CAPSTONE PROJECT Korean Hand Acupuncture (Sujichim) Literature Review with Classic Textbook Comparison and My Own Experience with Korean Hand Acupuncture By Myung S. Veronica Noh, L.Ac. Dipl of O.M. (NCCAOM), RN, CCRN DOCTOR OF ACUPUNCTURE AND ORIENTAL MEDICINE PROGRAM OREGON COLLEGE OF ORIENTAL MEDICINE August, 2007 1 Introduction The purpose of this project is to assist fellow TCM practitioners in easing their patients' pain by using simple hand acupuncture techniques. Through my experience with TCM and hand acupuncture, I will demonstrate the relative facility with which other practitioners can implement these methods in their practices. Through this project, I hope to instruct those in the field of Traditional Chinese Medicine so that they can better treat their patients and lessen their pain. Prior to practicing TCM, I studied Sujichim (the Korean word for “Hand Acupuncture” and also the name of the instructional manual.)1 This book appealed to me because of the ease of understanding and application in the instruction of hand acupuncture. (As a student of TCM, I could easily understand Sujichim and the shang image of our body on the hand). I became convinced that the methods taught in this book would be helpful in freeing people from agonizing pain in a short period of time. Eventually, I started practicing Sujichim; it soon became evident that the results from hand acupuncture were obtained more rapidly than those from body acupuncture. For this reason, I decided to share these simple methods with my colleagues and other non-professionals. Learning hand acupuncture could also benefit my patients and their loved ones who might use it in their homes as emergency care before a healthcare provider reaches them. Thus began my work in translating the methods of hand acupuncture into English. (A hand acupuncture book had already been translated by Tae Woo Yoo, but I found it difficult to understand as well as expensive for most people to purchase. However, some professionals might enjoy reading his book.) I commenced my translation of Sujichim with the intention of helping more people in their speedy recovery from pain. While translating the book, I examined other textbooks in order to present better and more accurate information to my readers. Consequently, not all of the information is exactly the same as in the Korean book. For example, I omitted some information that was not applicable to the United States, such as geographic places mentioned in the original book, and vegetables and herbs not available in the U. S. Also, some vague information was omitted in an effort to simplify the book and make it more readable for my audience. The purpose of this Capstone project is to convey the knowledge of Sujichim that I have acquired through my studies and experience to other practitioners. History of Development Dr. Tae Woo Yoo created the theory of Koryo Hand Therapy and developed it between 1971- 1975. Dr. Tae Woo Yoo stated that he resurrected the physiognomy and further studied the theory of the somatic reflex system. Through his experiments he found that a corresponding relationship between the hand and the whole body does indeed exist. That idea was the birth of a new medicine: “Koryo Hand Therapy.” Yong Kwun Kim did not mention where his Korean Hand Acupuncture originated but he studied Oriental Medicine through lectures and he also researched hand acupuncture and developed his own style of Hand Acupuncture Therapy. Tae Woe Yoo and Yong Kwun Kim have worked on the same principle but with a different approach on the hand, so the needle points are somewhat different when choosing places on the hand. Some points are the same but have different alphabetical names. For example, Ren 8 is called shinguel in Korean (Shenque is pinyin in Chinese) on the body point. Yong Kwun Kim 2 uses Ren 7 as a hand point name but Tae Woe Yoo uses K-A8. However, their needle point site is the same, which means that the shang image has the same corresponding relationship to the body. Personal Experience I learned hand acupuncture through Yong Kwun Kim’s follower, Mrs. Ensook Choi, who was a nurse who practiced hand acupuncture. She also gives lectures abroad throughout the Korea, Germany and America. As a nurse, it was easy for me to understand and apply this practice to myself, my family members and other people who needed attention immediately. It encouraged me to study TCM further. TCM body acupuncture and hand acupuncture therapy combined gives patients a better outcome and they seem to tolerate this better (especially children). Body acupuncture and hand acupuncture points can be applied with pressure, a magnet or massage to achieve the same goal as needles. Translation Several of the citations and indications in this paper can be found in other acupuncture books and have been referenced as such. The terminology used in this paper has been translated from Korean and Chinese when possible but at times has been retained in those languages when there was no English alternative. Some of the theory and most of the points used for this research come from Yong Kwun Kim’s book, Sujichim and the lectures from Ensook Choi. Since the majority of this paper is taken from these sources, it would be impossible to cite each reference. Herewith I acknowledge the use and translation of the Korean book on hand acupuncture, Sujichim in this project. Nature and Human Beings Oh-Heng story From the beginning of time, human tribes have worshiped the sun, water, trees, animals, and rocks. Humans looked at the universe as one object of change, the cause of things, and the origin of development from the very beginning of the universe. For this reason, the Five Elements think of each object as the center of life. The Five Elements look at the existence