Introduction to Acupuncture

1
Introduction to Acupuncture

• Ancient Art to Modern Science

2
Comparison of East West
East
West

• Empirical Observations over Thousands of Years

• Scientific Method Case-Based Medicine

• Technology of Medicine

• Art of Medicine

• Holistic View

• Molecular Organ View

• Circular Logic

• Energetic

• Linear Logic

• Mechanistic

3
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

4
Acupuncture History
Sun Yang Alias Bole Veterinarian Qinmugong
period 659 B.C. to 621 B.C. Bole Zhen-jing
5
Boles Canon of Veterinary Acupuncture

• Sun Yang
• 659 to 621 B.C.
• Bole Zhenjing

6
Acupuncture History
Yuan-Hengs Therapeutic Treatise of Horses
Yuan Heng Liao Ma Ji

• 1608
• Benyuan Yu
• Benheng Yu
• Veterinarian
• Ming Dynasty
• 1368 to 1644

7
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 GV26 leads to
  endorphin response, while high-frequency needling
  of GV26 leads to epinephrine response

8
Basic Acupuncture Techniques
8,000 years ago
Stone needles
New Acupuncture
Bones needles 3,000 years ago
Metal needles 2,200 years ago
Needles
Gold/silver needles
Electro-acupuncture Embedding Injectable
acupuncture (aquapuncture and pneumoacupuncture),
Bamboo needles
Fine needles
Zhen-jiu
Laser therapy Magnetic therapy Infrared therapy
(TDP)
Ai-jiu (moxa) moxibustion Alcohol (huo-jiu)
Herbal moxibustion Needle Moxa Fire-needling
Moxibustion
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Long
Nine needles (2,200 years ago)
Sword
Fine
Pressure
Arrowhead
Round
Sharp
Round/Sharp
Large
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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)
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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
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Acupuncture Needle Diameters in Gauge and
Millimeters
Gauge Millimeters Application
40 0.15 Hand/feet Needle
38 0.16 Baby needle
36 0.20 Baby needle
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
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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
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How to needle an acupoint

• Preparation
• Needle
• Animal
• Practitioner
• Insertion of a needle
• Pressing hand
• Angle
• Depth
• Manipulation of a needle
• Withdrawal of a needle

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How to needle an acupoint preparation

• Needle
• Sterile disposable
• The tip should be smooth
• sharp as a pine needle
• size
• Horse Ø 0.30-40 mm (28-30)
• 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

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How to needle an acupoint preparation

• Needle
• Small animal
• generally thinner
• not too thin
• Dog
• Ø0.25 (32)
• 13 mm (1/2)
• 25 mm (1)
• 50mm (2) large dog
• Cat
• Ø0.25 (32)
• 13 mm (1/2)

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How to needle an acupoint preparation

• Animal
• quiet
• relaxed (house call benefit)
• Restrained if needed (nose twisted), but not
  sedation/tranquilized
• The site of acupoints
• nice and clean

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How to needle an acupoint preparation

• Practitioner
• Sound plan of acupuncture treatment
• Considered as a surgical procedure
• others

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How to needle an acupoint Insertion

• Pressing Hand
• 1. Thumbing
• 2. Pinching

1
2
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How to needle an acupoint Insertion

• Pressing Hand
• 3. Holding
• 4. Stretching

3
4
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How to needle an acupoint Insertion

• How to insert a needle
• Jabbing a quick insertion (Flying technique)
• 0.5 (13 mm)
• 28 to 30 for horses
• 30 to 32 for small animals
• tube guiding
• Twirling a slow insertion

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How to needle an acupoint Insertion

• Angle
• Perpendicular insertion
• Angular insertion
• Horizontal insertion
• Depth
• Location
• De-Qi response
• Condition
• Patient

23

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

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How to induce De-Qi

• 1. Up-down thrusting
• 2. Left-right twisting
• 3. Flicking
• 4. Scraping

1
2
4
3
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Quantity/dose of needle stimulation

• Intensity
• De-Qi Response
• Intense
• Intermediate
• Mild
• Duration of stimulation
• Short lt 5 min
• Long gt60 min
• Intermediate 10 to 30 min

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Withdrawal of a needle

• Twirling
• Pulling the needle out
• Pressing the point after withdrawal
• Pressing---tonification
• No pressing ---sedation

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Practice needling an acupoint

• Orange
• a layer of paper
• a ball of cotton
• on self
• health animal
• real case

28
Elbow, sore throat, fever Abdominal pain,
vomiting, diarrhea Hypertension, seizure,
conjunctivitis
LI-11
29

• PC-6 over the median nerve
• 2 cun above the wist

Indication nausea, vomiting, chest pain
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History
2. Electro-acupuncture techniques

• 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.

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Advantage

• 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
• Amplitude (intensity of stimulation) a tolerance
  level
• Frequency
• Low level pain ----gt beta endorphin mediated
• High level internal medicine?gt serotonin mediated

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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.

• Pain management
• 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

Indications
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Contraindications

• 1) Weak/deficient patients
• 2) Heart problems
• 3) seizure/epilepsy
• 4) tumor

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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 F1 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 a and A ß B) high frequency 80 to
120 Hz Indications internal medical conditions
(diarrhea etc) Serotonin release
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How to Use the Electronic Acupunctoscope
A. Frequency 1) low frequency F1 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 F1 and F2 is set up 1)
Intermittent wave F10 F240 Indications
muscular atrophy 2) Dense and Disperse (DD)
wave F2120 and F1 80 Indications nerve
paralysis and internal medical conditions 3)
Continuing Wave F120-40 and F20 Indications
pain conditions
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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.
• 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.

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Electro-acupuncture how to pair the points
The general rules The same lead to pair 2 points

• 1) Bilateral connection
• a. Pair BL-54 on left side to right BL54 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
• 2) Same Channel connection.
• 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
• 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
• ST-36 GB-34 on the same side for vomiting, rear
  weakness
• ST-36 BL-20 on the same side for SP Qi
  deficiency

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Electro-acupuncture how to pair the points

• 5) From the top to bottoms for paralysis
• 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
• 6) Cover large areas
• a. BL-20 on the left right BL28 for T-L-S IVDD
• 7) Normal area to ?sick? area
• a. BL-21 to KID-1 for no deep pain caudal to
  BL-22
• b. ST-5 left to right for right facial paralysis

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Electro-acupuncture how to pair the points

• But, we must pay attention to the following
• 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

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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

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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
B1, B12, or B complexion . Antibiotics .
anesthetics, sedatives or anti-rheumatics .
biological products antitetanolysin .
Vaccine homeopathic remedies the patients own
blood Dosage . 1 to 15 ml for each point for
large animals . 0.1 - 1 ml each point in small
animals
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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
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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
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6. Pneumo-acupuncture

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

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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 dispe
lling cold and wind reviving Yang for
resuscitation promoting functional activities
46
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
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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
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8. Laser acupuncture

• Later 1970, Laser acupuncture for diarrhea in
  goats and sheep in Inner Mongolia using CO2 laser
  at GV-1
• CO2 no light
• Can be very dangerous
• 5-30 mW Helium-Neon (He-Ne laser) or cold laser
• infertility, anti-inflammatory, analgesic, and
  promotes wound healing
• 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 mW.
• treating superficial acupuncture points in areas
  of thin integument
• Avian skin is generally very thin
• Lie Que (Lung 7)
• Jing-well points.

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9. Infrared acupuncture

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

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10. Auriculotherapy

• Origin tip of ear
• Human auriculotherapy
• German
• China
• Diagnosis
• Treatment
• Canine ear points
• Diagnosis
• Treatment

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