Although recent tet national publications have featured articles describing the effectweness of Traditional Chinese Medicine (TCM), little has been published about the implementation of TCM in today's healthcare in the Netherlands. In this thesis, we tried to bridge this gap and interpret how TCM, and specifically acupuncture and moxibustion, can demonstrate its \alue in today's medicine as it is practiced in a Western country. To accomplish this aim we used a range of epidemiologic techniques leading to evidence-based results. In this introduction we will first describe acupuncture and moxibustion and review fundamental research of the working mechanisms. Acupuncture is one of the components of TCM. It can be described as the ancient practice of piercing specific points of the body with fine needles that are applied to relieve pain, to induce surgical anesthesia, and to serve therapeutic purposes ' (Figure |). The use of acupuncture is based on more than 3000 years of experience and study. Indeed, the oldest surviving book about acupuncture, the Hungdi Neiging Suwen, was published in 200 BC. It systematically describes a wealth of detail in patient care and cure?. Huang Ti, the Yellow Emperor. According to Chinese legend he is the third of the first emperors in Chinese history. The beginning of Huang-ti's reign traditionally given as 2697 BC (when Huang-ti was 7 years old), is usually taken as the beginning of Chinese history. lc. Huangdi Neijing (E35 A ®), also known as “The Inner Canon of Huangdì or Yellow Emperor's Inner Canon’, is an ancient Chinese medical text that has been treated as the fundamental doctrinal source for Chinese medicine for more than two millennia and unt today. Moxibuston mvolves burning the herb Mugwort (Artemisia Vulgars) either drectly on the skin or merrectty over acupuncture points, which decreases mflammation by mereasmg white blood cell count in the area (Figure 2). The acupunctumst selects certain acupuncture points, modalities and Chinese herbs, depending on which TCM-syndrome type presents itself. For mstance. f the TCM diagnosis is Cold dominate Bi syndrome, hke in rheumatord arthi tis, moxtbustion is the preferred choice. Acupuncture, or acupuncture together with moxibustion is not, nor has it ever been, a complete singular and independent system of medicine. In addition to acupuncture, the whole spectrum of TCM embraces many other forms of healing, such as Chinese herbal medicine, moxibustion, exercise, diet, and massage. Although banned by law in China at the beginning of the 20th century, TCM continued to be practiced as folk medicine until Mao Tse-tung (EER) reintegrated TCM into China's health care. President Nixon's visit to China in 1972 encouraged the Western interest in acupuncture, which in turn led to a significant growth in the study and practice of evidence-based acupuncture. Several reports have indicated the effectiveness of acupuncture when used to treat many conditions that often do not respond to con. ventional treatment — such as chronic neck and lower back pain, knee and hip osteoarthritis, epicondylitis lateralis, and fibromyalgia € '8, Furthermore, acupuncture treatment has also produced positive results for the relief of morning sickness in early pregnancy '°, breech presentation 2, menopausal problems ?'!, and headaches 27, Moxibustion has been shown to be effective for the treatment of rheumatoid arthritis ®, pain suppression 2, and for the correction of breech presentation 2. Thus, it appears that it would be incorrect to label TCM as “alternative” in the sense of alchemy and (modern) witchcraft. Given its history and scope, it is far less “alternative” than the art of medicine that is considered conventional in the West. Even without the help of modern scientific equipment, ancient Chinese scholars discovered - through observation - many now-familiar aspects of biomedical science, such as the various effects of emotional stress on the immune system. Traditional acupuncturists are no less schooled than Western clinicians in their understanding of how the body functions, although to this day they use terminology that reflects Chinese medicine's cultural and historic origins. In modern China, allopathic medicine and TCM are used side-by-side and TCM Is now taught at Chinese universities. In addition, its results are reproducible under experimental conditions. As part of their medical school training, Chinese physicians must learn both medical systems, TCM and Western medicine. Today, TCM is practiced throughout China in allopathic hospitals, in traditional hospitals and in conjunction with allopathic medicine. Subsequently, hybrids of both forms of medicine have been developed. Acupuncture is not only used by the Chinese. The Egyptians described their medical treatments in the Papyrus Ebers, 1550 BC, and referred to vessels that could correspond to the 12 main and a few minor meridians of acupuncture. Principles of acupuncture are also applied by the Inuit who live in our globe's northern regions, the Bantu of South Africa, Arabs, and by a cannibalistic tribe in Brazil 2, Broadening the scope of acupuncture outside China, Ben Kavoussi argues that Chinese natural philosophy and medicine have significant cognitive and epistemic similarities with certain esoteric health beliefs of pre-Christian Europe %, Following this line of argument, the non-decorative tattoos of the Stone Age mummies testify to the awareness of body locations suited to treat pain. These are now considered as acupuncture points, and it would seem therefore that a form of pain treatment, similar to TCM, was being practiced 5200 years ago in Central Europe 2’, The basic health concept in Traditional Chinese Medicine Five fundamental principles form the primary concepts of TCM; these are listed in the text box below.
- NATURAL LAWS GOVERN THE UNIVERSE. Humans are part of the universe and therefore exist according to and subject to those laws.
- THE NATURAL ORDER OF THE UNIVERSE IS HARMONIOUS AND ORGANIZED. A hfe hved according to these laws will be harmonious.
- THE UNIVERSE IS DYNAMIC; CHANGE IS A CONSTANT. tack of change is contrary to the universe and therefore causes illness.
- ALL LIFE IS INTERCONNECTED Onset of disease is described as an imbalance in hommeostasis, reflected in changes in multiple pathways that are interconnected and interdependent
- HUMANS ARE A PART OF THE UNIVERSE, AND INTIMATELY CONNECTED TO THE ENVIRONMENT AND THUS THE UNIVERSE. Heaith is affected by the environment.
Salutogenesis In accordance with these five fundamental principles, TCM endorses the principle of salutogenesis as the working mechanism of acupuncture. This is explained as follows. The human body is continually undergoing a process of injury, reaction and recovery. The healthy body is capable of responding to harmful influences with a curing process through which a new stabity is achieved and the damage is repaired. This is called the self-healing mechanism, or: salutogenesis (salus= health; genesis= origin). Maintaining balance in building up and breaking down the body's organism is vital for all life forms. Common ‘damaging stimuli’ (= injuries) and subsequent recoveries are part of our life-system, and necessary for our physical development, the health of our immune system and human growth. This is important, too, for our course in life and our personal, emotional development and growth. Thus, TCM sees the human body as a system of dynamic interactions, rather than an ensemble of anatomical units.
