Introduction to Acupuncture Ancient Art to Modern Science

Introduction to Acupuncture Ancient Art to Modern Science

Comparison of East & West East • Empirical Observations over Thousands of Years • Art of Medicine • Holistic View • Circular Logic • Energetic West • Scientific Method & Case-Based Medicine • Technology of Medicine • Molecular & Organ View • Linear Logic • Mechanistic

Science versus Art • Over the last 10 • years, there has been no change in mean life expectancy in human beings, dog or cats There is an increase in incidence of inflammatory diseases and cancer over our ability to detect the conditions

Acupuncture: History Sun Yang Alias Bole Veterinarian Qinmugong period 659 B. C. to 621 B. C. Bole Zhen-jing

Bole’s Canon of Veterinary Acupuncture • Sun Yang • 659 to 621 B. C. • Bole Zhenjing

Acupuncture: History Yuan-Heng’s Therapeutic Treatise of Horses Yuan Heng Liao Ma Ji – 1608 – Benyuan Yu – Benheng Yu • Veterinarian • Ming Dynasty • 1368 to 1644

Basic Tenets of AP • Based upon the AP point selected • Based upon the method of stimulation – – Dry needles Electrical AP Aquapuncture Hemoacupuncture • Based upon the length of stimulation • Low-rate, twisting stimulation of GV 26 leads to endorphin response, while highfrequency needling of GV 26 leads to epinephrine response

Basic Acupuncture Techniques Stone needles 8, 000 years ago Bones needles: 3, 000 years ago New Acupuncture Metal needles: 2, 200 years ago Needles Gold/silver needles Bamboo needles Fine needles Zhen-jiu Moxibustion Ai-jiu (moxa): moxibustion Alcohol (huo-jiu): Herbal moxibustion Needle + Moxa Fire-needling Electro-acupuncture Embedding Injectable acupuncture (aquapuncture and pneumoacupuncture), Laser therapy Magnetic therapy Infrared therapy (TDP)

Long Nine needles (2, 200 years ago) Sword Fine Pressure Arrowhead Round Sharp Round/Sharp Large

Arrowhead needle Sharp needle Sword needle Round needle sharp needle To drain abscesses To bleed superficial vessels (TCM Surgical tools) Round needles Pressure needles Acupressure (Not penetrate the skin) Fine or Filiform Long Large needles Penetrate the skin at known acupuncture points (commonly known acupuncture)

1. Dry Needle Acupuncture or Conventional Needling Techniques Dry Needle is also called (White Needle)—Bai-zhen. Not intentionally bleeding the most common treatment modality in veterinary and human practice is done with filiform needles. Sterile needle. With tube. Without tube Can be applied in most acupoints (GV-1, LI-4) Can be used any patterns of disease

Acupuncture Needle Diameters in Gauge and Millimeters Gauge 40 Millimeters 0. 15 Application Hand/feet Needle 38 0. 16 “Baby” needle 36 0. 20 34 0. 22 Cats, little dogs 32 0. 25 All the Small animals (dogs/cats/birds) 30 0. 30 Horses, cattle, llamas, pigs 28 0. 35 Large animals: horses, cattle, elephants

Acupuncture Needle Lengths in Millimeters and Inches Millimeters Inches Application 7 0. 25 (Korean Hand Needle) Dogs/cats: around eyes, nose, feet, or sensitive patients 13 0. 5 Dogs/cats: head, feet, lower limbs, ear, tail, mu pts Horses: ears/eyes, feet 25 1. 0 Dogs: back-shu, neck, shoulder, limbs Horses: feet, lower limbs, head, tail 40 1. 5 Dogs: hip, shoulder Horses: back-shu, mu points, limbs 50 2. 0 Dogs: hip, cervical hua-tuo-jia-ji for big dogs Horses: back-shu, limbs 75 3. 0 Horses: hip 100 4. 0 Horses: hip

How to needle an acupoint Ø Ø Preparation l Needle l Animal l Practitioner Insertion of a needle l Pressing hand l Angle l Depth Manipulation of a needle Withdrawal of a needle

