Rom J Morphol Embryol 2019, 60(2):411–418

RJME
REVIEW Romanian Journal of
Morphology & Embryology
http://www.rjme.ro/

Acupuncture and the retrospect of its modern research

FENG IFRIM CHEN1), ANDREEA-DANIELA ANTOCHI2), ADRIAN GHEORGHE BARBILIAN3)
1)
Department of Traditional Chinese Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
2)
Department of Medical Sciences, Academy of Medical Sciences of Romania
3)
Department of Orthopedics and Trauma, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

Abstract
Acupuncture is one of the oldest medical practices of Traditional Chinese Medicine (TCM). This method of treatment was discovered when
primitive Chinese people discovered that pain in one part of the body can be alleviated if it stings in a particular area of the body.
Acupuncture has achieved to a climax in Ming Dynasty (1368–1644 A.D.), when many famous doctors specialized in this field emerged with
a lot of exclusive books on acupuncture, but the most important one was Compendium of Acupuncture and Moxibustion by Yang Jizhou,
which represented a new milestone in the history of acupuncture’s evolution. Yang Jizhou compiled a book that presents a complete and
laborious description of the meridians, collaterals, acupuncture points, manipulating methods of acupuncture and their indications. According
to the ancient description of the meridians and collaterals and the research on the anatomy of Western medicine, some scholars think the
meridians and collaterals are closely related to the blood vessels. In recent years, many reports have showed that acupuncture has
remarkable effect on the pituitary gland and adrenal cortex system, the sympathetic nerve and adrenal medulla system, the pituitary gland
and thyroid gland system, the sexual glands, and the posterior pituitary system. Thus, some researchers put forth the theory of the meridians
and collaterals associated with regulatory function of the neurohumoral system, and the action of acupuncture and moxibustion is brought
about by the way of the nerves and body fluid.
Keywords: acupuncture, health status, meridian system, acupuncture points.

 Short history  The basic concepts of acupuncture

Since ancient times Traditional Chinese Medicine The theory of the meridians, or channels, and their
(TCM) has treated diseases by viewing the human body collaterals concerns the study of the complete ramification
as a map sectioned with different linings that are inter- and indications of each concerning the physiological
preted according to the natural laws of perceiving the functions and pathological changes of the meridians and
world, “yin and yang”. The main way to treat diseases collaterals of the human body and their relations to the
has been discovered through pain and it became the center internal organs, which is an essential part of the TCM
of attention in TCM – acupuncture. Common population fundamentals [4]. These channels and their collaterals
like it, because of its good curative effect, lesser suffering, form the basis of acupuncture, moxibustion, massage and
low cost, simple application and general safety [1]. all the other clinical departments of the TCM [5, 6].
Acupuncture was discovered when Chinese primitive The meridians are paths that run along the body like
people noted by chance that the pain in one part of the routes, which connect each and every part from head to toe
body would be alleviated when some other part was and from left to right. These are the main lines that trace
the body from the interior to the exterior. The collaterals
pricked. The treatment began with needles that went from
represent networks that run crisscross all over the body,
stone, bone, bamboo to bronze, iron, silver, gold, and the
being thinner and smaller lines, unlike the meridians.
most popular choice at the present, stainless steel.
The meridians and collaterals pertain to the internal
Since ancient times until present, these medical
organs and extend to the extremities and joints exteriorly,
practices have been recorded through books packed with integrating the internal organs, tissues and other organs
the knowledge of the recorded times and the evolution into an organic whole, by which they transport qi and
of TCM. blood and regulate the yin and yang flow, keeping the
Acupuncture has achieved to a climax in Ming functions and activities of all body parts in harmony.
Dynasty (1368–1644 A.D.), when many famous doctors In Chinese acceptance, qi is a vital energy that flows
specialized in this field emerged with a lot of exclusive through these meridians and participates in the homeo-
books on acupuncture, but the most important one was static regulation of the various functions of the body [7].
