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An Overview of Chinese Acupuncture from Past to Present  

中医鍼灸の過去と現在の全貌

Edited version of a lecture given by Dr. Yu Rong at the Kanazawa Medical University on November 29, 2009

兪 戎  2009年11月29日  於金沢医科大学

 

1. Introduction

From the moment of birth on human beings are subjected to constant physical and mental stresses [1]. Various regions of ancient China used different methods to accommodate: moxa in the cold North; needles of flint or Bian-stone in the East; medicines and herbals in the West; nine classical needles in the South; with remedial massage and breathing exercises or Qi-gong in Central China [2,23,24]. Acupuncture formed a basic part of treating the whole organism, can stimulate various biological activities; maintain natural homeostasis functions of the living body [2, 3, 4, 12, 14, 36]. Today acupuncture has been used and tested in a wide range of health problems not only in China but also in the world [5, 6, 7, 8].

In 1996, the U.S. Food and Drug Administration reclassified acupuncture needles and substantially equivalent devices from class III (premarket approval, investigational use) to class II (special controls), which includes medical devices for general use such as scalpels and syringes [9].

Clinical research provides a systematic approach for understanding of disease and dysfunction that can be effectively treated by acupuncture; physiological research examines how acupuncture works. Undoubtedly, understanding the mechanisms by which needling promotes healings enhances the acceptance of acupuncture in the West, particularly when changes are detected in cells or molecules related to neural [10,11,12,36,37,38], hormonal [13,33], immune [4,14,30,31,32], cardiovascular [15], gastrointestinal [16], and other biomedically defined systems [17,18]. In consequence, acupuncture is rapidly moving out of the arena of "alternative" medicine. However, the question guiding most mechanism-directed research "What biochemical or physiological changes correlate with acupuncture" is useful and indispensable but limiting. Equally needed are studies that ask the broader question "What can acupuncture tell us about how the body functions that Western medicine have not yet discovered?"  Although enthusiastic regarding the growth of acupuncture, it should be noted that many research papers have been published without mention of the philosophical traditions inherent in its practice. 

 

In China, acupuncture has a clearly recorded history of about 2,400 years [19,22]. It has always formed part of treating the whole organism through an individualized treatment system. The present paper reviews the progression of acupuncture in China with the potential to revealing additional biomedical correlates of acupuncture and for shedding light on new ways to understand  Traditional Chinese Medicine (TCM) and human health.

 

2. Acupuncture : when and how it was developed

The oldest records of ancient Chinese medicine were found on bone etchings with inscriptions from at least 2000 BC. Many Bian-stones for medical treatments were found from ruins in China dating back to the New Stone Age [20,22]. Some of these stone slivers were used to make skin incisions and to stimulate specific points on the body. According to the record in 'A Dictionary of Characters' compiled by Wang Bin during the Han dynasty (206 BC - 220 AD), 'bian' means 'the use of a sharp edged stone to treat disease'. This was the beginning of acupuncture. Bone needles and bamboo needles were also used. With the development of metal casting techniques, copper, bronze, gold and silver needles were developed. In 1968 a set of nine needles, four being of gold and five of silver were discovered in the tomb of one of the Han-Prince Chungshan, dating from 112 BC [22]. Today some acupuncturists use gold and silver needles, but the majority use only stainless steel filiform needles. 

Moxibustion was gradually created after discovery and using of fire. It was developed separately from acupuncture, although it is now very much a part of current acupuncture practice. The first recorded attempt at conceptualizing and treating disease by moxibustion dates back to 1324 BC during the Shang dynasty, was confirmed by the discovery of the tortoise shells with Chinese character inscriptions [20,22]. The main material of moxibustion is made from the dried leaves of Artemisia vulgaris. Today, moxibustion is generally applied over a group of the acu-points as acupuncture needles. Moxa can be used in a variety of ways. Loose moxa is made into a cone and burnt on the skin, the cone then being removed when it is half burnt, to avoid blistering. Moxa can also be used as a needle moxa, a moxa stick burnt a centimeter or two away from the skin, or over the herb-platform like ginger, garlic or aconite tuber etc. so that the practitioners can not only control the heat value of combustion, but also induce various immune system responses percutaneously based on the different chemical compositions of moxibustion materials [20]. Both animal and human studies suggest that stimulation of moxibustion can lead to a wide range of immune responses, including cell-mediated and humoral immunity [14, 30,31,32] and improve the depression state and myodynamia [33].

