Medical Therapies of TKM-Medicines and Prescriptions/ Acupuncture

Written by Jeonghwa Lee, Choonjae Lee, Published by Korea Institute of Oriental Medicine

A. Medicines and Prescriptions

In a narrow sense, prescription means a document specifying the names and doses of drugs to be administered. From a broader prospective, however, it refers to all treatment methods applicable to diseases. Thus, in TKM, prescription is not limited to simple administration of medicine, but covers therapeutic treatments based on the diagnosis of patient’s conditions, which include acupuncture, cupping, moxibustion, regimen (exercise) and dietary therapy as well as doctors’ directions and advice to patients.

In acupuncture therapy, prescription specifies acupuncture points according to the patient’s complaints or symptoms, or sites to be treated such as legs, fingers and toes. It is also used in the same meaning in moxibustion, exercise therapy, dietary therapy, and other available therapies.

In a narrow sense, prescription means that medicines are administered to a patient based on the results of his diagnosis. That is to prepare a remedy by mixing a number of medicinal substances in accurate dosage for a patient and to apply it to the patient to ease symptoms. Medicinal therapy has several principles, and is generally based on the principle of sovereign, minister, assistant and courier . The principle is as follows below.

Sovereign means sovereign medicinal, in which the prescription is composed of the medicinal ingredients that provides the principal curative action on the main pattern or symptom. Minister means minister medicinal and supplements and strengthens the effect of sovereign medicinal. That is, it is a medicinal ingredient that helps strengthen the principal curative action. Assistant means assistant medicinal. It plays a role of neutralizing the toxicity when the sovereign medicinal is toxic or relieving the side effects accompanied by the action of the sovereign ingredient. Courier means courier medicinal. It is composed of medicinal substances that direct action to the affected site and temper the functions of mixed medicinal ingredients. Among typical courier medicinal substances are jujube, licorice, ginger, etc.

B. Acupuncture

A needle is a long and slender medical tool to be used to treat diseases in humans and animals. According to various historical facts, acupuncture, which is the treatment of a person’s illness or pain by sticking needles into the body, was originally systematized in China.

It is guessed that needles were first used in the Stone Age. The oldest acupuncture tool is a stone needle, which was made by grinding a stone or a jade into an awl or a wedge. Such a stone needle was used to stimulate the skin, to cause bleeding through shallow pricking or to squeeze the pus out. In ancient primitive society, people might have suffered from various kinds of aches, pains, and wounds as they lived in hilly or dark and humid areas. Considering this, we can presume how a stone needle must have been used.

Traditionally used needles are largely divided into nine classical needles according to size, shape and use – shear needle, round-pointed needle, spoon needle, lance needle, stiletto needle, round-sharp needle, filiform needle, long needle and big needle. In general, needles are used to prick the skin or muscle, deep or shallow, sometimes to squeeze out blood or pus by cutting the skin with a knife-like needle, or to draw water out from a joint. Among these nine classical needles, filiform needles are used most widely in acupuncture, because they are 2~17 long and 0.2~0.4 thick, and relatively thin. They can be left partially in the skin for a while without irritation.

There are several other types of needles used today which are as follows:

• 

  Intradermal needle: a small needle for embedding in the skin
• Electric needle: a needle that combines acupuncture stimulus and electric stimulus
• Herbal needle: A needle that combines the effect of acupuncture and herb
• Skin needle: Also called a baby needle, a needle that is designed to stick 5~8 needles simultaneously for stimulating the skin
• Laser acupuncture: A new therapy using and toolslaser beam as a needle. Depending on the site to which needles are applied, various kinds of needles are developed and used – needles for ear acupuncture, facial acupuncture, nose
  acupuncture, head acupuncture, hand acupuncture, foot acupuncture, and body acupuncture. Acupuncture has been used to treat all kinds of diseases including internal, surgical, gynecologic, pediatric, otorhinolaryngologic and ophthalmologic diseases by controlling the flow of qi. It has also been used for anesthesia, diagnosis and the treatment of animals. In addition, acupuncture therapy is used to aid in smoking cessation. Acupuncture shows a quick relief and recovery effect in sprains, indi-gestion, children’s convulsion and acute diseases such as tonsillitis, conjunctivitis and syncope. For chronic diseases such as neuralgia, gastroparesis, hemiplegia caused by paralysis, and dysphasia, long term treatment is required to produce satisfactory results.

