In Support of an Integrative Medicine

Hence, scientifically speaking, physiology occurs when a universal wave moves throughout the body, creating new matter.

It has been almost 35 years since the late New York Times reporter, James Reston introduced Acupuncture to the American public in 1971, as he wrote a first-page story on the way he was relieved from post-surgical pain after an emergency operation in Beijing.  At that time in the United States, there had been only a handful of practitioners who were using the procedure mostly for chronic muscular and neural pain.

Acupuncture is now one of the most popular branches of TCM (Traditional Chinese Medicine) in this country.  The therapy is now a licensed practice here and most states have their own professional organizations .

A 2002 survey cited by the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institute of Health (NIH), revealed that about 8.2 million U.S. adults had used Acupuncture, and an estimated 2.1 million U.S. used  the procedure in the previous year.

According to Li Yongming, president of the Traditional Chinese Medicine Association and Alumni (TCMAA) cited by China View (www.chinaview.com)  there are about 50 Acupuncture schools throughout the country, and about 25,000 licensed acupuncturist (L.Ac, M.Ac.), including physicians with Acupuncture training.

Practitioners here borrowed from China, Korea, Japan and Europe and have also developed their own methods.  The classical, most common method is by insertion  of very fine needles -- standardized, disposable, and FDA-approved -- in specific points (acupoints, in Chinese called ‘sku’) on the surface of the body.  Most patients would not feel pain from this procedure, and there are no serious complications from it. The needle procedure has the most extensive scientific backing, according to NCCAM.  Reston, in fact, was treated with a form of Acupuncture called moxibustion, which is stimulation by Acupuncture with added heat from a burning herb (mugworth). 

Some modern techniques stimulate the acupoints with slight electrical shock (electroacupuncture), heat, or even laser beams or sonar rays.  An entire discipline, developed in France, is ear (auricular) acupuncture, that uses the surface of the ear to stimulate systems, organs and energy paths.  Less than a decade after Reston’s article, in 1978, there was of course ‘sexual Acupuncture,’ acupuncture for treating  bad sex, developed by Frank Warren M.D. and Walter Ian Fischman, C.M.D. (Doctor in Chinese Medicine).  Borrowed from Acupuncture is the acupressure method which is what its name implies, pressure applied to acupoints without needles.   Its Asian version shiatsu, is widely used in Japan. 

One form of Acupuncture stimulation invented in Europe is a gold implant in the ear for continuous stimulation.

Western Point

There are clearly demonstrated objective measurements in Acupuncture: the electromagnetic peculiarities of the acupoints; the effects on the immune system; the inducing of pain relief through release of endorphins and monamines, and hence its effect on hormonal and neural brain activities.  There is more to it, however.  Modern research show a variety of illnesses in which Acupuncture was proven useful, either in itself or complementary to other therapies. 

Some of the conditions cited by NCCAM are addictions, headache, Stroke rehabilitation, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low-Back Pain, carpal tunnel syndrome, and Asthma.  Some studies suggest that Acupuncture relieved depression as well. As revealed by these enumeration, acupuncture is not simply an endorphin booster for localized pain, but a systemic therapy as well.  In fact, in TCM, localized diseases do not exist, except in physical injury, as the entire organism is viewed in its totality. 

The Chinese medicine was developed within certain philosophical and cosmogonic views synthesized in Taosim(or Daoism) .  The first ‘Taoists’ lived in solitude and observed nature in great detail.  They came to believe that nature’s main characteristic is beyond the visible matter, lying in its constant transformation – or flow.   The ideal state of the living body (and the Taoist were much interested in this)  was harmony in flowing, that is harmony within constant change.  Thus the Tao cannot be described as an entity (“The Tao is not the Tao”) but as a flowing state – a difficult notion for Western science as a flowing state cannot be easily measured and quantified.  This constant change within  whole systems – from the largest to the smallest --  is due to the antagonizing forces of Yin and Yang. 

