Acupuncture and acupressure are two non-drug therapies which are making their presence felt in the complementary medicine scene. And acupressure and reflexology are getting the crowds because of ease of practice. But how do these gentle systems work?

The large airy first floor room of the Arya Samaj center in Santa Cruz, Mumbai, India, is teeming with frantic activity. Clusters of people flank the four walls, talking animatedly. At one end are two high beds holding a reclining form each, upon which therapists are vigorously administering what appears to be a massage. Judging by the people lining up, this seems to be a popular service. In the center of the room, like the still point of a turning world, sits a trim austere looking man whose youthful appearance belies his 75-odd years. This is Devendra Vora, author of the popular book, Health in Your Hands and an untiring apostle of acupressure.

People are waiting in a long queue to consult him, some have critical problems. One wan looking man is a cancer patient. Vora is unfazed. Taking his left hand, he presses a few points and watches the man wince with pain. Swiftly writing down something, he asks him to collect some medicine from a lady sitting at the other end of the hall and to meet one of the therapists. The patient hesitantly explains that he is on allopathic drugs. "That's okay," says Vora with supreme confidence. "You can do so for the first eight days but once you see the results for yourself, you must leave it off."

The treatment is for frozen shoulder and already in four sittings he is 30 per cent better, says Dharam. This, after allopathy, homoeopathy and other therapies failed to have any effect.

Bharati Bagaria, a 48-year-old housewife, was laid low by a crippling back pain that prevented her from sitting or standing. In desperation, she approached Seema Khandwala, a practitioner of Chinese acupuncture. The first session itself yielded results and in five or six sessions the back pain had disappeared.

Acupuncture and acupressure may or may not be the panacea its practitioners often claim them to be. But their growing popularity in India can hardly be doubted. While acupuncture is the senior and more respected of the two, it is acupressure which is climbing the popularity charts. Free training and treatment camps abound, run by people like Devendra Vora, who claims to have treated 20 lakh cases since his involvement in 1976. Chimanbhai Dave is another pioneer, having been deeply inspired by two books on reflexology (a variation of acupressure) written by Eunice Ingam called The Stories the Feet can Tell and The Stories the Feet have Told. His organization, Jay Bhagwan Acupressure Services Bombay (International) runs free training and healing workshops in about 300 centers in India and abroad. Another institution called Veer Savarkar Kendra in Vile Parle, also offers free treatment and training courses.

Anjali Nevrekar, Sujok and hand reflexology practitioner, claims to have trained over 10,000 therapists herself. And acupressure gizmos abound, such as acupressure shoes, whose soft spikes are calculated to pressure your acupoints while you walk about your daily routine. There are many types of acupressure rollers, points, even beds! While such over-enthusiasm may be both unwise and unnecessary (practitioners say that all you really need are your fingertips, and that prolonged application of pressure such as that arising from footwear and beds can damage), it speaks volumes for the widespread awareness of what is an alien therapy, coming from China.

At the core of these therapies, as indeed, all eastern sciences, is the presence of chi. Chi (prana, in India) is the bio-energy or life force that moves and sustains life. Indeed, it is the very essence of life. The universe is suffused with bio-energy, and its presence or absence within our system is the measure of our well being. Balancing chi is essentially a question of balancing the yin and yang, the twin polarities (+ve and -ve) that are at once in conflict and interdependent. The purpose of these therapies is therefore to ensure the smooth and harmonious flow of chi. Its focus then is more on maintaining health rather than treating ill health.

The flow of chi has a definite predictable route like a well-laid out railway track. The chi runs along 14 parallel lines called meridians that start from the tips of the fingers of each hand, go up to the head and then travel down to the toes. Of these, 12 are connected to each of the major 12 organs. There are numerous interconnections and stops en route. These stops are known as acupoints. When stimulated in a specific way for a specific period of time, these points can kick start energy blockages and stagnations and can increase the flow.

Stimulation of the points through the insertion of needles is known as acupuncture. The use of pressure is known as acupressure in any one of its forms.

Illness, according to the holistic understanding of eastern philosophy, is caused whenever the chi of the external environment, such as one's home, relationships, weather, and work conditions is disturbed, or if one's internal chi, the body-mind complex, is not in harmony. Healing is therefore a combination of correcting our outer environment (for instance, by moderating the lifestyle, or diet or mental attitudes) and by stimulating the acupoints. In India, acupressure is usually combined with ayurveda, homoeopathy, nature cure and other holistic practices.

Because of their emphasis on drugless, natural measures, they are considered to be safe and gentle, without the formidable cost or side effects of allopathy. Though Dr C.H. Asrani, an allopath, who also practices acupuncture, Chinese head and ear, does not consider the science to be entirely free of side effects. "Over-stimulation can cause headaches," he points out. The dos and the don'ts of the therapies must be observed, but within that framework, acupuncture and acupressure can be successfully used to treat many situations that are out of the purvey of other therapies.

