Other.echniques.im at “tonifying” Chinese : 补; pin yin : b or “sedating” Chinese : 泄; pin yin : xii qi. 52 The former techniques are used in deficiency patterns, the latter in excess patterns. 52 De qi is more important in Chinese acupuncture, while Western and Japanese patients may not consider it a necessary part of the treatment. 38 Sun simian published acupuncture-related diagrams and charts that established standardized methods for finding acupuncture sites on people of different sizes and categorized acupuncture sites in a set of modules. 29 Acupuncture became more established in ChiCa as improvements in paper led to the publication of more acupuncture books. It.s.difficult but not impossible to design rigorous research trials for acupuncture. 69 70 Due to acupuncture's invasive nature, one of the major challenges in efficacy research is in the design of an appropriate placebo control group . 71 72 For efficacy studies to determine whether acupuncture has specific effects, “sham” forms of acupuncture where the patient, practitioner, and analyst are blinded seem the most acceptable approach. 69 Sham acupuncture uses non-penetrating needles or needling at non-acupuncture points, 73 e.g. inserting needles on meridians not related to the specific condition being studied, 51 The skill level of the acupuncturist may influence how painful the needle insertion is, and a sufficiently skilled practitioner may be able to insert the needles without causing any pain. 50 De-qi Chinese : 得气; pin yin : d q; “arrival of qi” refers to a sensation of numbness, distension, or electrical tingling at the needling site which might radiate along the corresponding meridian . Moxibustion could be direct the cone was placed directly on the skin and allowed to burn the skin, producing a blister and eventually a scar, or indirect either a cone of moxa was placed on a slice of garlic, ginger or other vegetable, or a cylinder of moxa was held above the skin, close enough to either warm or burn it. 54 Cupping therapy is an ancient Chinese form of alternative medicine in which a local suction is created on the skin; practitioners believe this mobilizes blood flow in order to promote healing. 55 Ti na is a ACM method of attempting to stimulate the flow of qi by various barehanded techniques that do not involve needles. 56 Electroacupuncture is a form of acupuncture in which acupuncture needles are attached to a device that generates continuous electric pulses this has been described as “essentially operation; these demonstration cases were also frequently receiving morphine surreptitiously through an intravenous drip that observers were told contained only fluids and nutrients. 281 One patient receiving open heart surgery while awake was ultimately found to have received a combination of three powerful sedatives as well as large injections of a local aesthetic into the wound. 57 After the National Institute of Health expressed support for acupuncture for a limited number of conditions, adoption in the US grew further. 27 In 1972 the first legal acupuncture canter in the US was established in Washington DC 282 and in 1973 the American Internal Revenue Service allowed acupuncture to be deducted as a medical expense. 283 In 2006, a BBC documentary Alternative Medicine filmed a patient undergoing open heart surgery allegedly under acupuncture-induced anaesthesia.
Plinio.rioreschi, the earliest known historical record of aacupuncture is the Shih-Chi “Record of History”, written by a historian around 100 BC. 28 It is believed that this text was documenting what was established practice at the body, and eventually to balancing Yin and Yang energies as well. 28 According to Dr. G. or in places not associated with meridians. 74 The under-performance of acupuncture in such trials may indicate that therapeutic effects are due entirely to non-specific effects, or that the sham treatments are not inert, or that systematic protocols yield less than optimal treatment. 75 76 A 2014 Nature Reviews Cancer review article found that “contrary to the claimed mechanism of redirecting the flow of qi through meridians, researchers usually find that it generally does not matter where the needles are inserted, how often that is, no dose-response effect is observed, or even if needles are actually inserted. Although.cupuncture declined in China during this time period, it was also growing in popularity in other countries. 30 Reports included 38 cases of infections and 42 cases of organ trauma. 10 The most frequent adverse events included pneumothorax, and bacterial and viral infections . 10 A 2013 review found without restrictions regarding publication date, study type or language 295 cases of infections; mycobacterium was the pathogen in at least 96%. 18 Likely sources of infection include towels, hot packs or boiling tank water, and reusing reprocessed needles. 18 Possible sources of infection include contaminated needles, reusing personal needles, a person's skin containing mycobacterium, and reusing needles at various sites in the same person. 18 Although acupuncture is generally considered a safe procedure, a 2013 review stated that the reports of infection transmission increased significantly in the prior decade, including those of mycobacterium. 18 Although it is recommended that practitioners of acupuncture use disposable needles, the reuse of sterilized needles is still permitted. 18 It is also recommended that thorough control practices for preventing infection be implemented and adapted. 18 The Xingnao Kaiqiao approach appears to be a safe form of treatment. 147 Fainting was the most frequent adverse event. 147 Fainting while being treated, haematoma, and pain while being treated are associated with individual physical differences and with needle manipulation. 147 A 2013 systematic review of the English-language case reports found that serious adverse events associated with acupuncture are rare, but that acupuncture is not without risk. 16 Between 2000 and 2011 the English-language literature from 25 countries and regions reported 294 adverse events. 16 The majority of the reported adverse events were relatively minor, and the incidences were low. 16 For example, a prospective survey of 34,000 acupuncture clinic acupuncture treatments found no serious adverse events and 43 minor ones, a rate of 1.3 per 1000 interventions. 16 Another survey found there were 7.1% minor adverse events, of which 5 were serious, amid 97,733 acupuncture patients. 