Acupuncture. Basics of. Gabriel Stux Bruce Pomeranz. Springer-Verlag Berlin Heidelberg New York London Paris Tokyo

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2 Gabriel Stux Bruce Pomeranz Basics of Acupuncture Translations of Chinese Terms by K. A. Sahm Illustrations by Petra Kofen Second, Revised and Enlarged Edition With 72 Figures Springer-Verlag Berlin Heidelberg New York London Paris Tokyo Hong Kong Barcelona

3 Dr. med. Gabriel Stux Acupuncture Center GoltsteinstraBe 26, Dusseldorf Federal Republic of Germany Prof. Bruce Pomeranz MD, Ph.D Dept. of Physiology (Faculty of Medicine) Dept. of Zoology (Faculty of Arts and Science) University of Toronto 25, Harbord St., Toronto M5S1A1 Ontario, Canada This book is based on the following books published by Springer-Verlag: Acupuncture, Textbook and Atlas ISBN / Grundlagen der Akupunktur ISBN / ISBN-13 : e-isbn-j3 : : / This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data banks. Duplication of this publication or parts thereof is only permitted under the provisions of the Gennan Copyright Law of September 9, 1965, in its version of June 24, 1985, and a copyright fee must always be paid. Violations fall under the prosecution act of the German Copyright Law. Springer Verlag Berlin Heidelberg 1988, 1991 The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product Liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in the book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. Typesetting, printing, and binding: Appl, Wemding 2119/ Printed on acid free paper

4 Preface to the Second Edition We are very pleased that it has become necessary after such a short time to publish a new edition of this handy guide to acupuncture, which is intended to combine practicality with an affordable price. It, just like the first edition, is based on our larger Acupunclure Textbook and Atlas, but we have taken this opportunity to revise and update the text. For example, several scientific advances have been included in Chapter 2 (e. g., findings of recent studies on drug addiction, antiemetic effects, and urogenital efficacy). In response to numerous requests we have added a detailed account of traditional Chinese medicine (TCM) in Chapter 8. Although most practitioners in the West have been using "scientific" acupuncture (e. g., stimulating peripheral nerves to release endorphins), a growing number are now trying TCM approaches. The mechanism of action of TCM is unknown: the method is based on empirical phenomenology and pattern recognition rather than cause-and-effect logic. Nevertheless, double-blind, controlled scientific trials are required to determine whether TCM is more effective than "scientific" acupuncture. Scientific assessment of TCM in controlled clinical trials is possible even in the absence of a scientific explanation of its mechanism of action, i. e., even if we do not know how it works. Many successful Western medical procedures are empirical; for instance, gaseous anesthetics are used widely although we do not understand how they work. We hope that the inclusion of TCM in this book otherwise presenting the conventional Western understanding of acupuncture will encourage clinicians to undertake the clinical studies necessary to determine its efficacy. Autumn, 1990 The Authors v

5 Preface to the First Edition Basics of Acupuncture is an introduction to acupuncture based on several books published in Gennan by the first author. The chapters on the scientific basis of acupuncture and electroacupuncture were written by Prof. Bruce Pomeranz, an eminent neurophysiologist who is in the vanguard of basic research into acupuncture, and teaches acupuncture as an elective course at University of Toronto Medical School. Following an introduction to the philosophical and theoretical background of traditional Chinese medicine, the diagnostic system is presented. The Chinese system of channels and functional organs and the significance of the points are described. The 14 main channels with the most important acupuncture points for daily practice are presented with didactic emphasis on morphology and clinical applicability. The Chinese point names are given in the Pin Yin Transcription according to the latest standardization of the World Health Organization and are translated by Karl Alfried Sahm into English. The methods of needling and moxibustion are described in detail with their clinical applications. The chapter on treatment is based on Western modes of diagnosis, discussed in relation to Chinese diagnostic categories, and the major principles of therapy. The most important acupuncture points are given for the different diagnoses. They should not be used as "recipes" but as hints to which underlying rules should be used for the selection of points. For a more detailed book the reader is referred to the standard textbook: Acupuncture Textbook and Atlas by the same authors (Springer-Verlag ISBN ). VII

6 Thanks are due to Prof. A. Jayasuriya, Dr. Maria Vinnemeier, Prof. Zhang Jin, and Prof. Cheng Xingnong who have had important influences on this book. Thanks to BriUa Severin, Janet Dodsworth and Alison Fisher for translation work and for correction of the manuscript. Spring, 1988 Gabriel Stux VIII