and origin of the universe. The Theory of Hand Acupuncture All creatures want to protect themselves so that their clan will multiply from generation to generation. This is their instinct of self-preservation. For example, a lizard’s instinct is to run away from an enemy when it is being attacked. The lizard leaves its own tail behind in order to protect its life. For many small fish, their instinct is to lay billions of eggs so that their clan can multiply; this is because most of their clans will be eaten by bigger fish. All animals have these instincts, and human beings have the instincts to protect themselves from many diseases as well. The hands and feet are far from the heart and always an easily neglected part of our body. Humans move – they run, walk, stand up and handle and touch things with their hands. These 3 activities protect the feet and hands so that they will not become too cold or hot. Human hands and feet have to move in order to maintain health; otherwise they will be weak. If someone does not like to move, this person will have a problem somewhere in his body. However, movement keeps the qi and blood circulating and harmonizing the body. One can also detect a person’s health by monitoring his hands or feet. Even though they are far from the heart, the 6 channels of zang and 6 fu organs in the body run through the hands and feet. The human body has 51 billion capillary vessels; 70% of these capillary vessels are in the hands and feet. In ancient times when a person had an emergency, he was bled from the tips of his fingers (shi sun hyul)1. A sewing needle was used to do this. Whenever I had acute abdominal cramps, my grandmother used to rub a sewing needle against her hair or she nose breathed on the needle and then pricked my thumb to bleed a few drops of blood out. My problem disappeared miraculously! Modern thinking considers the sewing needle to be non-sterile and that infection could result from this type of treatment. But that never happened. Another example of ancient treatment was if a person fell on the floor and twisted his hands and legs, he would be bled from the dorsal part of his fingers (shi wang hyul)2. From this bleeding activity, people thought that the qi would be harmonized and the blood would move again. They also thought that if the qi and blood were harmonized far from the heart, it would make the body harmonized. When people feel cold, they rub their hands and place them near the fire to make them warm. They do this so that the blood and qi will be harmonized. The hands measure a person’s health. In a healthy person, the hands will be warm. If the hands and feet are cold, then that person's health is declining. If the liver is unhealthy, the white part of the fingernails will get smaller and lose their luster. If the spleen function is weak, then the color of the hands will change to yellow. If the qi and blood are not harmonizing, the hand color will turn blotchy yellow and red. People use their hands to express their feelings. For example, people quickly hold another person’s hand when they are delighted to see a guest, people clap their hands when applauding and cheering, and shake each other's hands when they first meet. Koreans have expressions for the hands called “son shipda" (which means “easy”). These expressions include joining hands, having something in your hands, a person with a big hands, etc. These words express our feelings with hands. From these expressions we know that people use the word “hand” to demonstrate or express their feelings. The frequent use of the hands is directly related to a person’s health; it is also related to the activity of the brain. We think most of the activities and expressions come out from the hands, and we use toys to develop children’s brains and to make objects. Repetitive activities (like habits and technical abilities) are difficult at first for a person's hands but after repeating these activities, the hands will become coordinated and finally everything will be harmonized. Korean people use hand activity toys a lot. Some of these activities are: marble games, stick-hitting games, playing with beads, Rock-Paper-Scissors, string games, etc. According to the theory of hand acupuncture, these games and activities are an important part of our health. Compared with modern children (who play with electric games or toys), ancient children grew up with good health because they used their hands more during play. Dong Uei Hak believes that the hands and feet are connected when meridians and channels connect to each other and move. 1 Shi sun hyul: 1 pun proximal distance point from the palm side of the 10 finger tips in each finger 2 shi wang hyul: 1 pun proximal distance point from the dorsal side of the 10 finger nails in each finger 4 The Theory of Systematic Movement of Nature in Humans In the Orient, one of the big theories is the Yin and Yang Theory and The Five Elements. The Five Elements view the universe as harmonies of the five substances. The yin and yang view the two sides. From the beginning, all things were of two standards in people’s points of view. This yin and yang theory of the Orient had a big influence on Western culture during ancient times. These thoughts (spirit vs. material, subject vs. object) caused people to believe that human beings consisted of an immortal soul but a mortal body. Western and Oriental points of the view were the same, but the original angle of the views was very different. Yin and yang are the property of relative concepts but also have antagonistic relationships. The Contraindication to Performed Hand Acupuncture If a person is very hungry, has a very full stomach, is extremely fatigued and thirsty, or is very upset, he or she should not receive hand acupuncture immediately. Right