Acupuncture: Textbook and Atlas

345 Pages·1987·8.438 MB·English

by  Dr. med. Gabriel Stux, Prof. Bruce Pomeranz (auth.)

Gabriel Stux Bruce Pomeranz
Acupuncture
Textbook and Atlas
Translations of Chinese Terms by Karl Alfried Sahm
Illustrations prepared by Petra Kofen
With 98 Figures and an Acupuncture Selector
Springer-Verlag
Berlin Heidelberg New York Tokyo
Dr. med. Gabriel Stux
Acupuncture Center
GoltsteinstraBe 26, 4000 Dusseldorf
Federal Republic of Germany
Prof. Bruce Pomeranz
25. Governor's Road
Toronto, M4W 2F9
Canada
This book is based on the following books published by Springer-Verlag:
Lehrbuch der klinischen Akupunktur Akupunktur: Lehrbuch und Atlas
Atlas der Akupunktur Grundlagen der Akupunktur
ISBN-13: 978-3-642-71744-4 e-ISBN-13: 978-3-642-71742-0
DOl: 10.1007/978-3-642-71742-0
This work is subject to copyright. All rights are reserved, whether the whole or part ofthe material is concerned, specifically the rights of
translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data
banks. Duplication of this publication or parts thereofis only permitted under the provisions ofthe German Copyright Law of September
9,1965, in its version of June 24,1985, and a copyright fee must always be paid. Violations fall under the prosecution act of the German
Copyright Law.
© Springer-Verlag Berlin Heidelberg 1987
Softcover reprint ofthe hardcover I sl edition 1987
The use of registered names, trademarks, etc. in the publication does not imply, even in the absence of a specific statement, that such
names are exempt from the relevant protective laws and regulations and therefore free for general use.
2119/3140-543210
Preface
Acupuncture: Textbook and Atlas is a fundamental textbook based on different books
published in German by the first author. It is intended to meet the needs of western
acupuncturists by providing a basic treatment of all the main fields of acupuncture.
The chapter on the scientific basis of acupuncture has been written by Prof. Bruce
Pomeranz, an eminent neurophysiologist who is in the vanguard of basic research into
acupuncture.
Following an introduction to the philosophical and theoretical background of tradi
tional Chinese medicine, the traditional diagnostic system is presented. This is funda
mentally different from western medical diagnosis. The Chinese system of channels
and functional organs and the significance of points and point categories are described
in detail in Chap. 5, the 14 main channels and about 150 acupuncture points important
in daily practice being presented with the didactic emphasis on morphology and clini
cal application. The Chinese point names are given in the Pin Yin transcription accord
ing to the latest standardized system of the World Health Organization and have been
translated into English by Karl Alfried Sahm.
The most important acupuncture points in the different regions of the body are listed
after the description of channels and points. The methods of needling and moxibustion
are described with reference to their historical origins and development and presented
in detail with their clinical applications. The treatment of adjunctive methods (laser
therapy and acupressure) and the different microsystems, such as scalp, hand and ear
acupuncture, is brief but comprehensive.
The chapter on treatment is based on western modes of diagnosis, which is discussed
in relation to Chinese diagnostic categories, and the major principles of therapy. The
most important acupuncture points are given for the different diagnoses. They should
not be used as "recipes", but as hints to underlying rules on the selection of points.
Thanks are due to my first acupuncture teachers, Prof. Anton Jayasuriya from Sri Lan
ka and Dr. Maria Vinnemeier from Velbert, West Germany. Many stimulating lectures
given by eminent scholars, for example Prof. Zhang Jin from Harbin and Prof. Cheng
Xingnong from Beijing, have had positive influences on this book.
Thanks to Janet Dodsworth and Britta Severin for translation work and for correction
of the manuscript.
