Acupuncture Science 5: Western & traditional
Part 5: Integrating Western Physiology with Traditional Chinese Medicine Philosophies
With its 5,000 year old history Traditional Chinese Medicine (TCM) has been widely recognised for its knowledge and therapeutic approach. Although, still not fully understood there is every reason to be able to impact on the future and development of modern medicine. Admittedly researchers have yet to be able to successfully integrate TCM to western medicine. One research exploring this concluded by suggesting three elements to understanding TCM;
- First part that is consistent with modern medicine, e.g. similarities in clinical examination methods (inspection, auscultation-olfaction, palpation), use of TCM treatments and prescription (including herbs) in modern medicine.
- Second part is described as involuntarily beyond modern medicine, encompassing unique TCM theories, concepts and other advanced TCM treatments.
- Third part requires further evaluation, consists of the knowledge of pulse diagnosis, prescriptions, herbs and other aspects.
The popularity and effectiveness of acupuncture has in the last decade prompted a wide integration of the use of acupuncture within most NHS pain clinics. Similarly, there are also an increasing number of physicians, physiotherapists, chiropractors and osteopaths offering it as part of an integrated practice. Based on the physiology and clinical approach there are now two schools of acupuncture;
- Traditional Chinese Acupuncture
- Western Acupuncture.
Western acupuncture is explained through the ‘Gate control theory of pain’ and largely restricted to the treatment of chronic pain. This theory was originally put forward by Ron Melzack and Patrick Wall in 1962, where they proposed that physical pain is not a direct result of the activation of pain receptors. Instead the perception of pain is modulated and changed through the interaction of different neurons. Using this theory we can explain that the stimulation of nerve fibres through acupuncture needles can cause chemicals (enkephalin and dynorphon) in the spinal cord to block the transmission of the pain messages to the brain, thus creating an analgesic effect.
Alternatively, Traditional Chinese Medicine (TCM) takes on an entirely different perspective using more than one philosophical theories including; Yin-Yang theory; Five Element theory; and Qi, blood and body fluid. Qi is defined as vital energy, which flows through a system of channels (also called meridians). The meridians are central to understanding TCM acupuncture and how it works. Following are its characteristics;
- Meridians are understood to be a network of channels through which Qi is circulated.
- They link up with the organs and tissue.
- The main trunks run longitudinally and in the interior of the body, while the collaterals run transversely and superficially from the meridians.
- There are a total of 12 major meridians, added to them are 8 extra meridians, additional collaterals and others.
- Each of the 12 major meridians is linked internally to an organ and externally with joints, limbs and other superficial tissue forming a whole organ system, for example the lung system encompasses the nose, respiratory tubes and the lungs.
In comparison western physiology is based on a number of systems, e.g. circulatory, respiratory, nervous, lymphatic, musculo-skeletal, urinary and digestive system. Effective functioning of each of these systems is essential to maintaining good health. Similarly TCM meridians also have functions including transporting qi, balance of yin and yang, resist pathogens, exhibit signs and symptoms of disease and disorder, and transmit acupuncture needing sensations to regulate any deficiency or excess conditions.
Meridian channels need to have free flowing and balanced Qi in order to maintain good body function. They have a special quality of being sensitive and able to carry the healing effects of acupuncture to distal parts of the body. Researchers have attempted to verify its exact anatomical location in the body but also what meridians constitute. Is it nerves, lymphatics, blood or tissue?
In Part 6 we will discuss, TCM Meridians.