PAPER

ACUPUNCTURE

Compiled by :
Oky Primaroni

J2C008049

Putri Anni M.

24030111130072

Amalia Fadhilah H.

24030111130073

Fauzan Ramadhan

24030111140091

Siti Shafalisa

24030111140092

CHEMISTRY MAJOR
FACULTY OF SAINS AND MATHEMATICS
DIPONEGORO UNIVERSITY
JUNE 2012

PART I
BACKGROUND

Acupuncture is an alternative medicine methodology originating in ancient

China that treats patients by manipulating thin, solid needles that have been
inserted into acupuncture points in the skin. According to Traditional Chinese
medicine, stimulating these points can correct imbalances in the flow of qi
through channels known as meridians. However, scientific research has not
found any histological or physiological correlates for qi, meridians and
acupuncture points, and some contemporary practitioners needle the body
without using the traditional theoretical framework.
Current scientific research supports acupuncture's efficacy in the relief of
certain types of pain and post-operative nausea. Other reviews have concluded
that positive results reported for acupuncture are too small to be of clinical
relevance and may be the result of inadequate experimental blinding, or can be
explained by placebo effects and publication bias. The invasiveness of
acupuncture make it difficult to design an experiment that adequately controls for
placebo effects.
The use of acupuncture for certain conditions has been tentatively
endorsed by the United States National Institutes of Health, the National Health
Service of the United Kingdom, the World Health Organization, and the National
Center for Complementary and Alternative Medicine, though most of these
endorsements have been criticized for being unduly credulous and not including
objections to or criticisms of the research used to support acupuncture's
effectiveness.
There is general agreement that acupuncture is safe when administered
by well-trained practitioners using sterile needles and carries a very low risk of
serious adverse effects. Many of these are not intrinsic to acupuncture but rather
to bad practices (such as improper needling or unsterile needles), which may be

why such complications have not been reported in surveys of adequately-trained

acupuncturists.

PART II
CONTENT

2.1 History
Acupuncture first came about during the Chou dynasty (1030BC to
221BC) of Chinese therapy, as a system of therapy that involved using needles
on precise points of the body. The points were derived from the philosophical
concepts of humanity and its relationship to the natural environment.

The

Warring States period (480BC to 221BC) is particularly important in the

development of acupunctures history as it incorporated two major philosophical
ideologies into mainstream Chinese thought Confucianism and Daoism.
One main belief of Confucianism is of the sacrosanct completeness of the
human body. The Dao in Daoism literally means the way to integrating human
beings with the forces of the natural world in a harmonious manner. This is
because the cyclic rhythm of these forces naturally balance and complement
each other in order to create an environment that is favourable to life. The
concepts of Chinese medicine that have been derived from Daoism maintain that
it is necessary for the regulation of each persons essential bodily processes to
line up with the need for natural harmony.
Acupuncture, a way of treating internal conditions using an external
means, evolved as a vital and needed addition to these beliefs. Fundamental to
both acupuncture and Chinese philosophy is energy. This energy flows along
pathways near the surface of the skin according to a diurnal cycle, and each
pathway of energy corresponds to a particular organ. Acupuncture points are

specific locations on the pathway that may be needled in order to affect the
balance of the energy it contains and thereby regulate the function of the
corresponding organ.
Over the centuries, acupuncture and Chinese medicine has evolved, as
new ideas and new schools of thought have been discussed. Chinese medicine
spread to neighbouring countries, especially Japan, Korea and Vietnam, and
each country developed certain aspects of theory and practice which distinguish
them from current Chinese approaches. There have been national schools and
government exams over the last 1,000 years in China but there were also many
private schools and family secrets were passed along from generation to
generation.
It was only in the 20th century that Chinese medicine faced its greatest
challenges. In the 1920s to 1940s, during the Nationalist vs. Communist civil
war, Western medicine was embraced by both sides of the dispute. In 1949, the
Communists took control of China, and Mao, the president, banned acupuncture
at first.