Autumn, 1986 Gabriel Stux
Table of Contents
1 Scientific Basis of Acupuncture (B. Pomeranz) . 1
1.1 Acupuncture Analgesia (Basis Research) 1
1.2 Acupuncture Analgesia for Chronic Pain . . . 17
1.3 Drug Addiction . . . . . . . . . . . . . . . . . 18
1.4 Asthma, Nerve Regeneration and Cardiovascular Effects of Acupuncture 19
1.5 Acupuncture Points (Do They Really Exist?) . . . . . . . . . . . . . . .. 20
2 History of Acupuncture (G. Stux) . . . . . . . . . . . . . . . . . . . . . .. 35
3 Background and Theory of Traditional Chinese Medicine (G. Stux) .. 37
3.1 Tao, Yin and Yang. . . . . . 37
3.2 The Cosmic Vital Energy: Qi . 39
3.3 Jing, the Life Essence . . 40
3.4 Shen, or Psychic Energy. . 40
3.5 Disturbances of Qi .... 41
3.6 The System of Five Phases 43
3.7 External Climatic Factors . 44
3.7.1 Description of the Climatic Factors 45
3.8 Internal Emotional Factors . . . . . 46
4 Diagnosis in Traditional Chinese Medicine (G. Stux) . 47
4.1 Eight Diagnostic Criteria, Ba gang . 47
4.2 Interior and Exterior Li, Biao . 48
4.3 Excess and Deficiency Shi, Xu 48
4.4 Heat and Cold Re, Han . . . 49
4.5 Yin and Yang . . . . . . . . . 50
4.6 Four Examinations Si zhen . . 50
4.7 Visual Observation Wang zhen . 51
4.8 Listening and Smelling Wen zhen 52
4.9 Questioning Wtm zhen ..... 52
4.10 Physical Examination Qie zhen . 54
5 Chinese System of Channels, Organs and Points (G. Stux) . 55
5.1 Channels and Organs . . . . . . . . 55
5.2 Presentation of the Point Categories 60
5.2.1 Shu Points or Transport Points 60
5.2.2 M u or Alarm Points . . . . . 60
5.2.3 Influential Points, Hui Xue . 62
5.2.4 Xi-Cleft Points. . . 62
5.2.5 Five Shu Points .. 63
5.2.6 Tonification Point . 63
5.2.7 Sedative Point . . . 64
VIII Table of Contents
5.2.8 Jing Well Point. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 64
5.2.9 Ying Point . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 64
5.2.10 Yuan Source Point .............................. 64
5.2.11 Jing Point ................................... 66
5.2.12 He Sea Point . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 66
5.2.13 Luo Connecting Point. . . . . . . . . . . . . . . . . . . . . . . . . . . .. 66
5.2.14 Confluent Points ............................... 68
5.3. Methods of Point Location . . . . . . . . . . . . . . . . . . . . . . . . .. 70
5.3.1 Anatomical Landmarks . . . . . . . . . . . . . . . . . . . . . . . . . . .. 70
5.3.2 Proportional Cun Measurement . . . . . . . . . . . . . . . . . . . . . .. 70
5.3.3 Proportional Measurement . . . . . . . . . . . . . . . . . . . . . . . . .. 72
5.3.4 Location by Means of Specific Posture ................... 72
5.3.5 Location by Measurement of Skin Resistance. . . . . . . . . . . . . . .. 74
5.3.6 Location with the Aid of Other Points . . . . . . . . . . . . . . . . . . .. 74
5.3.7 Combination of Different Methods . . . . . . . . . . . . . . . . . . . .. 74
5.3.8 Location of Painful, Sensitive or Tender Points . . . . . . . . . . . . . .. 74
6 Systematic Description of Channels and Points (G. Stux) .......... 77
6.1 Lung Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 77
6.2 Large Intestine Channel ........................... 84
6.3 Stomach Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 92
6.4 Spleen Channel ................................ 106
6.5 Heart Channel ................................. 114
6.6 Small Intestine Channel ........................... 120
6.7 Urinary Bladder Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
6.8 Kidney Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
6.9 Pericardium Channel ............................. 154
6.10 Sanjiao Channel ................................ 160
6.11 Gallbladder Channel ............................. 168