Western scientists have often removed animal organs, and more recently have modified DNA, in order to observe the effects and determine the function of that organ or of a gene. Such examination would be futile in TCM, as everything is seen as a whole and in constant movement and there is little relevance in a single organ in a static state. 

Even unexplained, acupuncture can be a valuable addition to Western medicine, that has used, and still uses therapies which have not been fully explained – such as aspirin.  However, the more we learn about physics, human physiology,  hormones, enzymes, RNA, and DNA,  the closer we get to that ancient view.

Acupuncture knowledge can, and is being used as a limited technique in electroacupuncture, which views acupoints from a direct cause and effect Western perspective. [“As science encounters Chinese medicine, Western investigation will inevitably  tend to reduce the techniques of Acupuncture and herbology to a biochemical Western model” (Kaptchuk, page.  264)].  Discarding the energetic concepts of TCM, this discipline stimulates, with success, only the points which correspond to anatomical realities of muscles and nerves.  The method has a track record in relieving pain, including some intractable chronic pain.

It would be a loss if Western medicine would limit itself, by ignoring the deeper insights of TCM.  The TCM , as Ted J. Kaptchuk notes in his book, The Web that has No Weaver, “…because it emphasizes balance and relationship more than measurable quantity, can also frequently discover and treat a disorder before it is perceptible by the most sophisticated Western diagnostic techniques.  Chinese medicine is capable of touching those places that evade the microscope and that, after all, constitute human reality.” 

Disease prevention and subtle treatments are not attractive to Western medical profession, where the spectacular aspect of the cure is essential.  Fortunately,  the American public becomes more and more educated on the possibilities offered by TCM. 
   
Classical Acupuncture presumes extensive knowledge, experience, intuition, and subtlety of observation.  It also presumes a diagnosis and treatment decision-making that corresponds to its TCM basic tenet:  the energetic view of life.  To have an idea of the complexity of Acupuncture, one may note that the literature mentions 12 to14 principal and 8 secondary meridians, and about 365 to 2000 (depending on who is counting) points on the surface of the body that correspond to them.

Which points are selected, the exact space where the needle is inserted, the way it is inserted, and the length of stimulation are all important details.  Moreover, in TCM, no two patients and no two diseases are exactly the same.  In addition, as far as diagnosis is concerned, the concept of disease based on Yin and Yang, the two opposite aspects of the universal energy Qi, offers a system of categorization of diseases which is alien to the Western medicine.

Pain and Anesthesia
 
According to  Kenneth R. Pelletier, former director of the NIH-funded Complementary and Alternative Medicine Program, “In the United States, acupuncture has found its greatest acceptance and success in the management of a wide variety of painful conditions, especially musculoskeletal pain.”

As an Anesthetic in surgery, acupuncture has had a long tradition in China. Western sinologists describe the use as Acupuncture as the sole means of surgery anesthesia.  However, surgery itself does not have a long history in China.  In modern times, acupuncture is being used in combination with drugs, to diminish the amount of anesthesia drugs and reduce  postoperative pain and side effects. The literature suggests that a vast array of surgeries from dental to open heart and to colonoscopy  benefit from Acupuncture.  There is evidence that the pain relieving  benefits of Acupuncture lasted in time, after the treatment.

Although the nature of needle procedure renders placebo control studies difficult, the interest in such studies is growing. A measure of increase respect for the procedure is the fact that magazines that publish Acupuncture research done here and abroad, are now better represented in Medline, the US-based Internet medical research compilation.

Here are some of the widely cited studies that speak for the value of Acupuncture.

German researchers studied the management of chronic and acute low back and leg pain in surgery patients with lumbar disc protrusion.  They concluded that classic Acupuncture, as a drug-free treatment, resulted in significant pain reduction that become increasingly stronger with the time of the treatment, a reduction that also lasted in time, after the treatment. 

