Discussion on Distinct Features of Acupuncture-Moxibustion 1

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[b:3d61fa3244]Discussion on the Distinct Features of Acupuncture and Moxibustion (Part II)[/b:3d61fa3244]


3). How to preserve and promote the distinct acupuncture-moxibustion features in the process of the modernization of acupuncture and moxibustion
In thousands of years, acupuncture and moxibustion has been developing within the theoretical frame of traditional Chinese medicine following the orientation guided by the traditional Chinese medicine theory. However, since the mid of 20th century, during the course of its development, acupuncture and moxibustion has been facing the fierce conflict with modern science and technology, especially the modern medical science and technology and many different ideas and opinions have appeared which have brought acupuncture and moxibustion to the crossroads. Among all the ideas and opinions, one which has been quite influential in the circle of western medicine holds that the traditional modality of acupuncture and moxibustion be changed by means of modern science and technology and be taken into the theoretic frame of western medicine. If acupuncture and moxibustion would have been developing in light of this opinion, the distinct features of acupuncture and moxibustion would have been totally lost and there would have been no any advantage of acupuncture and moxibustion. Nevertheless, is it meant that the development of acupuncture and moxibustion does not need modern science and technology? For sure it does not mean that. In the modern time with the science flourishing, not only the development of acupuncture and moxibustion cannot avoid the modern science and technology, but also active measures must be taken to combine with the modern science and technology, realizing gradually the modernization of acupuncture and moxibustion at length. In the course of the modernization, if the theoretic system of traditional Chinese medicine is consistently taken as the essential root and the modern science and technology are put into use for developing the traditional Chinese medicine theory and promoting the distinct features of acupuncture and moxibustion, there will be a bright future for acupuncture and moxibustion.
The following presents some opinions on how to preserve and promote the distinct features of acupuncture and moxibustion.
1). To deepen the clinical observation and experimental research to enhance the study on the applicability of the meridian-collateral theory.
In the past half a century, some researchers have proved with various scientific and technological means and methods the existence of the track of meridian running courses and different hypotheses have been put forward concerning the essence of the meridians on the basis of some research of mechanism of the meridians [37]. However, the meridian-collateral researches in the past were separated far from the clinical work, thus the outcomes of the research could do nothing to improve the clinical effect of acupuncture and moxibustion. Therefore, in a period of time in future, the focus of the research should be shifted to the applicableness of the meridians.
From ancient time up to now, the meridian-collateral theory has been used in clinic for the following three aspects: (1) the differential diagnosis, including the differentiation of the syndromes of meridians and the abnormalities appearing along the running courses of meridians; (2) the guidance of prescribing acupoints; and (3) helping to guide the manipulating techniques of acupuncture to manage to control the flow of Qi so as to enable the Qi to reach the focuses of disease. If good research ideas are set up in concerns with the above three aspects, laws and rules are summarized, and the mechanisms are well explored, not only it is beneficial to the revealing of the essence of meridians and collaterals, but also most probably the more advanced diagnostic and therapeutic approaches and techniques on the basis of meridians and collaterals could be innovated. So far, more attention should be paid by the academic circle on the technology and methods worked out for the public e.g. detection on the voltage-ampere property of meridians and collaterals, Voll’s electro-acupuncture diagnosis, Raodoraku therapy, Bi-digital O-ring test, etc.
I used to organize five medical institutions to observe jointly the clinical significance of the voltage-ampere property of meridians and collaterals and the observation found that this testing method can reveal the status of deficiency, excess, cold and heat in the meridians and collaterals as well as Zang-Fu organs [38]. Mr. Kang Jizhou, a friend of mine in USA, has obtained surprising therapeutic effect on the basis of Voll’s electro-acupuncture with integration of traditional Chinese medicine, acupuncture and moxibustion, western medicine, homeopathy, and chiropractice. I did see from his practice a possible road leading to the modernization of traditional Chinese medicine.
2). To study the specific actions of acupoints from the clinical view, with special attention paid on the research of Ashi points.