 

Chinese medicine developed and prospered greatly during the Zhou dynasty 1066-221 BC. State public health doctors were employed and kept very accurate clinical records [22]. One of them was the famous Dr. Bian Que. He developed and refined the radial pulse diagnostic microsystem, which can evaluate the patient's overall condition from minute to minute. The pulses also serve as a subjective measurement from visit to visit, revealing the stability of the changes made through the acupuncture treatments. Dr. Bian Que’s acupuncture treatment based on the visual and pulse diagnostic procedures, to cure a comatose prince of Kuo-State in 384 BC with the Bian-stones and metal needles, was described in details and marked the earliest known record of an effective cure by acupuncture [19,22]. This was also the first record of acupuncture being used with emergency medical situations. Not limited to the high society peoples, many discovered sculptures in northern China indicated that Dr. Bian Que and his followers practiced medicine including acupuncture for the common peoples [22]. 



 

Two silk scrolls recording meridians and collaterals dating from 200 BC, "Moxabustion Classic with Eleven Foot-Hand Meridians" and "Moxabustion Classic with Eleven Yin-Yang Meridians", which were discovered at Mawangdui, Changsha City in 1973, provided the earliest material proof for the description of the meridians, collaterals and acu-points [22]. 



 

The first significant milestone in the history of TCM and acupuncture is the Yellow Emperor's Nei Jing, or the Yellow Emperor's Classic of Internal Medicine [23, 24]. The Nei Jing, multiple authors contributed to this work, served as the earliest major source of classic medicine dating from the Han dynasty in the 2nd century BC, during the Warring States period. The Warring States period is a particularly prosperous time in Chinese history [19]. Two main philosophical ideologies surfaced: Taoism and Confucianism. Confucianism defined the social status. It was opposed to the development of anatomy and surgery, the whole body should remain complete throughout life and as well as in death. Compared to the closed system of Confucianism, Taoism was an open, natural and balanced holistic system. Chinese medicine is based on this open system. At that time, many people still believed in divination and superstitious myths and magic. The Yellow Emperor's Classic of Classic Medicine clearly stated that pathogenesis is connected with the internal and external environment. Therefore, Nei Jing represented the classical scientific view of medicine so as to defeat divination and superstition.

 

3. The spirit of TCM, what the Yellow Emperor's Nei Jing tells us?

The Nei Jing consists of two parts: the first part is Su Wen, means plain questions. It begins with a discussion between the Yellow Emperor Huang Ti and his Minister Chi Bo to introduce the philosophy of Chinese Medicine, such as the concepts of the five agents doctrine and the opposing effects of the Yin and Yang that states opposite ends of a spectrum are vital for change as well as internal balance. The Su Wen presented a unified and comprehensive system of Chinese medicine. These concepts are believed to illuminate the visionary aspects of the work that focused upon the climate, the environment, and behavior as precipitants of disease and the primary natural laws that govern illness. Furthermore, the objective to preserve and protect an individual's well being began to surface with descriptions that outline methods to normalize emotions, employ balanced diets, maintain personal hygiene, consume clean water and fresh food, and to incorporate regular exercise into one's daily regimen.

 

The second part of Nei Jing is the Ling Shu. Its focus was acupuncture. It described types of Qi, the meridians, locations and functions of 160 points, functions of the zang-fu organs, nine types of classical needles which most of them are still being used today, and their respective needling techniques. 