6.12 Liver Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
6.13 DuMai ..................................... 184
6.14 RenMai .................................... 192
6.15 Chong Mai . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 198
6.16 DaiMai .................................... 198
6.17 Yangqiao .................................... 198
6.18 Yinqiao .................................... 200
6.19 Yangwei .................................... 200
6.20 Yinwei ..................................... 200
6.21 Extra Points . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
7 Regions with Important Acupuncture Points (G. Stux) . . . . . . . . . . . . 212
7.1 Face ...................................... 212
7.1.1 Points Around the Orbita . . . . . . . . . . . . . . . . . . . . . . . . . . . 212
7.1.2 Points Around the Ear ............................ 212
7.1.3 Points Around the Nose ............................ 214
7.2 NeckArea ................................... 214
7.3 Dorsal Side of the Trunk .. . . . . . . . . . . . . . . . . . . . . . . . . . 216
7.4 Abdominal Area. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
7.4.1 Epigastrium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
7.4.2 Middle and Lower Parts of the Abdominal Area .............. 218
7.5 Shoulder Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220
7.6 Points Around the Knee Joint ........................ 220
Table of Contents IX
8 Technique of Acupuncture (G. Stux) . . . . . . . . . . . . . . . . . . . . . . 223
8.1 Acupuncture Needles ............................. 223
8.2 Technique ofInsertion and Stimulation of the Needles ........... 224
8.3 De Qi Sensation . . . . . . . . . . . . . . . . . .. ............ 225
8.4 Tonifying and Sedating Methods of Stimulation . . . . . . . . 225
8.5 Electroacupuncture, Electrostimulation . . . . .. ............ 226
8.6 Sterilization of the Needles . . . . . . . . . . . . . . 227
8.7 Complications of Acupuncture Treatment. . . . . . . . . . . . . . . . . . 227
9 Moxibustion (G. Stux) . . . .... . · .229
9.1 Indications and Methods. ... . . · .229
9.2 Direct Moxibustion . . .. .... . .230
9.3 Indirect Moxibustion with Ginger Slice Isolation . . . . . . · ....... 230
9.4 Moxibustion with "Moxa Cigars" . . . . . . . . . . . . .. · ....... 231
9.5 Moxibustion by Heating Acupuncture Needles .. · ....... 231
9.6 Infrared Moxibustion . . . . . . . . . . . . · ....... 231
10 Laser Acupuncture (G. Stux) ...... 233
11 Acupressure(G.Stux) ... ...... 235
12 Ear Acupuncture (G. Stux) . ..... . ... 237
12.1 Technique of Ear Acupuncture . . . . . . .238
12.2. Representation of the Body on the Auricle .238
12.3 Numbering of Ear Points . . . . . . . .242
12.4 Rules for Selection of Ear Points . . .246
13 Scalp Acupuncture (G. Stux) . .249
13.1 Fourteen Lines for Treatment. .249
13.2 Method of Needling ..... . · .252
14 Hand Acupuncture (G. Stux) ... .253
14.1 Points of the Dorsum of the Hand .253
14.2 Points on the Palm. . . . . . . . .256
15 Acupuncture Treatment (G. Stux) . . . . . . . . . . . . . . . . . . . . . . . 261
15.1 Principles of Acupuncture and Major Rules of Point Selection .. 261
15.2 Locomotor Disorders ............................. 270
15.2.1 Arthrosis of the Jaw Joint ........................... 270
15.2.2 Cervical Spondylitis, Torticollis, Rheumatoid Arthritis . . . . . . . . . . . 271
15.2.3 Intercostal Neuralgia, Trauma of the Thorax, Ankylosing Spondylitis,
Zoster Neuralgia ............................... 271
15.2.4 Sciatica, Lumbar Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272
15.2.5 Periarthritis Humeroscapularis, Frozen Shoulder . . . . . . . . . . . . . . 273
