Eastern Systems of Healing 597purposeful motor-physical movements to achieve control and
a more balanced physiological and psychological state. This
technique is particularly popular among senior adults, and
has been endorsed by the National Institute of Aging. Other
TCM approaches include acupuncture, acupressure, massage
(Tui Na), herbal medicine, and diet.
Acupunctureis employed to remove the obstruction caus-
ing the interruption of the ”ow of qi,or to redirect the ”ow of
qito where it is insuf“cient. Thin needles are inserted super-
“cially on the skin throughout the body where meridian
points are located (Spencer & Jacobs, 1999). To further en-
hance the movement of qi,acupuncture is often used in
conjunction with heat (moxibustion) or electric current (elec-
troacupuncture). Healing is proposed by restoration of a
balance of qi”ow within the body.
Acupressureuses the deep pressure of the “ngers or hands
to stimulate meridian points and qi”ow. It is an effective
self-care and preventative health care treatment for tension-
related ailments (The Burton Goldberg Group, 1995). Acu-
pressure is also prescribed to help decrease psychological
distress by assisting persons to increase their body awareness
and ability to cope with stress through release of built-up ten-
sion (Jacobs, 1996). Tui Nais a form of acupressure massage
that uses techniques such as pushing, rolling, kneading, rub-
bing, grasping, percussion, and vibration to improve circula-
tion and to stimulate stale blood and lymph from tissues (The
Burton Goldberg Group, 1995). It is often used as an adjunct
to acupuncture treatment, to increase the range of motion of a
joint, or in populations where acupuncture is contraindicated
(e.g., pediatric). A type of popular acupressure called Shiatsu
(“nger pressure) originated in Japan and uses applied pres-
sure for 3 to 10 seconds in a rhythmic fashion. Shiatsu uses
the same points as acupressure, but a practitioner of shiatsu
refers to such points as tsubo,rather than meridian points.
Shiatsu combines meridian point therapy with gentle stretch-
ing and both soft tissue and joint manipulation and relies on
gravity, rather than muscular force, to operate.
Althoughmagnetic therapyis not a TCM approach, it has
recently gained popularity in the Chinese culture because of
its self-help properties via the production of accessible de-
vices such as magnetic bracelets and small magnets that can
be easily adhered to the skin. The belief is that magnets
can heal and enhance health by placing them either along a
particular meridian or directly over the area of dysfunction to
remove the obstruction ofqi”ow. Despite the increasing use
of magnetic therapy as a form of self-help, empirical studies to
support its proposed bene“ts are lacking (Dexter, 1997).
Chinese herbal medicine is an integral part of Chinese
culture and medical practice. It includes not only plants, but
also mineral and animal parts as listed in the traditional
Chinese material medica (also Liu, 1988; Spencer & Jacobs,
1999). Prescribing rules exist for consideration of the com-
patibilities and incompatibilities of substances, the traditional
pairing of substances, and their combination for speci“c
symptoms (Liu, 1988). All of the formulas are organized in
such a way as to support the qithat is desired for returning the
body to a balanced and harmonious state.
Maintaining a balanced diet in TCM is extremely impor-
tant in maintaining health and in preventing, or recovering
from, diseases and other pathological conditions. Many of
the foods that are used for therapy in TCM are also routinely
prepared by families and are part of cultural practices. Spe-
cial foods, as characterized by their yin and yang properties,
may be prepared when seasons change or when a person is ill.
These food preparations are aimed at keeping yin and yang
in balance in the individual and preventing disturbance in
qi”ow.Clinical ApplicationsMost of the research studies in the literature on TCM focus
on meridian point therapies such as acupuncture, elec-
troacupuncture, and acupressure. Thus far, the evidence on
the ef“cacy of acupuncture in the management of chronic
pain is controvertible. One well-controlled study by Vincent
(1989) demonstrated the long-term effectiveness of acupunc-
ture in the treatment of migraine headaches. There was a 43%
reduction in past treatment pain scores and a 38% reduction
in medication usage for the acupuncture group compared to
the placebo group, and these results were maintained at four-
month and one-year follow-up. Patel, Gutzwiller, Paccand,
and Marazzi (1989) examined the effectiveness of acupunc-
ture for chronic pain in a meta-analysis of 14 randomized,
controlled trials comparing acupuncture with placebo or
standard care. The pooled results suggest that acupuncture
was effective in treating low back and chronic headache
pain. However, a second meta-analysis of 51 trials (ter Riet,
Kleijnen, & Knipschild, 1990) found that most of the studies
were of mediocre or poor quality with the best studies yield-
ing contradictory results, raising signi“cant debate over
effectiveness.
The bene“ts of acupuncture have also been explored in a
variety of other conditions. For example, acupuncture was
found to be effective in the management of symptoms associ-
ated with withdrawal from a variety of addictive substances
such as cocaine (Culliton & Kiresuk, 1996). Jobst (1995)
concluded that acupuncture produced favorable effects in the
management of patients with bronchial asthma, chronic bron-
chitis, and chronic disabling breathlessness. Although there is
no evidence that acupuncture is an effective treatment for