Page 322 Guide to Pain Management in Low-Resource Settings

310 Natalia Samoilova and Andreas Kopf

Small Intestine

Stomach Bladder

Heart

YANG YANG
YIN

Spleen

(Image courtesy of John F. Th ie, DC, from his book entitled Touch for Health)

acupuncture. But in the original (Chinese) approach to puncture into a simplifi ed acupuncture point selection
acupuncture, the points that the practitioner chooses for practical use. Th is strategy would allow the clinician
may not necessarily be at the site of the pain. to use acupuncture without becoming a specialist with
extensive training in clinical practice. Th e authors are
How is this very diff erent medical philosophy well aware that such an approach will be challenged by
on disease incorporated into Western
medical concepts? traditional acupuncturists, but scientifi c evidence may
allow such a simplifi ed approach to acupuncture.
From the frequent use of quotation marks, it should
be obvious that acupuncture is not easily transferred How are the eff ects of acupuncture explained
or translated into the Western concept of medicine. It with modern (patho)physiological knowledge?
should therefore be noted that the oriental defi nitions Historically, acupuncture points were believed to be
and terms do not necessarily refl ect a physiological view, “holes that allow entry” into the meridians or chan-
but a concept that was developed without the knowledge nels to allow alteration of “energy fl ows.” Th ese holes
of modern physiology by observing and describing. A provide, in traditional Chinese acupuncture, a gateway
great number of diff erent schools for acupuncture exist, to infl uence, redirect, increase, or decrease the body’s
using diff erent point localizations and point selections. vital substance, Qi, thus correcting many of the imbal-
Hence it is not possible to interpret acupuncture and re- ances mentioned earlier. Th ese traditional Chinese con-
defi ne it into a pragmatic pain approach. cepts may be irrelevant to understand the impact of
Recent large-scale studies in Germany have acupuncture, since modern physiological research has
added a lot to this discussion by showing that acu- been able to demonstrate that acupuncture does have a
puncture per se, but not the strict following of classical neuromodulatory eff ect on parts of the peripheral and
traditional Chinese rules for acupuncture point selec- central nervous system and on neurotransmitters. Th ese
tion, is eff ective in treating pain. Th erefore, it may be eff ects do not seem to be acupoint-specifi c and are at
a pragmatic solution to adapt traditional Chinese acu- least partly a psychophysiological phenomenon. Some