Compendium of Acupuncture and Moxibustion by Yang The meridians include 12 regular meridians, eight
Jizhou, which represented a new milestone in the history extra-meridians and the subordinated lines, the 12 divergent
of acupuncture’s evolution. Yang Jizhou compiled a book channels, the 12 muscle regions and 12 cutaneous regions
that presents a complete and laborious description of the [8].
meridians, collaterals, acupuncture points, manipulating The collaterals are made up of 15 collaterals, the
methods of acupuncture and their indications [2, 3]. superficial collaterals and the minute collaterals. Among

ISSN (print) 1220–0522 ISSN (online) 2066–8279

412 Feng Ifrim Chen et al.
the above, the most important ones are the eight extra- regions corresponds to the body–superficies courses of
meridians who hold the clear, stable and exact routes [9, the regular meridians. All the muscle regions function in
10]. a course which starts from the terminals of the limbs
The yin meridians are those that run along in the and runs on to the head and trunk. Instead of entering
medial aspect of the extremities, whereas those in the zang and fu organs, they travel along the body surface,
lateral aspect are called yang. The medial aspect of the and connect with the joints and bones. The main functions
extremities can be subdivided into the anterior border, of the muscle regions are to connect with all bones and
the mid-line and the posterior border, so the yin meridians control them to ensure easy flexing and extending of the
running through these parts called taiyin (greater yin), joints and normal motion of the body. This is referred to
jueyin (reverting yin) and shaoyin (lesser yin), accordingly. in Chapter 44 of the book Plain Questions: “The tendons
The lateral aspect of the extremities can also be sub- control and connect with bones to ensure proper joint
divided into the anterior border, the mid-line and the functions” [15].
posterior border, so yang meridians are termed yangming The 12 cutaneous regions refer to the body superficies
(yang brightness), shaoyang (lesser yang) and taiyang on which the functions of the 12 regular meridians are
(greater yang). reflected, and the sites where the qi of the collateral’s
Each meridian is determined by the organ name to spreads. The cutaneous regions are within the domains of
which the meridian pertains. For instance, the meridian the 12 regular meridians. In the Chapter 56 of the book
pertaining to the heart has the name the heart meridian. Plain Questions, it points out: “The cutaneous regions
The 12 regular meridians are linked with each other are marked by the regular channels”. Since the cutaneous
through the internal meridians and the reticular branches, regions are the most superficial part of the body tissue,
which constitute six pairs of exterior–interior relationship they render protection to the organism [16].
[11, 12]. The eight extra-channels are:
The exterior–interior relations of the 12 regular ▪ Du (back middle or governing) meridian;
meridians not only strength the connection between the ▪ Ren (front middle or conception) meridian;
exterior meridians and the interior meridians, coordinate ▪ Chong (penetrating or vital) meridian;
the viscera and bowels that are of mutual exterior–interior ▪ Dai (girdling or belt) meridian;
relationship in terms of physiology, but also cause them to ▪ Yin qiao (yin motility) meridian;
have a pathological influence on each other. In treatment, ▪ Yang qiao (yang motility) meridian;
the acupuncture points of the 12 regular meridians with ▪ Yin wei (yin linking or maintaining) meridian;
mutual exterior–interior relationship can be alternatively ▪ Yang wei (yang linking or maintaining) meridian.
used. For example, in treating disease of the large intestine, Unlike the 12 regular meridians, none of them belongs
the points of the lung meridian of hand – taiyin – can be to the zang–fu organs, nor are they exterior–interior
applied. related. Their courses are unique, and hence the name,
The motion of the qi and the blood inside the 12 the extrachannels. They have three main functions:
meridians is circulative and continuous [13]. The qi and (1) Strengthening the association between the 12 regular
blood start their circulation from the lung meridian of hand meridians;
– taiyin, then pass through the last channel, the liver (2) Regulating the qi and blood of the regular meridians,
meridian of foot – jueyin, and again to the lung meridian such as in storage, drainage of the qi and blood;
of hand – taiyin. The terminus of one meridian connects (3) Not only being closely related to the liver, the
with the starting point of another meridian, thus forming kidney and other internal organs, but also to the uterus,
an endless ring. brain, bone marrow and extraordinary organs [2, 11, 16].
