Acupuncture
Subtle ... but profound. (The Bus 3.13)
Welcome aboard The Bus!
The Stop
Acupuncture is a form of ancient Chinese medicine consisting of the ‘insertion of one or several small metal needles into the skin and underlying tissues at precise points on the body’ to relieve pain, cure disease and improve general health. The underlying principles were established in China before 2500 BCE, and the practice of acupuncture - thought to have begun as a formalised discipline around 1000 years later - was first described as an ‘organised system of diagnosis and treatment’ in the The Yellow Emperor's Classic of Internal Medicine (ca. 100 BCE). The first European to witness its use was the Dutch physician and botanist Willem ten Rhijne who, in about 1680, was working for the East India Company and witnessed acupuncture in Japan. A flurry of interest in the early 19th century proved short-lived, but by the late 20th century acupuncture had reached a level of widespread acceptability bolstered by a National Institute of Health (USA) report citing ‘positive evidence for its effectiveness’ in a range of conditions.1
Underlying acupuncture are principles found in the ancient Chinese philosophies of Confucianism and Taoism, and in particular these schools’ associated teachings on the dualism of yin and yang. The yin (the female principle) is considered to be passive and dark and is represented by the earth, whereas the yang (the male principle) is active and light and represented by the heavens. In the human body these powerful forces interact as they do ‘throughout the natural universe as a whole,’ and as long as they are balanced a person remains healthy. However, if there is an imbalance or ‘undue preponderance’ of these forces in the body, physical and/or emotional disease will follow. The goal of traditional Chinese medicine (TCM) is to return the yin and yang to a balance with each other, thereby restoring the patient’s health.
The philosophy of TCM explains that an imbalance of yin and yang leads to an obstruction in qi2- the name given to the life force believed to flow through 12 separate meridians, or pathways, in the body. Each of the meridians is associated with a major organ (liver, kidney, heart, etc.) and a balanced alignment between all of these meridians and a smooth flow of qi enables a ‘functional body system.’ As illness occurs when one or more of these meridians is blocked, acupuncture is designed to affect the yin and yang in these different channels in order to reopen the meridian and enable the qi to flow ‘freely and harmoniously.’
The practice of acupuncture consists of the insertion of small, hair-thin needles into a combination of hundreds of points located over the 12 primary meridians and a further number of specialised ones. Typically inserted between 3 to 10 mm (0.1 to 0.4 inch) deep, the needles may be slightly ‘arrow headed’ or have extremely fine points, and once placed may be twisted, twirled, or even connected to a low-voltage current for the duration of use. Needles are frequently inserted at a ‘considerable distance’ from the point on which they are intended to act, and ‘successive points on a specific meridian may affect widely different areas or conditions.’ The location of the points and their use alone and in combination is mastered over many years of training and mapped by ‘innumerable diagrams and models.’
Acupuncture remains controversial because scientific studies have not yet fully explained how it functions within a Western medical framework. Not accepting TCM’s philosophical explanation of the practice working due to its effect on qi, Western explanations tend to be biochemical: acupuncture points are believed to stimulate the central nervous system which releases chemicals into the muscles, spinal cord, and brain. These biochemical changes in turn ‘may stimulate the body's natural healing abilities and promote physical and emotional well-being,’ and - in a Western understanding at least - it is these ‘naturally released substances’ which provide the beneficial effects experienced with acupuncture.
The Detour
Today’s Detour is to a fabulously animated short (4:13) video, ‘La plongeuse.’ It’s the story of a professional diver driven to distraction by the relentless blasts of her trainer's whistle. Exhausted, she’s unable to dive again until she visits a masseur. Interesting throughout and worth the time.
