Advantages Of The Korean Hand
Microsystem In Clinical Practice:
Reflections After 15 Years Of Experience
Lowell E. Kobrin, MD
I began the transition from using the traditional body acupuncture points as my primary locus of treatment to using the corresponding points on the Korean Hand microsystem in 1988. I reported in this journal1 that the patient acceptance of using tiny needles that penetrate only 1 millimeter into the skin was excellent, and that results of treatment appeared the same as if the traditional body acupuncture points had been used. These observations, made early on in my adventure into this elegant treatment system, continued to be the case over the last 15 years as my use of the Korean Hand Therapy (KHT) model became more and more refined. I have used the Korean Hand microsystem to set up treatments based on the Traditional Chinese Medicine (TCM) model (Eight Principles), the Five Element System, French Energetics, the Distinct (Divergent) Meridians, the Tendinomuscular Meridians, the Cerebral Circulation, Extraordinary Meridian Therapy and others, all with results that paralleled deep needling on the body points.
When we, as physicians well-learned in the constructs governing contemporary Western medicine, were first exposed in our training to the paradigm under which the rules for using acupuncture operate, there was a certain "leap of faith" required until we actually witnessed the successful outcome of our treatments in our patients. Molecular medicine, with its linear thinking, that had been the fundamental basis for understanding the etiology and pathogenesis of human disease states throughout our entire medical education, was profoundly shaken up when we were taught the thinking process required to design acupuncture treatments. Our colleagues often looked upon us as "strangers in a strange land" as we practiced this ancient art - even though we, as physicians, were able to integrate this knowledge with the molecular model whenever possible. Nonetheless, we persisted in our "new" specialty over the last 2 decades, at last seeing acupuncture emerge as an accepted treatment modality by our colleagues. Most non-acupuncture trained physicians, however, can only appreciate acupuncture in a linear sense, i.e., as an alternative to pharmaceutical therapy or surgery for chronic pain. There is no sense of "wholeness," i.e., the ability to integrate the factors of emotions, physical complaints, diet, and lifestyle to formulate a treatment plan for the patient.
Figure 1. The traditional meridians and acupuncture points are duplicated in the micromeridians and points of the Korean Hand Therapy hologram.
With the introduction of the KHT system2,3 and its ability to effect treatment non-invasively, the physician acupuncture practitioner is faced with yet another "leap of faith." We (and our patients) have been obsessed with the requirement of breaking the skin as being the necessary input for effective treatments in acupuncture. The points on the KHT micromeridians are uniquely sensitive to metallic press pellets. These blunt-tipped pellets appropriately placed on the Korean Hand microsystem points have been found to be every bit as good as using the quarterinch KHT needles.4 Tonification of a KHT point is done using a gold pellet, while sedation of a point is effected using a silver pellet. Thus, an efficient, yet comprehensive needleless method for acutherapy has evolved. This is not to say that one must abandon using body points or auricular points or scalp acupuncture points. Indeed, while the KHT microsystem is used for the main treatment, it is perfectly acceptable and often advantageous, for example, to add appropriate auricular points. We use traditional body point palpation for Three Constitutions diagnosis.1 It is mandatory to use the traditional body points to bridge scars that cross meridians, and I often do local therapy on body, using acupuncture points that affect the local problem (Figure 1). However, I now even use non-invasive techniques to obtain De Qi on the body points.4 The advantages of using Korean Hand Therapy are obvious:
- Painless, non-invasive therapy is easy with children and those with needlephobia.
- Positioning and repositioning the patient is not necessary.
- Neither sterility nor contaminations are concerns.
- Placement of KHT pellets or needles is rapid and efficient.
- The patient does not have to remain for 30 or 40 minutes if needles are not used (however, it is often advantageous for the patient to sit quietly for about 15 minutes after a KHT needleless treatment is placed).
- Press pellets (gold and silver), a mini cun stick, a fine, water-soluble marker to measure relative distances on the hand, and a good point finder are all one needs to execute any treatment protocol using the KHT microsystem. These items will fit into a medium-size pocket.