The Nei Jing indicates six parenchymal, energy-producing organs relating to yin, six visceral, hollow, substance-transporting organs relating to yang. It is important to note that in TCM, the liver, heart, spleen, lung, and kidneys are not only the anatomical names, but also refers to the functional units to which each of them belongs, and entail a wide range of concepts. The Nei Jing authors regarded the human body as a microuniverse reflection of the macrouniverse, and considered the physician's role was that of maintaining the body's harmonious balance, both in relation to the internal and external environment. Organ pathology is identified either in conventional biomedical terms or as a disturbance in the organ's physiological activities according to acupuncture terms (e.g. nephrolithiasis is a disturbance in both Kidney and Bladder organs and spheres of influence). Based on the unified philosophy, classical anatomy, physiology, pathology, etiology, diagnosis procedures, and most important, strategies of preventive medicine, it is unequivocally that the Nei Jing is a leading classical science treatise.

 

4. The long prosperity and the sharp decline of TCM and acupuncture

The cornerstone of TCM is logic-based individualized therapy. Zhang Zhong Jing, in the 2nd century did the pioneering work of the systematization of TCM logic-based individualized therapy [22,25]. He approached the process through the use of four diagnostic procedures: visual examination, examination by auscultation and smell, inquiring, palpation, and more importantly, the analysis, to find the disease’s nature and root causes. These techniques allow the doctors to apply qualitative and quantitative research to gather and analyze information systematically, and to do so with attention to minimizing bias. For instance, the same disease with the same surface symptoms may constitute two or more differentiations based on TCM diagnostic procedures and the analysis. This was TCM’s greatest contribution to medicine. Combining acupuncture with medical herbs according to the traditional logic, and identification of pattern according to six meridians (which means classification of diseases into six stages of progression) were also his contributions. Although this article focuses on acupuncture, it must be realized that acupuncture and moxibustion represent only one facet of Chinese medical system.

In AD 282, acupuncture was comprehensively summed up in the "Rudiments of Acupuncture and Moxibustion" (Zhen Jiu Jia Yi Jing) by Huangfu Mi. It listed 349 points and their clinical indications for the first time, it was the first book devoted solely to acupuncture and moxibustion theory and treatment; Huangfu Mi also established the standards for safe practice. Some acu-points, mainly based on anatomical foundations, were forbidden to be used with acupuncture or moxa. The principle of a superior physician is to prevent; common physician is to treat the present disease; ignorant physician is to pass help, was presented by him. Today, the basic concepts of TCM acupuncture is to first, improve the overall state; second, prevent the disease before the disease-oriented state; and third, the treatment of disease [20]. Acupuncture therapy is not miraculous. It has its appropriate range of applications, and like any other medical intervention, yields good results in well-selected early problems and less successful results when chronicity and complexity of the presenting problems increase. Usually the best moment to initiate acupuncture therapy is early in the evolution of a problem. However, the flexibility and adaptability of acupuncture allow it to be practiced at almost any stage of treatment.  


From the Han dynasty (206 BC - AD 200) to the Ming dynasty (AD 1368-1644), acupuncture practice was refined and its literature underwent continual exegesis. Research, education, clinical refinement, and collation and commentary on previous classics flourished in the Ming dynasty. Acupuncture has evolved over 2 millennia, both through refinements based on treatment responses and through adaptations to changing social situations.

 

During the Tang period (AD 618-907), China was undergoing the process of economical and cultural prosperity of the feudal society. The Imperial Medical College set up a special acupuncture department. The institutions of acupuncture doctor, acupuncture instructor, acupuncturist, acupuncture student, besides the institutions of medical doctor, doctor and medical student were organized, and acupuncture was administered under the authorization of the national government [22]. Not only the knowledge and skills of TCM but also these medical policies had a profound influence on medical practice in Japan [43]. The Tang dynasty witnessed a great flowering of the art of acupuncture and moxibustion. The Thousand Golden Remedies by Sun Simiao was one of the products of this period. This text was the first to contain clear color charts of the channels with front, side and back views of the body, first to introduce the location and application of Ashi acu-points; obviously a great boon to students and teachers of acupuncture.