How to needle an acupoint: preparation Ø Needle • Sterile disposable • The tip: should be smooth l l & sharp as a pine needle size • Horse Ø: 0. 30 -40 mm (#28 -#30) l l l 13 mm (1/2’): in extremities (feet, tail, ear, head) 25 mm (1’): in lower limbs, head 50 mm (2’): in the trunk, back 75 mm (3’): in shoulder, hip 100 mm (4’): hip

How to needle an acupoint: preparation Ø Needle • Small animal l l generally thinner not too thin • Dog: l l Ø 0. 25 (#32) 13 mm (1/2’) 25 mm (1’) 50 mm (2’): large dog • Cat: l l Ø 0. 25 (#32) 13 mm (1/2’)

How to needle an acupoint: preparation Ø Animal l l quiet relaxed (house call benefit) Restrained if needed (nose twisted), but not sedation/tranquilized The site of acupoints • nice and clean

How to needle an acupoint: preparation Ø Practitioner l Sound plan of acupuncture treatment l Considered as a surgical procedure l others

How to needle an acupoint: Insertion Ø Pressing Hand l l 1. Thumbing 2. Pinching 1 2

How to needle an acupoint: Insertion Ø Pressing Hand l l 3. Holding 4. Stretching 3 4

How to needle an acupoint: Insertion Ø How to insert a needle l Jabbing: a quick insertion (Flying technique) • 0. 5’ (13 mm) l l #28 to 30 for horses #30 to 32 for small animals l tube guiding l Twirling: a slow insertion

How to needle an acupoint: Insertion Ø Angle l l l Perpendicular insertion Angular insertion Horizontal insertion Ø Depth l l Location De-Qi response Condition Patient

-Manipulating needles until "De‑Qi" response -10 to 30 min, manipulated once every 3 to 5 min -Indication: Any diseases -Or starting technique

How to induce De-Qi 1. Up-down thrusting Ø 2. Left-right twisting Ø 3. Flicking Ø 4. Scraping Ø 2 3 1 4

Quantity/dose of needle stimulation Ø Intensity l l De-Qi Response Intermediate Mild Ø Duration of stimulation l l l Short: < 5 min Long: >60 min Intermediate: 10 to 30 min

Withdrawal of a needle Ø Twirling Ø Pulling the needle out Ø Pressing the point after withdrawal l l Pressing---tonification No pressing ---sedation

Practice needling an acupoint Ø Orange Ø a layer of paper Ø a ball of cotton Ø on self Ø health animal Ø real case

Elbow, sore throat, fever Abdominal pain, vomiting, diarrhea Hypertension, seizure, conjunctivitis LI-11

l PC-6: over the median nerve • 2 cun above the wist Indication: nausea, vomiting, chest pain

2. Electro-acupuncture techniques History Ø After electro-acupuncture (EA) analgesia was found effectively to perform a surgery in China in the early 1970's, EA has been widely used in TCM practice.

Advantage: Ø Ø Ø 1) More effective 2) Less treatments 3) Less acupoints 4) Save labor to manipulate the needles (Classically, the needles should be manipulated every 2 to 3 minutes). 5) Objective control of frequency and amplitude l l Amplitude (intensity of stimulation): a tolerance level Frequency: • Low level: pain ----> beta endorphin mediated • High level: internal medicine� > serotonin mediated

Methods: Acupuncture Points: 6 to 10 points Frequency: 20 Hz Or 80 to 120 Hz Electrical intensity: gradually goes to the points the patient can tolerate. Indications: 1) Pain management 1) a) Bi syndromes (arthritis) b) Soft tissue injuries c) Disc problems d) colic/abdominal pain 2) Peripheral nerve paralysis a) facial b) radial c) others 3) Gastrointestinal conditions: vomiting, diarrhea, constipation, indigestion 4) Muscle atrophy

Contraindications: Ø 1) Weak/deficient patients Ø 2) Heart problems Ø 3) seizure/epilepsy Ø 4) tumor

How to Use the Electronic Acupunctoscope 1) Dial the AMPLITUDE and FREQUENCY to zero; 2) Plug the wire leads into sockets 1 to 7 and fasten the clips to the handles of needles; 3) Set the desirable frequencies and wave forms A. Frequency: A) low frequency F 1 = 20 -30 Hz Indication: pain conditions---Endorphin release * C fiber is sensitive to less than 10 Hz of electrical stimulations *: 20 to 120 Hz stimulates A α and A β B) high frequency 80 to 120 Hz Indications: internal medical conditions (diarrhea etc) Serotonin release