ACUPUNCTURE
According to legend, acupuncture was accidentally discovered when Chinese warriors found that arrows striking them at certain points in the body healed them of chronic conditions. Since then, it has acquired such a level of sophistication that there are now over 1,000-2,000 known acupoints in the body, performing different functions, some to stimulate, others to sedate. Of these, the therapist has the task of selecting 8 to 18 points for treatment. How does it work? Two theories have been forwarded by science. One is that the needle sends up impulses that travel faster than the pain impulses, thereby blocking them. The other is that it releases endorphins (the feel-good hormone) into the bloodstream.

Acupuncture came to India sometime in the middle of last century and according to Dr C.H. Asrani, an allopath who does Chinese head and ear acupuncture, it has not grown as it should have. The reason: "In the early days, the general practitioners who learnt acupuncture were charging four times their regular fees for acupuncture and were using it indiscriminately."

Sujok has many advantages over Chinese acupuncture. Because the needles are much smaller, it is possible to send the patient along his way instead of making him sit in the clinic. Unlike acupuncture, which uses anything up to 20 needles, Sujok uses only four to five.

Dr Shah practices both forms of acupuncture but is drawn to Su-jok. He says: "My personal experience is that most patients benefit by Sujok."

Aditi Pandya, a practitioner of ayurveda and Sujok, specializes primarily in hair treatment. Coming from a family where each member turned grey at 30, the young woman utilized her science background and the fact that her grandfather was an ayurvedic physician to experiment with herbs. Persistence paid and eventually she emerged with a preparation. The dreaded age of 30 came and went with nary a gray hair on her head, much to the envy of her already graying cousins. Taking pity on them, she gave them her magic potion for use, and pretty soon word of mouth gave her a flourishing practice. Feedback began pouring in that the medicine not just stopped hair from graying but was also causing hair to grow. Her waiting room was soon flooded with people looking for a cure to baldness. Looking for a way to speed up the process, she stumbled upon Sujok acupuncture. She asserts now: "Sujok gives excellent results in no time."

Although Aditi's primary specialty is hair rejuvenation, she has treated her patients for other ailments as well. A transporter, for instance, had approached her for baldness, but she says: "In the process I pulled out his back pain." Another of her patients was cured of infertility caused by a fibroid.

Amreen Ibrahim Kuradia (29) has good reason to be grateful to Pandya. Says she: "After my third delivery, I had to take treatment for thyroid, and in a month, 99 per cent of my hair had fallen. In desperation, I approached Aditi. In a few days, the hair fall stopped and new hair began to sprout." Having gone to her for a year, Amreen believes she has had 75 per cent recovery.

Many acupuncture practitioners have thrilling tales to narrate of patients healed from painful and hopeless cases. Dr K. Nirmalchandra Shetty, who has done an advanced course in acupuncture from China, talks of a 12-year-old spastic boy who had marked deformities in the right hand and had protruding hip and vertebra. He could neither sit nor stand by himself. Acupuncture for a few months corrected the deformities considerably. His right hand regained some movement, and he was able to walk with difficulty. Says Dr Shetty: "Acupuncture is a complete system of healing."

One of acupuncture's most spectacular results arises from its ability to manage pain. Dr Shetty is an honorary consultant with Shanti Avedna Ashram, the premier hospice in the country for the care of terminally ill cancer patients. "All patients are given pain-relieving drug, of which morphine is the last resort. I interfere only when the morphine dose is ineffective or causing side effects. Acupuncture is very effective in managing pain. I also insert a few needles of a special variety into their ears. Whenever they overcome pain, all they have to do is to press their needles and they will have an anesthetic effect."

So effective is acupuncture in handling pain that it has been developed as anesthesia in China and many western countries. In India, though, this function is undeveloped as yet. Says Dr Shetty somewhat bitterly: "In the USA, one million Americans use acupuncture. In the UK, 47 per cent of GPs refer patients to acupuncturists. In India, there are hardly any referrals from the medical community."

Dr Shetty is driven by a desire to do something to heal cancer through his therapy but despite his efforts for five years, Tata Memorial Hospital, one of the country's premier cancer hospitals, refused to give him a research project.

While acupuncture has a long way to go before it becomes a mainline therapy, the therapists swear that it is remarkably effective in many cases. Says Dr Shah: "Acupressure is a palliative; its effects are not long-lasting. Acupuncture can give a complete cure in most cases."