 

During the Sung dynasty (AD 960-1280), the improvement and extensive application of type case printing techniques greatly promoted the development of acupuncture as far more books became available. In 1027, 'The Illustrated Manual on the Points for Acupuncture and Moxibustion as Found on the Bronze Figure', was written by Wang Weiyi. Wang made bronze figures holed with acu-points, linked into meridians, for use in teaching and examinations. The statues were used in the Imperial acupuncture exams in ancient China. The statues were coated in thick wax and then filled with water. Students taking the exam would locate the acu-point and needle into the wax covered statue. When the needle was withdrawn a small drop of water would be evident if the student had needled the correct point.  Visual teaching methods of acupuncture were greatly developed.

 

During the Yuan dynasty (1279-1367), the famous TCM doctors, He Ruoyu and Dou Hanqing suggested that the acu-points should be selected according to the chronobiology (midnight-noon ebb-flow cycles) in the book of 'The Indication of Acupuncture', which the original thoughts could be traced back to the Nei Jing [23,24]. They discussed the rhythms of meridians, and explained the close relationship between selection, compatible application of acu-points and the time. There is by now indisputable evidence that physiological variables cycle on a daily basis, such as circadian rhythms [44] and immune responses [45].

 

Research, education, and clinical refinement flourished during the Ming dynasty (AD 1368-1644). In 1601, Yang Chichou edited the Great Compendium of Acupuncture and Moxibustion (Zhen Jiu Da Cheng), where pediatric acupuncture was introduced. The Zhen Jiu Da Cheng was the most influential medical text for later generations in Asia and Europe. It was the source of acupuncture information transmitted to Europe in the 17th through the 19th centuries via Latin translations by Portuguese, French, Dutch, and Danish missionaries, and physicians traveling and working in China and Japan. Li Shichen completed the classical Chinese Materia Medica and included a volume on the Eight Extra Channels.

 

During the Qing dynasty (AD 1644-1911) acupuncture faced its most testing period and fared quite. The Qing dynasty was a time of chaos for the Chinese Empire. Western influences pervaded a war-torn China, especially during the nineteenth century when various Western nations were given 'spheres of influence' on the Chinese mainland. A government decree was issued in 1822 by the Grand Medical College Board banning its practice on ethical grounds; the Federal Court considered exposure of the naked form indecent [22]. In spite of its decline, and even at the low level, acupuncture remained the medicine of the masses.

 

5. The renaissance of TCM and acupuncture in the 20th century 

In 1928, the Communist party of China was formed under the leadership of Chairman Mao Zedong. A long guerrilla war ensued and the Communist party finally took power in 1949. The Communists realized that there were little or no medical services in the rural areas and actively encouraged the use of traditional Chinese medicine to keep their troops on the move.

In 1944, Mao Zedong clearly defined the policy of uniting TCM and western medicines, proposed to scientize, sinicize and popularize TCM. As the ended suppression, the reviviscence of acupuncture had resurfaced. In 1954 TCM was merged with the Chinese medical system [22].  During the early 1950's many hospital opened clinics to provide, teach and investigate the traditional methods, the main research institutes being in Beijing, Shanghai and Nanjing. From 1950’s China began to build dedicated educational systems of TCM schools and universities [5, 22], and experimental acupuncture course newly created from 1994 in the department of acupuncture and moxibustion of TCM universities. According to statistics from 2008 compiled by the Chinese government, there are 2,718 traditional Chinese medical hospitals, 372 traditional Chinese medical clinics and over 378,000 TCM doctors in the whole country [5]. At the same time, acupuncture and related techniques have increasingly been offered in conventional medical settings in Western societies [9]. TCM clinics and schools have now been established in most countries and regions in the world [5, 7].

