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ACUPUNCTURE Acupuncture

Needles being inserted into a patient's skin 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. Scientific research has not found any histological or physiological correlates for qi, meridians and acupuncture points. 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. Qi, meridians and acupuncture points In a general sense, qi is something that is defined by five "cardinal functions": 1. Actuation 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 the body, especially the limbs. 3. Defense against Exogenous Pathogenic Factors 4. Containment of body fluids, i.e. keeping blood, sweat, urine, semen etc. from leakage or excessive emission. 5. Transformation of food, drink, and breath into qi, xue (blood), and jinye ("fluids"), and/or transformation of all of the latter into each other.
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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. TCM identifies 12 "regular" and 8 "extraordinary" 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. Acupuncture points are mainly (but not always) found at specified locations along the meridians. There also are 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. Traditional diagnosis The acupuncturist decides which points to treat by observing and questioning the patient in order to make a diagnosis according to the tradition which he or she utilizes. In TCM, there are four diagnostic methods: inspection, auscultation and olfaction, inquiring, and palpation.

Inspection focuses on the face and particularly on the tongue, including analysis of the tongue size, shape, tension, color and coating, and the absence or presence of teeth marks around the edge. Auscultation (examination with stethoscope) and olfaction refer, respectively, to listening for particular sounds (such as wheezing) and attending to body odor. Inquiring focuses on the "seven inquiries", which are: chills and fever; perspiration; appetite, thirst and taste; defecation and urination; pain; sleep; and menses and leukorrhea(discharges from vagina). Palpation includes feeling the body for tender A-shi points, and palpation of the left and right radial pulses.

Tongue and pulse Examination of the tongue and the pulse are among the principal diagnostic methods in TCM. Certain sectors of the tongue's surface are believed to correspond to the zng-f(organs). For example, teeth marks on one part of the tongue might indicate a problem with the Heart, while teeth marks on another part of the tongue might indicate a problem with the Liver. Needles

One type of acupuncture needle

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Acupuncture needles are typically made of stainless steel wire. They are usually disposable, but reusable needles are sometimes used as well, though they must be sterilized between uses. Needles vary in length between 13 to 130 millimetres (0.51 to 5.1 in), with shorter needles used near the face and eyes, and longer needles in more fleshy areas; needle diameters vary from 0.16 mm (0.006 in) to 0.46 mm (0.018 in), with thicker needles used on more robust patients. Thinner needles may be flexible and require tubes for insertion. The tip of the needle should not be made too sharp to prevent breakage, although blunt needles cause more pain. Insertion Since most pain is felt in the superficial layers of the skin, a quick insertion of the needle is recommended. If skilled enough, a practitioner purportedly can insert the needles without pain. Safety Because acupuncture needles penetrate the skin, many forms of acupuncture are invasive procedures, and therefore not without risk. Injuries are rare among patients treated by trained practitioners in some countries. Sometimes, needles are required by law to be sterile, disposable and used only once; in some places, needles may be reused if they are first resterilized, e.g. in an autoclave. When needles are contaminated, risk of bacterial or other blood-borne infection increases, as with re-use of any type of needle. Adverse events Serious adverse events are exceedingly rareon the order of five in one million and are usually associated with poorly trained, unlicensed acupuncturists. There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles. The vast majority of adverse events from acupuncture are minor, and are estimated to occur in approximately 7% to 12% of treatments, both in adults and children. The ones most commonly reported occur at the site of needle insertion: minor bleeding (3%), hematoma (23%), and pain from needling (up to 3%). Dizziness is reported in about 1% of treatments.

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