ScienceofAcupointsandMeridians

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The Science of Acupoints and Meridians

In the past few years, there has been much progress in the area of research on acupuncture, its
mechanisms, and effectiveness from the western biological and medical point of view. These
studies are important to understand and integrate acupuncture and oriental medicine with the
mainstream practices to better serve, and benefit the patient population for more effective
treatment and outcomes. Researchers, scientist, acupuncturists and medical doctors, input and
collaboration can achieve a better understanding of the scientific mechanism and explanation of
how acupuncture and oriental medicine works, to offer the best health care system possible.
The study by Cho represents a major first step toward understanding oriental acupuncture in
relationship to brain function, which has largely been ignored in classical oriental medicine.
The basic triangular relationship of the brain, target organs, and acupoints serves as a new
paradigm to be studied and clarified by both modern Western medicine as well as oriental
medicine. Based on our knowledge of Western medicine, it is difficult to believe that
acupuncture treats disorders and diseases by direct control of organs or organ-related disorders
and diseases. It is possible that acupuncture first stimulates or activates the corresponding brain
cortex via the CNS, thereby controlling the chemical or hormone release (via the CNS) to the
diseased or disordered organs for treatment. It is essential and also more plausible if
corresponding brain cortices and disease-related acupoints are consistent and related in terms of
known medical findings, especially those of fMRI data. These data demonstrate that both the
static and dynamic activation of the visual cortex by acupoint VA1 stimulation are consistent
with visual light stimulation previously observed by fMRI 1.

Functional MR imaging can demonstrate the CNS pathway for acupuncture stimulation.
Acupuncture at ST.36 and LI.4 activates structures of descending antinociceptive pathway and
deactivates multiple limbic areas subserving pain association. These findings may shed light on
the CNS mechanism of acupuncture analgesia and form a basis for future investigations of
endogenous pain modulation circuits in the human brain 2.

Cho et al.'s work was the first to identify that specific areas of the visual cortex appeared to be
activated in response to acupuncture points in the foot in the same way as it would respond to
stimulation from a light source shone into the eyes. The main point used to stimulate visual
cortex was UB67; Cho and co-workers claimed that a difference in character of the subjects (i.
e. Yin or Yan) accounted for variations in the pattern of response. This was point-specific and
so could not be reduplicated through similar stimulation in a non-acupuncture point. A number
of other visually active acupuncture points were manipulated and produced a similarly
predictable response in accordance with traditional Chinese principles. The stimulation of
auditory-related points similarly produced activation of the auditory cortex. Although the studies
only involved small numbers of volunteers, the science appeared convincing. Further
reduplication by others and continuing work by Cho and co-workers seems to support this
hypothesis. Siedentopf et al. suggests similar phenomena to needle puncture may be elicited by
soft laser acupuncture, a finding supported by Litscher et al. However, Gareus et al. throws
some doubt on Cho's findings. Therefore, while it appears that it is probable that acupuncture-
like stimulation of UB67 triggers specific activation of the occipital cortex, it is by no means a
uniform and consistent finding 3.

Li et al. have considered the possibility that a similar phenomenon may be elicited by using
points specific to language in 17 healthy Mandarin speaking Chinese volunteers. They suggest
that there is stronger activation in the left hemisphere and that electrical stimulation of two
acupuncture points (implicated in languages, i.e. SJ8 and Du15) produced significant activation
in an appropriate area of the brain, the right inferior frontal gyrus and in the left and right
superior temporal gyrie. However, activation was not seen in the left inferior frontal gyrus and
it is also clear that not all acupuncturists would agree that these points are related to language.
Non-acupuncture points did not produce significant brain activation, so these researchers
concluded that specific acupuncture points may have language-specific effects. Yoo et al. noted
that PC6 produces a well documented clinical response to acupuncture in nausea. They were
able to demonstrate consistently that acupuncture-specific neural substrates are selectively
activated in the left superior frontal gyrus, the anterior cingulate gyrus and the dorsomedial
nucleus of the thalamus as well as nausea-specific substrates in the cerebellum. This did not
occur with penetrating sham needling at a non-acupuncture point, thus suggesting a PC6-
specific effect that potentially correlates with proven clinical effectiveness. Yan et al. have
demonstrated point-specific patterns using fMRI in 37 healthy volunteers while needling LI4
and Liv3 as compared to sham points. Common activation areas for LI4 and Liv3 were in the
middle temporal gyrus and cerebellum, along with deactivation areas in the middle frontal gyrus
and inferior parietal lobule when compared with sham points. Acupuncture at Liv3 evoked
specific activation in the post-central gyrus, posterior cingulated, parahippocampal gyrus, BA 7,
19 and 41, but deactivation at the inferior frontal gyrus, anterior cingulated, BA 17 and 18
when compared with sham. LI4 evoked specific activation in the temporal lobe but deactivation
in the precentral gyrus, superior temporal gyrus, pulvinar and BA 8, 9 and 45 when compared
with sham. They suggest that these different patterns may be related to specific therapeutic
effects, although it is difficult to justify this based on data obtained from healthy volunteers
receiving one acupuncture treatment 3.