7 Table of Contents Introduction (B. Pomeranz).... Growth of Clinical Acupuncture in the West Scientific Basis of Acupuncture (B. Pomeranz) Acupuncture Analgesia (Basic Research).. Neural Mechanisms of Acupuncture Analgesia. Evidence for Endorphins and Acupuncture Analgesia Evidence for Midbrain Monoamines and Acupuncture Analgesia.... Evidence for Pituitary Hypothalamic System and Acupuncture Analgesia Conclusions.... Acupuncture Analgesia for Chronic Pain Drug Addiction.... Nerve Regeneration, Cardiovascular, Antiemetic and Urogenital Effects of Acupuncture.... Acupuncture Points (Do They Really Exist?).. Does Needling at True Points Work Better Than Needling at Sham Points?.... Are There Unique Anatomical Structures at Acupuncture Points?.... Do Acupuncture Points Have Unique Physiological Features?.... What Nerves Are Activated by Acupuncture?. Background and Theory of Traditional Chinese Medicine (G. Stux) Tao, Yin, and Yang IX

8 The Vital Energy, Life Force: Qi.... The System of Five Phases.... Diagnosis in Traditional Chinese Medicine Channels, Organs, and Points (G. Stux). 4.1 System of Channels and Organs 4.2 Point Categories Shu Points or Transport Points Mu or Alarm Points Influential Points, Hui Xue Xi-Cleft Points Five Shu Points Tonification Point Sedative Point Jing Well Point Ying Point Yuan Source Point Jing Point He Sea Point Luo Connecting Point Confluent Points Methods of Point Location 4.4 Description of Channels and Points Lung Channel Large Intestine Channel Stomach Channel Spleen Channel Heart Channel Small Intestine Channel Urinary Bladder Channel Kidney Channel Pericardium Channel Sanjiao Channel Gallbladder Channel Liver Channel Du Mai Ren Mai Extra Points X

9 Technique of Acupnncture (0. Stux). Acupuncture Needles.... De Qi Sensation Tonifying and Sedating Methods of Stimulation Sterilization of the Needles.... Complications of Acupuncture Treatment. Moxibustion.... Acupressure... Laser Acupuncture Acupuncture Treatment (0. Stux) Principles of Acupuncture and Rules of Point Selection Locomotor Disorders Cervical Spondylitis, Torticollis, Rheumatoid Arthritis Intercostal Neuralgia, Trauma of the Thorax, Ankylosing Spondylitis, Zoster Neuralgia.... Sciatica, Lumbar Pain.... Periarthritis Humeroscapularis, Frozen Shoulder Epicondylitis, Tennis Elbow Coxarthrosis, Coxarthritis Gonarthrosis, Pain in the Knee Joint. Rheumatoid Arthritis Respiratory Disorders Common Cold.. Maxillary Sinusitis. Frontal Sinusitis.. Chronic Bronchitis. Bronchial Asthma. Cardiovascular Disorders.... Coronary Heart Disease with Angina Pectoris. Cardiac Neurosis Exhaustion Conditions in Heart Disease. Hypertension.... Hypotension Disturbances of Peripheral Blood Supply XI

10 6.5 Gastroenterological Disorders Gastritis, Gastroenteritis Gastric and Duodenal Ulcers Diarrhea Irritable Bowel Disease Constipation Cholangitis, Cholecystitis, Biliary Dyskinesia, Biliary Colic Mental Disturbances and Illnesses Depression Exhaustion Conditions Agitation Sleep Disturbances Drug Addiction Alcohol Addiction Nicotine Addiction Overweight, Weight Loss Neurological Disorders.. Headache and Migraine. Trigeminal Neuralgia Hemiparesis Facial Paresis. Epilepsy... Gynecological Disorders Dysmenorrhea Pain Caused by Gynecological Tumors Analgesia During Childbirth Urological Disorders.... Pyelonephritis, Urinary Infections, Chronic Glomerulonephritis Prostatitis, Psychogenic Urological Symptoms Enuresis Skin Disorders Acne Vulgaris XII

11 Leg Ulcers, Deficient Wound Healing Eczema, Neurodermatitis Psoriasis Herpes Simplex Disorders of the Sense Organs Deafness Tinnitus Meniere's Syndrome, Dizziness, Motion Sickness, Labyrinthitis Chronic Conjunctivitis Visual Deficiency Acute Disorders and Emergencies Fainting, Collapse Epileptic Fits, Grand Mal Acutely Painful Conditions Electroacupuncture and Transcutaneous Electrical Nerve Stimulation (B. Pomeranz) Electroacupuncture, EA Transcutaneous Electrical Nerve Stimulation, TENS Acupuncture-like TENS Differs from Conventional TENS Habituation to Monotonous Stimuli Traditional Chinese Syndromes: The Diagnosis of Chinese Medicine (G. Stu x) Appendixes A-D (G. Stux) A. World Health Organization List of Indications for Acupuncture B. Nomenclature and Abbreviations for Channels and Points 276 C. Glossary of Chinese Terms D. Alphabetic List of Chinese Point Names 282 Bibliography XIII

Gabriel Stux Bruce Pomeranz Basics of Acupuncture. Fourth, Revised Edition

Gabriel Stux Bruce Pomeranz Basics of Acupuncture Fourth, Revised Edition Springer-Verlag Berlin Heidelberg GmbH Gabriel Stux Bruce Pomeranz Basics of Acupuncture Translations of Chinese Terms by K. A.