How to Use the Electronic Acupunctoscope A. Frequency: 1) low frequency F 1 = 20 -40 Hz Indication: pain conditions---Endorphin release 2) high frequency 80 to 120 Hz Indications: internal medical conditions (diarrhea etc) Serotonin release B. Wave Form: depends on how F 1 and F 2 is set up 1) Intermittent wave: F 1=0; F 2=40 Indications: muscular atrophy 2) Dense and Disperse (DD) wave: F 2=120 and F 1 =80 Indications: nerve paralysis and internal medical conditions 3) Continuing Wave: F 1=20 -40 and F 2=0 Indications: pain conditions

How to Use the Electronic Acupunctoscope 4) Turn on the power 3 5) Gradually increase AMPLITUDE bottons until the patient can tolerate. Can increase amplitude a little bit every 5 minutes. 6) The duration of a treatment session: 10 to 30 minutes. 7) The output socket between 4 and 5 is only used for the needleless technique, which acupuncture points are stimulated using the needleless electrode. Fill the cup of electrode with absorbent cotton soaked with saline. Tape the electrode onto the acupuncture points. Set � Hi - Lo�to Hi position. 8) Turn off power to terminate the acupuncture treatment.

Electro‑acupuncture: how to pair the points The general rules: The same lead to pair 2 points Ø 1) Bilateral connection l l l Ø 2) Same Channel connection. l l l Ø a. GV-14 + Bai-hui for disk disease, vestibular dx b. LI-10 + LI-15 on the same side for shoulder pain c. Tip of tail + GV-20 for vestibular dx, disk disease 3) Local connection l l Ø a. Pair BL-54 on left side to right BL 54 for hip dysplasia; b. Hua-tuo-jia-ji on the left to right side for disk diseases c. BL-21 on the left to right BL-21 for vomiting d. KID-1 on the left to right KID-1 for rear weakness e. Left Ding-chuan + right Ding-chuan for cough a. TH-14 + LI-15 on the same side for shoulder pain b. GB-34 + ST-35 on the same side for stifle pain 4) Same energetic connection l l ST-36 + GB-34 on the same side for vomiting, rear weakness ST-36 + BL-20 on the same side for SP Qi deficiency

Electro‑acupuncture: how to pair the points Ø 5) From the top to bottoms for paralysis l l l Ø 6) Cover large areas l Ø a. BL-54 + KID-1 for rear limb paralysis b. PC-8 + GV-14 for front limb paralysis c. GB-21 + HT-3 for front limb paralysis a. BL-20 on the left + right BL 28 for T-L-S IVDD 7) Normal area to � sick�area l l a. BL-21 to KID-1 for no deep pain caudal to BL-22 b. ST-5 left to right for right facial paralysis

Electro‑acupuncture: how to pair the points Ø But, we must pay attention to the following: l l 1) The wire (lead) should NOT be connected around the abdominal areas for pregnant moms. 2) The wire (lead) should NOT be connected through the chest if the patient has a pacemaker. 3) The wire (lead) should NOT be connected through the tumor mass. 4) Caution for seizure dogs when using EA

3. Aquapuncture (point injection) History: Herbal medication for pigs: very challenge Herbal extract: Injectable herbal liquid (Angelica Dang Gui) Patient own blood for chronic eye blood Fire Constitution of Animals: not remain still Some of points not available with dry-needling or EA Points: - Acupoints: except for hemo-acupoints - A‑shi Point -Needle: Dogs/cats: A 25 -27 gauge hypodermic syringe needle Horses: 20 to 22 # - After "De‑Qi" occurs, the injection is given - 1 -8 points per treatment - Once every 3 -7 days, for 3 to 5 times