The traditional concepts of the meridian system have been studied from morphogenesis
perspective. The relationship between the meridian system and embryogenesis has been noted
for decades. In a study conducted by, Mashansky and Markov, et al in 1983 on the gap
junction embryonic epithelial signal transduction model, proposed that the meridian system
contains relatively undifferentiated epithelial cells connected by gap junctions which transducer
signals and play a central role in mediating acupuncture effects. In another study conducted by
Shang, in 1989 the morphongenetic singularity theory applied the singularity theory of
mathematics to explain the origin, distribution, and nonspecific activation phenomena of the
meridian system 4.

Based on the morphogenetic singularity theory, the meridian system originates from a network
of organizing centers. As the individual embryonic development recapitulates the evolution of
the species, the evolutionary origin of the meridian system is likely to have preceded all the
other physiological systems, including the nervous system, circulatory, and immune systems. Its
genetic blueprint might have served as a template from which new systems evolved.
Consequently, it overlaps and interacts with the other systems but not simply as a part of them.
The growth control signal transduction is embedded in the activity of the function based

physiological system. Many neural, circulatory, and immune processes are regulated through
growth control mechanisms such a hypertrophy, hyperplasia, atrophy, apoptosis with shared
messenger molecules and common signal transduction pathways involving growth control genes
such as proto-oncogenes. Acupuncture also induces the expression of proto-oncogene c-fos.
Many nonexcitable cells have shown electrochemical oscillation, coupling, long range
intercellular communication, and can participate in the meridian signal transduction 4.

A was study conducted by Shang, Department of Medicine, Brockton Hospital to compare and
validate different modern biological models of acupuncture mechanism by reviewing their
consistency with the evidence in clinical and basic sciences to understand the biological basis of
acupuncture. Shang concluded that the growth control model encompasses the neurophysiology
of acupuncture and is supported by the research results on connective tissue at acupuncture
points. This model is more consistent with the facts in acupuncture research than other models.
The growth control model set the first example of a model with significant predictive power in
acupuncture research and integrative medicine by successful prediction of multiple research
results in both acupuncture and conventional biomedical sciences. The growth control model
also suggests a unified biological basis of the meridian system and chakra system 5.
In acupuncture, the often nonspecific perturbation at singular points (acupuncture points) may
not directly antagonize a pathological process, but may indirectly adjust the process and restore
normal function by activating the network of organizing centers in the organism. The activation
of the self-organizing activity is less likely to cause the adverse effects resulting from directly
antagonizing a pathological process, which often overlap with other normal and beneficial
physiological processes 6.

Dina Ralt states “The hypothesis is that the transmission of qi is based on an intercellular
communication system and that nitric oxide (NO) is a prime candidate to be a signaling
molecule in the meridian system”. Information links increase the ability to handle complexity
and thus, control mechanisms in the body can be regarded as information processing. This was
proposed by H. R. Maturana & F. Varela in the concept of Autopoiesis, the process by which
systems organize themselves out of disorder, forming a responsive, self-maintaining network
characteristic of life. Autopoiesis is parallel to the concept of qi, streaming along the meridians'
net, regulating our well being. It is expected that the qi type signal molecule in the body, will be
an essential entity and probably a gas so that it can spread as well as dissipate very quickly to
allow following information to be transferred. Furthermore, the dual nature of NO , being
either beneficial or detrimental, is parallel to the dual nature of qi and fits the basic character
of a signal. Signals can not always be beneficial, in that "cost" must be associated with them to
ensure their "integrity", e.g., those who wish to transmit information about their richness, are
likely to exhibit it by expensive jewels or costly cars, signals which are hazardous to poor people
who can't afford them. With biochemical signals, such integrity can be attained by variety of
costly characters, see for example cAMP and Ca2+ or Glutamate and GABA. One of such
characters may be the toxicity of a molecule like NO which demands very cautious and strict
handling. NO differs from other neurotransmitters in that its levels are regulated solely by
synthesis, rather than by storage, release or targeted degradation. NO is impossible to live
without, short lived, highly diffusible and is thus an excellent candidate for a cellular
communication signal which carries the qi information 7.

