Acupuncture has long been the subject of discussion and misunderstanding in the west. The term “acupuncture” is sometimes misunderstood as a synonym for traditional Chinese medicine (TCM), although it is only one of several methodologies within the larger medical system. For example, at the Nanjing College of TCM in China, only 108 hours of the five-year curriculum focuses on acupuncture. Chinese medicine neither claims that acupuncture cures all kinds of diseases nor applies TCM acupuncture to every patient. There are recognised indications and contra-indications for acupuncture, and the majority of patients in modern hospitals in the People’s Republic of China receive a prescription of either herbs or Western drugs.
The treatment stimulates acupuncture points with needles (acupuncture), pressure (acupressure), electricity (electroacupuncture) or heat (moxibustion). Injection of medicine into an acupuncture point is called aqua-puncture by some authors, although the effectiveness of this method is believed to more with the “needle effect” than drug. Recently, the application of laser has been used in single-blind and double-blind study designs. However, the effectiveness of laser is still being discussed. Kreczi and Klingler found it effective for low back pains, whereas Brockhaus, Elgers, Haker and Lundberg found it effective for placebo treatment.
Naeser et al confirmed its effectiveness by using needle acupuncture and laser acupuncture in post stroke paralysis with similar results. Acupuncture points are regions containing a rich supply of free nerve endings. Dung said that about one third of the points coincide with the motor lines of the underlying muscle. Rosenblatt showed lower electrodermal resistance at acupuncture points which is the basis of all acupoint locating devices.
In 1984, Zhu et al showed that during electrical excitement of one distant acupuncture point, the entire connected channel demonstrated low impedance. The same year, De Vernejoul et al showed that radioactive tracers would migrate along the Chinese channels after being injected into an acupuncture point. This was challenged by Lazorthes et al. Darras et al produced further evidence of the tracer migration along the channels in 1992. Heine described anatomical features of the two central channels, the Ren mai and the Du mai, claiming his findings could explain the control and coordination function of these two channels.
Acupuncture was majorly publicised in the 70s when Chinese doctors claimed that surgery could be performed during the exclusive use of acupuncture; thus, the term “acupuncture analgesia” was coined. Claims of 90 per cent effectiveness found an explanation when it came to light that the Chinese regarded a patient in need of large doses of morphine as an “effective case.” In retrospect, these claims led to extensive research in which different mechanisms of acupuncture were found.
(The author is Head of Acupuncture at Sir Ganga Ram Hospital, New Delhi)