The 12 divergent channels are the branches which They therefore more link up to reproduction and assist
derive from, enter, emerge from and join the 12 regular 12 regular meridians to maintain the whole body.
meridians which, in turn, reach the deeper parts of the The 15 collaterals include the 12 regular collaterals,
body through these branches. Most of the 12 divergent which separate from the 12 regular meridians, the collaterals
channels derive from the regular meridians at the upper of the ren and du and the major collateral of the spleen.
and lower regions of the elbows and knees and then enter They are named respectively after the names of the points
the thoracic and abdominal cavities, where they connect from where they start. Their main function is to strengthen
their pertaining zang or fu organs to which they pertain the association of the yin–yang meridians and the
[4, 14]. Then, they emerge from the body superficies at externally–internally related meridians on the body surface.
the head and the neck. In the regions, the yang divergent For example, the collateral of the ren meridian connects
channels join the regular meridians and yin divergent with the qi of the channel on the abdomen, the du meridian
channels connect the internally–externally related yang ensures fluent passage of the qi of the meridians on the
divergent channels. Thus, the 12 divergent channels back, and the major collateral of the spleen links up the
strengthen the connections between the zang and fu pass-ways of the qi of the meridian on the sides of the
organs, bring the 12 regular meridians and all parts of chest [17, 18].
the body closer, and extend the scope of indications of Superficial collaterals are those which are distributed
the acupoints. on the superficial parts of the body, and the smallest
The 12 muscle regions are the conduits which distribute branches of the collaterals are called “minute collaterals”.
the qi of the 12 regular meridians to the muscles, tendons, They are innumerable and spread all over the body
and joints, and which are the external connecting regions working to transport qi (vital energy) and blood to sustain
of the 12 regular meridians. The distribution of the muscle the body [19].
 Acupuncture and the retrospect of its modern research 413
The 14 meridians include the 12 regular meridians, mainly as “the qi meridian” in TCM. It connects the
and ren and du meridians, which are mostly associated with whole human body, which consists of the five viscera,
the clinical application. Their body–surface distribution six bowels, five sense organs, skin, muscles, tendons,
is as follows. The yin meridians pertaining the six zang bones, etc. Each of them has its own special physiological
organs (heart, liver, spleen, lung, kidney and pericardium) functions. It is through the connecting role of the
are distributed on the medial aspects of the four limbs, meridians that these functions can be coordinated, thus
and the thoracic and abdominal regions, among which, the making the body an organic whole. Only by receiving
three yin meridians of hand are distributed on the medial nourishment from the qi and the blood can each of the
aspects of the upper limbs, while the three yin meridians of organs in the body give full play to its physiological
foot in the medial aspects of the lower limbs. The yang functions. Most importantly, the meridians are the pass-
meridians pertaining to the six fu organs of the gallbladder, ways through which the qi and the blood circulate. Classic
stomach, large intestine, small intestine, urinary bladder on Medical Problems states: “the function of the meridian
and sanjiao (triple warmer), are mostly distributed on is to transport the qi” and the blood and circulate the yin
the lateral aspects of the four limbs, head and face, and and yang in order to nourish the body.
the lumbar region and the back. Among them, the three The meridians induce stimulation and transmit infor-
yang meridians of hand are distributed on the lateral mation. If some region of the human body is stimulated,
aspects of the upper limbs, while the three yang meridians such stimulation will be transmitted along the meridian
of foot, on the lateral aspects of the lower limbs. The to the related viscera or bowels in the body. As a result,
three yang meridians of hand and foot are arranged in a the relevant physiological or pathological changes take
sequence, in which yangming meridians are the anterior place. These changes are reflected on the body surface
ones, shaoyang meridians in the medium ones and taiyang through the meridians. “Getting the qi” and “circulating
meridians the posterior ones. With respect to the three the qi”, the normal sensation felt by the patient during
yin meridians of hand and foot, taiyin meridians are the acupuncture, truly embody the inducing and transmitting
anterior ones, jueyin meridians the medium ones, and functions of the meridians and collaterals.