By 1954, Mao realised that Western medicine was not capable of

reaching the entire Chinese population, so he ordered that four schools of

Chinese medicine be created.

These schools were required to excise all

spiritual, pagan and esoteric material from their curriculum, and the schools
became the backbone of modern Chinese medicine.
Currently, both Western and Chinese scientists are researching the
scientific basis of acupuncture. Though the exact workings of acupuncture are
not understood from a Western viewpoint, traditional acupuncture remains an
effective modality that is distinct from all others in its unique philosophical and
physiological understanding of life.

2.2 Theory
The general theory of acupuncture is based on the premise that bodily
functions are regulated by an energy called qi which flows through the body;
disruptions of this flow are believed to be responsible for disease. Acupuncture
describes a family of procedures aiming to correct imbalances in the flow of qi by

stimulation of anatomical locations on or under the skin (usually called

acupuncture points or acupoints), by a variety of techniques. The most common
mechanism of stimulation of acupuncture points employs penetration of the skin
by thin metal needles, which are manipulated manually or by electrical
stimulation.
The National Council Against Health Fraud stated in 1990 that
acupunctures theory and practice are based on primitive and fanciful concepts
of health and disease that bear no relationship to present scientific knowledge. In
1993 neurologist Arthur Taub called acupuncture nonsense with needles. The
website Quackwatch criticizes TCM as having unproven efficacy and an unsound
scientific basis. Physicist John P. Jackson, Acupuncture has also been
characterized as pseudoscience or pseudomedical by: Steven Salzberg, director
of the Center for Bioinformatics and Computational Biology and professor at the
University of Maryland; Steven Novella, Yale University professor of neurology,
and founder and executive editor of the blog Science Based Medicine; Wallace
Sampson, clinical professor emeritus of medicine at Stanford University and
editor-in-chief at the Scientific Review of Alternative Medicine.

2.3 Qi, Meridians and Acupuncture Points

Traditional Chinese medicine distinguishes not only one but several
different kinds of qi (). In a general sense, qi is something that is defined by five
"cardinal functions":
1. Actuation ( , tudng) of all physical processes in the body, especially
the circulation of all body fluids such as blood in their vessels. This includes
actuation of the functions of the zang-fu organs and meridians.
2. Warming (, pinyin: wnx) the body, especially the limbs.
3. Defense (, pinyin: fngy) against Exogenous Pathogenic Factors
4. Containment (, pinyin: gsh) of body fluids, i.e. keeping blood, sweat,
urine, semen etc. from leakage or excessive emission.

5. Transformation (, pinyin: qhu) of food, drink, and breath into qi, xue
(blood), and jinye (fluids), and/or transformation of all of the latter into each
other.

Old Chinese medical chart on acupuncture meridians

To fulfill its functions, qi has to steadily flow from the inside of the body
(where the zang-fu organs are located) to the "superficial" body tissues of the
skin, muscles, tendons, bones, and joints. It is assisted in its flow by "channels"
referred to as meridians ( , pinyin: jng-lu). TCM identifies 12 "regular" and 8
"extraordinary" meridians; the Chinese terms being (pinyin: sh-r
jngmi, lit. "the Twelve Vessels") and

(pinyin: q jng b mi)

respectively. There's also a number of less customary channels branching off

from the "regular" meridians. Contemporary research has not supported the
existence of qi or meridians. The meridians are believed to connect to the bodily
organs, of which those considered hollow organs (such as the stomach and
intestines) were also considered yang while those considered solid (such as the
liver and lungs) were considered yin. They were also symbolically linked to the
rivers found in ancient China, such as the Yangtze, Wei and Yellow Rivers.
Acupuncture points are mainly (but not always) found at specified
locations along the meridians. There also is a number of acupuncture points with
specified locations outside of the meridians; these are called "extraordinary"
points and often credited with special therapeutic properties. A third category of

acupuncture points called "A-shi" points have no fixed location but represent
tender or reflexive points appearing in the course of pain syndromes. The actual
number of points have varied considerably over time, initially they were
considered to number 365, symbolically aligning with the number of days in the
year (and in Han times, the number of bones thought to be in the body). The
Huangdi Neijing mentioned only 160 and a further 135 could be deduced giving a
total of 295. The modern total was once considered 670 but subsequently
expanded due to more recent interest in auricular (ear) acupuncture and the
treatment of further conditions. In addition, it is considered likely that some points
used historically have since ceased being used.

