• Overview
  • Forms of Treatment
  • Prevalence and Use in the U.S.
  • Costs and Coverage
  • Licensure and Credentials
  • Transmission of Chinese Medical Thought
  • East Asian Medical Theory and Diagnosis
• Interventions
  • Acupuncture
  • Chinese Herbal Medicine
  • Meditative Exercises
• Conditions
  • Acupuncture and Smoking Cessation
  • Acupuncture in the Treatment of Hypertension
  • Tai Chi and Cardiovascular Health

Forms of Treatment

East Asian Medicine (EAM) describes a system of health care and maintenance comprised of an array of treatment modalities and interventions. While the practice of acupuncture and EAM may primarily summon only the image of needles, a well-trained EAM practitioner will in fact employ a variety of treatment techniques in a single treatment. At its most basic level, EAM includes the use of acupuncture, Chinese herbal medicine, manual therapies, dietary guidelines and meditative exercises. These distinct modalities and treatment techniques share a theoretical framework defined by the interdependent relationship of Yin and Yang and arise from theories put forth in the canon of Chinese medical texts. Each technique is used to achieve a specific aspect of the treatment strategy which is determined as part of the diagnosis at the onset of the session.

Acupuncture

Acupuncture is essentially the insertion of sterile, filiform needles into predefined points on the body. Needles are inserted into acupoints at varying depths depending on their location and an individual's frame; some are inserted superficially at depths of 2-3 mm, and others, at points with more body tissue such as the gluteus medius muscle, are inserted to depths of 5cm or more . Most acupuncture points are located on a meridian or channel, which is a defined pathway in the body. Collectively the twelve meridians form a network for Qi movement and integration of different parts of the body including viscera. The choice of specific acupuncture points for treatment is made according to a combination of theoretical approaches resulting in a point prescription, which consists of about 10-20 points being needled in one treatment session. Each point prescription is individually tailored to the patient, their complaint and the diagnosis made by the clinician during the patient’s intake. Needles generally are retained for 20-40 minutes and are manipulated during that time to attain the desired therapeutic result.

In the US several styles of acupuncture are sometimes distinguished. Some styles broadly referred to as Japanese acupuncture, for example, call for fewer and finer needles inserted at more shallow depths. Little research has been done comparing different styles in terms of effectiveness or mechanism. See Cassidy [1] for more information.

An acupuncture session may also include the use of moxibustion or infrared heat therapy. In Chinese, the word for acupuncture is actually "needle and moxibustion"; thus these techniques are inextricable at their source. Moxibustion is the igniting of a cotton-like, processed version of the herb Ai Ye, Artemis vulgaris, near or on the skin with a barrier. It is used to warm and promote movement at a specific acupoint or area of a patient's body. Similarly, infrared heat is used to simulate the effects of moxibustion and is an example of the incorporation of modern science in East Asian Medicine.

Other methods that may be employed are magnets, ion pumping cords, pressballs, as well as intradermal and plum blossom needles. Types of acupuncture include electro-acupuncture, laser acupuncture and microsystems-based acupuncture (e.g., Auricular, Scalp, Hand). For more information see Interventions: Acupuncture.

Manual Therapies

Manual therapies provide additional hands-on techniques integral to the practice of East Asian Medicine (EAM). Massage-like procedures are used to increase circulation to body tissues, loosen joints and relax muscles in specific areas. One popular manual therapy used in EAM is Tui Na, a classical Chinese massage. Tui Na involves the stimulation of acupoints and areas of the body with the practitioner's hands and massage tools. Other Asian bodywork therapies such as Shiatsu or traditional Thai massage, extend the acupuncturist's treatment options for many musculoskeletal, structural and traumatic injuries. These methods are also used when treating children and may be used in place of acupuncture. For more information on EAM–based manual therapies, see the American Organization for Bodywork Therapies of Asia.

In addition to massage, EAM practitioners frequently incorporate two other manual therapies, cupping and Gua Sha. Cupping is a procedure used to bring Qi and blood to the surface of the body. It has been used for many years throughout much of the world, including in China, Turkey, Greece, France, Italy, and Eastern Europe.

In EAM, cupping is said to disperse and move Qi by exerting suction and pressure. Specific cups used for the procedure are made of strong glass or plastic. These cups are held in place on the patient’s body by a vacuum generated by special pumps designed for this practice. Alternately, a flame from a lighter or a burning cotton ball may be placed in the cup. When the oxygen in the cup is burned off, the cup is placed directly on the skin, where it is held in place by suction. Often, the skin inside the cup visibly rises. Cupping is generally quite comfortable for the patient. Patients usually lie down for a cupping treatment.

Gua Sha is a technique used by clinicians in EAM and by parents throughout much of Asia. It involves palpation and cutaneous stimulation where the skin is pressured in strokes by a round-edged instrument that results in the appearance of small red petechiae called 'Sha', which will fade in 2 to 3 days. Sometimes referred to as "coining" or "scraping", this technique is used to disperse localized stagnation. It is used in the treament of muscle pain and tightness and to relieve coughing and heat in the body.

Chinese Herbal Medicine

Chinese Herbal Medicine is used as a primary form of treatment and may thus be used alone or in combination with acupuncture. Substances in the Chinese herbal material medica are not only dried herbs; many are highly processed and no longer resemble their original form. Although we refer to the treatment as Chinese Herbal Medicine, the materia medica is only 80% plant-based. Substances include roots, rhizomes, bark, fruit, flowers, etc. and the remainder of the pharmacopoeia is mineral or animal in origin. Some non-plant examples are gypsum, oyster shell, fossilized bone, and gecko. Each substance is carefully categorized according to its characteristics and therapeutic actions.

Once a patient has been diagnosed according to East Asian medical theories, an appropriate combination of substances (a formula) is chosen. The derivation of a formula is based on the experience of combining various substances for specific conditions that has been documented in the canon of Chinese medical texts over the past millennia. Chinese Herbal Medicine is administered in many forms, depending upon the treatment goal. Methods of administration include water decoction (tea) made from boiling the herbs, concentrated powders, pills, tinctures, and external-use plasters. For more information see Interventions: Chinese Herbal Medicine.

Dietary guidelines

Diet is a vital aspect of healing and health maintenance in East Asian Medicine. As with Chinese herbs, foods are categorized according to their actions in the body, as well as by predetermined values, e.g., hot/cold, yin/yang, building/clearing. Chinese herbs also may be used as ingredients in meal preparation. One property associated with white rice, for example, is that it drains Damp (a pathogenic condition); therefore rice may be suggested to a patient presenting with diarrhea that's related to Damp.

Meditative Exercises

Meditative exercises were originally developed as a way to cultivate one's Qi — for personal health, for improving one’s ability to treat others, and for defensive purposes. External exercises, or the martial arts such as Kung Fu and Wushu, have long been a familiar practice in the West. Internal exercises such as Tai Chi and Qi Gong (also Chi Kung) are comprised of slow, graceful movements and breathing techniques which help to improve balance, strengthen the body and promote a general sense of well-being. For more information see Interventions: Meditative Exercises.