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A Modern
Engineering Study Demonstration
Of The Existence Of A Control System
In The Human Body Involving Traditional Chinese Medicine (TCM) Acupuncture
Meridian Points
Toshiyuki Maeda, MD
ABSTRACT
The author combined engineering mathematics and theory to study the
work of an acupuncture needle, using intraocular pressure changes as
a predicted work output. Using Traditional Chinese Medicine (TCM), clinical
history combined with a study of embryology of the eye and limb development,
predicted as logical eye pressure control points were TE 3, LI 4, LR
3, and GB 41. Experiments were done measuring intraocular pressure change
when the afore-mentioned acupuncture points were stimulated. Similar
measurements were done for non-acupuncture points and limb points on
meridians not predicted to relate to control of eye pressure. Measurements,
using the dominant eye side with retained needle stimulation every 15
minutes for 1 hour, produced the most consistent results proven capable
of being predicted by engineering mathematics. This approach to research,
termed "kinematical system medicine," proves that there are
control points on the body that can act at a distance and influence
other organs. In this case, TE 3 and LI 4 produced consistent changes
in intraocular pressure, with LR 3 and GB 41 producing similar but lesser
changes. Stimulation of non-acupuncture points and limb points on other
meridians did not result in mathematically-predictable or notable eye
pressure changes.
KEY WORDS
Acupuncture, Intraocular Pressure, Predicted Body Control Points, Kinematical
Medicine
INTRODUCTION
Historical Background and Overview
Human life is governed by a control system to keep the body functioning
normally. The author sought to prove the existence of such a feedback
loop control system by combining experimental and engineering knowledge
and mathematics. Related research for 20 years using system engineering
approaches to the body includes articles on the diagnosis of diabetes,1
control of treatment using artificial pancreatic islets,2 forecast in
leukemia,3,4 description of type B hepatitis,5 forecast in dialysis,6
effectiveness of dialysis,7 and chronic disease treatment.8
To define and
study a control system in a complex living organism, a simple input
capable of being measured mathematically using modern control theory
needed to be combined with an easily-measured and fairly consistent
output marker. It appeared that acupuncture meridian points might logically
prove to be useful. Intraocular pressure was chosen as an easily measured,
fairly consistent, and convenient outcome parameter. Acupuncture points
for input control were derived from a study of embryology coupled with
traditional acupuncture points purported to influence ocular function.
Engineering knowledge was combined with experiment to define constants
for equations to potentially predict the influence of acupuncture needling
on intraocular pressure. The experiment also investigated the use of
non-acupuncture points to confirm the specificity of the control points.
Study of
Embryology to Define Related Characteristics
Among Body Points and Organs
Fetal growth patterns indicate relationships among organs developed
from the same germ layer and time span. Differentiation into ectoderm,
mesoderm, and endoderm occurs by the 3rd week in the embryo stage of
development. Induction materials trigger differentiation and maturation.
Thirty types of cytokines, such as nerve growth factor and epidermal
growth factor, have been identified. These cytokines and the nervous,
hormone, and immunology systems recognize target cells and control cell
activation. They are important in the genesis and repair of damaged
tissue and possibly play a role in control mechanisms. The eye and the
upper limb bones develop almost concurrently, in the 4th to 15th weeks
of gestation.
Meridians
and Points
A meridian point is the receptor of stimuli stated to lead to body changes
both locally and distally. Medical research to date has focused on the
electrophysiology of the points with large variation. Thermographic
research also has been unsuccessful in proving the existence of meridians
and points. In embryology, the acupuncture points derive from ectoderm
(peripheral nerves and neuroreceptors) and mesoderm (connective tissue,
striated muscle, vessels, and lymph ducts). The eye organs controlling
intraocular pressure change develop from mesoderm. Meridian points Hegu
(LI 4) and Zhongzhu (TH 3) used in this study develop between the 4th
and 15th weeks of gestation, the same as for the eyes. Points in the
lower limbs develop a few days later and are expected to have less influence
on ocular function.
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| Figure 1 |
Input and
Output Factors for Research
To prove a predictable somatic control system, input and output need
to be described in quantitative physical values. Acupuncture needle
stimulation had to be expressed in terms of failure strength, internal
pressure of a needle cylinder, surface deformation resistance, 2-dimensional
elastic theory, and fluid lubrication theory of a slide-bearing. Acupuncture
stimulation, considering all these factors, was expressed quantitatively
as work of insertion and rotation. The surface state of a needle had
to be considered. Surface roughness in the axial direction was defined
in terms of isosceles triangles. The surface roughness in needle circumference
was simplified and evaluated mathematically as a sinusoidal wave. The
work of destruction and elastic tissue expansion of tissue entry perpendicular
to the needle axis was mathematically determined, as was the work against
friction at the contact plane of the cylindrical part of the needle.
