Traditional Chinese Medicine (TCM) is a 5000 year-old medical system that has been employed by millions of people in the past and present. TCM includes Acupuncture, Chinese Herbal Medicine, Nutrition, Tui Na massage, Tai Qi and Qi Gong. Acupuncture corrects the body's imbalances by regulating the Qi, or energy flow in the body's meridians. The World Health Organization recognizes acupuncture to be helpful in treating a wide range of symptoms including digestive disorders, gynecological problems, sports injuries, spinal disorders, hepatitis, men's disorders, colds and flu, and many others.

Newcomers to acupuncture want to know what to expect during an acupuncture treatment. After establishing a complete diagnosis, the acupuncturist will formulate a restorative treatment plan. Sterilized stainless steel needles are inserted into specific acupuncture points to create a desired homeostatic effect in the body. The needles are very fine and cause minimal pain. In fact, many patients often do not feel the needles as they are being inserted, or they feel a slight pricking sensation like a mosquito bite. The needles may be left in the body for twenty minutes or up to an hour and half. Most patients experience a state of profound relaxation, some report feeling euphoric and some sleep during the treatment.

During acupuncture treatments, significant, measurable physiological changes occur in the patient. These changes include a shifting of the relative involvement of the sympathetic and para-sympathetic nervous systems, which allow for greater and more rapid healing. There is a slowing of brain wave patterns and activity to those indicating states of deep relaxation and awareness. PET scan technology indicates changes in brain chemistry and the activation or de-activation of particular areas of the brain. These changes are consistent with the physiological changes noted in heightened relaxation, awareness and healing.

Electroacupuncture is a relatively new method of treatment in Chinese Medicine. Just as in a regular acupuncture treatment, needles are inserted into acupuncture points. Two small clips are then attached to the ends of two needles to connect the needles to an electroacupuncture device that transmits electric frequencies. The device allows the practitioner to adjust the frequency and intensity of the electric stimulation. This technique is relatively painless; patients usually feel only a slight pulsation at the two acupuncture points. The advantage of using electroacupuncture is that it provides extra stimulation for a longer duration of time. A practitioner does not need to manually stimulate the needles. Electroacupuncture is effectively used for pain management, musculoskeletal problems, circulation problems and many other conditions.

Although practiced in California since the Gold Rush, acupuncture was first broadly recognized in the United States when a journalist traveling to China with Henry A. Kissinger, the Secretary of State in President Richard Nixon's administration, received an emergency appendectomy. Acupuncture was used to provide surgical anesthesia.

Today, acupuncture is a licensed health care profession in the U.S. with more than 10,000 licensed practitioners. The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) administers national exams for Acupuncture and Chinese Herbal Medicine. NCCAOM is a non-profit organization that is devoted to promoting nationally recognized standards of competency and safety in acupuncture and Oriental medicine.

NCCAOM is the only nationally recognized certification available to qualified practitioners of TCM and in many States is a requirement for licensure.

A few states such as California have their own state board licensures. California adds significantly higher educational requirements for licensure when compared to most states. California administers its own exam which includes Herbology.

Title of Practitioner: Licensed Acupucturist (L.Ac.)

Education and Examination Requirements:
Current applicants must graduate from an approved school or tutorial program and complete four academic years of education with a minimum of over 3,000 hours education and training. This training includes Western Sciences (including biochemistry, chemistry, biophysics, anatomy, physiology, medical terminology and Western medical diagnosis and treatment principles), Chinese medical theory (including clinical medicine, TCM theory, diagnosis, Qi Gong, Tai Ji, needling techniques, moxibustion, acupressure, herbology), medical ethics and minimum of 800 hours of clinical training.

The first written record of Chinese Medicine has been dated, by some historians, to 2598 B.C.E. The Huang Di Nei Jing or the Yellow Emperor's Classic of Internal Medicine is the oldest extant Chinese Medical text and is comprised of two books, the Su Wen and Ling Shu.

The Su Wen describes Chinese Medical theory, diagnosis, etiology of disease and the relationship between human beings and the environment. The Ling Shu emphasizes acupuncture theory and gives specific treatment methods.

The historical significance of the Huang Di Nei Jing is difficult to comprehend. This work is attributed probably apocryphally to the legendary king, The Yellow Emperor who united all of China. It is of extreme significance that the most important work of Chinese Medicine is attributed to the most important historical and political figure in all of Chinese history. This demonstrates the significance of the ideas in the Huang Di Nei Jing which are the foundation of Traditional Chinese Medicine. Emperor Huang Di mandated a written national language which has allowed these works to be built upon without interruption for thousands of years.

The first instrument used for acupuncture was the "bian stone," a sharp edged stone. It was used to stimulate the acupuncture points to treat diseases during the New Stone Age (10,000-4,000 years ago.) During the Warring States Period (421-221 B.C.E.) the bian stones were replaced by metal acupuncture needles. The Nan Jing, or the Classic of Difficulties, another great text of Chinese Medicine, was written during this period as well. This treatise accurately explained the flow of Qi and Blood through the vessels and meridians of the body.

Chinese physicians such as Hua Tuo performed advanced surgical procedures 100-200 A.D. These surgeries included open cavity organ surgeries, which required the sophisticated use of anesthesia, antiseptic procedures and utilized very advanced surgical techniques. Many of these surgical techniques were abandoned over the following centuries as physicians became aware of more effective techniques to treat diseases of the internal organs.

During the Tang Dynasty (618-907 C.E.), acupuncture schools were established for the first time in China under the auspices of the Imperial Medical Bureau. Extensive training and testing methodologies were created to insure quality care.