The Recommendation
Today’s Recommendation is Alan Watts’s Tao: The Watercourse Way. Published posthumously in 1975, the book is a distillation of Watts’s understanding of the Chinese philosophy of Taoism. A master at interpreting and communicating Eastern philosophies to a Western audience, Watts produced numerous texts considered classics of the form. This text, however, is uniquely clear-eyed and concise: ‘a profound and worthy work, left by a teacher to echo and re-echo’ (LA Times). Highly recommended for anyone interested in these matters.3
Remember: though you can buy Tao: The Watercourse Way from Amazon, you can also get it from your local new or used bookstore - or even check it out from the library. And those options are better for everyone.
The Sounds
Today’s playlist is composed of five tracks that appeared on an early version of last week’s Nostalgia issue4 and I didn’t want to let them slip away. So, though they have nothing to do with acupuncture … here they are anyway: ‘Carolina in My Mind’ (James Taylor, 1976),5 ‘Reminiscing’ (Little River Band, 1978), ‘Never Going Back Again’ (Fleetwood Mac, 1977), ‘Black Cow’ (Steely Dan, 1977) and ‘I Saw the Light’ (Todd Rundgren, 1972). Enjoy!
The Thought
Today’s Thought is attributed to the ancient Greek philosopher and physician, Hippocrates.6 Though not an acupuncturist, in many ways this sums up an important underlying philosophy of the practice:
‘It is more important to know what sort of person has a disease than to know what sort of disease a person has.’
If you have a thought on this Thought - or any part of today’s issue - please leave a comment below:
And that’s the end of this Stop - I hope you enjoyed the diversion!
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Until the next Stop …
In particular, ‘systematic reviews’ have provided reliable evidence for acupuncture’s use in treating nausea (from various causes), dental pain, back pain, headache, fertility problems and issues surrounding addiction. I’ve had acupuncture many, many times - not least because my brother is a highly-respected acupuncturist who, it just happens, is having a birthday today! Happy Birthday, Greg! Anyway … acupuncture is a big topic - not least because of its connection to various versions of Chinese philosophy and Chinese Traditional Medicine for which there’s no space in a single issue to explore. Future Stops, though. Sources for today’s Stop include: Acupuncture (Britannica), Acupuncture (NIH), Rheumatology (Oxford U Press) and Acupuncture (Johns Hopkins).
Pronounced ‘chee.’
My copy is dated 4 February 1999, and I obviously read it closely: its pages are filled with underlinings, notes and questions, all in my handwriting - but it’s been so many years since then, I’ve mostly forgotten reading it. At the time, I was mentoring a student - Rob - on his Senior Project: a paper on Taoism and a book of photographs illustrating the various aspects of the philosophy, in particular the principles of li, wu-wei and te. Realising I couldn’t help him if I didn’t understand what was going on, I did a lot of personal research that ended up affecting my thinking today. I just wish I still had a copy of his project - it was an amazing achievement.
The Bus 3.10. I usually make several versions of a playlist and the tracks that don’t make the cut get stored for potential future use - though some are consigned to deletion. The playlists are one of my favourite parts of The Bus - especially, as over 560 tracks have been recommended, deeper cuts are starting to emerge.
Though originally recorded in 1969, ‘Carolina in My Mind’ was re-recorded for his Greatest Hits album - which provided the version everyone seems to know.
Traditionally thought of as the ‘father of medicine,’ Hippocrates (460-375 BCE) is a fascinating individual. A future Bus Stop for certain, but in the meantime: Hippocrates (Britannica)
In my position at the VA I work with Complementary and Integrative Health providers including acupuncturists. I’ve heard countless success stories, including Veterans with chronic pain finding relief from needles in the ear (Battlefield Acupuncture). I also hear from the skeptical physicians. While there’s significant evidence for its efficacy, I also wonder about the role of non-specific factors, such as the benefit of another person touching and caring for you. Like energy medicine, the success rates don’t make intuitive sense...but they’re real. We also know the placebo effect is startlingly powerful, and that may play a role. Regardless, I’m an advocate for its effectiveness even without knowing the mechanism. Great overview Bryan!
Every time I hop on the Bus, there are hidden elements of a 30 year Time Machine!