How is acupuncture practised?

The job of the acupuncturist is to assess his patient and ensure that the life-giving force Qi flows in a balanced way around the body. The first phase is the examination and diagnosis. A fundamental part of acupuncture therapy is to regard the patient as a whole and treat the underlying causes ^f the symptoms in addition to the symptoms themselves. Thus the treatment programme is built up at three levels: treating the local symptom; investigation, and treating, if necessary, any meridians associated with the symptoms; and correcting any energy imbalances within the body as a whole. The Yin and Yang balance affects the pulse, which is a particularly important aspect of traditional Chinese diagnosis. Mainstream practitioners assess the condition of each organ using the pulse. This is because each of the six meridians on each side of the body pass through the wrist. The pulse of each meridian is felt by pressing lightly or firmly at various points along the radial artery (the one used by conventional Western doctors for pulse-taking). It is said the experienced acupuncturist can detect up to 28 qualities in each pulse that indicate how Qi is flowing and where the problems lie.

Traditional Chinese diagnosis also involves detailed questioning about general health, senses of smell and taste, the quality of the voice and the colour of the face and tongue. The tongue is especially revealing and is scrutinized closely for colour and coating. Some practitioners obtain an approximate indication of the energy balance within the body by measuring the electrical resistance across its top and bottom halves. There is a normal ‘healthy’ range and some illnesses can be characterized by departures from this range; part of the treatment would then be to restore this balance. Progress can be monitored by checking the resistance at each session.

Needle insertion

Traditional practitioners may use gold or silver needles but stainless steel is now normally employed. The needles are typically 12mm long excluding the handle and are inserted through the skin to depths of 2 to 5mm. The procedure is not without its risks, but then neither are conventional medical practices in the West totally without their dangers. The number of needles employed may vary from one or two inserted into the ear for uncomplicated, acute musculoskeletal complaints, to 20 or more for involved cases; the more traditional practitioners generally use more needles. The points into which the needles are inserted do not correspond in any obvious endorphins: way (to Western eyes) to the part of the body where the complaint seems to be centred. For example, to treat migraine headache the acupuncturist may consider that the point known as ‘Liver 3’ needs stimulating, and this point is between the first and second toes. The length of time the needles are left varies from a few seconds to half an hour or more.

Variations on basic technique

Acupuncture needles, once inserted, can be stimulated by a variety of techniques such as twisting, heat or weak electrical currents.

Heat is often generated by burning a preparation of herbs known as moxa made predominantly from the herb mugwort (Artemisia moxa), either in a cone placed on the skin or attached to the needle itself. This variation is termed moxibustion. Another variation is acupressure or Shiatsu, in which acupuncture points are stimulated by pressing them with the thumb.

Another development is electro-acupuncture whereby selected needles are stimulated using low-power electric currents. These are usually just detectable by the patient and the frequency and strength of the impulses vary with the complaint. And for those who do not like the idea of needles, more recent innovations include ‘needleless’ stimulation of acupuncture points with electromagnetic fields, low-power ‘cold’ lasers and direct electrical impulses passed into the skin through electrodes. A subspeciality of acupuncture is auricular therapy in which needles are inserted into specific points in the external ear flap (auricle). Dysfunction in certain parts of the body is said to cause tender areas, or areas of high electrical conductivity, on the ear; these points are then needled in the usual way. Some practitioners combine whole-body acupuncture with auriculo-therapy, particularly for control of pain and to help treat withdrawal symptoms in cases of addiction, for example, cigarette smoking. (Artemisia moxa),