- If one masters the Three Constitutions System5,6 of diagnosis unique to KHT, the practitioner will see a level of accuracy in diagnosis which, in my experience, surpasses anything I have learned to date in my acupuncture training. That diagnostic system gives the practitioner the flexibility to design appropriate treatments ranging from simple sedation or tonification of the appropriate meridians to elegant Five Element or Extraordinary Meridian treatments. In fact, Three Constitutions Diagnosis is the most accurate system I have found for the appropriate use of the Extraordinary Meridians.6
- The patient can be taught the most basic therapeutic level, i.e., Correspondence Therapy,2,5 to easily and accurately use press pellets at home to help reduce pain instead of using pharmaceuticals - with the understanding that self-therapy is not a substitute for returning as advised to the practitioner, who is trained to design treatments that go far beyond this temporary pain relief.
So why is the acupuncture community so slow to explore and convert to the KHT microsystem? I believe there are several reasons: 1) Tradition: Not unlike Tevye, the main character in "Fiddler on the Roof," we are reluctant to change from a system that works even if the system is, by comparison, more cumbersome and time-consuming. There is definite gratification in having the knowledge and skill to perform needling, cupping, etc. It took many hours to master this art. This method has worked for thousands of years and the patient expects it; 2) Anatomy: The traditional acupuncture meridians and points are at least more closely related to the body's "real" anatomy, which is emotionally more comfortable to many practitioners than using the Korean hand hologram of the body. We can give some sort of structural and physiologic credence to the effects of acupuncture when body points are needled (influencing movement in the ionic milieu in the interstitial fluid), but when the KHT micromeridians and points are used in treatments to get the same effect as body needling, we are truly at a loss to explain any possible mechanism of action. In an interesting and provocative article, Bouevitch suggests that microacupuncture systems may be based on the principle of fractalization;7 and 3) Time Constraints: Work overload often makes us reluctant to expend the time to learn yet another system to accomplish the same ends – even if it has significant benefits.
Nevertheless, here is the challenge...Learn enough of the main KHT correspondent points so that you can apply a treatment on the hand,using any system of acupuncture diagnostics in which you are comfortable, to design the treatment. Ask a few of your long-standing patients to allow their next 3 treatments to be placed on the KHT points in lieu of the traditional body points. Question them as to the efficacy of the KHT treatment compared with prior treatments that were done using the traditional system. If your treatment protocol is appropriate and you placed the KHT points accurately, the effectiveness of the treatment should be equal to that seen from piquring the traditional points.
I believe that the use of the KHT microsystem is destined to become the next step in the evolution of acupuncture medicine. I make this prognostication because this system is the only complete point by point miniature template (much like your remote control is to your TV set) of the traditional body system known.8
- Kobrin LE. Experience on the incorporation of Koryo Sooji Chim Hand Acupuncture into a medical acupuncture practice. Am Acad Med Acupuncture Rev. 1989;1(1):11-12.
- Yoo TW, Chung J, Murphey E, DTSM, Translators and Editors. KHT Koryo Hand Therapy. Vol. 1. 2nd ed. Revised and Enlarged Edition. Seoul, South Korea: Eum Yang Mek Jin Publishing Co; May 2001.
- Eckman P. An introduction to Koryo Sooji Chim: Korean Hand Acupuncture. Am J Acupuncture. 1990;18(2):135.
- Kobrin LE. Comprehensive acupuncture therapy without needles. Medical Acupuncture. 2000;12(2):29-30.
- Kobrin LE. Three Constitutions Diagnosis as a basis for Five Element Therapy: a first line approach to patients using korean hand acupuncture. Am Acad Med Acupuncture Rev. 1990;2(2):5.
- Kobrin LE. Three Constitutions Diagnosis as a first line approach to patients using korean hand acupuncture: part II – Extraordinary Meridian Therapy. Am Acad Med Acupuncture Rev. 1991;3(1):37-48.
- Bouevitch V. Microacupuncture systems as fractals of the human body. Medical Acupuncture. 2003;14(2):14-16.
- Dale RA. The holograms of hand micro-acupuncture: a study in systems of correspondence. Am J Acupuncture. 1990;18(2):141.
GUEST EDITOR INFORMATION
Dr Lowell Kobrin is in private practice in Coos Bay, Oregon, is a Diplomate of the American Board of Obstetrics and Gynecology, and is a founding member of the American Academy of Medical Acupuncture (AAMA).
Lowell E. Kobrin, MD, PhD, FAAMA*
North Bend Medical Center
Coos Bay, OR 97420
Phone: 541-267-5151 • Fax: 541-269-1545 • E-mail: email@example.com
*Correspondence and reprint requests