shaoyin meridians the posterior ones, jueyin meridians The meridians and collaterals can regulate the functional
are the anterior ones, taiyin meridians the medium ones. activities of the human body, keeping them coordinated
The ren and du meridians are distributed along the and balanced. When dysfunctions occur in some organ,
anterior and posterior midline of the trunk, neck and acupuncture and other therapy can be used in order to
nape, and the head and face, with the ren meridian on help further stimulate the regulating function of the
the anterior midline. Both the du and the ren meridians meridians and bring the organ back to normality. For
have their clearly independent points, which are also example, experiments have proved that it can regulate
popularly used in the treatment of diseases [2]. peristalsis and secretion of the stomach to puncture Zusanli
Acupoints are the loci through which the qi of the point of the stomach meridian of foot – yangming. When
zang–fu organs and the meridians is transported to the deficiency occurs in peristalsis and secretion of the
body surface, 365 of which have so far been discovered stomach, stimulating this point gently with a needle may
[20]. It falls roughly into three categories: acupoints of strengthen the peristalsis of the stomach and increase
the 14 meridians, extraordinary points and Ashi points. gastric acidity. If peristalsis and secretion of the stomach
Acupoints of the 14 meridians, also known as the are excessive, a forceful stimulation in the point with a
“regular points”, are distributed along the 12 regular needle will have an inhibitory effect. Another example,
meridians and the du and ren meridians. As the major part puncturing the Neiguan point of the pericardium meridian
of acupoints they have their regular locations, regular of hand – jueyin can cure both bradycardia and tachycardia,
names and pertaining meridians, but due to their large performing a biphasic regulative function.
content, herein not been described in detail. The meridians and collaterals have a direct bearing on
Besides, there are also specific points on the 14 the occurrence and progress of diseases. If a meridian is in
meridians. The specific points of the 14 meridians refer functional disorder, it is apt to be attacked by exogenous
to those that have specific therapeutic properties. They factors; then, the exogenous factors will further intrude
have their special names given after their different into the internal organs along the meridians [22].
indications and functions. Ten types of specific points The theory of the meridians and collaterals has long
have been summarized out, which are five shu points, been widely applied to direct clinical treatment of all
yuan (primary) points, luo (connecting) points, xi (cleft) the departments of TCM, in particular, acupuncture,
points, back – shu points, front – mu points, crossing moxibustion, massage and herbal prescriptions. For
points, influential points, confluence points and lower instance, “the method of selecting points along the
he (sea) points [21]. meridians” is a good example. To be specific, the Zusanli
Extraordinary points have regular names and regular point of the stomach meridian of foot – yangming should
locations, but do not enter in the 14 meridians. They are be selected for the treatment of stomach; the Qimen point
also named “extra points” and are especially effective in of the liver meridian of foot – jueyin should be punctured
the treatment of certain diseases. for curing liver disease. The selection of regions of
Ashi points are also called “tender spots”. They have massage is also based on this theory.
no specific names and definite locations, and the tender It is also through the meridians and collaterals that the
spots and other sensitive spots are places of response and herbs exert an influence on the pathological region and
reaction on needing and moxibustion. take effect as expected. Through protracted and repeated
The physiological functions of the meridians are known practice, TCM doctors have discovered that a certain
414 Feng Ifrim Chen et al.
herb possesses a selective effect for a certain disease of moxibustion under the guidance of the theories of TCM.
some meridians and its pertaining organ, thus creatively They are of universal significance in decision of the
formulating a theory of “classifying herbs according to treating methods, selection of points and manipulations
their respective therapeutic effect on the disease of a [24–26].