1. Ear Acupuncture

Ear acupuncture treats diseases in various parts of the human body by putting needles into certain points of the ear. It has been developed into an extensively used therapy, based on ancient Oriental medicine. Since long ago, there have been people who had their ears pierced and put on earrings for fashion. This is a kind of ear acupuncture, and is effective in treating ophthalmologic diseases. There have been folk therapies that treat conjunctivitis by pricking the earlobe with needles or treat pharyngolaryngitis caused by a cold through pricking a certain point behind the ear with needles.

Today’s ear acupuncture was developed by a French physician P. Nogier. Learning that his patient’s back pains and leg pains had disappeared after the patient got burnt in the ear, he applied it clinically and attained satisfactory results. He reported the success of his treatment to the conference of the International Acupuncture & Moxibustion Society in Marseille, France in 1956, and as a result, it was the official beginning of ear acupuncture treatment.

Dr. P. Nogier understood the anatomical characteristics of the ear and observed that certain points on the external ear responded to diseases in the five viscera and six bowels. He explored, measured and systematized the distribution and the exact positions of the ear points. As the appearance of the external ear points looked like a fetus upside down, he based his research on his findings.

These days, ear acupuncture is being utilized in clinics in various ways, and has been found effective in relieving pains and symptoms in the nervous system, endocrine system, and other illnesses. Ear acupuncture is also used to anesthetize and utilized to end smoking habits.

2. Hand and Foot Acupuncture

Hand and foot acupuncture is a kind of acupuncture therapy and treats diseases by applying needles to acupoints on the hands or feet. There are two basic principles related to hand and foot acupuncture. One principle is that each part of the human body represents the whole body. That is, the face contains points connected to the organs and systems of the body,
and each of the ears, the hands and the feet have points reacting to their corresponding parts of the body.

Accordingly, if there happens to be a disorder in an organ of the body, the organ can be treated by pricking and stimulating a specific point on the hand or the foot linked to the organ. The other principle is that the hands and feet are key parts for facilitating the circulation of qi and blood through the whole body.

There are five important acupuncture points, called five transport points, in each median from the fingertip to the elbow and from the tip of the toe to the knee. Those acupuncture points are linked to internal organs corresponding to the meridians and collaterals. Using the acupuncture points, we can treat diseases in the whole body by applying acupuncture to the hands and feet.

3. Herbal Acupuncture

Herbal acupuncture is also called water acupuncture or acupoint injection therapy. Based on the meridian and collateral theory, medicine is injected into acupoints and thus, treatment is done through the combined effects of acupuncture and medicine. From ancient times, in treating patients, Oriental medical therapies have emphasized the use of acupuncture as the first part of treatment, moxibustion as the second, and medicine as the third.

Acupuncture is an external therapy that stimulates the body from the outside, and medicinal treatment is an internal therapy that stimulates internal organs from the inside. The two types of therapies can be applied separately or together. Recently, however, herbal acupuncture, which is a combination of medicine and acupuncture, begins to be spotlighted in response to the practical needs of higher effective treatment including the expansion of the areas of TKM.

Herbal acupuncture therapy consists of injecting substances extracted from herbs into key acupoints. Of course, the stimulation of acupoints alone can produce positive effects, but the additional injection of specific medicines into the acupoints increases the effect considerably. The Korean Oriental Medical Society is making efforts to research and spread herbal acupuncture through its Subdivision of Herbal Acupuncture. The new herbal acupuncture is under development not only in Korea but also, in China, North Korea, and Japan. It will be researched and developed into a high-tech therapy of TKM, and advanced even further through international collaboration.

4. Laser Acupuncture

Laser acupuncture is a type of acupuncture therapy that uses laser beam. It was initiated by Inuyshin in Russia in the early 1970s. He applied very weak laser to the skin and found that it produced effects such as vasodilation, pain alleviation
and anti-inflammation. Since then, there have been various clinical reports and theses on animal experiments in China, Germany and Austria as well as in Korea.

The principle of laser acupuncture is simple. If a laser beam is concentrated on an acupoint, reaction to the laser beam and the stimulation of electromagnetic field on the spot makes changes in the meridian and collateral system of the body. Laser treatment is known to regulate the uneven circulation of qi and blood and facilitate biological functions.