Work of the counter force against friction at both the tapered and circular
cylinder needle parts was mathematically derived, as well as the counter
force against tissue deformation due to surface roughness of the needle.
The work of penetration and needle rotation were compared, with the
latter requiring a fluid lubrication of a slide-bearing engineering
approach as well as boundary friction elastic theory. A Reynolds equation
for 3- and 2-dimensional problems was used. (The mathematics involved
compile 6 pages of text and are available from the author on request.)
The output variables,
i.e., in this case deviation of intraocular pressure following acupuncture
needling of control points, was mathematically predicted using control
theory engineering mathematics. The stimulation-to-reaction ratio, namely
the transmission function, is generally expressed using a logarithmic
function or an exponential function. A differential equation was used
and adopted for the external description of intraocular change, dy/dt
-Ay = Bu = const, where y is an output and A and B are constants. The
input, u, is considered to be constant.
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| Figure
2 |
Figure
3 |
METHODS
Subjects
Oral informed consent was obtained from the numerous healthy adult volunteers
who took part in the study.
Instruments
Smooth-surface stainless steel acupuncture needles, 40 mm long and 0.22
mm and 0.30 mm in diameter, were used. They were penetrated 12 mm perpendicular
to the skin surface. An intraocular tonometer, a non-contact air pressure
instrument, was used for measurement. A minimum of 3 pressure measurements
were automatically recorded and printed out for each study.
Procedure
The types of needle stimulation included a perpendicular insertion to
12 mm and removal of the needle after 1 minute, insertion of the needle
for a prolonged period without stimulation, insertion and rotation of
the needle 180º at 60 rpm for 1 minute, and insertion with electrical
stimulation at 21 V and 250 mA for 1 minute of every 15 minutes. Rotational
stimulation every 5, 15, and 30 minutes was studied. The most consistent
and appropriate experiment was determined to be insertion with rotation
every 15 minutes.
Intraocular
pressure was measured in each case at baseline followed by 14 intervals
of 5 minutes each. Needling of the non-dominant eye side points, the
dominant side points, and bilaterally was examined. There was wide fluctuation
in intraocular pressure readings when needling was bilateral, and when
the non-dominant side points were needled. The study was, therefore,
done with needles on the dominant eye side of the body. The act of needle
insertion and removal caused increases in intraocular pressure due to
the emotional distress of discomfort. Consequently, needles once inserted
were left in place. Since intraocular pressure has a circadian rhythm,
measurement was made at the same time of day. To avoid subject fatigue,
the study's maximum time was 150 minutes. Subjects were always seated
so that change in posture would not affect the data.
To obtain the
most definitive value for the change in intraocular pressure with acupuncture
needling, the experiment was repeated 12 times under the same conditions,
resulting in 36 values. The measured values were found to allow an error
within 20%, and the effects of variation could not be neglected. If
the average was calculated for pressure changes and used to derive the
constants A and B for comparing 2 theoretical values of discrete and
continuous systems predicted from dynamic equations, the agreement was
poor. Simple introduction of a standard deviation for correction could
not suppress the errors induced by the fluctuation of intraocular pressures.
Neither an increased number of repetitions nor a larger rejection limit
could solve the problem. The averaging process amplified the variation.
To correct intraocular pressure fluctuation and improve accuracy, the
most definitive value of intraocular pressure was taken by using a curve
involving the lowest points of pressure at 0, 15, 30, and 45 minutes.
These points occurred just before each needle rotation and obviated
the pressure increases following needle stimulation (Figure 1). The
intraocular pressure change curve then is positioned as a single-stage
differential equation, and the state equation allows processing measurements
mathematically to prove the validity of the input-output engineering
approach to prediction of the extent of pressure change with needle
input at an appropriate acupuncture point.
Experiments
were done needling Hegu (LI 4) and Zhongzhu (TE 3) on the forearm. These
points were considered most likely to be control points for intraocular
pressure and are used to treat eye disorders in Oriental medicine. They
are also related to the eye according to embryology development. Yuji
(LU 10), considered a non-control acupuncture arm point, and non-acupuncture
points in the lateral central forearm and hand were also studied. Lower
limb points Taichong (LR 3) and Zulinqi (GB 41) are clinically related
to the eyes and were added to the experiment. Gongsun (SP 4), an expected
acupuncture non-control point similar to Yuji on the forearm, and non-acupuncture
points between Taichong and Zulinqi and on the lower leg completed the
points studied.
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| Figure
4 |
Figure
5 |
RESULTS
When rotational stimulus was applied to Yuji (LU 10), there was no visible
effect on the intraocular pressure (Figure 2). Stimulating the Yuji
needle electrically had a similar lack of effect. Foot Gongsun (SP 4)
stimulation by both rotation and electrical means showed an even smaller
effect. A relationship between these points and control of intraocular
pressure was not seen directly by experiment, and could not be demonstrated
by engineering control theory and mathematics.
