Meridian field pharmacopuncture (MFP) is a unique theory and treatment developed by Sang-chun Nam based on clinical experience and research. MFP is a therapy that injects extracts from raw herbs and animal products, such as ginseng, deer antler, astragalus, and Ziziphi spinosae semen, into the induration area (meridian body) to prevent diseases and to treat patients with those diseases. When a disease occurs, the human body consumes much lubrication to produce Qi to resist the disease. In this process, fiber induration is formed, and this is called the meridian body (MB). The MB is easily palpated at acupuncture points, the upper part of the periosteum, ligaments, and tendons, and is formed in the muscles of the abdomen and the thigh. An imbalance in the body occurs during the process of vital activity and induces an imbalance in the six factors. The action to be triggered by the MB in order to treat the imbalance is called a meridian action. The MB supplies body lubrication (潤) to each organ and defends the external pathogens and six excesses: wind, cold, summer heat, dampness, dryness, and fire. The MB tries to prevent a sickly constitution and decrepitude, balances the six sources, and promotes pain and induces fever or perspiration, both of which help to expel foreign substances. The particular areas of the body, which express the identical properties of the acupuncture points and the MB in the part of body to diagnose and treat, are called the MF. The MF is divided into the heat MF and the cold MF. The heat MF includes the wind, heat, fire, and dry MFs and is formed in the area above diaphragm. The cold MF includes the cold and damp MFs [1, 4].
The MB generates Qi and consumes lubrication to overcome a disorder. Body lubrication is the nutrients, and Qi is an energy. Both are used in the prevention and the treatment of decrepitude and weak constitution. Diseases can be diagnosed and treated by using the principles of the MF and the MB. Aromatic and oil-based pharmacopuncture, two types of MFP, are applied to the MB or to responsive points related to the disease. Aromatic pharmacopuncture is used for acute pain disorders caused by Qi stagnation and Blood stasis and consists of Carthami-flos pharmacopuncture (CF), Juglans sinensis dode pharmacopuncture (JSD), Cervi cornu parvum pharmacopuncture (CC) and so on, whereas oil-based pharmacopuncture is administrated for kinetic disorders caused by the deficiency of body lubrication and consists of BUM (Fel ursi + Bezoar + Moschus) and BU (Fel ursi + Bezoar bovis) [1, 8].
EPP is the method of treating disease by using pharmacopuncture distilled and extracted from herbs based on the eight principles of Korean medicine, Yin/Yang, internal/ external, cold/heat, and deficiency/excess, and on the syndrome differentiation of Korean medicine. In EPP, a distilled extract is injected into an alarm point, a transport point, other important acupuncture points related to the illness, and tender points to treat the diseases. The distilled herbal extract of EPP contains aromatic substances that are the energy of Qi. EPP is effective when symptoms are accurately diagnosed and treated by using the proper EPP based on the eight principles and can be applies to treat various diseases because EPP does not induce tolerance, toxicity, and addiction. EPP has various types, such as hwangyeonhaedoktang pharmacopuncture (HHP), anti- inflammatory pharmacopuncture (AIP), neutral-nature blood-stasis pharmacopuncture (NBSP), liver yang rising pharmacopuncture, and so on. For example, liver yang rising pharmacopuncture, among EPP, is applied to relieve the hypertension and palpitation caused by ascendant hyperactivity of liver yang [1, 6].
Animal-based pharmacopuncture (ABP) consists of BV, sweet bee venom (SBV) and Scolopendran (蜈蚣) pharmacopuncture (SP), all three of which contain toxic ingredients, Placenta (紫河車) pharmacopuncture (PP), and so on. In addition, much research has focused on ABP in attempts to develop anti-cancer medications or anesthetic agents by using the toad venom, as well as remedial agents to treat specific diseases by using viper venom, and so on. Such research will contribute to expanding the scope of TKM.
