TCM FROM A WESTERN MEDICAL PERSPECTIVE
The following information was compiled from various medical texts, research articles and other books. Although backed up by these sources, it is still only one of many interpretations exploring why acupuncture continually produces effective clinical results. At this time, there is no way to know exactly what the Chinese meant when they founded TCM, but we hope to help you better grasp some of these foreign concepts and shed light on this misunderstood medical system.
Traditional Chinese Medicine (TCM)
Thousands of years ago, when TCM was developed by ancient practitioners, several Chinese medical texts, including the famous 'Huang Di Nei Jing', or 'The Yellow Emperor’s Classic of Internal Medicine' were generated. Since then, these texts have been translated into various languages in order to keep this medical tradition alive. Unfortunately, some of the most fundamental concepts of TCM have been distorted along the way, precipitating a lot of confusion and misunderstanding among the medical community. Today, some practitioners aim to demystify the concepts of acupuncture and it's complementary therapies and explain them in simple, scientific and more modern terms (1,2).
At the very foundation of TCM lies one of the most common yet widely misunderstood concepts of all time: the theory of Qi. The majority of people know the most universal translation of this Chinese term as "energy". If you look up "Qi" in the Chinese dictionary, however, words such as "air", "gas" and "vital vapor" pop up. The term "vital energy" also appears under this definition, yet not in the same sense that we discuss "energy" in regards to various types of "energy medicine" and other metaphysical healing modalities today (1,2,3).
According to recent literature, the concept of "Qi" in Chinese medicine may be less abstract than most have come to understand. Ancient Chinese practitioners recognized that "Qi" could be derived from specific sources. We receive some of it from our parents before we are born; after we are born, it is derived from a portion of the air we breathe and the food and drink we consume (4). Since then, science has revealed that during cellular respiration, if you add oxygen (from air) to glucose (from food and drink), various metabolic reactions occur resulting in the production of vital energy that can be used by cells. Because the air we breath only contains 20% oxygen, and food and drink sources contain approximately 60% glucose, it appears that the Chinese understood these proportions. It is fair to assume that perhaps what the Chinese termed "Qi" was equal to the production of cellular energy created by oxygen and glucose through this metabolic process (5,6).
As further possible evidence, the first English translation of "Qi" was simply "air". The ancient Chinese understood that our lungs took in air from our environment, and that this air contained a substance crucial to our survival (7). At the time, the Chinese had been performing complex dissections of the human body, which led to their discovery of the circulatory system thousands of years before other cultures. With this knowledge, they further determined that when breathed into the body, this substance circulated through the blood stream and was a vital aspect of all physiological activities in the body. This substance was later recognized by scientists as "oxygen". The oxygen derived from air may very well be a key ingredient in the formation of "Qi" (1).
The Meridian System
It is commonly known that "Qi" travels along pathways called "meridians" or "channels". These English translations were generated from the Chinese term "Mai" written in ancient medical texts. Based on 21st century analysis, however, "Mai" may be more accurately defined as "vessel" in the English language. This makes a lot more sense, as it is well known that the oxygen and glucose required to produce cellular energy/ "Qi" flows in the vessels/ "Mai" of the human body (1,2,6).
TCM originally described what we call an "acupuncture point" today as the Chinese term “Jie”. More literally translated as a "node" or what anatomists refer to as a "neurovascular bundle", these points indicate small regions of the body that contain high concentrations of arteries, veins, nerves, lymph vessels and various immune cells. These nodes have the ability to carry electrical impulses to and from the central nervous system (brain and spinal cord) and all organs, muscles and other tissues of the body. The skin layers above these nodes are thinner and demonstrate lower electrical resistance than other spots on the surface of the body (7). This theory correlates with today's modern studies, as research suggests that "acupuncture points" in fact have lower electrical resistance, as well as higher electrical potential and conductance (8,9). Science has proven the existence of bioelectricity, or electric currents, present in all living organisms. These currents are produced by various physiological activities and can be used by cells to conduct impulses along nerves, regulate the tissues and organs of the body and aid in metabolism. They are also regularly tapped into by the medical community by devices such as electrocardiographs (ECG) to detect and monitor certain health conditions (10).