specific meridian and its pertaining organ”. For example, The regulation of yin and yang is a fundamental
through the work done by Chinese Ephedra (Ephedrae principle in clinical acupuncture treatment. According to
herba) on the meridians of the lung and the urinary the theories of TCM, diseases result mainly from relative
bladder, sweat is induced, asthma relived, and diuresis imbalance of yin and yang, where yang in excess or
promoted. Another example, through Bupleurum root deficiency or yin in excess or deficiency. The mechanism
(Bupleuri radix) acts on the meridians of the liver and the of acupuncture treatment lies in regulation of yin and
gallbladder and regulate the vital energy by alleviation yang; in doing so, it brings the body back to the
of mental depression. The theory of “medicinal guides” physiological state of “yin and yang in equilibrium” and
was formulated by ancient Chinese medical men according cures patients of the illness.
to the theory of the meridians and collaterals. Taking Regulation of yin and yang by acupuncture is completed
some examples, in treating headache, Notopterygium root by point prescription and needling manipulations.
(Notopterygii rhizoma et radix) should be prescribed if it Point prescription includes two or more points, which
is due to taifang disturbance, or Angelica dahurica root are selected according to the symptoms and cause of
(Angelicae dahuricae radix) should be prescribed if due disease, and the functions and the natures of the points.
to the disturbance of the yangming, or thorax – Bupleuri The methods often used in clinical treatment for point
radix prescribed if due to the disturbance of the shaoyang. prescription are such as selection of points on the diseased
The above-mentioned “medicinal druids” do not only meridian, the combination of the exterior–interior points,
work their way through the relative channel and its the combination of the anterior–posterior points (also
pertaining organ, but also direct other medicines to the known as the combination of abdomen – yin points and
right meridian and organ to bring their therapeutic action
the back – yang points), the combination of the distant–
into play [23].
local points and the combination of the left–right points.
In addition, the clinical applications of acupuncture
For example: Zhongfu, Chize, and other points of the
anesthesia, auricular needles are created under the guidance
lung meridian of hand – taiyin – selected to make up a
of the theory of the channels and collaterals and will
prescription for cough due to disease of the lung; if the
inevitably further prove and develop this theory.
kidney meridian of foot – shaoyin – is affected, selecting
The therapeutic properties of acupoints manifest
Kunlun and Jinggu of the urinary bladder meridian of foot
themselves in the following three aspects.
– taiyang; selecting Zhongwan anteriorly and Weishu
Local and adjacent therapeutic properties posteriorly for epigastric pain; selecting Hegu on the
All the points in the body share the common feature right side to treat facial paralysis on the left side, and
in terms of their therapeutic properties. Each point vice-versa and also the points on both sides selected
located on a particular area is able to treat any disorder clinically in treatment of the diseases of the internal
of the nearby tissues and organs. organs, so as to strengthen the coordinating effects.
Needling manipulations and needling methods play
Remote therapeutic properties an important role to induce the needling sensation, bring
This is the basic regularity of the therapeutic properties about the desired therapeutic results and guarantee safety.
of the points of the 14 meridians. The points of the 14 Generally, the angle and depth of needling insertion, the
meridians, especially those of the 12 regular meridians speed of needling insertion and withdrawing the needle
located below the elbow and knee joints, are effective and others depend on the pathological condition, the
not only for local disorders but also for disorders of the location of points, the different objectives and the seasons;
tissues and zang–fu organs so far as the course of their patients with different constitutions and body types have
pertaining meridians can reach. Some even have systemic not same needling sensation and treating effects. Therefore,
therapeutic properties. For example, Zusanli point not only the consideration must be fully paid according to each
treats the disorders of the lower limbs, but also regulates patient’s concrete condition and location of points. Only
the whole digestive system, even has certain effect on by doing it in such a way can better therapeutic results
body defensive and immune reactions of the body. be obtained [16, 27, 28].
