Acupuncture is the procedure of inserting and manipulating needles into
various points on the body to relieve pain or for therapeutic purposes.
The earliest written record of acupuncture is the Chinese text Shiji
(Records of the Grand Historian) with elaboration of its history in the
second century BCE medical text Huangdi Neijing (Yellow Emperor's Inner
Canon). Different variations of acupuncture are practiced and taught
throughout the world.
Acupuncture has been the subject of active scientific research both in
regard to its basis and therapeutic effectiveness since the late 20th
century, but it remains controversial among medical researchers and
clinicians. Research on acupuncture points and meridians is preliminary
and has not conclusively demonstrated their existence or properties.
Clinical assessment of acupuncture treatments, due to its invasive and
easily detected nature, makes it difficult to use proper scientific
controls for placebo effects.
The World Health Organization and the United States' National Institutes
of Health (NIH) have stated that acupuncture can be effective in the
treatment of neurological conditions and pain, though these statements
have been criticized for bias and a reliance on studies that used poor
methodology. Reports from the USA's National Center for Complementary
and Alternative Medicine (NCCAM), the American Medical Association (AMA)
and various USA government reports have studied and commented on the
efficacy (or lack thereof) of acupuncture. There is general agreement
that acupuncture is safe when administered by well-trained practitioners
using sterile needles, and that further research is needed.
Acupuncture points and
Classical texts describe most of the main acupuncture points as existing
on the twelve main and two of eight extra meridians for a total of
fourteen "channels" through which qi and Blood flow. Other points not on
the fourteen channels are also needled. Local pain is treated by
needling the tender "ashi" points where qi or Blood is believed to have
The zang-fu of the twelve main channels are Lung, Large Intestine,
Stomach, Spleen, Heart, Small Intestine, Bladder, Kidney, Pericardium,
Gall Bladder, Liver and the intangible San Jiao. The eight other
pathways, referred to collectively as the qi jing ba mai, include the
Luo Vessels, Divergents, Sinew Channels, ren mai and du mai though only
the latter two are needled. The remaining six qi jing ba mai are
manipulated by needling points on the twelve main meridians.
Normally qi is described as flowing through each channel in a continuous
circuit. In addition, each channel has a specific aspect and occupies
two hours of the "Chinese clock".
The zang-fu are divided into yin and yang channels, with three of each
type located on each limb. Qi is believed to move in a circuit through
the body, traveling both superficially and deeply. The external pathways
correspond to the acupuncture points shown on an acupuncture chart while
the deep pathways correspond to where a channel enters the bodily cavity
related to each organ.
The three yin channels of the hand (Lung, Pericardium, and Heart) begin
on the chest and travel along the inner surface of the arm to the hand.
The three yang channels of the hand (Large Intestine, San Jiao, and
Small Intestine) begin on the hand and travel along the outer surface of
the arm to the head. The three yin channels of the foot (Spleen, Liver,
and Kidney) begin on the foot and travel along the inner surface of the
leg to the chest or flank.
The three yang channels of the foot (Stomach, Gallbladder, and Urinary
Bladder) begin on the face, in the region of the eye, and travel down
the body and along the outer surface of the leg to the foot. Each
channel is also associated with a yin or yang aspect, either "absolute"
(jue-), "lesser" (shao-), "greater" (tai-) or "brightness" (-ming).
The theory of the channels is interrelated with the theory of the
Organs. Traditionally, the internal Organs have never been regarded as
independent anatomical entities. Rather, attention has centered upon the
functional and pathological interrelationships between the channel
network and the Organs. So close is this identification that each of the
twelve traditional Primary channels bears the name of one or another of
the vital Organs. In the clinic, the entire framework of diagnostics,
therapeutics and point selection is based upon the theoretical framework
of the channels. "It is because of the twelve Primary channels that
people live, that disease is formed, that people are treated and disease
arises.". From the beginning, however, we should recognize that, like
other aspects of traditional medicine, channel theory reflects the
limitations in the level of scientific development at the time of its
formation, and is therefore tainted with the philosophical idealism and
metaphysics of its day. That which has continuing clinical value needs
to be reexamined through practice and research to determine its true
The meridians are part of the controversy in the efforts to reconcile
acupuncture with conventional medicine. The National Institutes of
Health 1997 consensus development statement on acupuncture stated that
acupuncture points, Qi, the meridian system and related theories play an
important role in the use of acupuncture, but are difficult to relate to
a contemporary understanding of the body. Chinese medicine forbade
dissection, and as a result the understanding of how the body functioned
was based on a system that related to the world around the body rather
than its internal structures. The 365 "divisions" of the body were based
on the number of days in a year, and the twelve meridians proposed in
the TCM system are thought to be based on the twelve major rivers that
run through China. However, these ancient traditions of Qi and meridians
have no counterpart in modern studies of chemistry, biology and physics
and to date scientists have been unable to find evidence that supports