In hospitals, acupuncture has been integrated into the care pathways since 1959. Since then, acupuncture has become an integrated therapeutic modality both for outpatients in the clinic setting and for inpatients in the wards. It has been observed that acupuncture performed in a hospital differs in specific characteristics when compared with acupuncture performed in an outpatient setting [5, 22]. Besides acute and chronic body pain, stroke, cardiac diseases, various carcinoma, hypertension, hypotension, epilepsy, neuroimmuno suppression, female infertility, menopausal and perimenopausal syndrome, smoking, depression, and drug addiction are treated in the wards by acupuncture and moxibustion [5].

Today acupuncture plays a more important roll in medical practice in China with the wind of integrative medicine. It is adaptable to most clinical practices and used either as the primary or a complementary treatment. At least 15.7% of the cancer patients received acupuncture, moxibustion, acu-pressure and Qi-gong therapy during cancer treatment [41]. Future plans include offering acupuncture in the emergency ward and surgical centre. Acupuncture can be used as the initiating therapy for many common medical problems and can be combined with other modalities and disciplines according to the needs of the patient.

 

6. Newly developed acupuncture systems 

In the past half century, acupuncture gained new momentum. The physician acupuncturist creatively developed following new systems of acupuncture.

1. New micro-remote acupuncture system on the nose, ear, face, hand, foot and fingers. One of the most challenging aspects of acupuncture is the use of acu-points on body organs that are distant from the site of pathology. One such remote system is the application of acupuncture to specific regions of external ears or auricle. The Ling Shu states: 'The ear is the place where all the channels meet' [5,23,24], and with this statement the Chinese revised the use of auricular acupuncture in 1958 [22]. The external ear indicates a homunculus, or inverted fetus, with all the organs and parts of the body being represented on the ear. There is growing scientific evidence which not only supports its use as an effective modality [34] but also suggests that acu-points on the ear have specific connections to the central nervous system, which then affect reflexes in other parts of the body [35].

2. Electro-acupuncture (EA), a electronic stimulator invented in 1960’s [20,22], which can generating electrical pulses of selected frequency, intensity, and pulse-width, was improved during the studies of acupuncture anaesthesia (AA) in 1970’s [36]. This technique was named electro-acupuncture to be distinguished from manual acupuncture. Electro-acupuncture has been used to avoid prolonged, continual manual stimulation of acupuncture needles throughout long operations, under acupuncture anesthesia. Now electro-acupuncture is one of the widely used equipment for acupuncture therapy, as well as for anesthesia.

3. Water acupuncture is injection with TCM or western medicine solutions into acu-points with ordinary injection needles, which is still expanding in clinical application [20,22].

 

4. Scalp acupuncture, a technique invented in 1970s is a direct development from the neuro-anatomy of the CNS. Although there is no clear connection between the nerves in the skin of the scalp and the brain, this method produces an effect on the brain, which could regulate the level of CGRP of brain hemorrhage patients [20,22].

 

Furthermore, a novel method for gene delivery, electro-acupuncture-needle-mediated gene transfer combined acupuncture with modem gene therapy, was developed in 1998 [29]. Efficient gene delivery with acupuncture needle carrying exogenous gene into the muscles was achieved after direct electronic stimuli. Acupuncture causes slight tissue injury, and the inflammatory reaction induced by acupuncture tissue injury helps gene transfer [31], which may be one of the mechanisms. Moreover, electronic field effect on plasmid DNA with negative charge may promote gene transfer into tissue. The mechanisms of electro-acupuncture-mediated gene transfer will need further investigation.

