For centuries cultures around the world have been intrigued by the fascinating art of restoring health by inserting small, seemingly innocuous needles in the surface of the skin. Chinese explanations of how acupuncture works are rooted in Chinese medical philosophy and theory. Eastern concepts about the cause of disease do not have specific counterparts in Western science. Terms such as yin/yang and Qi (pronounced chee) do not have exact English equivalents. Western scientists are uncomfortable, at best, with concepts like, “balancing energy”, that the Eastern theorists and practitioners use to describe a healthy mind/body relationship.

Western scientists want to know exactly what is happening when an acupuncture treatment seems to get results. They want to be able to describe the process in the scientific jargon which they are most familiar. Westerners believe they can understand how a process operates when it can be broken down into elements that can be named and measured while being reproduced in the laboratory. Quantifying these dynamics in terms of electrical current, chemical compounds, and substances whose size, shape, and temperature can be described are essential for acceptance in the Western scientific community.

HISTORICAL PERSPECTIVE
For three thousand years or more, acupuncture has been used to treat pain. Less than forty years ago, with the revival of Traditional Chinese Medicine in China, acupuncture was brought into modern operating rooms to control pain, during and after surgery. Western Physicians learned of acupuncture’s dramatic effectiveness when in 1972; James Reston had gone to Beijing at the invitation of the Chinese government. During his first visit, he had to undergo an emergency appendectomy. His Chinese doctors used acupuncture for his postoperative pain, and Reston recovered quickly. Upon his return delegations of Western doctors went to observe for themselves the “miracle” that traditional practitioners had been working there since 1000 BC

ENDORPHINS DISCOVERED
Just a few years later, in 1976, the actual mechanism by which morphine and aspirin “kill” pain was discovered. Scientists isolated a group of substances called endorphins that are released by the pituitary gland in the front part of the brain. Receptor sites in the brain respond to these endorphins by blocking pain sensations. Substances such as aspirin and morphine, as well as, processes like acupuncture stimulate the natural production of endorphins.

Our bodies manufacture endorphins under various conditions, for example, when we experience severe physical trauma or intense emotional distress. Individuals injured in motor vehicle accidents often report that they experienced no pain until after the immediate danger was past. In such instances, the body produces endorphins, numbing the pain until people can act to save themselves and get medical attention, which generally includes receiving “something for the pain”.

Endorphins are chemical messengers of a type known as neuro-transmitters, which communicate between nerve cells. These cells, called neurons, are not connected physically to one another. Nerve impulses are actually electrical charges that travel from one end of the elongated neuron to the other; coming to a complete stop at the end of the neuron in a structure called the axon. At the end of the axon is physical gap called a synapse. Nerve impulses cannot jump across the synapse to the next nerve cell without the help of chemical transmitters that are merely messengers that move the impulse across the gap. Neurotransmitters move at very high speeds and interact with specific receptors at the next nerve cell, passing information to them. This process occurs rapidly and constantly throughout the entire nervous system.

SCIENCE AND ACUPUNCTURE
After the breakthrough discovery of endorphins in 1976, a Canadian Physician named Bruce Pomeranz with a Ph.D. in neurobiology conducted a series of experiments that provided the first physical evidence that acupuncture stimulates endorphin release. His work demonstrated that pain relief from acupuncture was mediated through endorphins. He theorized that acupuncture killed pain by stimulating the release of endorphins.

Subsequent experiments were directed at measuring pain intensity and how well acupuncture could control it. These experiments demonstrated that pain sedation actually occurred in a time release fashion as endorphins with varying molecular structures were produced and released. These were named alpha, beta, and gamma endorphins. The pain relieving effects of the alpha and beta-endorphins are short-lived, peaking at about twenty minutes. The gamma endorphins, however, may not reach their peak effectiveness for as long as four hours.

EASTERN VIEW
Chinese scientists are convinced that endorphin release is central to acupuncture pain relief because they have measured elevations of endorphins through radio wave analysis of the entire brain. They are not convinced that endorphin release is the only mechanism involved. In recent years, numerous other substances whose release is stimulated by acupuncture have been identified and isolated. Some of these substances include serotonin, dopamine, epinephrine, norepinephrine, acetycholine, glycine, gamma-aminobutyrill (GABA), and glutamate.

