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acupuncture(ăk`yo͝opŭng'chər), technique of traditional Chinese medicine, in which a number of very fine metal needles are inserted into the skin at specially designated points. For thousands of years acupuncture has been used, along with herbal medicine, for pain relief and treatment of various ailments. It has often been combined with moxabustion, the burning of leaves of moxa, the Chinese wormwood tree. Today it is widely used in China in the treatment of hay fever, headaches, and ulcers, and some types of blindness, arthritis, diarrhea, and hypertension. Acupuncture is also used, especially in China, as a general anesthetic during childbirth and some types of surgery. Unlike conventional anesthesia, acupuncture does not reduce blood pressure or depress breathing; in addition, the patient stays fully conscious and there is no postoperative hangover or nausea.
Generally, in the practice of acupuncture, needles varying in length from 1-2 in. (1.27 cm) to several inches are inserted in appropriate points of the body, not necessarily near the affected organ. The needles are twirled and vibrated in specific ways; the depth of insertion also affects the treatment. Modern technique sometimes adds electrical stimulation applied through the needles. The traditional acupuncture points (there are about 800) are arranged along 14 lines, or meridians, running the length of the body from head to foot.
The traditional Chinese explanation of the effectiveness of acupuncture is based on the Taoist philosophy (see TaoismTaoism
, refers both to a Chinese system of thought and to one of the four major religions of China (with Confucianism, Buddhism, and Chinese popular religion). Philosophical Taoism
The philosophical system stems largely from the Tao-te-ching,
..... Click the link for more information. ), according to which good health depends on a free circulation of chi (qi), or life-force energy, throughout all the organs of the body. The chi, in turn, depends upon a balance of the two opposing energies of yin (negative, dark, feminine) and yang (positive, bright, masculine). The meridians are the main channels of flow. When energy flow is impeded at any point, e.g., because of a diseased organ or stress, illness in other organs may result. Piercing the channels at the proper points is believed to correct the imbalances.
Western researchers have found that the acupuncture points correspond to points on the skin having less electrical resistance than other skin areas. It has been suggested that acupuncture works by stimulating or repressing the autonomic nervous systemnervous system,
network of specialized tissue that controls actions and reactions of the body and its adjustment to the environment. Virtually all members of the animal kingdom have at least a rudimentary nervous system.
..... Click the link for more information. in various ways, and there is some evidence that stimulation of the skin can affect internal organs by means of nerve reflex pathways. One theory is that acupuncture stimulates the release of natural pain-relieving chemicals called endorphinsendorphins
, neurotransmitters found in the brain that have pain-relieving properties similar to morphine. There are three major types of endorphins: beta endorpins, found primarily in the pituitary gland; and enkephalins and dynorphin, both distributed throughout the nervous
..... Click the link for more information. . Another is that it stimulates the pituitary gland, which in turn stimulates the adrenal gland to release anti-inflammatory chemicals.
Since the early 1970s, acupuncture has gradually become more accepted in the United States. Many states now accredit schools of acupuncture and administer licensing examinations for nonphysicians. Some physicians are studying and using acupuncture as an adjunct treatment. In the United States acupuncture has been used most often for pain control and drug and alcohol addiction. One impediment to total acceptance is the difficulty of fitting a traditional technique from another culture into the strict methods of scientific clinical trials customary in Western medicine. Studies have shown some benefit from acupuncture, but it is difficult to control for the placeboplacebo
, inert substance given instead of a potent drug. Placebo medications are sometimes prescribed when a drug is not really needed or when one would not be appropriate because they make patients feel well taken care of.
..... Click the link for more information. effect; so-called sham acupuncture, involving the use of needles superficially at points not used in acupuncture, has also shown some pain-relief benefits when used as a control in studies.
See S. T. Chang, The Complete Book of Acupuncture (1976); G. S. De Morant, Chinese Acupuncture (2 vol., tr. 1989).
Chen-Chiu therapy, a method of treatment in which special metallic needles of varying length are inserted into body tissues at strictly determined points.
There are two kinds of acupuncture: acupuncture proper and ignipuncture (moxibustion)—punctate cauterization with special pressed rods of plant matter. Both varieties of the method have been used in Chinese folk medicine since ancient times, have spread to other countries, and have found application in clinical medicine. There are 664 known “active” points on the body, and, depending on the nature of the disease, the physician chooses the appropriate ones. These “active” points differ from neighboring areas of the skin in a number of features: higher sensitivity to pain, a higher level of metabolic processes, higher electric potential, and low electrocutaneous resistance.
Needles for acupuncture are made of metal and are 1.5–12 cm long and 0.3–0.45 mm thick. When the needles are inserted into the “active” points, there arise sensations of rheumatic pain and rupture and a feeling of the passage of current, which serve as criteria of the accuracy of the insertion. The needles are inserted either by slow rotation or by rapid puncture, or the needle is driven deeper into the tissue by slowly rotating it after a rapid puncture. Usually two to four needles are inserted and left in the body for 5–10–20 minutes. The course of treatment consists of 10–15 such sessions carried out every other day or daily; then there is an interval of 10–15 days after which the course may be repeated. The effect of acupuncture is explained by the moderate stimulation of the sensory nerve branches in the skin, muscles, and blood vessels. This stimulates and regulates the activity of the nervous system, improves the neural regulation and nutrition of organs and tissues, and alters the production of hormones and biologically active substances.
Acupuncture has a therapeutic effect in many diseases of the peripheral nervous system (neuralgia, neuritis, including neuritis of the facial nerve, and radiculitis); some diseases of the central nervous system (chorea, epilepsy, residual effects of poliomyelitis); diseases of the autonomic nervous system with vascular, trophic, and secretory disturbances; functional diseases of the nervous system (neurasthenia, psychasthenia); a number of diseases of internal organs (gastroenteritis, stomach ulcers, colitis, bronchial asthma); rheumatic arthritis; allergic states; and disturbances of the menstrual cycle. In some acute infectious diseases acupuncture may serve as an ancillary method of treatment. Acupuncture is contraindicated in diseases that require immediate surgical intervention, such as appendicitis, hemorrhage of internal organs, pathologic parturition, and malignant neoplasms.
REFERENCESChu-yen. Dostizheniia dremekitaiskoi meditsiny. Moscow, 1958. (Translated from Chinese.)
Chin Hsin-chung. Kitaiskaia narodnaia meditsina, 2nd ed. Moscow, 1959.
V. S. ROTENBERG