A study with surgery patients in Japan on  89 subjects and  86 controls (patients who did not received Acupuncture treatment), found that Acupuncture before surgery resulted in postoperative pain relief, a 50 percent reduction in morphine, 20 to 30 percent reduction in Nausea, a 30 to 50 percent reduced plasma cortisol and epinephrine concentration ( which are normally increased following surgery).

A Chinese study on brain surgery found that an anesthesia combination of Acupuncture and anesthesia drug resulted in a reduction of brain injury risk, especially in the area of speech.  Medline features other studies on brain surgery that corroborate the conclusions of this study.

In a 49-week study by Danish researchers on osteoarthrosis and Acupuncture revealed a considerable reduction in pain in both subjective (as described by patients) and objective measurements (as quantified by medical devices). The study  was performed by ‘blinded’ researchers who did not know which patients had Acupuncture treatments, and which were the controls.

A study by Hollinger et al., a report of 800 cases of anesthesia for open heart surgery (including valvular disease and by-pass) using ‘acupuncture in combination with chemical anesthesia and neuromuscular relaxant,’  found that this method  “can be successful for cardiac surgery, and that it allows light planes of anesthesia with less interference to circulatory regulation.”   The authors conclude that from the 800 patients studies, “it seems justifiable to recommend this Anesthetic procedure for cardiac surgery.”

The department of surgery in a cardiology hospital in Lyon, France, also has verified the value of Acupuncture in anesthesiology.  They tested the procedure in view of reducing the pain (scapulohumeral pain) during early stages following heart surgery. Using needle stimulation of certain acupoints, which (by Western physiology)  “were  not related to the anatomical part involved,” the French surgeons found  that the “Reduction of pain and angular gain were almost immediate, durable, measurable and reproducible…”

Another study on 32 mothers-to-be demonstrated the efficacy of Acupuncture in normal deliveries.  The conclusions of the study was that ‘Definite subjective and objective relief of labor pain was produced in about 60 percent and respectively 90 percent of single birth and multi-birth mothers.”  The sedation was ‘significant’ and the duration  of delivery particularly in the second and third stages was shortened, and no adverse or harmful effects were noted. 
 
In an attempt to help the decision-making process in dental anesthesia, the Department of Medical Informatics at the University of Utah, , Salt Lake City, analyzed published studies and concluded that Acupuncture is the preferred method in dental patients with myocardial infarction as it reduces the need for Anesthetic drugs. 

In the Netherlands, a comparison study between surgery with and without Acupuncture anesthesia revealed  that “A more rapid return to consciousness, an absence of hypercapnia and a smaller decrease in pH was observed with Acupuncture and transcutaneous stimulation” with no clinical disadvantages.

A study in China on brain tumor surgery complemented by Acupuncture anesthesia demonstrated that combined drug-acupuncture anesthesia resulted in “high tumor resection rate and low incidence of disability.”

Can the West Swallow the TCM Views?

The TCM, which relies on an ancient tradition dating thousands of years, views the body as consisting primarily of fields of energies, while the Western Medicine relies on structural entities such as cells and organs. The points used in classical Acupuncture (sku) are viewed by TCM physicians to be confluence points for the body’s energetic paths. The energy itself,Qi, is a universal field that is created by two opposite forces, Yin and Yang.

The history of Chinese tradition combines legend and fact.  The tradition claims that the principal Chinese book of herbs was written by the emperor Shen Nung, the “Heavenly Cultivator”  who is believed to have lived around  3000 B.C.  His pharmacopoeia that supposedly contained 365 remedies and the medical tenets that went with them, was transmitted and enriched over generations.

