During graduate school I was part of an acupuncture education outreach effort. When I told our program director the topic of our presentation—how does acupuncture work—she laughed.
“Good luck figuring that out!”
She was right. Acupuncture is not easy to explain—and I watch it in action every day.
Despite this challenge, I’ve learned that educating people about how acupuncture works is important. We are curious beings, after all. Also, patients and practitioners, not to mention insurance providers and medical doctors, all want to understand how acupuncture provides relief.
In this post I hope to shed some light on this difficult question by giving you a short-and-sweet primer on the theory behind this powerful medicine.
The Roots of Acupuncture
The answer to “how does acupuncture work?” is embedded in a cultural perspective that is different from Western medical science. While Chinese medicine is based on observation of nature—with humans being an inextricable part of their environment—the ancient Chinese were not conducting double-blind placebo-controlled studies. Nor did they have the concept of germ theory or the endocrine system.
Even still, Chinese medicine is highly empirical, meaning it developed based on visible changes in wellbeing after implementing certain therapeutic techniques. Acupuncture and herbal medicine are not just theoretical—or superstitious—forms of medicine. In fact, Chinese medicine is the oldest and most contiguous body of textual medicine in the world, meaning what we use today has been refined through clinical practice and passed down in books over millennia.
Chinese medicine is also highly adaptable to modern illness, which is why it remains so clinically relevant and important to modern healthcare. Many theories and treatment methods used in the contemporary clinic were discovered over 2,000 years ago and are still applicable to patients with iPhones and Facebook accounts.
So just what was in these ancient texts?
The history of Chinese medicine began with the first herbal medicine text, the Shennong Bencao—The Divine Husbandman’s Classic of Materia Medica. This book was compiled 2,500 years ago and includes many well-known herbs that are still in use today, including ginseng and ginger.
The first acupuncture text was the Huang Di Nei Jing—The Yellow Emperor’s Classic of Medicine, compiled 2,200 years ago during the Warring States Period in China. This manuscript introduced the ideas of yin and yang into medicine, concepts that could already by found in the religious philosophy of Taoism.
These ideas were flexible in that they could be applied to broad scenarios, such as weather and climate, or minute workings in the body, like growth and development, death and decay. The flexibility of Chinese medical theory is really what keeps it clinically effective even today.
Qi, Blood, Yin and Yang: Navigating the Inner Ecosystem
Much like an ecosystem, Chinese medicine is based on patterns and relationships that are visible in the natural environment.
We think of the outside world as a complex system of elemental interactions: water, soil, wind, sunlight. Similarly, the body is its own ecosystem. However, the primary relationships in your body occur between qi, blood, yin and yang.
Yin and yang are opposites, yin being dark, moist, heavy, cool, and receptive, and yang being light, warm, expansive, and generative. An important thing to remember about yin and yang is that these terms only have meaning in relationship to one another; they are inextricably connected. If we say a person who is cold lacks yang, we can only determine this by weighing it against the yin qualities present in their body.
Qi and blood have a similar relationship. Qi is life-force energy in Chinese medicine. It permeates and animates everything. I like to think of it as the electrical impulse that is always present in living organisms. Blood, like yin, is dense and nutritive. It moves all over the body, feeding the cells of the muscles, brain, and all the internal organs. The qi carries the blood around the body, pulling it forward with a magnetic force.
When qi, blood, yin and yang are in a state of balance, people feel good. When these forces are out of whack, disease comes about. The job of an acupuncturist is to determine what is imbalanced and adjust it through sending a corrective message through the needles.
Diagnosing Imbalances of Qi, Blood, Yin and Yang
But just how does an acupuncturist diagnose disease? First, we need to know how the yin, yang, blood and qi are interacting.
As an acupuncturist, I use many methods of investigation to determine what is out of balance in my patients. Some imbalances are temporary, acute, surface-level disease states, such as a cold, flu, or injury.
Other problems run deeper and become a part of a patient’s constitutional makeup. They grow from the little things we do, or that happen to us, over months or years. Sometimes they are even with us from childhood. I often think of these imbalances as “body habits.” They are harder to interrupt and often require maintenance support, including acupuncture treatment or herbal medicine, over a longer period of time.
Your body’s symptoms are subjective messages sent to alert you that something is off. My role is to question you about these symptoms so that a pattern emerges.
Through interpreting the relationship between symptoms (subjective) and signs (objective), I then reach a diagnosis designed to address the imbalances of qi, blood, yin and yang.
Next time, in How Does Acupuncture Work Part II, we’ll look at the role the internal organs play in diagnosing and treating disease. We’ll also learn the theory behind why acupuncture needles impact the health of qi, blood, yin, and yang.
The mystery continues…