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How Does Acupuncture Work?

Updated: Dec 13, 2021

‘So how does acupuncture work?' It's a question I hear often enough—sometimes with a “really” in there, as in “how does acupuncture really work?”

Every few years there’s a new idea about what happens biochemically while you’re resting with needles on the treatment table. Frankly, I’m not especially interested in these mechanistic explanations, because it’s both more illuminating and more useful to take acupuncture on its own terms.

Acupuncture is part of a coherent system of medicine that’s rooted in a very different view of the world than the one that talks about enzymes and neurons. Not a better worldview, but a different one that is equally compelling and, most importantly to you as a patient, one that translates to clinical efficacy.

There are a few good books on the system(s) of East Asian Medicine as a whole, and it takes a book to do the subject justice. But curious patients and prospective patients also deserve a shorter answer. So here goes.

Acupuncture tunes the body, rather like an instrument: slackening here, tightening there, until there’s harmony. (Indeed, the Chinese character yao 藥 for medicine includes the character for music, in conjunction with the radical for plant or herb.) In this metaphor, what are the strings that are being tuned? They’re different channels, each of which corresponds to an organ.

When I treat someone, I am adjusting the balance between organs. For instance, the Heart is hot, a fiery organ. It can be deficient, which looks like physical or emotional cold—fear, chilliness, hypofunction in general. Or that same Heart fire can be in excess, which looks like physical or emotional heat--extreme loquaciousness and uncontainable enthusiasm, for example. We all know people who could use some more Heart fire, and others who could perhaps get by with less. When there is too much Heart fire, I might choose to bring the Urinary Bladder’s cold water qi to bear in order to balance things out. The points I choose might be on the Bladder channel itself as well as on related channels, all to feed the Water so it can control Fire.

Hot and cold, damp and dry, full and empty, consolidated and expansive, upward and downward, tense and relaxed; these are pairs of qualities I track in each patient. Adjusting them through interactions of the elements and organs, the body is brought back in tune.

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