 The most important medical text, Nei Ching Su Wen is also partly a legend, supposedly dating from the times of the Yellow Emperor, between the  26th and 25th centuries B.C.  According to some historians, the book, which has many additions and added commentaries, was compiled around the year 1000 B.C.  The science of the pulse diagnosis was developed later, believed to have the origins in the fifth century B.C.  There are more than 20 types of pulses and they are supposed to read into the status of Yin and Yang and  determine the subtle moves of Qi.  The detailed manual for Acupuncture, moxibustion, respiratory therapy and massage was written at about the same time, by Hua T’o.  Hua T’o made observations on animal behavior and compiled a series of therapeutic movements that imitated animal movements.  Versions of these type of therapies abound in China at the present times, and they seem to become  very popular throughout the world, including the United States.  The book contains drawings with explanations and often with the name of the disease which the movement is supposed to treat (Cohen).

A widely cited study on ‘Qi’ is that of the French researcher Pierre de Vernejoul who injected a radioactive substance into Acupuncture points and then observed its movement throughout the body with a special camera.  The map that he developed corresponds to TCM meridians, with no apparent connection with any of the Western anatomic circulatory pathways.  Measurements of Galvanic Skin Responses (GSR) at the Acupuncture points demonstrate that there is a difference between the electrical activity at those points and that at other points on the skin surface. 

It was also observed that some electrical characteristics of a certain acupoint are different in health and disease states.  Author and researcher Robert Becker  gives countless testimony of the energetic nature of human body and of life in general.  His eye-opening books, Electromagnetism and Life  (1982) and The Body Electric (1985,) describing life as primarily energy-dependent,  contain perhaps some of the best, albeit indirect, arguments for the validity of TCM and Acupuncture.   Kenneth S. Cohen’s book The Ways of Qigong has an entire chapter dedicated to the scientific evidence behind Qi ) Qigong Science: Correlates of Healing Energy) (Cohen, pg. 42).

Some promoters of TCM contend that the worldview conceived by the Chinese several thousands of years ago is compatible with modern physics of quantum mechanics and field theories.  The detractors however simply claim that quantum physics and the chaos theories do not apply to our everyday world, and to medicine for that matter. 
Leaving this controversy aside (for now)  we can only limit ourselves to spelling out some of the major conclusions that the TCM drew from centuries of observation of nature, of man, and of the universe, and relate them with modern science.

Confluence Points

Yin and Yang.  In traditional Chinese system, the vital energy, Qi, is created from  the antagonism between Yin and Yang, two opposite forces that naturally tend to form a harmonious whole.   In disease,  Yin and Yang are out of balance, which means the vital energy is blocked, or there is too much of it (congestion) or too little of it (lack of vitality) or too much in one place and too little somewhere else.

 In TCM, the emotions and the organic body are indivisible and form the whole of a human being.  As the science advances in its study of the influence of the ‘mind’ on disease, it wonders which is the promoter, the mind, or the body.  In TCM, there is no such question, as the emotion may carry a disease and a disease may induce emotions.  The TCM actually relates emotions with certain energetic organ disharmony: liver with anger, sadness with lungs, anxiety and fear with kidneys and bladder.  The disease manifests itself under both aspects, as it is in fact a disruption of the flow energy that ultimately reverberates throughout the whole body, if not corrected.  This concept is already at home with the science of brain neurotransmitters: “Many researchers and physicians now agree that the brain/body split is over.  The field that studies this connection is psychoneuroimunology” (Sahelian, pg.49).  The word ‘many’ seems to be more a wishful thinking notion than reality, as after 10 years of this writing, the American Medical Association still holds on to old believes.

Western medicine gets the closest it can be to TCM through the science of hormones, endocrinology.   The endocrinologist cannot escape the language common to TCM.  Here’s how Jay Tepperman, a professor of experimental medicine, describes holistic medicine  in a text book“… the study of endocrinology can be viewed as one long exercise in correlation. Anatomy, histology, biochemistry,  and histochemistry, microbiology, immunology, pathology, clinical medicine, public health, and preventive medicine, genetics and information theory all converge in reflections about the Endocrine system. “

A striking resemblance to TCM biological concept is offered by the ephemeral action of enzymes.  The enzymes, at the base of all physiological processes, have a function-like quality about them, as they come in and out of existence at an extremely fast, immeasurable, pace.