15.2.6 Epicondylitis, Tennis Elbow . . . . . . . . . . . . . . . . . . . . . . . . . 273
15.2.7 Pain in the WristJoint ............................. 274
15.2.8 Pain in the Hand, Rheumatoid Arthritis, Dupuytren's Contraction . . . . 274
15.2.9 Coxarthrosis, Coxarthritis ......... . ...... 274
15.2.10 Gonarthrosis, Pain in the Knee Joint. . .. 275
15.2.11 Pain in the Ankle Joint .. 275
15.2.12 Pain in the Toes . . . . . . 275
15.2.13 Rheumatoid Arthritis . . . 276
X Table of Contents
15.3 Respiratory Disorders .277
15.3.1 Common Cold. . . . .278
15.3.2 Tonsillitis, Laryngitis .278
15.3.3 Maxillary Sinusitis .278
15.3.4 Frontal Sinusitis . . .279
15.3.5 Chronic Bronchitis .279
15.3.6 Bronchial Asthma . .279
15.4 Cardiovascular Disorders . . . . . . . . . . . . . . ... 280
15.4.1 Coronary Heart Disease with Angina Pectoris .. ... 280
15.4.2 Cardiac Neurosis . . . . . . . . . . . . . · . 281
15.4.3 Cardiac Arrhythmia . . . . . . . . . . . . · . 281
15.4.4 Exhaustion Conditions in Heart Disease · . 281
15.4.5 Hypertension .............. . · .282
15.4.6 Hypotension . . . . . . . . . . . . . . . . · .282
15.4.7 Disturbances of Peripheral Blood Supply .282
15.5 Gastroenterological Disorders . . 283
15.5.1 Esophagitis, Dysphagia . . . .283
15.5.2 Gastritis, Gastroenteritis .. .284
15.5.3 Gastric and Duodenal Ulcer .284
15.5.4 Diarrhea ....... . .284
15.5.5 Irritable Bowel Disease . . . .285
15.5.6 Constipation . . . . . . . . . .286
15.5.7 Hemorrhoids, Anal Fissure . .286
15.5.8 Cholangitis, Cholecystitis, Biliary Dyskinesia, Biliary Colic . . . . . . · . 286
15.5.9 Hepatitis ................................. . · .287
15.6 Mental Disturbances and Illnesses .287
15.6.1 Depression . . . . . . . .288
15.6.2 Exhaustion Conditions .289
15.6.3 Agitation ..... . .289
15.6.4 Sleep Disturbances .289
15.6.5 Schizophrenia . . . .290
15.6.6 Drug Addiction . . .290
15.6.7 Alcohol Addiction. .290
15.6.8 Nicotine Addiction .290
15.6.9 Overweight, Weight Loss .291
15.6.10 Sexual Disturbances . 291
15.7 Neurologic Disorders .292
15.7.1 Headache and Migraine .292
15.7.2 Trigeminal Neuralgia .294
15.7.3 Hemiparesis . .295
15.7.4 Facial Paresis .296
15.7.5 Epilepsy ... .296
15.8 Gynecological Disorders . .297
15.8.1 Dysmenorrhea. . . . .297
15.8.2 Amenorrhea . . . . . . . · .297
15.8.3 Adnexitis, Salpingitis . . .298
15.8.4 Pain caused by Gynecological Tumors . .298
15.8.5 Pruritus Vulvae ............ . .298
Table of Contents XI
15.8.6 Hyperemesis Gravidarum . . 299
15.8.7 Analgesia During Childbirth . 299
15.8.8 Deficient Lactation . . 300
15.9 Urological Disorders . .300
15.9.1 Pyelonephritis, Urinary Infections, Chronic Glomerulonephritis .... 301
15.9.2 Renal Colic ................... .... . ... 301
15.9.3 Prostatitis, Psychogenic Urological Symptoms · 301
15.9.4 Impotence and Male Fertility Disorders . . · 302
15.9.5 Enuresis .... .302
15.10 Skin Disorders . · 303
15.10.1 Acne Vulgaris . · 303
15.10.2 Leg Ulcers, Deficient Wound Healing .304
15.10.3 Eczema, N eurodermitis . . . . . .304
15.10.4 Psoriasis ............ . .304
15.10.5 Herpes Zoster, Zoster Neuralgia .304
15.10.6 Herpes Simplex . . . . . . . . · 305
15.11 Disorders of the Sense Organs . · 305
15.11.1 Deafness ........... . · 305
15.11.2 Tinnitus ........... . · 305
15.11.3 Meniere's Syndrome, Dizziness, Motion Sickness, Labyrinthitis. . · . 306
15.11.4 Chronic Conjunctivitis .306
15.11.5 Glaucoma Simplex · 306
15.11.6 Visual Deficiency ... .307
15.12 Acute Disorders and Emergencies . .307
15.12.1 Fainting, Collapse . . . . . . .307
15.12.2 Epileptic Fits, Grand Mal. . .307
15.12.3 Acutely Painful Conditions . .307
Appendixes A -H . . . . . . . . . . . .308
A. World Health Organization List ofIndications for Acupuncture · . 309