In the past, although the relative specific actions of acupoints have been proved from different views e.g. tissue structure, stimulation effect, physical property, etc. However, from the clinical view, many questions in relations with clinical practice have not been undertaken except the difference of effect between acupoints and non-acupoint sites observed in the acupoint injection. So stress should be laid in the future researches. The following aspects should be focused to start the study on the specific actions of acupoints in the view of clinic: (1) to study the relationship between the three dimensions of acupoints and the effect of acupuncture needling, including the boundary between the acupoints and non-acupoint sites, the depth and the effect, etc; (2) to conduct the research for comparing the acupoints with the same indication and to find which are the ones primarily effective for treating indication; (3) to explore the possible synergistic and antagonizing effects among the acupoints so as to study the rule and laws of how to combine the acupoints; and (4) to study Ashi points, i.e. the reacting points of some diseases often appearing in certain parts of the body [39]. Some physicians pay special attention on this type of reacting points to diagnose diseases [40], while some would select these points to treat some refractory and intractable diseases and have obtained more satisfactory effect than the acupoints in meridians. So, attention should be paid on summarizing the rule and law of how the reacting points appear so to find by means of modern science and technology the quicker and more accurate method of detecting the reacting points.
3). To carry on the essence of the traditional acupuncture therapy, and to make innovation of the needling techniques of acupuncture in the prerequisite of preserving the distinct features of the conventional acupuncture methods.
At present, acupuncture physicians in some country, in order to avoid the pain and bleeding during acupuncture treatment, managed to make the acupuncture needles so thin as no manipulating techniques can be performed. This fact has seriously hindered the play of the therapeutic advantage of acupuncture. Actually, the injection and the blood taking for laboratory tests in western medicine can also cause pain, so why is it so strict on acupuncture?
In order to improve the therapeutic effect of acupuncture, the conventional needling techniques of acupuncture should be conscientiously carried forward. Some of my friends are greatly welcomed by their patients because of their skilled traditional needling techniques. In spite of their thick needles used in treatment, or even the bleeding or red-hot needling therapy, patients like their treatment. Dr. Wen, one of my students in USA wrote me: “It is the key for the achievement of satisfactory effect of acupuncture that the factors such as the acupuncture physicians’ finger force training, their Qigong training, accuracy of locating the acupoints, the thickness of the needles, appropriate performance of the needling techniques, the use of the spiritual energy, and the concentration of the Qi on the manipulating fingers ” are all well put together [41]. This is indeed the real personal experience!
Some researchers feel the needling techniques of acupuncture too complicated to make the quantitative control, so they prefer the electro-acupuncture instead of the manual acupuncture manipulation, but they have neglected an important fact that the arrival of Qi must be obtained by the manual manipulating methods before the electric current is connected to the needles, otherwise the clinical effect would be lessened. I have made the statistic work on the articles concerning the electro-acupuncture treatment published in the journal “Chinese Acupuncture and Moxibustion” from 1996 to 2003, 72% of the authors required the arrival of Qi before the electric stimulation, some even made the reinforcing-reducing techniques of needling before the connection of the electric current. In addition, other acupuncture therapies e.g. acupoint injection, laser acupuncture, microwave acupuncture, etc. should be also performed on the basis of the arrival of Qi in majority of cases.
Since acupuncture needling techniques are so important, can we utilize the advanced scientific techniques to imitate the manual manipulation? I saw several trans-cutaneous electric stimulating apparatus on acupoints, which can all enable the patients to feel the sensation of arrival of Qi, or even can induce the propagation of needling sensation along meridians. Recently, dynamic electric stimulating signals were employed to imitate the mechanic stimulating signals by the manual needling techniques of acupuncture, enabling the electric stimulation to achieve the actions of the manual manipulation for reinforcing the deficiency and reducing the excess [42], this is indeed a significant scientific exploration.
4). To carry on the essence of the traditional moxibustion therapy, and to abandon its demerits in the prerequisite of preserving the distinct features of the conventional moxibustion methods.
The demerits of the conventional moxibustion therapy include: (1) smoking; and (2) difficult to adjust the heat or fire accurately, thus the reform is entirely necessary. However, during the reform, first of all the synergistic relationship between the thermo action and the medicinal action must be stressed; and secondly the importance of selecting the optimal acupoints on which the moxibustion is performed should be emphasized so moxibustion is not taken as a pure thermotherapy.
Herein, what I’m going to mention specially is the festering moxibustion. I agree with some acupuncture professionals who have been engaged in the study of moxibustion for many years that festering moxibustion has higher effect indeed than the methods of mild moxibustion in treating some refractory and intractable diseases. Nevertheless, the burning pain of this type moxibustion is unacceptable. In order to solve this problem, some people would inject procaine hydrochloride superficially in the acupoints where the moxibustion is given; and some would apply the herbal extracts in alcohol on the surface of the local area; and these methods can minimize the pain [43]. There is also a thinking mode that the “moxa serum” be used for treating diseases and animal experiments proved that it is a practicable method as well [44, 45].