 

7. The rediscovery of acupuncture through acupuncture anaesthesia  

In 1958 acupuncture anaesthesia was discovered [22]. Acupuncture was used to control post-operative pain and then began to be used as an anesthetic for simple operations [21, 22]. In 1965, a case of pulmonary lobectomy operated with acupuncture anaesthesia was performed in Beijing Medical College [26]. The female patient had 10 acupuncture needles inserted in each limb, with four acupuncturists each working on one of her limbs. After 30 minutes of needle manipulation to induce strong “deqi” Qi-arrival sensation, the surgeon started to make the skin incision. Acupuncture anesthesia, which is now more adequately called acupuncture analgesia (AA) [26]. The possibility of a neurochemical factor involved in mediating the effect of AA was first reported in 1973 [27]. Han et al. performed a cerebrospinal fluid (CSF) transfusion experiment in 1974 and identified serotonin (5-HT) both in the brain and spinal cord as one of the key neurotransmitters in mediating AA [28]. The discovery of enkephalins, the first family of endogenous opioids, by Hughes et al. in 1975 triggered the search for endogenous substrates [36]. In the same year when the discovery of enkephalin was reported, an article was published discussing the possible existence of anti-opioid substance (AOS) in the brain.

How to validate the idea of neurochemical involvement like endogenous opioids in mediating AA? A rational thing to do was to check whether AA can be blocked by naloxone, the opioid receptor antagonist. After serious experiments, it was confirmed that different opioid peptides including enkephalin and dynorphin mediated low and high frequency (from 1 Hz up to 100 Hz) electro-acupuncture analgesia [36]. In these studies, the researchers designed an acupuncture treatment for rat by fixing to the leg a thin needle that is connected to an electronic stimulator generating electrical pulses of selected frequency, intensity, and pulse-width. This was named electro-acupuncture to be distinguished from manual acupuncture. In the studies using various kinds of animal models, Chiang CY et al. revealed that the peripheral nervous system is crucial in mediating the effect in acupuncture analgesia. The analgesia can be abolished if the acupuncture site is affected by injection of local anesthetis [46]. By various clinical observations, it was demonstrated that neuropathic pain responded preferably to 2 Hz EA (mediated by enkephalin) than that of 100 Hz, whereas the pain caused by muscle spasm in patients suffered from spinal cord injury responded preferably to 100 Hz EA (mediated by dynorphin) but not to 2 Hz EA [38,39]. These results agreed with the fact that in TCM acupuncture practice, different types of needle manipulation at the same acupuncture point can result in different therapeutic effect [20, 22].

 

Although studies have demonstrated that the mechanism of acupuncture analgesia (AA) is attributable to the release of opioids from the central nervous system (CNS), recent studies have revealed that, a peripheral opioid system exists which is also involved in modulating pain. Zhang et al. reported that AA is partially blocked by local application of naloxone, suggesting that peripheral opioids are released following electro-acupuncture [47].

Another problem is: if acupuncture works effectively in the field of analgesia, why does acupuncture not always work for everyone? Actually in animals, in about 10–15% of the rat population, a standard 30-minutes electro-acupuncture produces no analgesic effect [26]. Other animal studies have also demonstrated the acupuncture-induced released of anti-opioid substances. Early in the 1970s, a component that had an anti-opioid activity which has a molecular weight of approximately 1,000 Da was found from the brain extracts of the acupuncture tolerant rats. During the period of acupuncture tolerant (AT), there is a concomitant reduction of the analgesic effect in response to morphine, suggesting a cross tolerance to morphine. In the recent anti-opioid substances (AOS) research, it was confirmed that cholecystokinin octapeptide (CCK-8) is most likely AOS) responsible for the development of acupuncture tolerant [39]. Indeed, AT can be reversed by CCK receptors antagonist proglumide and by the antiserum against CCK-8 administered intrathecally or intracerebroventricularly [40]. CCK might play an import role in determining the effectiveness of AA. Thus, the relationship between opioids and CCK could be an example of Yin and Yang in certain measure. It is reasonable to consider that a good responder to acupuncture can be converted to a nonresponder by central administration of a nontoxic CCK vector resulting in an over expression of CCK in the CNS. On the other hand, a nonresponder to acupuncture can be converted to a responder by central administration of 1) CCK-B receptor antagonist L-365264, 2) antibody against CCK-8, or 3) CCK antisense oli­gonucleotide to down regulate the gene expression of CCK [40]. CCK seems to play a role in a negative feedback system against excessive opioid activity. This feedback control is achieved by multiple mechanisms, 1) high levels of opioids (whether exogenous or endogenous) promote CCK gene expression, 2) CCK-8, upon binding to CCK receptor induces allosteric changes in the nearby opioid receptors, and 3) CCK mobilizes intracellular calcium storage that cancels out the ability of opioids to lower calcium influx [26].

