem to lower medication. In former times people with heart failure died, because they had not that good medication. What you mentioned about Diabetes Type 2 is also nonsense, you can’t fix that in every case with diet only and there is no guarantee, that you will never get diabetes, cause of your super lifestyle. I miss some differentiation in your arguments, all drugs are bad, that’s nonsense. I agree that NSAID are not the best medications, and they are only good in short term use, but most western doctors know that. Other medications are very good. As you mentioned, without antibiotics, people would die! And this is not just treating symptoms! There are some doctors that know both sides of medicine. Chinese medicine will never be connected to western medicine with such an opinion like yours.

  52. Chrid says

    An interesting series. I was already provisionally pro-acupuncture from the success it showed in medical studies, but I always knew the “energy” explanation was a load of crap. Thanks for providing the real information!
    But I do have a question. In this last article you talk about Western medicine being mostly emergency and reaction based rather than preventative. Aren’t general practitioners and nutritionists exceptions to this rule though? While many times primary care physicians will prescribe drugs for things like cholesterol or high blood pressure, they will often also prescribe better diet or exercise. Chinese medicine obviously has some interesting uses (acupuncture being the best example not duplicated by Western medicine), but isn’t it a little unfair to say Western medicine ignores root causes, holistic views of health, and only focuses on reacting to symptoms?

  53. says

    I understand.
     
    You also said, “Western medicine, on the other hand, confuses symptoms with disease. Treatment is almost always directed at the symptom, not the disease.”
     
    Would you say that, for the most part, only symptoms are treated because it is so difficult to discover the root causes, so most of them haven’t been figured out yet, or is it something more fundamental about western medicine?

  54. admin says

    I would say that’s true for the most part, although it depends on the nature of the chronic condition.

    Chinese medicine = improves quality of life and reduces morbidity

    Western medicine = serious disease management and emergency care

  55. Jesse says

    So western medicine has been better at treating acute life-threatening situations, while Chinese medicine is better for curing chronic conditions and making life more enjoyable?
    I don’t know that the article was unclear; perhaps I didn’t read carefully enough.

  56. admin says

    Jesse,

    That’s not exactly what I’m saying.

    What I’m saying is that Chinese medicine is a better method of healthcare than western medicine.  I understand healthcare to be simply defined as “promoting health”.  I see little in western medicine that promotes health.

    On the other hand, as I explained in the article, western medicine is superior to Chinese medicine in dealing with trauma and emergency situations.  This includes the management of some serious diseases that require pharmaceutical or surgical intervention for the survival of the patient.

    Chinese and western medicine are complementary.  I use them both myself.  For example, if I get in an accident and break a leg I’ll definitely be going to the hospital.  But then I’ll use acupuncture and herbs to recover much more quickly from the injury.

    Using Chinese medicine to stay healthy and address common issues such as digestive problems, headaches, musculoskeletal pain, immune deficiencies, insomnia, anxiety, etc., and using western medicine for trauma and emergency care is the best approach.

    Perhaps I need to re-write this article to clarify.

  57. says

    If I understand correctly, you’re saying acupuncture is comparable to the entirety of western medicine? That acupuncture is better for most conditions, though western medicine is better for some?

  58. says

    Hiya. Thank you for this detailed explaination! I have always been curious about Chinese medicine and acupunture. I had a friend who did acupressure and taught me some – I always wondered what the difference was. I have shied away from acupressure, and most Chinese medicines because in this country (England) at least, they seem to be very linked with Chinese religion and I’m a pastor’s wife! Not something we want to mix. I appreciate your explainations that this is medical, not spiritual. Alot the think about and go read more about…………..

    • admin says

      Hi Deedee,
      I’m glad you enjoyed the series. There’s nothing religious about acupuncture. As you now know it works by stimulating the body’s natural healing mechanisms. Give it a try!

  59. Rhonda says

    How does one tell if an acupuncturist is “good”, qualified?
    Also, how does one find such a person?  (I live in San Francisco; we have lots of acupuncturists in the Bay Area, but I do not know the difference between a “quack” and the real thing.)
     
    Thanking you in advance for your reply.