5). To follow the theories of traditional Chinese medicine especially the meridian-collateral theory and to develop the boundary therapies and the boundary science at the junction points of acupuncture and moxibustion with the related scientific branches of modern science.
For instance, the acupoint injection, being formed at the junction point between acupuncture and medication, has better clinical effect than both the simple acupuncture and the medication through other administering approaches [46] and there is a broad prospect of development. What should be solved in future is to study how to improve the special needles for the acupoint injection, to fulfill the principle of treatment based on the differential diagnosis of syndromes from three angles of acupoints, needling, and medication, and to make research on the rules and mechanism of the mutual interaction between the needling and medication.
Moreover, acupuncture anesthesia, acupotomizing method (mini needle-knife), application of herbs on acupoints, new Bian-stone therapy, etc. are also the products resulting from the combination of acupuncture and the related branches of science. The future development of acupuncture anesthesia should be the compound anesthesia integrated with both acupuncture and medication and the purpose of acupuncture is to decrease the dosage of medication so as to stabilize the physiological functions of the patients during surgical operations, accelerating the recovery of various functions after operations. Thus, theory of traditional Chinese medicine should play an important directing role during the anesthesia. As the acupotomizing method is concerned, it is originally the product of the integration of acupuncture and orthopedic surgery and it puts forward the theory of dynamic balance of human body and the restoration of the balance through the acupotomizing therapy from the angle of the biomechanics, but it does not break the theoretic frame of traditional Chinese medicine. Therefore, it should be well rooted in traditional Chinese medicine, and directed by the theory of traditional Chinese medicine.
6). To make the advantage of acupuncture and moxibustion into full play and to expand their extent of indications, so as to make a greater use of acupuncture and moxibustion in the medical treatment and health preservation.
The researches for over half a century have proved that acupuncture can be used in many aspects such as diagnosis, treatment, anesthesia, prevention of diseases, preservation of health, and cosmetics, more than 800 kinds of diseases are involved with acupuncture even only the treatment is concerned [47]. Not only acupuncture can treat various common diseases, but also can treat the refractory and intractable diseases as well, e.g. the vegetable status of the brain trauma treated with acupuncture [48], incomplete traumatic paraplegia treated with acupuncture or acupoint injection [49], vascular dementia treated with various acupuncture therapies [50], intractable pulmonary tuberculosis treated with moxibustion [51], ankylosing spondylitis treated with acupotomizing method [52], etc. all of them have achieved fairly good therapeutic effect. Dr. Sun, my student in Hong Kong, treated children’s autism with tongue acupuncture and obtained noticeable effect. Besides, acupuncture can be also used for emergency treatment, abstinence of narcotics, buffering the toxic and untoward reactions of the chemical drugs, promoting the restoration of the transplanted organs, and raising the conceiving rate of the embryo transplantation [53], and it is apparent that there is a large variety of indications for acupuncture.
Although acupuncture has a large range of indications, the man-made hindrance results in the ignorance of the distinct features of acupuncture and moxibustion, and it is misunderstood that acupuncture and moxibustion is mainly used for pain, numbness, and the dysfunctions of some organs, thus the play of the advantage of acupuncture has been gravely limited. How to change this situation? I have three suggestions: (1) self reliance: to make consistent efforts to improve the level of the acupuncture practitioners and to persuade the others by the good therapeutic effect and the convincing outcomes of scientific research; (2) to strengthen the cooperation and collaboration, including the cooperation and collaboration in between the acupuncture practitioners and between traditional Chinese medicine and western medicine, especially with the well-known institutions so as to increase the popularity of acupuncture and moxibustion t the public; and (3) to endeavor to persuade the authorities concerned to lift the unreasonable official restrictions so let the acupuncture practitioners have the right to choose any traditional acupuncture therapies and the new technology of acupuncture and moxibustion created in modern time.
In the above-mentioned view points in six aspects on preserving and promoting the distinct features of acupuncture and moxibustion, there must be some missing parts which have not been taken into consideration, so they are only the personal opinions for your reference. However, I am confident that in the course of the modernization of acupuncture and moxibustion, if consistently the distinct features of acupuncture and moxibustion are persisted on, acupuncture and moxibustion will be developed and promoted, and a modern acupuncture medicine which embodies the theoretic view points of traditional Chinese medicine and possesses the modern scientific contents will appear in the world!


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