Bee venom pharmacopuncture (BVP) is a treatment combining acupuncture stimulation and the pharmacological action of BV extracted from the poison sac of a live honey bee (Api mellifera) and refined, with the BVP being injected at acupuncture points. The BV therapy conducted in Western countries generally injects the BV subcutaneously into the region of pain or at trigger points while the BVP in Korea is applied to not only trigger points and regions of pain but also acupuncture points that are selected by using a diagnosis based on syndrome differentiation. Even a small quantity of BV can provide a large stimulus and induce anaphylactic shock or critical injury. Therefore, the proper protocols to use BVP and the skills to protect against possible side effects have to be acquired before clinical application [9, 10]. BVP has been reported to have anti-inflammation, analgesia, antipyretic action, activating blood (活血), anticonvulsant, and reinforcement of immunization effects, as well as others. Thus, BVP is applied to treat autoimmune diseases, cancer, painful diseases, and musculoskeletal diseases, such as lumbar spinal stenosis, herniation of an intervertebral disc, arthritis, neuralgia, myofascial pain syndrome, frozen shoulder, and so on [9, 10].
SBV is a pharmacopuncture that was developed to reduce the side effects, such as anaphylactic shock, of BVP and that contains refined melittin, molecular weight 2836, isolated from BV; 40% − 50% of BV is melittin. Based on the principle that core allergens such as phospholipase A2 (PLA2) and other ingredients have molecular weights of more than 10,000, molecular peptides with molecular weights of more than 10,000 are removed from BV by using a protein separation technique, gel filtration. Not only does the use of SBV result in fewer local allergic and systemic immediate hypersensitive reactions than BVP does, the effect of SBV is as good as or even better than that of BVP. Furthermore, a high dosage of SBV can be applied to patients with severe symptoms at an early stage of treatment, and SBV can be injected at most acupuncture points [1, 11, 12].
PP is an ABP that is extracted and hydrolyzed from the villi tissue of the placenta. PP is generally injected into major acupuncture points of meridians, the alarm point, and the transport point to treat diseases. Placenta contains estradiol, progesterone, acetyl glucosamine, D-galactose, mannose, amino acids, cellular growth factors, interferons, interleukins, colony-stimulating factors, diverse hormones and precursors, and so on. PP is known to have the effects of promoting growth, preventing infections, increasing resistance, and improving liver function. PP is applied to treat patients with dysmenorrhea, sleep disorders, increased skin temperature, asthma, hwa-byung, and so on [13-16].
SP is an ABP extracted from the giant scolopendrid centipede (Scolopendra subspinipes mutilans), whose head, legs, and tail have been removed. The treatment method combines the stimulation provided by acupuncture with the pharmacological action of the extract derived from the centipede. The centipede contains toxins, such as histamine and hemolytic proteins, the main ingredients of which are alanine, glycine, glutamic acid, and 16 types of amino acid, such as proline, arginine, asparagine, serine, and so on. It also contains tyrosin, leucine, formic acid, fatty oil, cholesterol, and so on. However, the head, legs, and tail, which contain the toxin, are removed before extraction, and the fatty oil is eliminated during extracting process [17, 18]. SP is used to treat entrapment neuropathy, inflammation diseases, herniation of a lumbar intervertebral disc, neuropathic pain, and so on because SP’s pharmacological actions include central inhibition, anti-inflammation, analgesic, anti-spasm, and anti-bacterial effects, a lowering of the blood pressure, an improvement of blood circulation, and regulation of immunity. A skin test has to be performed before the SP procedure. SP is injected into the ashi points of the primary painful area, primary points pertaining to specific diseases, alarm and transport points, and five phase (transport) points [17, 18].
Mountain ginseng pharmacopuncture (MGP) is a typical single-compound pharmacopuncture (SCP) widely used in Korean medical clinics. MGP is a new type of pharmacopuncture distilled and extracted from either mountain- cultivated ginseng or mountain wild ginseng as identified by using a specific gene analysis technique. MGP was first injected into a vein in Korea. According to analyses using gas chromatography (GC) or GC-mass spectroscopy (MS), MGP contains diverse aromatic substances with low molecular weight between 86 − 213, which are presumed to be flavonoids, such as quercetin, hesperidin, and anthocyanidin, and sesquiterpene compounds, such as panacene and β-elemene [19, 20]. The aromatic substances of MGP have been reported to have no toxicity, to have anti-oxidation and anti-cancer effects, to prevent normal cell from anti-tumor agents, and to inhibition cancer metastasis. MGP of high dosage ranging from 20 mL to 60 mL can be injected intravenously to treat most deficient conditions, especially Qi deficiency, terminal-stage cancer, immune diseases, and intractable diseases; it can also be used to help patients undergoing chemotherapy [19, 20].