Injectable agents: . Angelica sinesis (Dang‑gui). Carthamus tinctorius (Hong‑hua). Coptis chinensis (Huang‑lian). Andrographis paniculata (Chuan‑xin‑lian). Sterile water. 5‑ 10% dextrose. 0. 25‑ 0. 5% procaine. vitamin B 1, B 12, or B complexion. Antibiotics. anesthetics, sedatives or anti‑rheumatics. biological products: antitetanolysin. Vaccine homeopathic remedies the patient’s own blood Dosage: . 1 to 15 ml for each point for large animals. 0. 1 - 1 ml each point in small animals

4. Acupuncture point embedding (Implantation) - the point injection of a solid substance a. Thread/catgut b. magnetic bead, or pellets c. Gold bead/wire - used for treatments of diarrhea in young animals - hip dysplasia - Epilepsy - lameness - eye infection

5. Hemoacupuncture Is also called Red Needle. intentionally puncture a blood vessel to draw blood Needle: a sharp traditional needle (three edged needle, or wide needle) hypodermic needle #27, 25 for small animals #25, 23, 20 for large animals Only used for specific points that have a history of hemoacupuncture in TCVM such as Er-jian, Wei-jian, Tai-yang, Xiong-tang. Indications: Blood Stagnation, Blood Heat Excess Heat Contraindications and cautions: Weak and debilitated animals Qi or/and Blood Deficiency dehydrated or severely Yin-deficient patients Pregnant animals Patients with potentially zoonotic blood-borne pathogens Hemo-acupuncture can not repeat the same point for a week

6. Pneumo-acupuncture Inject fresh air into an acupoint Ø subcutaneous tissues Ø Local ash Point (the worst atrophied spot) Ø Equine: Gong-zi for should atrophy Ø Canine: 5 to 50 cc of air Ø Indication Ø l l Ø Shoulder atrophy Hip atrophy Avoid the head

7. Moxibustion - Using burning herbs to stimulate acupoints originates from the Japanese "mogusa" - "moxa" or "moxibustion" Moxa is the crushed dried leaves of Artemisia argyi (Ai-ye). Therapeutic effects: dredging meridians dispelling cold and wind reviving Yang for resuscitation promoting functional activities

Moxa Stick Moxibustion Moxa sticks: 20 cm in length and 1. 5 cm in diameter Mild moxibustion: . 1 to 2 cm distance against the acupoint. 5 to 10 min. for each point Circling moxibustion: . With a circulating motion. For larger area of rheumatism. Pecking moxibustion: . With a pecking motion. touches the skin. 2 to 5 min. For chronic diseases which need stronger stimulation

Moxa cone Moxibustion a). Direct Moxibustion up to 5 zhuangs. b). Indirect Moxibustion - a slice of ginger or garlic placed b/w the burning cone and the acupoint. - The ginger or garlic slice is about 3 mm thick with some pores Moxa + Needling

8. Laser acupuncture Ø Later 1970, Laser acupuncture for diarrhea in goats and sheep in Inner Mongolia using CO 2 laser at GV-1 l l Ø CO 2: no light Can be very dangerous 5 -30 m. W Helium-Neon (He-Ne laser): or cold laser l infertility, anti-inflammatory, analgesic, and promotes wound healing l cannot penetrate accurately and deeply into most acupuncture points because the light is refracted in the first 1 -15 mm of tissue Almost no effect if less than 5 m. W. l treating superficial acupuncture points in areas of thin integument l • Avian: skin is generally very thin • Lie Que (Lung 7) • Jing-well points.

9. Infrared acupuncture Ø Ø Ø Its radiation: heat (moxibustion) a 250 W infrared bulb TDP lamps (Teding Diancipo Pu): l l Ø Indication l l Ø heat a metal plate constructed from numerous mineral substrates Developed in Chong-qing, China in the 1980’s. Bi syndrome Wound Caution: avoiding too hot.

10. Auriculotherapy Ø Origin: tip of ear Ø Human auriculotherapy l l German China • Diagnosis • Treatment Ø Canine ear points l l Diagnosis Treatment

Other Acupuncture techniques. Cupping. Tui-na (massage and chiropractic). Scalp Acupuncture. Microwave acupuncture

TCM Prayer • Just for today, I will let go of my anger. • Just for today, I will let joy in my heart. • I will not worry or be sad. • Just for today, I will embrace life. • I will live without fear, in harmony with myself and the Universe.