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Medical Acupuncture
/ West





HISTORY OF MEDICAL ACUPUNCTURE


Medical acupuncture was created for Western practitioners such as Medical Doctor s, Physiotherapist s, Chiropractor s and Osteopath s who wish to use acupuncture based practices without the lengthy study of Traditional Chinese Medicine theory which is usually required for Acupuncturist s. This Western version of medical acupuncture is lesser known than the traditional Chinese, but is increasing in popularity as otherwise mainstream medical practitioners in the West are seeing and taking more interest in Alternative Medicine . Medical acupuncture can also be seen as an attempt by orthodox Western medicine to understand the effects of acupuncture from a western scientific perspective rather than within the paradigm of Chinese traditional medicine. The British Medical Acupuncture Society publishes a quarterly peer reviewed journal, Acupuncture in Medicine , which is listed on Medline and Index Medicus.

The term "acupuncture" is a Western one, derived from Latin and meaning "puncturing with needles". It was first used by the Dutchman Wilhelm Ten Rijn , who wrote a monograph in Latin on the subject (De Acupunctura) at the end of the seventeenth century. Traditional Chinese medicine had an influence on Europe due to exchange via the Silk Road trade routes. Goods and ideas both travelled between cultures in this way.

Acupuncture continued to attract interest from Western allopathic physicians in the eighteenth and
nineteenth centuries though generally without much reference to its Oriental roots. This interest has continued down to the present, receiving considerable interest after President Nixon 's Visit To China in 1972 , when surgeons witnessed surgical operations being carried out using acupuncture Analgesia instead of Anaesthetics . As a result of this interest, traditional Chinese medicine has become a global phenomena. With this interest came a desire by medical professionals to learn acupuncture without the difficult theory. Some traditional Chinese medicine theories include reference to philosophies of Taoist Cosmology and to some Westerners these philosophies border on Shamanism and Mysticism , all of which can be difficult for some Westerners to understand. In the United Kingdom most practitioners of acupuncture are medical acupuncturists, either medical doctors or allied health professionals. The. British Medical Acupuncture Society provides training for medical doctors and allied health professionals. Many countries have similar organisations and there is an International Council of Medical Acupunturists ICMART which represents medical acupuncturists from over 80 countries.


DIFFERENCES BETWEEN CLASSICAL CHINESE ACUPUNCTURE, TRADITIONAL CHINESE MEDICINE AND WESTERN MEDICAL ACUPUNCTURE


The main differences between Classical Chinese Acupuncture, Traditional Chinese Medicine and Western Medical Acupuncture are as follows.

Classical Chinese Acupuncture is the form of acupuncture that has been practiced for thousands of years and is based on Taoist thought and elements of naturalism.

Traditional Chinese Medicine (TCM) is the revised form of acupuncture and herbal medicine that was revived by Mao Zedong during the Cultural Revolution. Despite the misnomer, acupuncture based on Traditional Chinese Medicine is actually a modern form of acupuncture that has been well-integrated with western medical concepts of anatomy and physiology and has been used in hospitals alongside Medical Doctors in China for well over fifty years. This modern form of acupuncture is also situated in hosptials in Korea, Japan and parts of Europe.

Medical Acupuncture is a contemporary form of acupuncture that was developed by Medical Doctors in the United States and, recently, Great Britain over the last twenty years.

# The traditional theory of "points" and "meridians" is either ignored altogether or is radically reinterpreted because there is supposedly no physically verifiable Anatomical or Histological basis for the existence of Acupuncture Points or Meridians .
# The concepts of disease are derived from modern Western Pathology instead of Oriental medical theory which predates use of the Scientific Method , and has received various criticisms based on western thinking.
# Medical acupuncture is understood to work via the western biomedical understanding of Anatomy , Physiology and Biochemistry .

