Summary
Traditional Chinese Medicine (TCM) uses 80% herbs and 20% acupuncture (AP). AP is based on the relationships between the input-output terminals of the body's data transmission system. This system links superficial reflex (reactive) points and the organs or parts that relate to these points via the neuroendocrine and autonomic systems. AP is about clinical assessment and treatment of acupoints, especially those along the Twelve Channel-Organ Systems (COSs). The Channels are the main pathways to reflect, transmit, and store vital energy (Qi). Each named Channel relates to its named Organ System, the TCM Functions of that COS, and its relationships to other COSs and the external environment. Successful AP relies on knowing the location and function of the main acupoints and their relationships with the COSs.
AP diagnosis and therapy depend on TCM concepts. AP is not a panacea; if used alone, it has little effect in disease with severe organic pathology or if the normal homeostatic responses of the body are incapacitated. However, AP helps to complement conventional treatment of many serious diseases. It has many uses, notably to treat trauma, wounds, burns, lameness, and musculoskeletal pain; some forms of paralysis, epilepsy; and functional disorders. These include vomiting, diarrhea, hormonal, immunological, and neurological disorders. Mastery of AP demands years of study under expert teachers. Most veterinarians will not invest the time and effort needed for that. In contrast, veterinarians can learn the basics of AP in 40–120 hours of course-work and 6–12 months part-time home study. That training can give excellent clinical results in properly selected cases. For free online study material, see [http://homepage.eircom.net/~progers/study.htm].
One may study veterinary AP (VAP) in two main ways: a) traditional VAP (TVAP) and b) modern VAP (MVAP). VAP uses both methods. TVAP relies on ancient Chinese texts that do not describe Channels in animals. MVAP relies on the study of human AP points/Channels and their transposition to anatomically comparable positions in animals. It has advantages for beginners: 1) MVAP is integrated and relatively easy to learn, whereas TVAP is not integrated and is more difficult to learn; 2) MVAP is easily available through dozens of texts, whereas TVAP has few texts in European languages; and 3) Western Vet experience with MVAP indicates that it is effective. It has some disadvantages, especially where anatomical differences between species make some points difficult or impossible to locate. However, its disadvantages can be overcome by choosing alternative point combinations.
Introduction
The codes for Channel-Organ-Systems (COSs) in this text are: LU=Lung; LI=Large Intestine or colon; ST=Stomach; SP=Spleen-Pancreas; HT=Heart; SI=Small Intestine; BL=Bladder, with BL40=WeiZhong; KI=Kidney; PC=Pericardium, Circulation-Sex, or Heart Constrictor; TH=Triple Heater/Endocrine; GB=GallBladder; LV=Liver; GV=Governing Vessel (Du, dorsal midline); CV=Conception Vessel (Ren, ventral midline). Other authors may use different codes. There is no guarantee that other authors use these codes because there is no international standard nomenclature. Point codes and names are at [http://homepage.eircom.net/~progers/pt.htm]. The course of the Channels and the location of human points are at http://users.med.auth.gr/~karanik/english/vet/source1.htm
To use AP successfully, one must know the location and functions of the main acupoints. AP is about where, how, and why to insert needles into the body. Human and animal acupoints have diagnostic, therapeutic, and prognostic value. An energetic imbalance in a Channel, and/or pathology in the related organ or part changes acupoint reactivity; increased or decreased point sensitivity on or related to a Channel has diagnostic value. Provided that the capacity to respond exists, stimulation of relevant points by AP or related methods activates homeostatic/adaptive responses via the neuroendocrine and immune systems; this has therapeutic value. During a course of successful therapy, point reactivity returns to the normal resting state; disappearance of point reactivity during therapy indicates a good prognosis and the likelihood of a good clinical response. See “The study of Acupuncture: points and channels in animals” at [http://users.med.auth.gr/~karanik/english/vet/ptsmer1.htm].
TCM uses concepts that include the need for balance and control in all aspects of life. It includes diagnosis based on TCM principles of vital energy (Qi), Change, the Qi-Clock, Yin-Yang, Five Phases, Five Emotions, Six Evils, Eight Principles and Twelve COSs. The Channels are the main pathways to transmit and store Qi. There is not time to cover methods of AP stimulation, clinical uses, successes and failures, nor fundamental TCM principles. For those aspects, see [http://homepage.eircom.net/~progers/study.htm].
Most veterinarians regard TCM principles as irrelevant; veterinarians experienced in AP regard them as essential. However, this paper will emphasize MVAP because it is easier to learn than TVAP and it can be used to treat most animals.