According to the theories of TCM, xu (insufficiency
Special therapeutic properties or asthenia) indicates the insufficiency of genuine qi
Clinical practice has proved that needling certain (including the body resistance). Shi (excess) indicates the
points may forth biphasic beneficial regulation on a variety exuberance of pathogenic qi (or pathogen). For patient
of functional abnormalities of the body. For instance, with excessive heat syndrome, superficial puncture to
puncturing the Tianshu point relieves both diarrhea and cause bleeding should be used often for elimination of the
constipation. In addition, the therapeutic properties of excessive heat; for patient with asthenic cold syndrome,
some points show relative specificity, e.g., the Dazhui reinforcing method, such as prolonged retaining of needle
point, which has an antipyretic effect, and the Zhiyin or applying moxibustion for restoring qi and dispelling
point helps correct the malposition of a fetus. cold, is often employed; for patient with intermingled
The general principles of acupuncture treatment are insufficiency and excess syndrome, reinforcing and reducing
worked out by repeatedly practicing acupuncture and methods are used simultaneously.
 Acupuncture and the retrospect of its modern research 415
The conception of the primary fundamental and the and the front – Mu points and the points of the ren
secondary incidental are relative to each other involving channel are identical with the internal organs to which
different meaning. For instance, the genuine qi is the these points pertain and which they govern in the neural
primary, and the pathogenic factor is the secondary; segments. For instance, Zhongfu, the front – Mu point of
the etiology is the primary, and the manifestation is the lung, and Feishu, the back – Shu point of the lung,
the secondary; the original disease is the primary, while are both controlled by the 1st–5th segments of the thoracic
the consequent disease is the secondary. This concept nerves and the nerves which control the lung come from
represents the two opposite aspects of one entity during the same neural segments. Another example is that the Shan
the course of a disease. The incidental is generally the Zhong point controlled by the 4th neural segment of the
phenomenon and the secondary aspect, the fundamental thoracic nerve is indicated in diseases of the respiratory
cause is generally the nature and the primary aspect of system. This shows points and their corresponding internal
a disease. Under general circumstances, the principle is organs have identity in the neural segments.
treating the incidental first when it is acute or emergent, ▪ And secondly, judging from analysis of the therapeutic
and treating the fundamental later when the cause becomes properties of the points of the meridians and collaterals,
insidious or gradual. However, if the incidental and the the meridians and collaterals are closely related to the
fundamental are both emergent, they must be treated at neural segments. For instance, the points of the heart
the same time. meridian of hand – Shaoyin may be used to treat diseases
In acupuncture treatment, a disease should be assessed of the heart, lung and trachea; the same meridian passes
according to such different situations of the primary, the the medial aspect of the tip of little finger, the medial
secondary, the root cause, the symptoms, the acute and aspect of the forearm and the chest; the skin of these areas,
the chronic so as to determine the principle of treatment. where the meridian passes, is controlled by the 1st–3rd
For some diseases resulting in constipation and dysuria, for neural segments of the thoracic nerves, which at the same
example, points helping defecation and urination should time control the cutaneous nerves of these areas. This
be selected first to treat the disease, that is, to treat the indicates that these areas and the heart, lung and trachea
symptoms first when they are acute; then some points to are under the domination of the same neural segments
treat the root cause or original disease are selected, that [30].
is, to treat the root cause when the acute symptoms are The research on the phenomena of meridian trans-
relieved. For edema due to insufficiency of genuine qi mission further confirms the existence of the meridians
or blood resistance weakened while pathogenic factor and collaterals. The course of the meridian transmission
still prevailing, select both the points strengthening body is basically similar to the course of the meridian described
resistance to treat the root cause and the points inducing in the ancient Chinese medical books, but it’s quite
diuresis to alleviate edema. The latter is most widely difficult to explain it. Because the tissue structure of the
used in clinic [28, 29]. meridians and collaterals is not found in the peripheral
As how the ancient Chinese medical men to find the part of the body, some scholars hold that the meridians
meridians and acupoints has been a discussed miracle, transmission takes place in the central nervous system
how to bring them to light of their structure, function and (CNS). There are three main arguments:
nature has also at least partly been a mystery to modern (1) Phantom limb sensation, which is that the amputee
human beings. Numerous scientific people from not only still feels the needling sensation transmitted to his missing
medicine province but also biology, chemistry, physiology, limb on arrival of qi, when given acupuncture.