Surgical acupuncture anaesthesia has been used for a wide variety of major and minor operations in hospitals, it has many advantages including safety and swift post-operative recovery; however, it does not always provide complete pain relief, and the patient is easy to feel fatigue during the operation. Since 1980’s, acupuncture-drug balanced anaesthesia was exploited [22]. The accurate insertion of a needle into a specific acu-point is crucial, the correct continued manipulation of the needles in order to induce constant, strong “deqi” Qi-arrival sensation in operation is more important. Arrival of Qi, an important component of traditional theory of acupuncture and moxibustion, is the key factor in determining clinical therapeutic effect of acupuncture. At present, there is more subjective in the study on Qi-arrival, so the key problem in research on Qi-arrival is how the Qi-arrival state is measured by an objective quantization standard. The cerebral function imaging, a new technique, may be used in objectification research on Qi-arrival [48].

 

8. The ultimate goal of acupuncture therapy 

Yin and Yang are opposite aspects of the material world, describing the innate fluctuating balance that exists in nature. Based on leads provided by Nei Jing and other literature, analyze origins of the three-yin and the three-yang and the their respective contents of yin and yang, indicating the principle that the order of yang-qi from more to less is Yang ming, Tai yang, Shao yang, and the order of yin-qi is Tai yin, Shao yin, Jue yin. According to the location of six zang-organs, respective yin-qi content is defined, and according to the principle of more yin-qi matches more, and less yin-qi matches less, six zang-organs match each other. The zang-organs above the diaphragm joints with the Hand-meridians, and the zang-organs below the diaphragm with the Foot-meridians, complete the nomenclature of twelve meridians. The names of the six yang-channels correspond to the yin-channels of the exterior-interior relationship, the yin-meridians link with hands (feet), and the yang-meridians also link with hands (feet). TCM, by yin-yang, illustrates living phenomena from the whole to the system and organ level in human body, and the scientific principle "yin-yang can be unlimitedly divided" and its significance, which could guide the studies on living phenomena with modern life sciences from the whole to the molecular level.

 

What are the meridians and collaterals system? Meridians serve as an interface between the inner organism and external environment.  A variety studies indicate meridians and acu-points relate to:

1. the electromagnetic bio-information system,

2. the blood circulation system,

3. the nervous system, which includes neuro-humural system,

4. the organizing central nervous system,

5. the bio-cybernetics-system,

6. the growth control system.

The meridians and collaterals system overlaps and interacts with above systems but is not simply part of them. Many details of the current theories remain to be tested and clarified. Many of the teachings of the Nei Jing appear to have seamlessly transcended time, especially with today's health care and the intense focus upon disease prevention. The advantages of acupuncture and moxibustion may be evident over time through an individual's enhanced cardiovascular performance, cognitive function, or weight management, but the initial benefits must begin at the cellular level to eventually be translated into improved clinical well being and the possible prevention of disease. Constructing of TCM and acupuncture based on molecular biology, for instance, the property analysis of genes with Yin-Yang theory, molecular dynamics in view of Yin-Yang theory, molecular definition of viscera-status theory etc., may not only promote the evolution of TCM but also elucidate the future direction of medicine.

Although acupuncture has become modernized, acupuncture effect depends on the manual needling, it’s a real world in which TCM doctors can tinker with DNA through acupuncture technique according to the personal will. It will take many researchers many years to work out all the implications, before that happens, let acupuncture help people more.

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