What is Chinese Medicine? — Acupuncture and related arts

When I began thinking about this blog I knew that I was going to attract a lot of different kinds of people. Some will have a grasp of the theory and practice of Chinese medicine, some will not. Visitors who do have that basic grasp will have diverse backgrounds and experience. Visitors new to Chinese medicine will be coming for diverse reasons, with diverse expectations. Further, there are several well-established sites on the Internet covering basic Chinese medicine material in a mainstream TCM way. So my goal has been, and continues to be, to contribute to the discussion with a unique focus that can appeal to many groups of people. My particular perspective is influenced by my training in the Classical Chinese Medicine tradition (as opposed to the Traditional Chinese Medicine tradition) as well as my status as a student and patient.

Despite the fact that I am a student and also despite the fact that there is ample information on the Internet regarding the accepted basics of Chinese medicine I feel compelled to provide the basics for those who reach this site and have no knowledge of the theory or practice of CM but have need or desire to learn. My hope in this series, which began with What is Chinese Medicine? — Herbal Medicine, is not to reiterate the same old dry details as might be present in any TCM introductory textbook but to provide my unique, developing perspective. Please remember this as you read. With that preamble – please continue to learn more about acupuncture and its related arts…

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What is acupuncture? An overview.

On the surface this is an easy question to answer. Acupuncture is the use of needles to puncture the skin and enter the interior of the body with the aim of contacting the energy of the person and subtly manipulating that energy to effect a change in the state of the patient. Contemporary needles are very fine (typically less than .5mm in thickness) and made of primarily surgical stainless steel, are single-use and sometimes even coated with special compounds to increase ease of insertion and decrease unpleasant sensation. It was not always this way, of course. Needles of the past were usually thicker, coarser, reused (with or without sterilization) and in ancient times were obviously made from bone, stone and other natural materials. So count yourself as lucky!

But this is only a surface explanation. What *is* acupuncture – beyond its outward trappings? One of my cherished professors refers to the process of giving acupuncture as simply making a suggestion to the patient’s body. So, in this way, talking about “manipulation” is probably incorrect. If you think of the energy streams of the person’s body as literal streams, imagine acupuncture as putting a stone in the path of the stream. We’ve all done this as children, probably many of us as adults – trying to divert the flow of the stream so we can accomplish some aim. Actually, using this analogy – acupuncture is probably a little more like taking a previously placed stone OUT so as to restore the natural course of the stream.

I also think of acupuncture like a person riding a horse without reins. There is very close communication between the person’s body and the horse’s body. The communication is so close, in fact, that even a slight nudge with the knee can cause the horse to veer back on the path or urge it to jump over an obstacle. It’s a dance with purpose.

What about the channels/meridians?

Note: I will be referring to the channels or meridians exclusively as channels. I have heard arguments both ways, but I favor thinking about these pathways as something really existing – “meridian” implies something imaginary, made up by human beings.

So far I haven’t talked about channels -why? Well – some acupuncture isn’t done on channels, for one thing. I have recently learned about the concept of “A Shi” points which are points on the body that experience pain or discomfort but are not “official” acupuncture points. These are often used in cases of muscular tension and are very effective in relieving specific areas of pain. There is also auricular acupuncture – a self-contained system of acupuncture focused on the ear as a reflection of the entire body. I think it is important to remember that acupuncture doesn’t have to be confined to the 12 primary channels so often discussed.

But the primary channels do exist and their treatment composes a significant portion of acupuncture treatment, so it is important to talk about them. The channels as I understand them now are pathways through which all of the substances of the body flow. It is along the channels that one finds the acupuncture points you will see referred to on this site and elsewhere (eg. “Stomach-36). There is actually an entire system of channels of varying size and depth, something like the concept of watersheds on Earth. Most of the system is neglected in contemporary acupuncture, which diminishes the power of the system.