In human physiology, the most vital aspects are characterized by pairs of chemicals in opposition and homeostasis - the proteins in the genetic material, vitamins, minerals, hormones, fatty acids, prostaglandins.  A specific disease occurs when the balance within a pair is disrupted. Well-known examples are sodium vs. potassium,, calcium vs. phosphorus, Omega 3 vs. Omega 6 fatty acids, and especially the hormones. The  concept of Yin and Yang are suggested by Tepperman’s  observation that  “The most impressive single feature of hormonal regulation is its coordinate nature. …The basis of this kind of coordination is the fact that biochemical processes are often controlled by hormonal antagonists (parathyroid hormone versus calcitonin; insulin versus glucagon). Often, a signal which elicits the secretion of a hormone appropriate for a certain physiologic circumstance simultaneously inhibits that of its antagonist.”

The physicians in endocrinology have the hardest time diagnosing disease,  relating direct cause and effect, and treating conditions.  They also are the most familiar with the changes in behavior and emotional wellbeing related to hormone metabolism.  The effects of hormones are present within every cell of the body.

“If one analyzes the overall effect of any hormone on its sensitive cell, the most impressive single fact one can observe is the  coordinate nature of the cell’s response to its hormonal stimulus.”

In trying to  correlate the state of constant flow with modern science, I would think of the atom in its delicate  homeostasis with its positively-charged proton and the negative electron in temporary, co-dependent relationship, in which the electron is always checking out the environment for a better more stable relationship.   The electron has no mass, according to the latest research, and it acts more like a wave than a material entity.  If, itself, is not a wave, it is known to cause waves – as it constantly moves in and out of atoms, creating new atoms and constant electromagnetic fields. It’s role appears to be moving energy fields from one place to another. If I really wanted to find an ‘evidence-based’ subtle universal life force with my high school biochemistry, I could look at the carbon electrons, which, in Western thought,  constitute the basis of all biological change.  Upon each transformation, the carbon’s frantic activity, gives out billions of subtle energy fields, all different from each other. 

Hence, scientifically speaking, physiology occurs when a universal wave moves throughout the body, creating new matter.

Even More Far Out
 
It has been speculated that the knowledge of the meridians was transmitted over generations through exceptional people able to see fields of energy  -- spectra of electromagnetic waves, or colors -- which are outside our visual range.  This extra-sensory ability, which the Chinese have called,  the ‘third eye’ apparently has enabled these people to draw maps of the pathways, meridians, which are at the basis of the Acupuncture system.  There are still people all around the world , claiming to have a variety of visual perceptions beyond what the mainstream human sees, but most scientists are not taking them seriously. The ‘third eye’ in TCM is located somewhere behind the middle of the forehead, where, in Western anatomy, the pineal gland is located.  The pineal gland is, coincidentally, the ‘master clock’ gland that determines the body circadian cycle.  

It is structurally close to the eye retina.  Studies on the pineal gland have found it to be connected with the reproduction system, the gonads which in the TCM form the primary stores of one’s energy, the ‘jing ‘ The gland contains a unique enzyme that allows for the transformation of serotonin into the ‘light’ hormone melatonin.  How everything fits together is not clear, but we know that it does. The pineal gland is believed in Western medicine to read light due to its link to the eyes through the nervous system, however some research with ‘blinded’ subjects show that there is more to the pineal gland that meets the eyes -- so to speak.   Studies on the so-called biorhythms, on hormones,  as well as experiments and observations by NASA on lengthy flights, do suggest that human physiology and even anatomy are affected by our electromagnetic environment -- which is invisible to most of us.  We know about the vitamin D synthesis, and there is some  research (ex. with Canadian children and whole spectrum lighting in schools) showing normal hormon metabolism depends on the whole electromagnetic spectrum.

