In our classification scheme, acupuncture is part of a world medicine system (traditional Chinese medicine) and is categorized as both a stimulation-based and an energy-based technique. Its origin dates to at least 600bc, preceding the availability of iron and steel for fashioning needles.26 Acupuncture theory postulates a system of channels or meridians on the body named after organs or
Table 23.1 Categories of individual CAM therapies with examples.
Mindful Spiritual Energy based Stimulation-based Movement-based Mechanical/manipulative Nutriceutical
Imagery Spiritual healing
Acupuncture Massage Aromatherapy Therapeutic touch Music
Chiropractic Osteopathy Massage
Cranio-sacral therapy Rolfing
TENS, trancutaneous electrical nerve stimulation.
bodily systems, and a vital energy called qi that flows through the channels. Acupuncture points lie along the channels. Good health and well-being occur when the flow of energy is balanced. Illness occurs when the energy flow is out of balance. It may be depleted from a channel or it may accumulate within a channel at a point of obstruction. By needling acupuncture points, the flow of qi can be restored to its proper balance.
Acupuncture technique and theory are embedded in traditional Chinese medicine, which in turn springs from Taoist philosophy. Taoism emphasizes the inextricable relationship between humans and the natural world drawing upon three fundamental concepts: yin and yang, the system of five phases or elements, and the vital energy qi.27 Yin and yang conceptualize the dualistic nature of the universe and living systems in particular. Cold (yin) and heat (yang), internal (yin) and external (yang), deficiency (yin) and excess (yang) help characterize the balance of nature and the processes leading to disease. Another way to characterize the properties of matter or of processes that occur in the universe is with the system of five phases or five elements: wood, fire, earth, metal, and water. These are not elements in the same way we think of the more than 100 universal elements of modern science. The five elements of traditional Chinese medicine are metaphors describing different properties or behavior of things in nature. Unlike yin and yang and the five elements, which pertain to both living and nonliving things in the universe, the concept of qi defines living systems. It is created and replenished by breathing and eating. It flows through the 12 pairs of meridians throughout a 24hour day, so it takes about two hours to traverse from one channel to the next.
The traditional acupuncturist will access information about the balance of qi in the various organs through a systematic diagnostic process that relies on history, and some unique physical assessments such as the appearance of the tongue and a complex analysis of the characteristics of the radial pulse. Pain indicates stagnation of qi in one or more of the channels or invasion of the channel by wind, heat, or cold. All of these concepts are crystallized in the world's first medical text entitled Huang Ti Nei Ching translated as The Yellow Emperor's Classic of Internal Medicine, which dates at least as early as 200bc.27
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