One of the main advantages of laser acupuncture is that the patient does not feel pain during treatment. In general, acupuncture involves some pain in the patients, but laser acupuncture is painless, though it may be slightly prickly to sensitive persons. What is more, it does not leave any marks after treatment, and is safe and free of side effects because it does not contact the skin directly. Besides, it takes only a short time and can conveniently control the intensity of stimulation. Laser acupuncture is applied frequently to dermatologic, internal and pediatric diseases, and also to almost every area of acupuncture and moxibustion.

5. Acupuncture Anesthesia

Acupuncture anesthesia, a branch of acupuncture and moxibustion that has been developed based on clinical practices of acupuncture, is an anesthetizing method that numbs a specific part of the body by pricking the part with a needle and allows surgery while the patient remains conscious. This process was developed from the traditional effect of acupuncture. Looking back on history, it has been recorded in Huhanseo, Samgukji and other medical books that a noted doctor, Hwata11, during the Period of the late Han Dynasty in China, used anesthesia in surgery.

As to the mechanism of acupuncture anesthesia, various theories have been suggested, including the phenomenon of meridian transmission, gate control theory, neuroendocrine therapy, and the hypnosis principle, of which only some have been supported. Some of them have been supported but others have not been fully explained yet.

One of the characteristics of acupuncture anesthesia is in its safety. While the use of anesthetic is likely to cause side effects, acupuncture anesthesia has little risk of side effects in the functions of organs. Therefore, it is reported that there have been no grave accidents caused by acupuncture anesthesia.

Second, it does not disrupt the balance of physiological mechanisms. Acupuncture regulates various body functions, and if acupuncture anesthesia is used in surgery, the patien’s various physiological functions are intact and postoperative recovery is also fast. Third, because the patient is conscious during surgery, he/she can give active cooperation. For example, in finger
surgery, the doctor can have the patient move the finger to see the effect of surgery. Fourth, acupuncture anesthesia does not need expensive and complicated special equipments, so it is convenient and economically efficient.

However, the downside is that it may result in the tension of internal organs due to incomplete pain killing or muscular relaxation. Acupuncture anesthesia was attempted by Kyunghee University and the National Medical Center. It is being spotlighted as a new area of acupuncture and moxibustion by both Oriental and Western medicine, but there are still many problems to be solved through research in the future.

6. Saam Acupuncture

Saam Acupuncture was created by Saamdoin who is known to have lived in the mid Chosun Dynasty. Saam Acupuncture is a Korean original acupuncture method created based on the mutual engendering and restraining principle of the yin and yang and five elements.

Saamdoin, the originator of Saam Acupuncture, was originally a Buddhist monk with his name unknown. He was called Saam because he achieved spiritual enlightenment in a stone cave. According to a tradition, he is known to be one of the best disciples of Buddhist saint Samyeongdang, the famous leader of monk soldiers during the war against Japan in 1592. His only book Saam doinchimgooyogyeol (Essential Rhymes on Acupuncture and Moxibustion by Master Saam) listed clinical cases without detailed explanations of principles, theories and application methods.

In Hwangjenaegyeong, which lays the theoretical foundation of Oriental medicine, is written, Heojeukbogimo Siljeuksagija, which means that deficiency tones up the acupoint corresponding to its mother and excess tones down the acupoint corresponding to its child. However, although Hwangjenaegyeong suggested theoretical principles, many of the principles were not utilized clinically.

Based on such theories, Saam Acupuncture applied new acupuncture and moxibustion methods to clinical cases. Therefore, Saam Acupuncture is an orthodox acupuncture method inheriting the acupuncture and moxibustion method of Hwangjenaegyeong and, at the same time, a new acupuncture and moxibustion created in Korea. The characteristics of Saam Acupuncture can be summarized as follows. First, unlike body acupuncture that puts needles to the whole body, Saam Acupuncture uses acupoints below the elbow and the knee, so it does not have the risk of damaging organs.

Second, unlike ordinary body acupuncture that pricks tens of acupoints at once, Saam Acupuncture selects less than 8 acupoints, which are essential and show a high treatment effect, so it can be applied conveniently.

Third, as Saam Acupuncture selects characteristic acupoints with high treatment effect, its treatment effect is fast and excellent not only in newly acquired diseases but also in chronic ones. 
Fourth, Saam Acupuncture can be applied extensively according to patients mental and physical condition.
Fifth, Saam Acupuncture has a definite theoretical ground because it is applied in accordance with its unique theoretical system.
Sixth, Saam Acupuncture is a kind of theoretical acupuncture that is administered according to specific theories that understand the human body holistically.