2.4 Acupuncture Needles

As acupuncture developed, the Bian stones were discarded and needles
of stone and pottery were used. These simple, primitive needles are still used in
some of the rural areas of China. Eventually metal needles began to appear and
these took the form of the classical 'nine needles'. The 'nine needles' comprised
the arrowhead needle for superficial pricking, the round needle for massaging,
the blunt needle for knocking or pressing, the three edged needle for puncturing
a vein, the sword-like needle for draining abscesses, the sharp round needle for
rapid pricking, the filliform needle, the long needle for thick muscles and the large
needle for puncturing painful joints.
The main needle now used for acupuncture is the filliform as most of the
others have been replaced by more sophisticated surgical instruments, for
instance, the sword-like needle has been replaced by the scalpel.
The 'nine needles' were initially made of either bronze, or gold and silver,
and seem to have been first used about 2,000 years ago. The tomb of the Prince
of Chungshan, dating from the second century BC, was excavated in 1968 and
contained a set of nine needles, four being of gold and five of silver. Some
acupuncturists use gold and silver needles but the majority only stainless steel
filliform needles.

2.5 Advantages and Disadvantages of Acupunture

2.5.1 Advantages of Acupunture
One of the most important advantages of acupuncture is that The WHO
(World Health Organization) has reported that acupuncture is an effective
treatment for therapeutic purposes. According to traditional Chinese medicine
(TCM), the main idea behind acupuncture is to restore and maintain health by
working on vital energy (Qi) points of the body. It is widely used by
acupuncturists, dentists, physicians and other health practitioners for relieving
pain and several other health related problems. Let's see the benefits of
acupuncture.
There are no side effects, if carried out by a registered and well-trained
practitioner. The NIH (National Institutes of Health) has reported that acupuncture
has lower adverse effects compared to the prescribed medications and other
medical procedures followed for treatment of the similar conditions.
Acupuncture can be performed in any age group such as children, adults
and elderly persons. Usually it does not hurt and is done without disturbing other
treatments and medications. Even people who have a compromised immune
system can benefit from acupuncture treatment.
Studies have found out that acupuncture can be used to treat both
physical and mental illnesses. It is also useful for treatment of chronic diseases. It
helps in improving memory, boosting immune system, and in regulating

hormones. Many people have reported that they get relief from headache, back
pain, joint pain, insomnia, stress and fatigue after completing prescribed
acupuncture sessions. It restores energy and increases overall stamina of the
body.
It has been suggested that acupuncture is used for effective treatment of
osteoarthritis, hearing loss, dental pain, asthma, diabetes, infertility, migraine,
tennis elbow, allergies, hypertension and several other diseases. However, more
researches need to be done to identify various acupressure points of the body
and understand the effects of acupuncture on brain during treatment.

2.5.2 Disadvantages of Acupunture

Acupuncture is safe as far as the procedure is followed by a licensed
acupuncturist (practitioner) and the needles used are sterile and nontoxic. The
U.S. Food and Drug Administration (FDA) has set certain standards for
acupuncture needles. It has been recommended that needles should be labeled
and properly sealed.
Some of the points to be noted while performing acupuncture techniques
are - the practitioner should swab the treatment sites with disinfectants such as
alcohol before inserting needles. Needles should be used only once (for one
patient) and after completion, needles should be disposed properly.
Every person responds differently to acupuncture and hence,
effectiveness of this technique varies for every patient. Some may require doing
more than 10 sessions in order to have long-lasting benefits. There can be mild
soreness in the treatment sites after treatment.
Very rare cases of complications are reported from use of acupuncture.
However, certain problems of infection and organ rupture are observed if not
delivered properly. Always make sure that the acupuncturist is registered and
qualified enough to perform acupuncture, otherwise there may be chances of
improper needle placement that can lead to bleeding, swelling and pain in the
treatment site.