Most agree though that the therapy has its limitations. Says Dr Asrani: "If I feel a patient is better served by surgery, I tell him so." Adds Dr Shetty, "Acupuncture cannot help in emergencies, cardiac problems, epidemics, infectious diseases, accidents, etc."

An acupuncture sitting lasting half an hour or so usually costs between Rs 100-150, though it can go as high as Rs 300.

Apart from Sujok, there are a few more variations of acupuncture. One is ear acupuncture, where it is believed that the ear is the prototype of the fetus and therefore has all the body parts represented in it. Head acupuncture treats all the body parts simply by inserting needles within the scalp area. In laser acupuncture, a laser beam is directed at the acupoints instead of using needles. In homoeo-puncture, the appropriate homoeopathic medicine is applied at the tip of the needles.

Lastly, the insertion of needles, which are very fine, is not painful. So, there should be no fear on that part.

ACUPRESSURE
Within its short period of existence in India, acupressure has made tremendous inroads into the public consciousness over the last 20 years, thanks largely to the ease of its practice and use. As a therapy it has several advantages which have conspired to give it a runaway popularity, fuelled by the missionary zeal with which its practitioners propagate it. Says Anjali Nevrekar, holistic healer: "Acupressure therapy has to spread as widely as possible if the people are to be freed from the clutches of the present day expensive medical treatment."

She adds: "Acupressure can give one a sound mind and healthy body, as it improves blood circulation, unblocks nerve impulses and relieves stress and tension." She is at pains to highlight its advantages. "It is cost-free, simple and can be practised by self, it does not require space (a weighty consideration in space-scarce Mumbai), patients of all ages can benefit by it, it does not take much time and it has no side effects."

If responsibly followed, acupressure in its various manifestations can be an effective self-healing and self-regulating system. Nevrekar was drawn to it by her own experience. Having suffered for a prolonged period from osteo-arthritis that left her virtually crippled, she was advised an operation. Just before the scheduled date, a friend introduced her to acupressure. Intuitively, she felt that it would help her recover, which indeed it did within three to four months. "Earlier, I was not able to move my fingers or walk. Now I am fully active all the time," she says.

It can also be, as Devendra Vora points out, an excellent diagnostic tool. Press a point on the hand and if it is tender or painful, chances are that the organ or gland it represents is in need of repair. When I met him, the good healer deftly pressed a few points and diagnosed a sore throat, which I had developed that morning itself.

Sujata Pandit, a Mumbai housewife, presses the endocrine points each time she wants relief for water retention. Some years ago, when her daughter returned home distraught from an examination she had not done well, a little aromatherapy and pressing of the acupressure points sent her into a sound sleep from which she woke up refreshed and ready to face the next examination. When 15-year-old Nishi Megh has a headache or backache, she hightails it to Kiran Goel, who gives her Su-jok acupressure. Claims Goel: "You can heal headaches in less than a minute."

And, of course, most are profoundly convinced that, like all good things, it originated in India.

Says Devendra Vora: "Bhishma staying alive on that bed of arrows for six months in Mahabharata is nothing but a practical example of acupressure." And Anjali Nevrekar points to the Indian habit of adorning oneself liberally with jewellery, such as rings, anklets, armlets, waistbands, toe rings, all of which exert pressure on that specific point.

While acupressure has around 200 points all over the body to remember, most practitioners resort to the simpler hand or foot reflexology or Sujok. They believe that the hand and the foot are switchboards to the system and that stimulating points there create a reflex within its representative body part. All one has to do to ensure sound health within one's system or to diagnose impending problems is to press the hand or foot thoroughly once a day. Says Jitubhai Vora of the Jay Bhagwan Acupressure Centre, which makes use of foot reflexology exclusively: "The results are miraculous." He cites the case of a lady who was bent over almost 90 per cent. Having been advised an operation, she came to have acupressure and within four or five sittings, she was walking erect.

Probodh Doshi, who employs both reflexology and ayurveda, has been able to get excellent results for slipped discs and other painful conditions.

Like acupressure, shiatsu, of Japanese derivation, also makes use of points all over the body. Unlike acupressure, however, it also makes use of gentle body manipulations. The G-Jo Fingertip technique makes use of points that go directly to the organ.

Most therapists combine the use of various holistic therapies when treating patients for acupressure. Vora, for instance, insists the intake of some homoeopathic medicine as well as naturopathic green juices and fruit juices. He even prescribes charged water made out of soaking metals like gold, silver and copper in water and boiling it down to half the quantity. He also prescribes various ayurvedic treatments.

Vora claims that many of his cures are intuitively arrived at while in meditation. "Many acupressure therapist have not bothered to go deep into the root of the problem. But my mission is to heal the world, and I am deeply moved by suffering. I saw a film on TV about children suffering for muscular dystrophy and I was so upset that I wept. That intensity of feeling gives me the motivation to go deep into causes," he reveals.

