Friday, 17 April 2015

Acupuncture: Traditional and Modern: Reflections on Acupuncture, Osteopathy, and the history of medical science

Acupuncture:  Traditional and Modern:  Reflections on Acupuncture, Osteopathy, and the history of medical science.

Traditional Acupuncture has long used the inner and outer bladder lines, and also the Huatuo Jiaji points, 0.5 cun from the mid-line of the spine.   Very useful from a practical point of view for back pain, but also pertaining to the spinal nerves, and therefore able to influence the whole body and nervous system. 

No doubt the famous Chinese physician and acupuncturist Huatuo realized their importance, even though he didn't know the anatomical terms, as the ancient Chinese physicians didn't dissect cadavers, and were not anatomists, like their early European counterparts we beginning to become.  

Early recorded European records show that it was the ancient Greeks that began dissection and the study of anatomy, later followed by Romans such as Galen.  However the only cadavers they had access to were from convicted felons, and it the thought of being permanently crippled and maimed (as ghosts) in the underworld and the afterlife was a gruesome punishment for such criminals. Perhaps all serving as an additional deterrent, to help maintain law and order, and social harmony.

OK there might also have been a bit of grave-robbing  going on, as not doubt also happened in later centuries once medical schools were more widely established and bodies were in demand for dissection.  All together a gruesome subject  - and perhaps why a more civilized culture like ancient China did not resort to such barbarities.  After all, they knew how energy circulated in meridians the body  (from qigong practice and meditation) and were far more advanced in their own understanding of physiology in terms of qi and blood, yin and yang, excess and deficiency and so on.

To return to the Acupuncture points (and Chinese physicians such as Huatuo) the mechanism and action and underpinning neuroanatomy and physiology of these back points is now well understood.  Acupuncture here stimulates paraspinal muscle (spinalis, semi-spinalis, etc.) and their segmental spinal nerves, and feedback into the dorsal horns and associated spinal reflexes. 

One of the mechanisms of acupuncture is likely to be via alpha-delta fibres that inhibit the nocieceptive pathway in the dorsal horn of each vertebrae, and this segmental effect can influence visceral conditions, both for pain and disturbed autonomic reflexes.  The intermediate cells in the dorsal horns, by way of collateral terminals, also release the neurotransmitter enkephalin (which blocks pain transmission).

The somato-visceral reflexes involved here, pertain to underlying viscera (via the sympathetics and segmental vasomotor reflexes) and again these effects seemed to be well known to the ancient Chinese physicians and acupuncturists, as they noticed that acupuncture had benefits well beyond musculo-skeletal medicine.  They were effecting the nervous system itself, not just treating muscle and joint pain.  

Integration of modern and and ancient medicine can give a much better understanding.  Both world-views have a great deal to contribute.

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