methods of treatment

The word "Acupuncture" is derived from two Latin words "acus" which means 'needle' and "punctura" which means 'to penetrate'. The word "acupuncture" therefore means, "to penetrate with a needle".

In acupuncture very thin needles, slightly thicker than a human hair, are inserted into acupuncture points. The objective of acupuncture as explained earlier is to regulate and normalize the flow of the Chi, so that the Yin and the Yang return to a state of dynamic equilibrium. Acupuncture aims to relieve symptoms by curing the disease.

It is possible for an acupuncturist to treat the symptoms of various diseases very effectively; for example a pain in the back can be relieved in minutes. However a mere symptomatic treatment, which just removes the symptoms.

The acupuncturist should treat the fundamental cause of the illness and as the cure progresses the symptoms disappear on their own. Of course it often takes a great deal of skill to find the true cause of some illnesses!

The choice of acupuncture points to be used is the most crucial part of the treatment. The acupuncturist must know the function of each acupuncture point and its interaction with other acupuncture points. He can then plan the treatment to eliminate obstructions in the flow of Chi and to balance the Yin and Yang. After the acupuncturist has examined the patient and reached a diagnosis, he decides how the patient should be treated.

An experienced acupuncturist uses as few needles as possible to balance the energy flows. In contrast, a novice may use many needles and still be unable to balance the energy flows. Most patients need ten to fifteen acupuncture needles for each treatment, but sometimes only a single needle may be enough. While treating a frozen shoulder, a single needle is inserted into the leg and then twirled. In a few minutes, a shoulder that has been immobile for up to three months moves freely and without pain. Though cartoonists are fond of drawing patients with needles stuck all over them, actually only a few needles are used for each patient.

the tools of an acupuncturlst – needles

The earliest acupuncture implements were sharp pieces of bone or flint in the shape of arrowheads called Bian stones. Their use was limited because of their size and shape and they were used to prick acupuncture points. Later, sharp pieces of pottery were used for this purpose. As time went on, the Chinese refined this process eventually using needles to stimulate acupuncture points.

Early acupuncture needles were made from bamboo and bone and as they were rather thick, their insertion was painful. In spite of there being no knowledge of sterilization before the 19th century, it is surprising to note that infection rarely occurred with acupuncture. This is because acupuncture stimulates the immune system enhancing the body's protective mechanisms.

With the advent of the Iron Age and the Bronze Age the next type of needles to be developed were metal needles. As the art of metallurgy progressed, different types of needles were made. Early needles were made from iron, copper, bronze, silver and gold. At the time when the "Nei ching" was written, there were nine different types of acupuncture needles in use. These were similar to present day needles. Very thin, fine needles were used for routine treatment. Arrowhead needles were used to prick the points. Blunt and round needles were used for acupressure. Scalpel like needles were used for cutting boils and abscesses. Larger and heavier needles were available for insertion into joints and when the acupuncture points lay deep below the skin, longer needles were used.

Small thumbtacks shaped needles were used for insertion at ear acupuncture points when prolonged stimulation was required. Three-sided needles were used to bleed the patient in cases of coma and high fever. The drawing of a few drops of blood from certain acupuncture points can bring down high fever, stop convulsions and restore consciousness in a matter of minutes without any other treatment. Finally there were the plum blossom needles also called the seven star needles which was used to tap the skin over acupuncture points. This was mainly used to treat skin diseases, children, old people and patients who were afraid of needles.

These needles were in widespread use for thousands of years until the early years of the 20th century, when the invention of stainless steel revolutionized the art of acupuncture.

Some acupuncturists claim that needles made from silver or gold have special therapeutic properties. Needles made from sliver and gold are expensive and so are often resharpened, straightened and reused. Unfortunately, the process of sharpening needles is laborious and time consuming and it is rarely possible to get as sharp a point on these needles as on a stainless steel needle. In my experience needles made from stainless steel are as effective in therapy as needles made from any other material.

Needles made from two metals act as a thermocouple, and generate a small electric current. So the handles of some acupuncture needles are made from metals like copper, silver and gold with the needle itself being made from stainless steel. Needle handles made with copper and silver get oxidized during use and storage, which reduces their electrical conductivity making them unsuitable for electrical stimulation.

Treatment by acupuncture: pain or pain relief?

An average acupuncture needle is slightly thicker than human hair and its insertion is virtually painless. Many patients are dissuaded from trying acupuncture by the pictures they see of acupuncture where long, thick needles are inserted into the patient. This has given rise to the misconception that acupuncture is painful. This misconception also arises from the belief that acupuncture needles are similar to injection needles. There are several fundamental differences between acupuncture needles and hypodermic needles used for giving an injection.

Normal acupuncture needles are so thin that they cannot be seen in a picture or on television. The needles used for demonstration are far thicker than those used for acupuncture. As you know, a silver needle slightly thicker than a human hair is hard to see.

An acupuncture needle is very thin, ranging from 0.16 mm to 0.38 mm in thickness, while injection needles range from 0.6 mm to 2 mm (in blood transfusion needles). The tip of an acupuncture needle is conical in shape, which allows it to penetrate the tissues separating the fibres of the muscle as it enters, without causing damage. Similarly on removing the needle the separated fibres close smoothly around the needle, preventing bleeding.