after hand acupuncture, patients should avoid having sex, becoming fatigued or angry. These patients should also make themselves relaxed before they receive hand acupuncture instead of arriving just after driving a car, doing exercise at the gym, or being short of breath. Cautions after Hand Acupuncture Do not touch dirty objects or handle water right after receiving a treatment because these activities may cause a bacterial infection at the needle site. If a patient experiences blood spotting after needle removal, it is a good sign. The hand has arteries that run, but they run at a deep level. Puncturing a 0.3-0.5 mm insertion will not harm the arteries. Blood spotting comes from the blockage of the capillaries or congestion of the capillary. It is the shang image of the body. Maintaining Health with Hand Acupuncture One advantage of hand acupuncture is that it can be done anywhere and the patient will still receive benefits. As long as the patient remembers to relax prior to receiving hand acupuncture, then the benefits will be good; if the patient has an emergency condition, the benefits will be at a maximum. Some examples of emergency conditions are: acute indigestion with severe abdominal pain, gas intoxication, collapse from hypertension, heat stroke, severe leg pain after a long walk, and a foot or ankle sprain. Even if a person knows only a little hand acupuncture, this can save a patient’s life or act as first aid while waiting for the ambulance to arrive. 5 Shang Image of the body 6 Corresponding treatment Correspondence Theory is the idea that the hands reflect the anatomy and physiology of the whole body; therefore, all the functions of the internal organs can be controlled by stimulating the proper points and areas on the hands for the treatment and prevention of diseases. 7 The palm side of the hand corresponds to the anterior side of the body. The posterior side of the hand corresponds to the posterior side of the body. Tae Woo Yoo used K-A to indicate Korean Hand Acupuncture points along the vertical midline of the hand from the lower end of the palm to the apical tip of the middle finger. Young Kwun Kim used the label "Ren," which is the same as the body acupuncture point of the Ren meridian. Tae Woo Yoo used K-B as the Du meridian of the body point of the body; Young kwun Kim used Du as the body point of the meridian. Dr. Yoo wanted to differentiate his correspondent points from the body acupuncture points. So he used each point, starting with K- A, K-B, K-C etc. This method of using an alphabetical name nomenclature in the channel was hard to memorize and understand for TCM practitioners like me. However, a practitioner who does not have a TCM background will find it easier to learn. Dr. Kim used the same names for body acupuncture points but some of the numbers were different from body acupuncture numbers. I made these more accessible so that the practitioner could understand and apply them easily. For this reason, Young Kwun Kim’s nomenclature numbers are more familiar to the TCM practitioner and help to understand them better. Since I learned Young Kwun Kim’s method of hand acupuncture, I was able to utilize it much better than other types of hand acupuncture. For example, due to the numbering nomenclature, the Ren meridians in the body are called “Ren” in the hand acupuncture, the Du Meridians are called “Du”, Lung are called “Lung,”and so on. This is easier for me since I am familiar with Western medical terminology. I used this method in my ICU setting. I used aluminum balls (which I made from aluminum foil) for each point and taped them on the patient’s hand for at least 30 minutes or longer, depending on my patient’s condition. Afterwards, when I was studying TCM, it was very easy to understand why these points were working on my patients. After I learned TCM, I did not depend on the hand acupuncture book but utilized the TCM theory for the hand. It worked well with those aluminum foil balls, and this confirmed the shang image on the hand from the body. The following table will help to understand the names of each meridian starting with TCM, Tae Woo Yoo, and Yong Kwun Kim. The number will follow after each name. TCM Yong Kwun Kim Tae Woo Yoo Ren Meridian (R) Ren (R) K-A Du Meridian (Du) Du (Du) K-B Lung Meridian (Lu) Lung (Lu) K-C Large Intestine Meridian (LI) Large Intestine (LI) K-D Stomach Meridian (ST) Stomach (ST) K-E Spleen Meridian (SP) Spleen (SP) K-F Heart Meridian (H) Heart (H) K-G Small Intestine Meridian (SI) Small Intestine (SI) K-H Bladder Meridian (B) Bladder (B) K-I Kidney Meridian (K) Kidney (K) K-J Pericardium Meridian (PC) Pericardium (PC) K-K San Jiao Meridian (SJ) San Jiao (SJ) K-L Gall Bladder Meridian (GB) Gall Bladder (GB) K-M Liver Meridian (LR) Liver (LR) K-N 8 If a patient has an eye problem (such as conjunctivitis, an allergic reaction, a sty in the eye, or keratitis) he or she can use hand acupuncture to relieve the symptoms. In hand acupuncture, the tip of the middle finger corresponds to the eye. The patient should find the corresponding point on the tip of the middle finger. If the right eye has a problem, look at the middle finger on the right hand and find the painful spot with either a toothpick, the tip of a ballpoint pen, the other fingertips or another small sharp object. This is the corresponding point of the right eye and also the treatment spot. Press this spot and your eye will feel more comfortable. If your problem is relatively simple, it will recover quickly. If your problem is chronic, make a little ball out of aluminum foil, press the spot and affix it with a band-aid. Then this problem gradually resolved itself with treatments. This method can be used for a runny or blocked nose, and also for snoring. For a bloody nose, you should