The principal differences between classical and medical acupuncture can be summarized as follows:



















CLASSICAL WESTERN MEDICAL
Follows procedures based on thousands of years' experience Largely ignores the traditional theories and technique
Based on traditional observations and theory Based on western concepts of anatomy and physiology
Often described with Taoist Metaphor and everyday language Based on western biomedicine


These differences are theoretical, but there are also practical
differences. Whereas traditional acupuncture practitioners, at least
today in the West, tend to work wholistically and address deficiencies
or overall energy imbalances (often inserting several or large numbers of needles
and maybe leaving them in place for 20 minutes or longer, some Western acupuncturists
use many fewer needles (sometimes only one) and practise brief insertion (from two or
three minutes right down to one second). Brief needling techniques are also used by
those traditionally trained, though they may be less common.

Medical acupuncture lends itself to use in a busy practice where
there is little time to spend on each patient. It also has the advantage
that it can be learned much more easily than traditional acupuncture by modern health
practitioners such as doctors, physiotherapists, osteopaths,
chiropractors, and podiatrists. Such people do not have to learn another system of thought or technique; rather, they see acupuncture as
an extension of what they are already doing.

For traditionalists, western medical acupuncture appears to be a watered-down
version of "real" acupuncture, having at best a limited degree of
effectiveness in certain situations. In some jurisdictions, the practice of
needle insertion based on local physical symptoms, and without traditional
acupuncture training, is called ' Dry Needling ' to distinguish it from
traditional acupuncture.

Unfortunately, there is still relatively small amounts of research conducted
to support the use of acupuncture, traditional or modern, and very little comparative
research comparing various approaches. Research dollars are not readily available
in medicine that does not show large profits, compared to pharmaceutical or surgical
interventions.


Choosing where to needle


If acupuncture is not based on the full range of traditional oriental medicine ideas,
how can we choose where to insert the needles? There are several possibilities. One
popular idea is to use the concept of Trigger Point s. These are tender areas, mostly in muscles, from which pain and other sensations may radiate to distant areas. In Traditional
Chinese Medicine (TCM) these are considered Ah Shi points, or spontaneously tender points,
which are often appropriate for needling as part of a treatment.

Another idea is to base the needling on body segments. The spinal cord
is arranged segmentally, with pairs of nerve roots emerging from it
along its length. These nerve root pairs supply the skin in a series of
stripes, so that it is possible to say which spinal segments supply
sensation to different parts of the body. A similar arrangement exists at
deeper levels, so that we may speak of Myotome s (related to the muscles)
and Sclerotome s (related to the bones and joints). In some versions of
medical acupuncture the needles are inserted in segments that are related
to the internal organs that one wishes to treat. This is very similar to the
TCM approach of using tendino-muscular meridians or regions, which closely match
the same areas.

Other simplified ways of choosing where to needle also exist. However, some medical
acupuncturists think that it often makes relatively little difference
where the needles are inserted, at least in quite broad terms. Certainly
there seem to be some patients who react very strongly to needling and some
in whom the actual site of treatment seems not very important. A traditionally-trained acupuncturist, however, might consider this belief Heresy , and consider this
random approach potentially harmful or even dangerous.

There are also many techniques of electroacupuncture (mostly developed by Japanese and European acupuncture researchers), one which uses only 24 points. Each meridian has a so-called test point, a tonification point, and a sedation point. A machine records the electrodermal current at the identified test point for each meridian. The values are placed into a chart. Based on the clustering of the values of the test points for each meridian - the practitioner is able to identify meridians which are hyperfunctioning and hypofunctioning. If the meridian is hypofunctioning - then the tonification point is needled to increase the electronic impulse flowing through said meridian. If the meridian is hyperfunctioning, then the sedation point is needled to decrease the electronic activity in the meridian. The process is called balancing the meridians. There are no complex points to remember, just 24 points on the bilateral meridians.


MECHANISM


Two attempts at western medical explanation of analgesic and pain control action have been suggested:

# The Gate Theory of pain, first put forward some thirty years ago by Patrick Wall and Robert Melzack , postulates the existence of gates or filters in the Spinal Cord that can modulate (increase or decrease) transmission of pain information within the nervous system.
# The second explanation is based on the existence of natural Opiate s (pain-relieving substances such as Endorphin s and Enkephalin s) in the Central Nervous System and elsewhere in the body

Scientific research in recent decades have shown that these theories, although they support some of the possible partial mechanisms of pain relief from local and distal needling, are not quite accurate even on the pain control mechanism of acupuncture.


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