A hypodermic needle in contrast, has a sharp edge and its insertion cuts out a small cylinder of flesh as it enters. This fact is used for carrying out a needle biopsy to diagnose cancer. A hypodermic needle also has a hole through which a liquid is forced while giving the injection. The forcing of the medicine into a closed space also causes pain.

In acupuncture, no fluid is injected into the body and as the needle does not have a cavity in the middle, it is much thinner than a hypodermic needle. The sensation felt when an acupuncture needle is inserted is very different from the sensation felt when a hypodermic needle is used. In contrast to an injection, an acupuncture needle produces its effect by altering the energy flow inside the human body.

Acupuncture needles come in various sizes and thicknesses ranging from two millimeters to ten centimeters in length. The handles are one to three centimeters long. The longest needles are used on fat people in areas where there is thick muscle and a lot of fat, like the buttocks and hips. On the forehead, hands and face, only the tip of the needle is inserted. The depth of insertion of the needle varies from one millimeter to about ten centimeters depending on the depth of the acupuncture point to be treated.

moxibuxtion

Acupuncture points are also stimulated by burning a herb called "moxa" over the point. The name "moxa" is derived from its Japanese name Mogusa. The botanical name of the herb is Artemis Vulgaris commonly known as Mugwort. Before use, the raw herb is processed into moxawool by grinding the dry leaves of this plant into a fine wool. When the moxa is burnt, the smoke has a characteristic odour that is similar to the smell of hashish.

Moxa is used in two ways, either directly on the skin or indirectly through a needle, garlic, salt and ginger. Direct moxibuxtion is carried out with a smouldering cigar of moxa, which is used to warm the acupuncture point from a distance of one centimeter.

In indirect moxibuxtion a slice of ginger, or garlic is placed over the acupuncture point. The moxa is then placed on it and ignited. Another method of indirect moxibuxtion is to place a small ball of Moxawool on the head of an acupuncture needle. This is then lit, allowing the needle to transmit this heat directly to the acupuncture point through the needle. In a patient with severe pain in the abdomen, coma or shock the navel is filled with salt and a small ball of moxa is lit over it. This can revive a patient within a few minutes!

Moxa disperses the cold and so is used in the treatment of diseases like arthritis, and bronchitis, which are said to be caused by wind and cold. Moxibuxtion is used to treat chronic bronchitis, bronchial asthma, chronic diarrhoea, arthritis and some conditions where there has been an inadequate response to acupuncture with needles. Many other substances have been tried as alternatives to moxa, but it appears that none of these alternatives are as effective as moxa in healing.

Cupping

Another means of eliminating cold is cupping. A glass or a plastic cup is placed on the thigh or the chest, after a burning paper has been inserted into it. This creates a vacuum, which makes the cup stick to the skin. After a few minutes, the cup slips off the skin, leaving faint red marks. This is quite useful in treating bronchitis and fibrositis. This acts by increasing the flow of blood to the area being treated.

techniques of treatment

Patients will see that the acupuncturist uses different techniques of insertion of needles and different methods of stimulation of the needles at different stages in the treatment. This is because each patient requires an individual form of treatment that will vary from sitting to sitting.

The patient will also find that the acupuncturist may insert needles in different acupuncture points each time. This is because an acupuncture point used too often loses its sensitivity and is not as effective as it was earlier. When a patient is treated every day, he is given a course of eight to ten treatments. He is then given a break for a week to allow the acupuncture points to regain their sensitivity. If a patient requires continuous treatment, the acupuncture points used are rotated to allow the points that have been used to regain their sensitivity.

If a patient is treated on alternate days or once or twice a week, there is no need for a break between treatments. The course of treatment is decided after assessing each individual's requirements so that he receives the maximum benefit from the treatment.

I normally treat a patient daily, until he starts to improve. The frequency of the treatment is then reduced to three times a week, then to twice a week and finally to once a week. The patient is asked to return to reassessment four to six weeks after completion of treatment.

Most patients have multiple problems that are interrelated. Acupuncture treats the whole person and all his ailments are attended to. Even though there are numerous instances of quick and near miraculous cures, some ailments do respond slower than others. The patient should not feel disheartened if he finds that some of his problems take longer to respond than others. A cure requires a balancing of the energy flow that may be a slow process. In long standing ailments the response to treatment is slow, as the energy flows that have been disturbed for many years can take time to return to normal.

There are many methods used in acupuncture. The needles may be inserted for a few seconds and taken out immediately. They may be inserted, manipulated for a minute or two and removed or they may be left in for fifteen to thirty minutes without any stimulation. The needles may be inserted and stimulated periodically by hand or with a small battery operated electrical stimulator, which electrically vibrates the needles.

Each of these methods is used on different patients depending on the diagnosis that the acupuncturist makes. Chinese acupuncturists even leave the acupuncture needles in until they fall out. This can be a time consuming process!

There are many other methods of stimulating acupuncture points. These include electrical stimulation, where electric conducting pads are placed over the skin and a low frequency electric current is passed through it. Acupuncture points may also be stimulated with pressure, lasers, and ultrasound or with audible sound.