electricity, magnetism fields and so forth have made a (2) Conditional reflex generalization: some researchers
great deal of study in order to seek the answer. gave acupuncture on the Zusanli point of a dog to produce
a conditional stimulation and gave food to the dog to cause
 Modern studies on the meridians and its salivary secretion as an unconditional stimulation.
collaterals After repeated stimulation, when the conditioned reflex
was established, acupuncture on the Zusanli point along
The meridians and collaterals, and the neural
may cause its salivary secretion. At the same time, needling
segments
the other points of the stomach meridian may also bring
TCM considers the meridians and collaterals are the about its salivary secretion, but needling the points of the
pathways which connect the exterior and interior, and foot – taiyang or foot – shaoyang meridian will certainly
zang–fu organs. In the light of modern medicine, the not. This indicates that the conditioned reflex has a
nerves associate the body surface with the internal organs. tendency to be generalizes along the meridian. In light of
Therefore, the relationship between the meridians and the physiological view, the conditional reflex generali-
collaterals and the nerves should be considered, or in zation goes on in the CNS, not in the exterior of the
another word, it should be thought whether or not the body [30, 31].
meridians and collaterals are actually the nerves. Some (3) Acupuncture transmission under anesthesia: it is
researchers explain the association of the meridians, found that after lumbar anesthesia, needling the Qihu point
collaterals and acupoints, and internal organs to connection on the chest may produce acupuncture transmission in
link of body–neural segments–internal organs. Because: most of the subjects, which may travel along the lower
▪ Firstly, judging from the relationship between the limb on to the anesthesia area, and further to the tip of
locations and indications of the acupoints on the trunk of the toe [32, 33].
the body, and the neural segments, through anatomical From the description above, it is assumed that the
observations and analysis, it is found that the back – Shu meridians and collaterals are the specific functional
416 Feng Ifrim Chen et al.
association between the areas of the cerebral cortex. potential changes produced, and the electric current travels
Needling a certain point may activate the corresponding along the specific pathways crisscross and all over the
excitation spot in the cerebral cortex. The excitation body, forming the system of the meridians and collaterals
spreads regularly, according to its specific functional [30, 35, 37].
association and along a certain course, when the excitation Other researchers say the meridians and collaterals
occurs in a corresponding projection area of the body are the electromagnetic waves formed by electrons or
surface [28]. electron beams traveling along specific pathways. For
According to the ancient description of the meridians this reason, some doctors apply a high magnetic body
and collaterals and the research on the anatomy of to the acupoint of the meridian and collateral to make
Western medicine, some scholars think the meridians advantage of the effect of the magnetic field exerted on
and collaterals are closely related to the blood vessels. the bioelectric activities of the meridians and collaterals.
During the autopsy, scholars observed 309 acupoints, of This is known as “magnetotherapy” [38].
which 24 are located at arterial trunk, making up 7.77% As the mentioned, we have known that acupoints are
of all the points they observed, 206 by the sides of the the specific points closely relating to the activities of the
arterial or venous trunk, accounting for 84.79% of the channels and collaterals and zang–fu organs, through
total. This indicates that acupoints are closely associated which, qi and blood can gather and travel by applying
with the blood vessels. In the Anhui Medical College, there acupuncture. Therefore, herein the collections of acupoints’
was an experiment in which Chinese ink was injected studies concentrate on the research of their morphological
into the acupoints on the freshly amputated legs, and the structures which link to or condition the roles of the
57 points observed. The local tissue around 17 points on acupoints.