    • admin says

      I would ask where they did their training, how long they’ve been in practice for, what additional training or specializations they have, and what their success rates are with the condition you’re seeking treatment for.

      You can also use Yelp to search for an acupuncturist in your neighborhood and read reviews from other patients.

    • admin says

      Josh,

      As I wrote in Part II, if we’re talking about the qi that moves around the body in vessels (erroneously called meridians), then the most accurate translation is probably oxygen. But qi can also refer to the function of something, so there are several different types of qi described in Chinese medicine (i.e. Zhong Qi, Zheng Qi, etc.)

      Second, as a Ba Gua and internal arts practitioner myself, I’m familiar with the experiences you describe. But I don’t think we need the concept of “energy” and meridians to describe what happens when we train.

      For me it’s just a question of reframing what i’m experiencing. It doesn’t change the actual experience. My Ba Gua teacher is adamant that there’s no magic or mystery involved in the kind of “soft power” one can cultivate. I’ve seen him send huge guys across the room without much effort. We have a tendency in the west to assume this is somehow non-physical (probably because of movies like crouching tiger), but my teacher will be the first to say that it’s 100% a matter of body awareness and organization.

      I don’t know all of the mechanisms involved, but certainly increasing the amount of oxygen available to tissues, increasing heart rate, increasing blood flow (through movement and different standing postures), contracting and extending muscles, etc. will have a profound effect on physiology.

      The tenderness in various points you describe is probably a reflection of something called “referred organ pain”. This is a fundamental aspect of Chinese medicine, but wasn’t discovered in the west until the 1800s. When there is a disharmony in the internal organs, that can manifest as a tender spot on the skin. Tender spots can also be trigger points, which are small contraction knots in the skeletal muscle.

      The propagated sensation you describe as the needles are inserted is the subjective feeling of nerve activation that travels along nodal pathways of the body. Muscle action potentials can be measured along the course of the propagated sensation (PS), and PS can be blocked by mechanical pressure on the node or lowered temperature, indicating involvement of static load muscle spindle fibers.

      I think you answered your last question.

      Thanks for your comments, Josh.

  60. Josh says

    Chris,
     
    I’ve really enjoyed this series of articles, though I had some questions that I feel weren’t directly answered.
     
    Firstly, how can you define Qi? If it is not “energy”, then what is it? You’ve mentioned before about it being (or being related to) breath, and I understand how proper breathing is important with internal practice, but how does this coincide the feeling of qi one experiences when practicing internal arts (I know when I adopt a stance from Ba Gua Zhang, I feel it immediately in my palms) or occasionally during acupuncture treatment? I have waited with baited breath to see if this would be explained in detail in your series of articles :D.
     
     
    Further, I am curious if there is any reason why sometimes this feeling is stronger and sometimes lighter? I know there was one spot I’ve experienced under the knee (the aim was to treat an inflamed hamstring tendon that was giving me discomfort proximal to the isheal tuberosity when I sat down) that was very intense, like a river of qi! Lastly, I’ve noticed that lots of times an area that needs needling (at least based on my experience as a patient) always seemed to be very sore. My acupuncturist would palpate and it was always the sorest of spots that would be needled; most of the time this was to treat various pain issues. Why is there this connection between these points, the aching pain, and needle location?
     
     
    Another question for you. You’ve said that acupuncture can help loosen the muscles, so perhaps this answers my question. In the past I was treated by an acupuncturist for my scoliosis. My acupuncturist found that in addition to spinal deviation, my left scapula was raised slightly as well.
     
     
    She would palpate along my spine and back and would insert a needle next to one of the vertibrae that were out of alignment and would also insert a needle into sore spots on my back (most commonly in the area south of the scapula and proximal to the spine). Sometimes she would also use a (what she said was) Japanese method of acupuncture on my head (the scalp). My spine did seem to straighten and my scapula lowered (the feeling was very strange and I couldn’t place it at first what the cause was. It felt like there was a trigger point under my scapula almost. Later I rememebered that she said she was lowering my scapula and then it made sense why I had a trigger point feeling in an area that doesn’t form trigger points). Did this process occur only due to the muscles loosening and thus allowing the bones to shit into their proper location?

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