R.G. van Bussel M.D., Amsterdam, Holland
The basis of the segmental acupuncture is the segmental innervation.
A segment consists of a dermatome (skin), myotome (muscles), sclerotome (joints) and
The relation and interaction between these parts is possible by the
shared (somatic and autonomic) innervation. In this way symptoms can be found in one part
of the segment (f.i. the dermatome) as a result of pathology in an other part (f.i. the
viscerotome). By classifying the segmental symptoms we can trace the disturbed segment(s).
We call this the segmental diagnosis. It is also possible to use this nervous connection
for therapeutic purposes. In the segmental acupuncture treatment we try to use the
acupuncture points which are found in the dermatome and myotome of the disturbed segment.
The afferent sensory information as a result of the (manual or electrical) stimulation of
the acupuncture point ends in the first modulating centre; the sensory posterior horn of
the spinal cord.
From here different pathways are possible:
- via ascending fibres to the higher centres (from the segmental point
of view less interest-ing)
- via intrasegmental fibres to the anterior horn (somatic nervous
- via intrasegmental fibres to the lateral horn (autonomic nervous
The efferent innervation (and the effect of the acupuncture) of all
parts of the segment consists of the latter two, but does no always innervate the same
parts of the body. So we can find the efferent somatic innervation (myotome) of f.i. T 1/5
on the thorax and the efferent autonomic (sympathetic) innervation of the segments I 1/5
also on the thorax but also on the head, neck and arm. The explanation of this difference
lies in the origin of the sympathetic innervation: from only a limited part of the spinal
cord (C8-L2) the whole body is innervated by the sympathetic nervous system. The knowledge
of the above mentioned autonomic nervous patterns can be used for the selection of the
acupuncture points. Especially when we need distant points and want to influence the
pathology by using the autonomic nervous system.