B. Nomenclature and Abbreviations for Channels and Points · . 310
C. Glossary of Chinese Terms . . . . . . . . . . . . . . . · . 311
D. Translation of Chinese Ideograms and Point Names. · 315
E. Alphabetic List of Chinese Point Names ...... . · 326
F. Index ofIndications for Acupuncture . . . . . . . . . .329
G. Historical Illustrations from the Golden Mirror ofM edicine · 331
H. System of the Five Phases .334
Literature . . · 335
Subject Index · 339
1 Scientific Basis of Acupuncture
B.Pomeranz
In this chapter we review 228 of modem scientific studies on acupuncture. As most
research has focused on acupuncture analgesia (AA) this will be the major topic. Two
main conclusions are drawn: first that AA is effective in treating chronic pain (working
better than placebo), and second that the neurological mechanisms of AA are rapidly
becoming apparent. We conclude that acupuncture activates small myelinated nerve
fibres in the muscle, which send impulses to the spinal cord, and then activates three
centres (spinal cord, midbrain and pituitary-hypothalamus) to cause analgesia. The
spinal cord centre uses enkephalin and dynorphin to block incoming painful informa
tion. The midbrain centre uses enkephalin to activate the raphe descending system
which inhibits spinal cord pain transmission using the monoamines (serotonin and
norepinephrine). The third centre is the hypothalamus-pituitary, which releases beta
endorphin into the blood and cerebrospinal fluid to cause analgesia at a distance. Thus
all three endorphins (enkephalin, beta endorphin, and dynorphin) have a role in AA,
and two monamines (serotonin and norepinephrine) are also involved. When high fre
quency low intensity stimulation is used a non-endorphin type of analgesia occurs.
Unfortunately, much less research has been done into the other claims made in addi
tion for acupuncture, and these will be given less coverage (Sects. 1.3 and 1.4). Finally,
the specificity of acupuncture points will be discussed in Section 1.5.
1.1 Acupuncture Analgesia (Basic Research)
Western scientists only began to take acupuncture seriously in 1972 after diplomatic
visits to China increased in frequency. In the ensuing years delegations of American
physicians were especially impressed by major surgery performed in China on awake
patients, in whom pain was greatly reduced by acupuncture analgesia (AA). Instead of
twirling the acupuncture needles by hand according to the ancient methods, needles
were electrically stimulated at approximately the same low frequency (2-4 Hz). This is
much more convenient than having acupuncturists reach under the sheets on the
operating table to manipulate the needles manually for 3 h during surgery. The new
method is called electro acupuncture (EA). Visitors were told that over 400,000 major
surgical procedures had been done in China in the 1960s using AA. Now that chemical
anaesthetics are more readily available in China, fewer than 10% of patients continue
to get AA, because it is rather difficult to administer, is more time consuming and is not
100% reliable, failing to work in many cases. In addition, AA is not used for abdominal
surgery because muscle relaxation is not possible. AA requires that patients be care
fully selected and trained to ensure that they will not become squeamish during sur
gery. Even when AA abolishes most of the pain, many conscious patients cannot toler
ate the emotional stress of the operation. For this reason many operations were done
on medicated patients (given tranquillizers, opiates etc.), and this has raised consider
able controversy as to how effective AA is for surgical procedures. Recent statements
from China suggest that some deception was used during the Mao regime to exagger-