A similar set of experiments was done by needling a non-acupuncture
point on the central-lateral forearm, and 1 between Hegu and Zhongzhu
of the hand. No demonstrable change in intraocular pressure occurred
when these non-acupuncture points were stimulated. Wider variation in
pressure occurred with hand stimulation, likely as a result of the greater
discomfort (Figure 3). Similar non-acupuncture point stimulation on
the lower limb, 1 at the lateral-central leg, and 1 between Taichong
and Zulinqi on the foot produced similar results. (The effect of needle
insertion on intraocular pressure for Hegu and Taichong is shown in
Figure 4.) The effect accelerated from no needle stimulation to electrical
stimulation to needle rotation. In all cases, Hegu was a more effective
control point than Taichong. When Zulinqi and Zhongzhu points were similarly
treated, the comparison of effects with electrical, rotational, and
no stimulation produced graphs similar to those of Hegu and Taichong,
but with smaller effect (Figure 5).
Numerical calculations
for prediction of ocular pressure control effect were made using the
data from the Hegu and Zhongzhu experiments. Needling equals work of
rotation and of penetration, but intraocular pressure change was mostly
due to the effect of rotation. (Subsequent mathematical analysis of
results with and without the use of the work of penetration demonstrated
that it could be ignored.)
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| Figure 6 |
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| Figure 7 |
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| Figure
8 |
Rotational friction
force and viscosity stress equations were done, and the work calculated
by 2 theories. The numerical representation of needling was of the same
magnitude for each, and the mathematical work representation is considered
accurate. Calculation of input variables by both continuous and discrete
equations determined that work of discrete rotational periods could
be handled as though a constant input occurred throughout the experiment.
Mathematically, control engineering theory using the experimental data
could predict the extent of decreased intraocular pressure at the 45-
and 60-minute time of stimulation. This was true when different subjects
were compared (Figure 6), when the same subject was studied under different
experimental conditions (Figure 7), and when different control points
were used for the same subject (Figure 8).
CONCLUSION
Results from needling non-acupuncture points were impossible to analyze
with modern control theory dynamic equations, indicating no control
system between these points and the eye. Stimulation of non-acupuncture
points on the arm and leg unrelated to ocular control produced little
intraocular pressure change. Stimulation of actual acupuncture points
Yuji (LU 10) and Gongsun (SP 4), not related to the eyes, produced little
variation. Hegu and Zhongzhu points on the arm were found to be control
points experimentally. More important, their effect on intraocular pressure
change could be predicted mathematically using modern engineering control
theory. The predicted control effect is seen at 45 and 60 minutes of
stimulation, when the effective pressure decrease appears to be at its
maximum. The effect is lost and pressure slowly returns to normal with
persisting stimulation. The effect of too-frequent stimulation, every
5 minutes instead of 15 minutes, is a more rapid and chaotic pressure
decrease with a rapid rising return that cannot be predicted by control
theory calculation. Likewise, too-infrequent and prolonged stimulation,
every 30 minutes, produced more erratic results that again could not
be used in mathematical prediction of effect. Further examination of
these results appears warranted.
The control
system between both Hegu and Zhongzhu and the eye is present and can
be mathematically analyzed only for a limited time, apparently 1 hour.
The change in intraocular pressure then disappears and converges to
a fixed value. This phenomenon might be similar to the mechanism of
signal transmission of neurons studied in physiology. Muscle nerve can
be stimulated to increase excitatory post-synaptic potential for a time,
then returns to baseline. This is attributable to promoted change in
release of signal transmitters followed by their diminution. The fact
that the amount of decrease caused by acupuncture point stimulation
can be predicted using control theory mathematics is perhaps proof that
such meridian control points exist. The confirmed points Hegu (LI 4)
and Zhongzhu (TE 3) correspond with ancient Oriental findings regarding
the clinical use of the control points. Points in other meridians and
non-acupuncture points lacked control of intraocular pressure. In considering
experiments for other potential control points, embryology and state
space method studies may be of importance.
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AUTHOR INFORMATION
Toshiyuki Maeda was a Doctor of Engineering, Medicine, Physiology, and
Religion; President, Medical Trainer College, Japan; President of the
Japan Society of Kinematic System Medicine; Vice-President, The International
Academy of Education University, USA; Adjunct Professor, Institute of
International Health, Michigan State University, USA; Honorary Professor,
Shanghai University of TCM and Pharmacology, China.
We regret to
inform you that Professor Maeda recently passed away. Any questions
or correspondence regarding this article should be directed to
ussell J. Erickson,
MD,
10 Ridge Place, Pleasant
Hill, CA 94523;
Phone: 925-229-0889; Fax: 925-228-4976; E-mail: Russpat@netvista.net.
Toshiyuki Maeda
5-23-4, ARAI, Nakano-Ku
Tokyo, 165-0026 Japan
Phone: (03) 3319-0696 o E-mail: Noriyuki Fujii at info@iiet.co.jp
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