WESTERN VIEW
The belief that other neurotransmitters may be involved in needling effects is supported by evidence concerning some significant differences between morphine and acupuncture use. Morphine and other opiates depress respiratory functions; acupuncture does not. Acupuncture relieves constipation, bronchospasms, and gastrointestinal spasms; opiates have the opposite effect. Constriction of the eye’s pupil is a characteristic effect of morphine-like substances; no such constriction occurs during acupuncture. Needling points promotes the release of corticosteroid from the adrenal cortex; opiates depress the cortex.

Dr. Yoshiaki Omura of Manhatten College in New York City thinks that acupuncture may release a large molecule from the pituitary called adrenocorticotropic hormone (ACTH). The level of this substance stimulated by acupuncture may explain the prolonged pain relief provided for joint and motor disorders, both acute and chronic. Furthermore, increased serum serotonin levels may account for the relaxed, sleepy sensation that often follows an acupuncture treatment.

OTHER HYPOTHESES
Numerous other hypotheses have emerged to explain the diversified effects of acupuncture in non-pain related disorders. The FENG and SHIZEN Hypothesis attempts to relate the diverse effects of acupuncture to target cells in the brain, which are stimulated by acupuncture.

The PNS theory asserts that energy channels (called meridians) parallel the distribution of nerves throughout the body and that the stimulation provided by the acupuncture needles has a normalizing effect within the channel, as well as, a spillover effect on the nerve supply to the associated area.

VARIOUS APPLICATIONS
Like anything else, there is a wide range of ways that you can use acupuncture. You should know that acupuncture is not right for everyone and not all techniques are right for everyone. The acupuncturist will determine what is best for you and your ailments. You will find that this type of therapy can help you with stomachaches, headaches, arthritis, infertility, back pains, and certain diseases or conditions. You will find that it can help you with just about any type of pain and your pain can be improved or eliminated by the use of acupuncture.

DIVERSE STYLES OF ACUPUNCTURE
When considering any form of acupuncture, many consider it to be Traditional Chinese Medicine (TCM). Although most popular in the world overall and certainly within the United States, TCM acupuncture is not the only technique that can help you improve the impaired flow of energy it is designed to correct. Regardless of the particular style of acupuncture employed needles only slightly thicker than hairs are inserted into the body in multiple spots, called meridians, in order to improve the energy flow of the body, called qi (chee).

Japanese acupuncturists have a slightly varied technique. When it comes to getting Japanese acupuncture, you will find that it can be less intrusive and rigorous, but you may also find it to be more pleasing and appealing. They often use thinner or shorter needles. Japanese acupuncture also uses fewer needles in general.

Another technique is Korean hand acupuncture. This is a good type for those who have issues with sitting or lying for long periods. It is also a good way to begin acupuncture if the methods are at first a bit scary to you. Korean hand acupuncture not only targets problems with the hands and fingers, such as arthritis, but you will find that there are points on your hands that will affect the entire body. Learning these many points is an art and a science. Korean hand acupuncturists are highly skilled professionals.

Another highly effective form of acupuncture that can be performed for those who cannot tolerate needles being placed at all points on the body is called auricular acupuncture. With this form of acupuncture the needles are placed at various locations in and around the ears. This has been proven to be very effective in drug and alcohol rehabilitation programs.

A YING/YANG CONCLUSION
In the final analysis no completely satisfactory explanation of the effectiveness of needling has been agreed upon. Obviously, it works. Just as obviously a multifaceted, multidisciplinary approach is needed to unravel the mysteries of acupuncture to the satisfaction of the rational minds in medicine. We must remain aware of how the various parts of the body are connected, how they communicate, and how distress in one area affects the other areas. Further research must continue in body chemistry, the electrical functioning of the nerve cells, and the nervous system as a whole. When considering acupuncture, we must conceive of the body as a system of complex interdependencies, which is precisely the view-point that Traditional Chinese medicine has emphasized for thousands of years.