He points to the key role played by endocrine glands in maintaining the harmony and health of the body. Their vital role, he complains, has not been understood by western science. Disturbances of the glands cause most of the problems, he says. For instance, high BP is caused by the malfunctioning of the pineal gland and therefore the point to be pressed is that.

How does one press the points? There are many methods. Vora suggests intermittent pressing and releasing, others have their preferences. Michael Blate, author of The Natural Healer's Acupressure Handbook, suggests stimulating the spot deeply and briskly with a fingertip in a counterclockwise movement for about 15 to 20 seconds. If more pressure needs to be exerted, one can use the knuckle, thumb or even a blunt instrument like a pencil. There is an instrument called the jimmy or the acupressure thumb that helps exert pressure. In Sujok, they advocate the use of a spiral ring, which you are supposed to run through your fingers.

Most therapists warn against over-stimulation. Never press a point more than three times a day, for about two to three minutes, says Vora.

The symptoms may increase after the first stimulation, but this is an indication that the treatment is working and the body is throwing off the toxins.

After applying treatment for the required points, always press the kidney point as well, to stimulate it to throw out the toxins.

The introduction of acupuncture in the world in recent times is a fascinating story. Delhi-based Dr Ravinder K. Tuli, the leading acupuncturist in the country, recounts that during World War II when the Red Army was fighting the Imperial army, there was an outbreak of malaria. Though quinine was around, Mao Tse Tung was informed about the efficacy of acupuncture in treating, curing and preventing malaria. Indeed, when tried, it proved as effective as quinine. Gradually, the Red Army started using acupuncture in varied conditions. Later in 1949, when Mao took over the reins in China, one of his first pronouncements in the Red Book was that while they should modernize, they should also adopt, develop and popularize traditional Chinese medicine, of which herbal practice and acupuncture are two parts. And when the barefoot doctors concept was formulated to take medicare to grassroot levels, basic training in both the use of herbs and acupuncture was provided to them.

The second episode relates to President Nixon's ice-breaking visit to China in 1971. James Reston, senior editor of The New York Times, who was in his entourage, developed acute abdominal pain which was diagnosed as appendicitis. A surgical team specially summoned from the USA removed the appendix, but the pain did not disappear. Eventually, they accepted their Chinese hosts' offer of trying acupuncture and the relief was immediate. The incident made headline news in America. Acupuncture prominently figured in the MoUs signed between the two countries, and a department was set up in George Washington University to understand the practice. Today, acupuncture education and practice is fairly developed throughout the USA.

An MD doctor who has worked for the Indian Air Force and who has learnt acupuncture in China and Sri Lanka, Dr Tuli has been practising the system since 1977. He also uses acupressure, yoga, nature cure, reiki, pranic healing, etc.

He is at pains to explode the myth that alternative systems are good only for treating chronic cases. He relates the story of how once when he went trekking to Gaumukh, India, he found a person in his rest house suffering from acute mountain sickness (breathing problem due to water in the lungs) caused by lack of acclimatization at high altitudes. Dr Tuli volunteered his services. But since he did not have access to even acupuncture needles, he employed acupressure and within minutes the patient was up on his feet.

He cites various other cases such as asthma attacks, where he could provide instant relief. Dr Tuli has also successfully treated a curious mix of emergencies, ranging from an actor losing his voice on the eve of a performance to a racehorse coming down with an attack of nerve paralysis just before a race. He has also treated a few pets. ''Acupuncture is a complete and versatile system that can treat any ailment, complementing any other system,'' Dr Tuli says confidently.

With his wife, Dr Poonam Tuli, and two junior doctors assisting him in his clinic in the upscale Friends Colony, his practice is flourishing. His grateful clientele includes diplomats, industrialists, politicians, sportspeople and artistes. Yet, he feels that acceptance of acupuncture is slow in the medical community. At the Indraprastha Apollo Hospital in Delhi, India, where Dr Tuli is a consultant, referrals are often totally burnt-out cases.

Dr Tuli refers to acupuncture as a spiritual practice because it is a holistic (meaning wholesome) system that creates harmony in the mind, body and spirit. Test cricketer Nikhil Chopra visited Dr Tuli for a shoulder problem. Not only was the cricketer cured, but he also wrote in Tuli's visitors book: ''It was a great spiritual experience, I felt a sense of well-being.'' Veera Hirano, a Britisher who works for the WHO, believes that her level of meditation took a leap after taking acupuncture sessions with Dr Tuli.

One reason for the slow acceptance of acupuncture in India, says DrTuli, could be the fear that the use of needles exposes one to diseases like hepatitis and AIDS. ''We either use disposable or sterilized needles,'' he assures.