How Acupuncture Works
Acupuncture needles are made of stainless steel, which is a good conductor of electricity. When they puncture the skin at these "nodes", or sites of heightened electrical conductivity, they therefore stimulate the underlying network of vessels. These vessels send signals to every major organ system in the body, leading to a cascade of mechanisms that aid in pain relief, decrease inflammation and return the body to homeostatic balance. It is widely recognized that these disturbances, especially inflammation, are tightly linked to many commonly known health conditions. With bioelectrical stimulation by acupuncture needles, the body's innate healing actions are set into motion as there is an increase in blood flow, flooding the area with more oxygen for energy production and a variety of immune cells. As the central nervous system is signaled, natural pain killers, such as endorphins, are released. Hormone pathways are also engaged, stimulating various substances such as oxytocin that help to regulate the body's stress response (1,11).
There is much speculation that acupuncture also engages the 'Gate Control Theory' when it comes to pain relief. This theory was proposed in 1965 by psychologist and professor Ronald Melzack, and physiologist and neuroscientist Patrick David Wall while carrying out pain research. The Gate Control Theory focuses on individual pain perception and why pain levels and sensations tend to change according to various internal and external stimuli. According to their theory, pain signals generated by bodily injuries have to go through special "gates" before entering the brain. These "gates" are located in the spinal cord and their job is to decide whether or not a pain signal will reach the brain. If the gates are open, these signals are able to reach the brain and the person perceives sensations of pain. If the gates are closed, these signals do not make it to the brain and the person either feels no pain or reduced levels of pain. It is theorized that these "gates" open and close according to psychological factors, such as our mood, thoughts and emotions, as well as certain external influences such as acupuncture. Acupuncture may very well work to close these "gates"so that pain cannot be perceived or is at least significantly lessened. This theory may help to partially explain acupuncture's outstanding ability to relieve pain (12,13).
Debunking the Myths of Acupuncture
It is clear that when we look deeper into the concepts of this ancient medicine, TCM and modern medical practices, though treated with different modalities, are much more similar than is commonly perceived. If "Qi" is more accurately translated as the cellular energy generated by oxygen and glucose, "Mai" as "vessel" and "Jie" as "neurovascular bundle" or "node", it becomes clear that these opposing medical systems aim to engage many of the same body systems that aid in healing and pain relief. TCM can therefore be viewed as an effective physiological approach to healing that focuses on the adequate supply of oxygen to all tissues, generation of abundant cellular energy, inflammation reduction, homeostatic balance and the optimal functioning of all biological processes in the human body (1).
1. Kresser, C. Chinese Medicine Demystified (Parts I-4): A Case of Mistaken Identity. Retrieved from https://chriskresser.com/chinese-medicine-demystified-part-i-a-case-of-mistaken-identity/
2. Unschuld, PU. Huang Di Nei Jing Su Wen: Nature, Knowledge, Imagery in Ancient Chinese Medical Text. Berkeley. University of California Press. 2003.
3. Schnorrenberger, CC. Morphological foundations of acupuncture: an anatomical nomenclature of acupuncture structures. BMAS Acupuncture in Medicine, 1996. Nov;14(3):89-103.
4. Maciocia, Giovanni. The Foundations of Chinese Medicine: a Comprehensive Text. Elsevier, 2015.
5. Jahnke, R. Feel the Qi- Oxygen Metabolism and Qi Cultivation. Retrieved from http://www.feeltheqi.com/articles/rc-oxygen.htm
6. Khan Academy. Cellular Respiration Review. Retrieved from https://www.khanacademy.org/science/high-school-biology/hs-energy-and-transport/hs-cellular-respiration/a/hs-cellular-respiration-review
7. Kendall, Donald. The Dao of Chinese Medicine. Oxford University Press, 2002.
8. Langevin HM, Yandow JA. Relationship of acupuncture points and meridians to connective tissue planes. The Anatomical Record, 2002. Dec;269(6), 257-265.
9. Zhou, F, Huang, D, Yingxia. Neuroanatomic Basis of Acupuncture Points. Acupuncture Therapy for Neurological Diseases, 2010. 32-80.
10. Hyland, GJ. Bio-Electromagnetism. Integrative Biophysics, 2003. 117-148.
11. Cabýoglu, MT, Ergene, N, Tan, U. The Mechanism Of Acupuncture And Clinical Applications. International Journal of Neuroscience, 2006. 116(2), 115-125.
12. Devitt, Michael. “Research Finds Acupuncture Effective for Chronic Pain.” AAFP Home, 21 May 2018, www.aafp.org/news/health-of-the-public/20180521acupuncture.html.
13. Dorsher, Peter T. “Trigger Points and Myofascial Pain.” Myofascial Trigger Points, 2013, pp. 41–48.