The Ming Dynasty (1568-1644) was an enlightening period for the culture of China including acupuncture. Many classical texts were revised, medical encyclopedias were created and new modalities such as indirect moxibustion were developed.

The acupuncture profession took new prominence in the 1940's with the Communist Revolution under the leadership of Mao Zedong. With a shortage of medical doctors and the prohibitive costs of pharmaceutical drugs, acupuncturists became popularized as the "barefoot doctors" who successfully treated the masses. Mao Zedong encouraged the practice of acupuncture under his communist party and established numerous hospitals uniting Western Medicine and Chinese Medicine. Today, research and development of acupuncture continue to play an important role in the Chinese healthcare system.

A Chinese Medical practitioner diagnoses a patient based on the five methods: looking, hearing, smelling, asking and feeling. The goal of Chinese diagnosis is to arrive at a pattern of organ disharmonies. The information we seek during our intake creates a holistic picture of the patient's health condition. For example, in Western Medicine, a symptom such as bitter taste in the mouth holds little clinical significance, while in Chinese Medicine, bitter taste in the mouth indicates a specific Gall Bladder pattern. The external signs and symptoms are mirrors to the condition of our internal organs.

By gathering information through the five methods of diagnosis, we can identify the root cause of an illness and treat the whole person, rather than merely relieve the symptoms. When treating a patient with TCM, it is assumed and expected that the overall health of the patient improve, as well as relief of the presenting symptoms. This can be contrasted with the use of pharmaceutical drugs, where the symptoms may be alleviated, but there is nearly always some negative side effects. The side effects may necessitate additional treatment.

Looking: Diagnosis by looking includes observation of a person's physical and spiritual presentation. Physically, we place great emphasis in observing the condition of the tongue. We examine it's color, shape and coating. The condition of the tongue tells us the health of all the vital organs and the fundamental substances of the body. It can also signal a progression of disease and indicate whether a person is recovering from illness or if their health is declining. We also observe the facial complexion, the eyes, texture and color of the hair and body posture. Depending on a person's body shape, movement and demeanor, we can diagnose their constitutional patterns according to the Five Element body types.

We observe a person's spiritual health through their posture, breathing, complexion and eyes. A person is said to "have spirit" or "Shen," when they have enough vitality or life force to maintain a healthy mental and emotional state. A person's spirit or Shen is observed primarily by looking at the eyes of the patient. We look to see if the eyes are clear and that they glitter. If the eyes are dull or cloudy, it means that the mind and spirit are depressed or disturbed.

Hearing and Smelling: Diagnosis by hearing includes listening to the voice, breathing and cough. A weak voice can be due to a general deficiency of Qi, while a loud and coarse voice may indicate an excess pattern. Types of voice can be categorized according to the Five Elements. Shouting indicates a Liver pattern, laughing voice a Heart pattern, singing voice a Spleen pattern, whimpering voice a Lung pattern and a groaning voice a Kidney pattern. Style of breathing is also distinguished between deficiency and excess conditions. Various sounds of cough can indicate dryness, phlegm, deficient or excess patterns. It is not unusual for an experienced acupuncture practitioner to accurately and fully diagnose a patient during the trip from the waiting room to the treatment room.

Apart from the general body odor, as perceived by the practitioner, which is analyzed according to Five Element correspondences, a practitioner may inquire if there is a strong smell of urine or stool or if they have very little or no smell.

Asking: Inquiring about a patient's health condition is an important part of Chinese diagnoses. The answers to the set of questions below help to establish when the illness began, possible causes and triggers of the illness and severity of the condition. They will also provide other pertinent information needed to identify a particular pattern of disharmony. The topics of inquiry include: chills and fever, sweating, pain, food and taste, stool and urine, sleep, thirst and drink, emotional state and gynecological condition in women.

The questions are detailed as we look for specific and precise information. For example, in asking about sleep, we will ask if you have difficulty falling asleep or if you wake up in the middle of the night and cannot fall back asleep. If so, what time do you wake up at night and how long does it take you to fall back asleep? Do you have any themes in your dreams? A person who has difficulty falling asleep may have Blood deficiency while a person who wakes up in the middle of the night and cannot fall asleep may have Kidney yin deficiency. Dreams centered around certain themes also indicate organ imbalances.

Feeling: Diagnosis by feeling includes palpation of the body and pulse diagnosis. In palpating the body, we note the temperature, moisture and texture of the skin. After many years of training, an acupuncturist is able to feel minute changes in Qi flow and electromagnetic imbalance in the patient, through the use of their sensitized awareness of touch. Body parts such as the limbs, chest, abdomen, and individual acupuncture points may be palpated to assess the condition of organs and channels. Abdominal diagnosis is a complex system that is helpful in evaluating the health of each vital organ with great accuracy.

Pulse reading is by far the most respected and difficult method of diagnosis in Chinese Medicine. It is said that only when a practitioner has felt 10,000 pulses does he or she master pulse reading. Each wrist is palpated with three fingers to feel the three positions and three levels of the radial pulse at the wrists. The three positions on each wrist indicate the condition of the different organs. The right wrist contains the pulses of Lung, Spleen and Kidney, the left wrist the Heart, Liver and Kidney. The practitioner will describe what he or she feels in the pulses according to the 28 categories and their combinations. For example, a pulse may feel slippery and deep or floating and rapid. In addition, depending on the pulse position, a type of pulse will have different meanings. A slippery pulse felt in the Lung position indicates phlegm retention in the Lungs, while a slippery pulse felt in the Spleen position indicates Spleen dampness and phlegm. Also, a person's age, lifestyle and pregnancy will affect the quality of the pulse.