eight of the amputated legs, a fibrous structure filled with Some researchers think the blood vessels of the point
Chinese ink started from each of this area. The fibrous distribute with the regularity of some 45.15% points
structures extended along these different courses of the located by main vessels and 18.6% points, at the blood
three yin meridians, eight of them along the liver meridian, vessels. The others believe the nerve–vessel doctrine that
four of them along the spleen meridian and five of them stimulating points has the action on puncturing autonomic
along the kidney meridian. On each of the legs, the fibrous nerves and fine blood vessels, so that the reflexive effect
structures filled with Chinese ink were close each other comes through the conduction of the neural fibers. Because
at the Sanyinjiao point, having a tendency of confluence. they found through histological observation that very rich
It was verified by the tissue slices that all the fine vessels fine blood vessels and more developed capillary network
filled with Chinese ink were small veins. This shows the exist in around 99.6% of the subcutaneous tissue underneath
idea that meridians and collaterals and their points are the points. Other gross-anatomic researches on the histo-
very close to the system of blood vessels [21]. logical morphology of the point confirm the most points
The meridians and collaterals, and the neurohumoral locate at the neural trunks or nerve branches and the fine
system mainly involve researches on the relationship neural fibers pass through most points [39].
between the neural mediums and hormones, and the The morphological study of the Sanyinjiao point by
channels and collaterals. The neural mediums are important observing the grossly stratified dissection and computed
substances, which regulates the physiological activities tomography (CT) cross-section of the point reported as
of the organism. At present, researchers are focused on follows. No special structures have been found besides
monoamines and choline. A large number of study results nerves, blood vessels, lymphs, fascias, tendons and muscles
have confirmed that the neural mediums play a big role comparing the areas of points and non-points. However,
in acupuncture analgesia. In recent years, many reports the distribution of the normal structures of the body is
have showed that acupuncture has remarkable effect different and the Sanyinjiao point is made up of not one
on the pituitary gland and adrenal cortex system, the kind of tissue, while a co-built stereo-structure of many
sympathetic nerve and adrenal medulla system, the types of different tissues [40].
pituitary gland and thyroid gland system, the sexual The latest report on the experimental approach and
glands, and the posterior pituitary system. Thus, some research thinking of the structural basis of the meridians
researchers put forth the theory of the meridians and and collaterals was put forth these recent three years.
collaterals associated with regulatory function of the The researchers have spent more than eight years on the
neurohumoral system, and the action of acupuncture and research and established:
moxibustion is brought about by the way of the nerves (1) The point is a complicated structural system
and body fluid [34–36]. including concentrated fine blood vessels, autonomic
Certain research data show that there is a regularity neural plexuses and lymph vessels.
between the meridians and collaterals and the electric (2) The finding, existing a length of 15.5 μm sponta-
changes of the skin at the acupoints. Indeed, on the skin neously shape-narrowed wave in each point, reflects that
there are some opts with higher magnitude of current, there must be a radiation structure with focused particular
which are distributed in the as way as the acupoints, energy.
moreover, some spots are arranged in a line, which (3) In the stereo-structure of each point, the multi-
confirms to the course of the meridian and collateral. mineral element-concentrated loci and areas were found.
Therefore, some research fellows think the meridians and The Ca2+ density increases during needling points. As
collaterals, in fact, are the specific pathways of bioelectric every knows, each mineral element has special close
current; while the qi and blood of the zang–fu organs are relation with the neural functions, and then a series of
traveling in the meridians and collaterals, certain electric reactions after neural activities.
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Corresponding author
Feng Ifrim Chen, Associate Professor, MD, PhD, Department of Traditional Chinese Medicine, “Carol Davila”
University of Medicine and Pharmacy, 8 Eroilor Sanitari Avenue, Sector 5, 050474 Bucharest, Romania; Phone
+40722–303 681, e-mail: adsm.adsm@yahoo.com

Received: February 25, 2019

Accepted: October 18, 2019