tie off the end of the knuckle of the middle finger for a minute. This will make the bleeding stop, or will prevent recurrent bleeding. For acute nausea, stomach pain, hiccups, and indigestion you have to find the point on the palm of your hand in this way: put your middle finger backward and find the protruding spot on your palm. Press this point to solve your problem. For a headache, press the tip of your middle finger. If you have an occipital headache, find the corresponding spot on the dorsal part of the end of your middle finger and rub. If the right shoulder has a dull pain and you have difficulty rotating it, press the first knuckle of the right 4th finger that is attached to the palm and rotate it for about 5 minutes. Massage the area so that the pain in the first knuckle is significantly reduced or will release the dull pain and also reduce the difficulty. For a right ankle sprain: press the ankle with a sharp object or prick that spot to make it bleed. Using hand acupuncture, make aluminum foil balls and press the corresponding spot to release the congestion of the right ankle. This point is the dorsal part of the first knuckle of the right little finger. For acute low back sprain or dysmenorrheal condition, apply pressure on the back of the hand (in the mid-to-lower part of the hand) and the front of the palm at the same time. If you do this for awhile, the pain will be released. In an emergency case such as acute gas intoxication, collapse due to hypertension crisis, sunstroke, acute indigestion, acute respiratory distress, baby’s seizure, alcoholic gastritis, overdose of alcohol, collapse from overwork or emotional distress, you should first call 911. While you are waiting for the ambulance to arrive, prick all 10 fingertips to release several drops of blood. This will prevent sudden death. Zhang Fu and Channel Theory Zhang fu Story In Oriental Medicine Theory, the body has 6 zang and 6 fu. But judging from the anatomy, we have only 5 zang and 5 fu. Therefore, one zang and one fu are not recognized in Western medicine while in Oriental medicine, one zang and fu have been added. We cannot see them with our eyes but their function is described as a pericardium and triple burner. These differences come from viewing how the body functions. In Western medicine they are recognized by anatomy, function, and physiology only; in Oriental medicine anatomy, function, physiology and Oriental philosophy are all included. Medicine is a science; it is not a religion. However, the human body is more than science – it is also a mystery. Even though science has made enormous developments, we still cannot 9 understand our body completely. Dealing with and trying to solve all the problems we can be puzzling at times. Oriental medicine cannot explain all of the functions of the human body as Western medicine can. The organ is visible or not visible, scientifically proven or not. In Oriental medicine the human body is accepted as itself; the medical view is not limited only to proof of evidence but also through philosophy. We do not know which one is better. In Oriental medicine, the human body cannot be explained in the same detail as in Western medicine. Both types of practices are superior in certain areas as well as deficient in other areas. Western medicine and Oriental medicine should support each other to the best of their efforts in order to improve medical practices. Zang organs work constantly to keep human survival in contrast and fu organs work only when they are needed. The zang fu organs are inside of the body and disharmony of these organs can produce symptoms. For example, one can develop headaches, back pain, numbness of fingers, and hemorrhoids. Oriental medicine looks at this as a problem or disharmony of zang fu organs, which is different from the way that Western medicine views it. Another example is if a patient does not have a gall bladder, he might have air in his lungs, or his liver may shrink like a bean or swell up. These expressions have nothing to do with zang fu organ problems. It means that the channel of the zang fu organs is feeble/frail or substantial/solid. The kidney’s function is not only to filter blood but also to control menstruation/ reproduction capability. The kidney’s essence is prenatal. Oriental Medicine Theory believes that the kidneys have more functions and a more important role in our body system than Western medicine practitioners believe. Five Zang Fu Zang Fu elements Wood Liver Gall Bladder Fire (king) Heart Small Intestine Fire (prime minister) Pericardium Triple burner Earth Spleen Stomach Metal Lung Large Intestine Water Kidney Bladder The Meridians and Collaterals (Channel) About 2000 years ago, Nei Jing mentioned “Channel Theory” and since then this theory has become one of the big branches of Oriental medicine. But this has become neglected due to a lack of logical evidence. In Korea, in the era of Japan’s invasion, the name of “Dongue” was changed to “Hanue”; their intention was to erase “Dongue” from people’s minds. In India, the channel is called “Nadi” and it deals with 14 Nadi. Chinese scientists reported that they could prove that there were 14 channels in animals and humans.3 The meridians and collaterals are pathways of the circulating blood and qi (energy) of the human body. In Oriental medicine, they describe the channel as a canal of energy (qi) and blood passage. The blood forms from the middle jiao and energy forms from the lower jiao. Meridian (kyung, Jing) is a canal of longitude which runs vertically inside of the body. Collateral (rak, luo) is represented by branches of the meridians, and runs transversely and superficially from the meridians. This system of meridians and collaterals includes the twelve 3 Hankyoreh Newspaper, July 7th, 1992 10