2.6 How Acupunture Works

The mechanisms of acupuncture, though not solidly proven, have
exhibited several commonly accepted effects to the body. Most notable is that
acupuncture stimulates the central nervous systemthe brain and spinal cord.
Most people report a tingling sensation, feeling relaxed or even energized. Again,
this is largely based on the individual receiving the acupuncture treatment and
how he or she perceives it.

During an acupuncture treatment session, anywhere from 1 to 20 FDAapproved, metallic needles are inserted into the body, ranging from just breaking
the surface to up to 1 or several inches long. The longer acupuncture needles
(such as 5 to 9 inches) are inserted into areas of deeper muscle/fat layers or
along, under the skin or even scalp, depending on what is being treated and the
required depth or penetration. The acupuncture needles are often left in for
approximately 15 to 30 minutes. Some practitioners insert needles, turn them
either in one direction or the other or both, depending on what they are
attempting to achieve, and these needles are inserted for perhaps 10 seconds
only, removed and the same needle is used for treatment of other points on that
same patient. In certain instances, needles are warmed or electrically charged
after insertion. The electrical acupuncture can be used with needles or through
the use of a non-penetrating probe.

2.7 Acupuncture for children

Acupuncture hasn't often been used to treat children, mainly because
youngsters tend to be afraid of needles. But several studies have suggested that
this fear can be overcome and that children can benefit from acupuncture
treatment for certain conditions. One study on this subject was conducted at the
Harvard-affiliated Children's Hospital in Boston by Yuan-Chi Lin, MD, an
anesthesiologist who specializes in pain management in children. Dr. Lin's study

included 243 youngsters ranging in age from six months to 18 years who were
being treated for headaches, stomachaches, back pain and other chronic
complaints that often caused them to miss school. When the study began, the
young patients rated their pain as an "eight" on a scale of one to ten. (One of Dr.
Lin's methods of demonstrating to the kids that the needles won't hurt is by
inserting them first in the children's parents.)
When the year-long study was over, the average pain rating among the
youngsters was a "three." The kids also reported missing less school, sleeping
better, and being more able to participate in extracurricular activities as a result of
treatment.
In an earlier study at the same hospital 70 percent of the 47 youngsters
participating reported that acupuncture helped relieve their pain and 59 percent
of their parents agreed.The conditions for which these patients were treated
included migraines , endometriosis in teenage girls, and reflex sympathetic
dystrophy (a syndrome in which pain becomes chronic after an injury). In this
study, 15 were aged 12 or under while 32 were between 13 and 20 years
old. Other studies have looked at acupuncture as a treatment for attention deficit
hyperactivity disorder (ADHD) and cerebral palsy in children. While not many
acupuncturists specialize in treating children, Dr. Lin estimates that about a third
of pediatric pain centers nationwide now offer acupuncture to their young
patients. I believe that acupuncture is best used for pain reduction as part of
comprehensive treatment that includes relaxation techniques, clinical hypnosis
and various forms of bodywork.

REFERENCES

Bauer, M (2006). "The Final Days of Traditional Beliefs? Part One". Chinese
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Ernst, E. (2006). "Acupuncture - a critical analysis". Journal of Internal Medicine
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Flachskampf, F. A.; Gallasch, J.; Gefeller, O.; Gan, J.; Mao, J.; Pfahlberg, A. B.;
Wortmann, A.; Klinghammer, L. et al. (2007). "Randomized Trial of
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Mayhew E; Ernst E (2007). "Acupuncture for fibromyalgiaa systematic review
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801 4
Singh, S; Ernst E (2008). "The Truth about Acupuncture". Trick or treatment: The
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