16 The most common adverse effect observed was infection e.g. mycobacterium, and the majority of infections were bacterial in nature, caused by skin contact at the needling site. 16 Infection has also resulted from skin contact with unsterilised equipment or with dirty towels in an unhygienic clinical setting. 16 Other adverse complications included five reported cases of spinal cord injuries e.g. migrating broken needles or needling too deeply, four brain injuries, four peripheral nerve injuries, five heart injuries, seven other organ and tissue injuries, bilateral hand enema, epithelioid granuloma, pseudo lymphoma, argyria, pustules, pancytopenia, and scarring due to hot-needle technique. 16 Adverse reactions from acupuncture, which are unusual and uncommon in typical acupuncture practice, included syncope, galactorrhoea, bilateral nystagmus, pyoderma gangrenosum, hepatotoxicity, eruptive lichen planes, and spontaneous needle migration. 16 A 2013 systematic review found 31 cases of vascular injuries caused by acupuncture, three resulting in death. 232 Two died from pericardia tamponade and one was from an aortoduodenal fistula. 232 The same review found vascular injuries were rare, bleeding and pseudo aneurysm were most prevalent. 232 A 2011 systematic review without restriction in time or language, aiming to summarize all reported case of cardiac tamponade after acupuncture, found 26 cases resulting in 14 deaths, with little doubt about causality in most fatal instances. 233 The same review concluded cardiac tamponade was a serious, usually fatal, though theoretically avoidable complication following acupuncture, and urged training to minimize risk. 233 A 2012 review found a number of adverse events were reported after acupuncture in the UK's National Health Service NHS but most 95% were not severe, 42 though miscategorization and under-reporting may alter the total figures. 42 From January 2009 to December 2011, 468 safety incidents were recognized within the NHS organizations. 42 The adverse events recorded included retained needles 31%, dizziness 30%, loss of consciousness/unresponsive 19%, falls 4%, bruising or soreness at needle site 2%, pneumothorax 1% and other adverse side effects 12%. 42 Acupuncture practitioners should know, and be prepared to be responsible for, any substantial harm from treatments. 42 Some acupuncture proponents argue that the long history of acupuncture suggests it is safe. 42 However, there is an increasing literature on adverse events e.g. spinal-cord injury. 42 Acupuncture seems to be safe in people getting anticoagulants, assuming needles are used at the correct location and depth. 234 Studies are required to verify these findings. 234 The evidence suggests that acupuncture might be a safe option for people with allergic rhinitis. 118 Chinese, South Korean, and Japanese-language A 2010 systematic review of the Chinese-language literature found numerous acupuncture-related adverse events, including pneumothorax, fainting, sub arachnoid haemorrhage, and infection as the most frequent, and cardiovascular injuries, sub arachnoid haemorrhage, pneumothorax, and recurrent cerebral haemorrhage as the most serious, most of which were due to improper technique. 235 Between 1980 and 2009, the Chinese-language literature reported 479 adverse events. 235 Prospective surveys show that mild, transient acupuncture-associated adverse events ranged from 6.71% to 15%. 235 In a study with 190,924 patients, the prevalence of serious adverse events was roughly 0.024%. 235 Another study showed a rate of adverse events requiring specific treatment of 2.2%, 4,963 incidences among 229,230 patients. 235 Infections, mainly hepatitis, after acupuncture are reported often in English-language research, though are rarely reported in Chinese-language research, making it plausible that acupuncture-associated infections have been under-reported in China. 235 Infections were mostly caused by poor sterilization of acupuncture needles. 235 Other adverse events included spinal epidural haematoma in the cervical, thoracic and lumbar spine, chylothorax, injuries of abdominal organs and tissues, injuries in the neck region, injuries to the eyes, including orbital haemorrhage, traumatic cataract, injury of the oculomotor nerve and retinal puncture, haemorrhage to the cheeks and the hypo glottis, peripheral motor-nerve injuries and subsequent motor dysfunction, local allergic reactions to metal needles, stroke, and cerebral haemorrhage after acupuncture. 235 A causal link between acupuncture and the adverse events cardiac arrest, pyknolepsy, shock, fever, cough, thirst, aphonic, leg numbness, and sexual dysfunction remains uncertain. 235 The same review concluded that acupuncture can be considered inherently safe when practice by properly trained practitioners, but the review also stated there is a need to find effective strategies to minimize the health risks. 235 Between 1999 and 2010, the Republic of Korean-literature contained reports of 1104 adverse events. 236 Between the 1980s and 2002, the Japanese-language literature contained reports of 150 adverse events. 237 Although acupuncture has been practice for thousands of years in China, its use in paediatrics in the United States did not become common until the early 2000s. The US Congress created the Office of Alternative Medicine in 1992 and the National Institutes many governments have adopted similar standards. 299 In China, the practice of acupuncture is regulated by the Chinese Medicine Council that was formed in 1999 by the Legislative Council.
Korea is believed to be the first country in Asia that acupuncture spread to outside of China. 29 Within Korea there is a legend that acupuncture was developed by emperor Dan gun, that curing diseases relied on the alignment of both heavenly then and earthly Fi forces that were attuned to cycles like that of the sun and moon. 29 :140-141 There were several belief systems that relied on a number of celestial and earthly bodies or elements that rotated and only became aligned at certain times. 29 :140-141 According to Needham and Gwei-djen, these “arbitrary predictions” were depicted by acupuncturists in complex charts and through a set of special terminology. 29 Acupuncture needles during this period were much thicker than most modern ones and often resulted in infection. Although acupuncture declined in China during this time period, it was also growing in popularity in other countries. 30 Needles. 48 Japanese acupuncturists use extremely thin needles that are used superficially, sometimes without penetrating the skin, and surrounded by a guide tube a 17th-century invention adopted in China and the West. Rheumatology. 47 8: 1132–1136. dBi conflicted with the West's own anatomical diagrams.