In their book Electromagnetism and Life,  Becker and  Marino demonstrate that the electromagnetic aspects of life are not mere side effects of chemical processes, but intrinsic components of health. As an osteopath, Robert Becker  himself has used electromagnetism to heal bones, and he envisions a time when electromagnetism will become  a valuable therapeutic tool.

Russians have long been at the forefront of energetic medicine based on scientific studies.  Scientists here have developed a number of electromagnetic devices emitting a wide range of electromagnetic fields, which are not only used to diagnose disease, but also to treat them, by causing beneficial electromagnetic interference with diseased organs. Researchers at the department of therapies for painful syndromes at the Russian Center of Surgery of the Russian Academy of Medical Sciences, extol the use of integrative methods of treatments for pain relief, including resonance electroacupuncture analgesia and therapy. 

According to these researchers, “Integrative methods of clinical reflex therapy create conditions for replacing traumatic surgical and radiological method used in the treatment of critically ill patients…”  Various bioelectromagnetic forms of treatments are being used now around the world, and Americans remain  behind in this technology. In China, an electromagnetic device that emits electromagnetic fields in the ranges of heart and brain was shown to boost the immune system in rabbits, and help children with Asthma.

 In TCM, all edible plants have some kind of action on Qi, moving it in some direction or another.  Studying the therapeutic qualities of a plant, the Chinese health practitioners have considered the taste, the color, the time of the day, and of the year when budding, flowering occur, or when it is harvested, and whether or not it grows in the ground or above it.  In laboratory, each plant contains dozens of chemicals (phytochemicals) such as flavonoids, hormones, fatty acids, volatile oils, and, obviously,  their existence depend on, among other factors,  their relationship with the plant’s energy source, the sun. 

Modern studies are finding more and more therapeutic uses for these chemicals.  Many of them affect major physiological  functions in the body, and some have specific affinities for certain organs. Ironically,  increased research on phytochemicals’, have lead some Western nutritionists use visual terms much like the TCM physicians, although their language reveals a primitive, simplified concepts such as:  the dark green  may diminish heart risk, the deep blue, the yellow and the orange may improve eyesight, and may even prevent brain Atherosclerosis,  and the bitter plants may improve digestion, etc…  

In the TCM, even the shape of a plant is significant,  a fact that was the subject of great ridicule by some Western ‘scientists’ detractors, such as those in The Skeptics group.  In TCM, the  kidney-shaped bean nourishes the kidneys, and the famous ginseng root was noted to have the  shape of a human being.  And yet, Western science has not offered any explanation to date as to why the beans are shaped the way they are, and why the kidneys are shaped the way they are.

And they haven’t offered an explanation yet for why the chromosomes are set in a weird, contorted, helix-shaped position, the same shape the magnetic field has.  The science can explain the sand dunes, but cannot explain yet the shape of the kidneys. Yet, if we observe nature like the ancient Chinese did, we can see that invisible waves may explain shapes.

The ginseng root, by the way,  is one of the few known ‘adaptogen’ plants, that is, plants that, when used therapeutically, have a tendency towards homeostasis. If one has high Blood pressure for example, the root tends to lower it, if one has low Blood pressure, ginseng will raise it. Both Western and TCM systems acknowledge that homeostasis is a desirable condition that best characterizes the state of health.

The Western science does not have the tools and the knowledge to disprove the concepts of  TCM knowledge – and whatever transpires, appears to corroborate it.

Sources of Reference

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Kenneth R. Pelletier, The Best Alternative Medicine. What Works? What Does Not? 2000. Simon & Schuster, New York,

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http://news.xinhuanet.com

Ray Sahelian, M.D.,  DHEA – A practical Guide  1996, Avery Publishing Group, New York.

Kenneth S. Cohen, The Way of Qigong,  1997, Ballantine Books, New York.

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This article written by, Elena Marcus