Alternative explanations of subjective Meridians phenomena seem necessary in light of reports
of amputees who experience needling induced sensations propagating along meridians into
phantom limbs. As with phantom limb pain, these sensations are likely to reflect neural
connectivity patterns in the spinal cord and brain. The subjective effect may be likened to that
produced by a neon sign, on which a critical frequency of successive flashing lights creates the
sensation that a single light is following a path around the sign’s perimeter. In the case of

acupuncture induced propagating sensation, needling at a single acupoint may trigger the
sequential firing of a series of spinal neurons connected by axon collaterals and interneurons.
The scheme also requires that the neurons at successively higher and lower spinal segments,
which are functionally linked in ascending and descending chains, correspond to acupoint sites
along a traditional meridian. Because of the slight delays imposed by synaptic transmission, the
impulse initiated by each successive afferent neuron in the chain reaches the brain at a
proportionately later time, giving rise to the propagated sensation. A similar theory describes
the propagating sensation arising from neural activity in a higher brain center, the parietal
lobe. A corollary of these hypotheses is that propagating neural signals triggered by
acupuncture may be a common physiological event, which only a relatively few sensitive
individuals experience as conscious sensations 8.

For the past 30 years, a general assumption of acupuncture research has been that the
therapeutic effects of acupuncture essentially take place via the nervous system. This view was
suggested by early experiments, showing that the analgesic effect of acupuncture manipulation is
eliminated by blocking the sensory nerve supply to deep tissues and by the observation that many
acupuncture points are located near sensory nerves and neuromuscular attachments. Numerous
neural effects of acupuncture treatments have since been demonstrated, such as the release of
central nervous system endogenous pain-inhibitory substances, activation of autonomic nervous
system reflexes, and changes in specific brain structures seen with fMRI . The study conducted
by Langevin, et al on Evidence of Connective Tissue Involvement in Acupuncture conducted in
2002 provides evidence of subcutaneous connective tissue involvement in needle grasp, and
suggests that the mechanism of action of acupuncture also involves extraneural tissues and
paves the way for further investigations of local cellular and molecular effects of acupuncture
needle manipulation. The results of this study also highlight the potentially important role of
interstitial connective tissue in neuromodulation. Subcutaneous connective tissue forms a
continuous tissue plane throughout the body. This tissue plane is itself continuous with dermis,
with interstitial planes separating muscles, bones, and tendons and with intramuscular
connective tissue. These connective tissue planes also constitute the milieu surrounding a wide
variety of sensory mechanoreceptors and nociceptors. Techniques such as acupuncture may act
not simply via neural stimulation, but also by producing changes in the connective tissue milieu
surrounding sensory afferent nerve fibers. These connective tissue changes may be long lasting,
which may explain claims that acupuncture can have prolonged effects 9.

Acupuncture in health care is more readily being proven scientifically with current Western
biology. Such theories and studies such as the ones mentioned in this paper may well constitute
the next steps in our scientific understanding of biology and physics itself. If successfully
developed and further researched, it could result in a major paradigm shift in both biology and
medicine, which will benefit consumers, health professionals, scientists, institutions and
governments.

References:
1. Cho Z, Chung S, Jones J, Park J, Park H, Lee H, et al. New findings of the correlation
between acupoints and corresponding brain cortices using functional MRI Proc Natl Acad Sci
USA 1998; 95: 2670–3
2. Wu MT, Hsieh JC, Xiong J, Yang CF, Pan HB, Chen YC, et al. Central nervous pathway for
acupuncture stimulation: localization of processing with functional MR imaging of the brain—
preliminary experience Radiology 1999; 212: 133–41

3. Lewith GT, White PJ and Pariente J. Investigating Acupuncture Using Brain Imaging
Techniques: The Current State of Play. eCAM 2005 2(3):315-319
4. Stux G, Hammerschlag R, Clinical Acupuncture Scientific Basis, Springer-Verlag, Berlin
Hiedelberg, 2001
5. Shang C , Biology of acupuncture: from observations to confirmed predictions, http://www.
bridgehealth.com/cahc_content/abstracts/posters/basic_science/shang.html
6. Shang C, Mechanism Of Acupuncture - Beyond Neurohumeral Theory, Medical Acupuncture,
Fall 1999/Winter 2000, Vol 11, Number 2
7. Ralt D, Intercellular communication, NO and the biology of Chinese medicine, Cell
Communication and Signaling 2005, 3:8
8. Cassidy CM, Contemporary Chinese Medicine and Acupuncture, Churchill Livingstone,
Philadelphia, Pennsylvania, 2002
9. Langevin HM, et al, Evidence of Connective Tissue Involvement in Acupuncture, The
FASEB Journal express article 10.1096/fj.01-0925fje. Published online April 10, 2002.