The entire system, or watershed, of energy channels in the body has 6 major sections (listed in order of depth from the surface of the body):

1. Cutaneous regions/skin areas – Pi Bu (皮部)
2. Sinew channels – Jin Jing (经筋)
3. Minute connecting channels (aka Grandson Luo) – Sun Luo (孙络)
4. Connecting channels (aka Luo-connecting or collaterals) – Luo Mai (络脉)
5. Divergent channels – Jing Bie (经别)
6. 8 Extraordinary channels – Ji Jing Ba Mai (奇经八脉)
7. Primary channels (aka Regular channels) – (正经)

Now, I could easily spend a 3,000 word post on each section – let’s simplify. Think of the deepest of the channels (Primary and Extraordinary) as huge rivers attached to even larger oceans and seas (which would be the organs). In fact, each primary channel is affiliated in name and energy with one of the 12 organ systems of the body (eg: the “Lung channel”) Then imagine that the progressively more shallow parts of the system are ways for the transported substance to reach throughout the whole body. Qi and Blood need to reach everywhere! The different parts of the system also have diverse functions, associations and treatment options as I have already mentioned – but we will leave it here for now.

The acupuncture points

In general, when you get an acupuncture treatment, the doctor will be stimulating particular points. Most of these will be along the Primary channels (#7 above) and most of them will be in the list of approximately 365 points “officially” recognized. The listing of points has grown, shrunk and otherwise changed in the thousands of years that Chinese medicine has been developing, but this seems to be the set that is “sticking.” Any website or book can list the points, but I’d like to introduce how I try to experience the points in a deeper way. In my current understanding, acupuncture points are each unique portals through which we can access the energy of the body in a very particular way. Each point has a particular character that is influenced by many factors. Understanding the particular nature of a point is undoubtedly important when deciding what points to use in a treatment – I don’t think relying on a cookbook of “point actions” is the best way to approach treatment. Here are some of the things I consider when I am studying points seeking to understand their functions.

1. Point name and etymology of the characters: In other words, the “story” of the point as it was laid down by the ancient Chinese. Investigating the places, people and creatures associated with each point name help me to understand what kind of effect the point is likely to have. Digging into the etymology adds an additional layer.
2. What channel the point is on: This seems simple, but I always look at each point against the background of its particular channel. Points on the Heart channel are going to carry a Heart quality and are going to impact the Heart channel, regardless of what other qualities the point possesses.
3. Whether it is on the extremities or the trunk: Points at the extremities tend to be strong and I always pay special attention to these points.
4. Whether it is on a Yang or Yin surface of the body: Points on the back are going to be more Yang in activity than those on the front of the body. This is, of course, quite relative and not an ironclad metric but I have found it helpful in looking at points that have many similarities.
5. What point categories the point belongs to: This is a very complicated topic. Let it suffice to say that there are several methods for classifying specific points and that thinking about a point’s category affiliations helps us to fully comprehend the flavor of that point and what effect it will have on the body. I’ll go into point categories someday.

I feel that along with forming an actual physical relationship with the points through meditation and self-treatment these considerations have helped me to have an understanding of acupuncture points that deepens every day.

So, what happens in an acupuncture appointment?

I have already briefly covered what happens in an acupuncture appointment in my article 10 Things to expect at your first acupuncture appointment, but here’s a little more background. When your doctor makes a diagnosis she will probably already have some points in mind that she has learned either through study or experience (preferably both!) are good for your condition. She will take into account your constitution and your openness to acupuncture. She will create a formula of points – anywhere from one point to twenty (some acupuncturists may use more, some conditions may warrant more) to be needled, usually in a particular order. These formulas are similar to herbal formulas insofar that they are carefully constructed and meant to address many dimensions of the problem you are experiencing.

She may choose to use standard needles, bleeding needles, implements with several small needles on them, press needles, acupressure (using a blunt object or the hand to stimulate the point), Tuina or Shiatsu (a kind of Asian bodywork along the channels), moxibustion, cupping or other more modern methods — but all of these will have a similar aim, to stimulate either specific points or an entire section of a channel to get you on the path to optimal wellness! Treatments may focus on tonifying a deficiency in your body (giving more of something where there was not enough), on reducing an excess (getting rid of something that’s not supposed to be there), on balancing the energy between two parts of your body or a combination of these. You are very likely to feel better after your first treatment, but most conditions require multiple treatments for resolution.

What kinds of points your physician chooses, the way she constructs her point formula and the methods she uses to stimulate the points will have a lot to do with the system she works within. There are many schools of acupuncture and even sub-schools within the schools. While this is an interesting topic it still remains that all the schools will be operating generally with the information I have already presented. They may simply have a different understanding of the material or put emphasis on different aspects of the system.

I am sure I will want to add more to this article as my comprehension grows. Please look for my next What is Chinese medicine? article to be published soon.

Eric Grey

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