Acupoints—peripheral terminals of the body's auto-control system
The skin interfaces between the internal and external environment. Xue (“hole”) is the Chinese name for an acupoint. Acupoints are entry and exit holes for external and internal energies and are a system that facilitates bringing these energies into balance. Acupoints and Channels have diagnostic, therapeutic, and prognostic value. Their properties and connections with neural structures allow them to become reactive in disease in their related Channels, organs, and body functions or parts. Disappearance of point reactivity during therapy is a good prognostic sign. Human texts describe > 1021 acupoints on the limbs, back, belly, head, ears, face, scalp, nose, hands, foot zones etc.(1,2) Many points lie over peripheral nerves. Needling them stimulates the nerves with a sensation of paraesthesia, like an electric shock, running away from the needle. Other points are where a nerve enters or leaves a muscle, the “motor points” of physiotherapy. Others correspond with “trigger points” (TPs), zones of referred pain and the AhShi (“Ouch” or “Ah yes!”), or pressure-sensitive points (pain points). AP at sensitive points stimulates the cerebral cortex and induces a reflex action, i.e., the response to GV26, LU11, A_01 in shock. Each point has a name that describes its function, location or character in some way. As few texts translate the point names, most Western readers do not know these meanings. For example, Xinshu (BL15) = Heart Shu; Zusanli (ST36) = Foot Three Measures; Lanwei = Appendix, etc.
AP texts in European languages are based on originals from the east. European phonetic spelling of the original calligraphs varies widely for the same points. This confuses Western readers who are trying to index points under their names. Therefore, Chinese and Western texts also give an alphanumeric or numeric code to each point. Even then, confusion may arise, as ST01 may be called M01 in Dutch and German texts, E01 in French texts, S01 in other English texts, and ST08 or S08 in still more texts! Thus, it is essential that students adopt one convention, based on one textbook that they will use as their basic reference work. If they hope to integrate new material with the old, they must check each new text or reference point by point against their basic reference. If necessary, they must rename and re-code the points in the new texts.
TVAP—Isolated Acupoints and poor integration
TVAP is much less integrated and complete than traditional human AP. It may be that those who used TVAP were also familiar with TCM principles, as applied in humans. However, TVAP texts, or rather their translations into European languages, show little evidence of that. The texts show points used for the main domestic species: horse, ox, goat, pig, camel, duck and fowl. There are incomplete texts from other countries on the elephant. There are no texts available on small animals (dog, cat), laboratory animals (rats, mice, guinea pigs), zoo animals or primates.
In TVAP texts, acupoints are shown as isolated positions, in relation to body landmarks, such as bones, joints, body cleavages, orifices or other anatomical landmarks. Each point has a name (denoted by a Chinese or Japanese symbol), an alphanumeric code (e.g., FL 7), or a Chinese numeric code (81), a position, a list of its therapeutic functions, and advice on the method of stimulation. For examples, see the Chinese text (Chinese Vet Handbook, Anon 1972, Lan Chou Vet. Res., Institute, Ganshu, China), from which Klide and Kung prepared their section on cattle AP.
Difficulties in learning TVAP
1. Busy practitioners are unlikely to learn TVAP properly because the points are isolated (not on Channels) and bear little relationship to each other in function; they must be memorized in detail.
2. There are within-species differences. The Chinese name, symbol and translation for a particular point may vary between texts on the same species. Even if the symbol is the same, the European alphabetic version and the codes may differ. Also, points in a precise position may have different therapeutic indications, depending on which reference text is being used. Part of this problem is due to the difficulty of translating Chinese into precise European equivalents. For instance, T 1 (Tan Tien) might be used for sunstroke (hyperthermia?, Heat Patterns?) or exhaustion (collapse?, shock?) depending on the skill of the translator! Similarly, Tan Tien (HN 1) might be used for cerebral congestion (apoplexy?, collapse?) or epilepsy (= convulsions). HL 1 and FL 1 might be used for twisted pelvic and shoulder joints respectively but these might also translate as strained, sprained or painful joints. The fact is that little or no integration sources and translation has been done between (and even within species).
3. Between-species differences occur in the symbols, names, codes, positions, functions, and method of stimulation. Thus, a practitioner could know the points in the ox very well, yet not know TVAP as applied to other species.
4. Unacceptable methods of stimulation are often recommended in the traditional texts. The use of thick or spear-like needles, hot irons, and severe cautery would not be acceptable to Western veterinary surgeons, their clients and their patients.
5. TVAP cannot cater for many species because texts do not exist for them.
6. TVAP experts are trying to integrate existing traditional texts to produce a single authoritative text for each species for which texts exist. This will make it easier to study and use TVAP. Until then, most veterinarians who use TVAP will follow one particular school or text. For those who wish to study TVAP, I recommend the texts of Klide and Kung; Westermayer; Rubin; Yu and Hwang and any other good translations of modern Chinese or Japanese veterinary texts that may appear soon.
MVAP—Transposition from Humans to Animals
In animals, transposition has difficulties and disadvantages:
Important human points occur between the elbow and digit or knee (stifle) and digit. Few animals have five digits, so it can be difficult to locate anatomically comparable points in animals. Where would one locate Shangyang (LI01) or Hegu (LI04) in the horse? Also, paravertebral Shu points (organ-associated diagnostic points) are important for therapy. We have 12 pairs of ribs, 12 thoracic vertebrae, five lumbar vertebrae and five sacral vertebrae, but few animals fit this pattern. Thus, if Pishu (BL20) (spleen/pancreas reflex point) lies between vertebrae T11-12 in man (with 12 pairs of ribs), where does it lie in the horse, with 18 pairs of ribs? Drs. Cain, Giniaux, Guray, Kothbauer, Thoresen, Westermayer, van den Bosch, etc., have described locations for these points.
Other anatomical differences (for instance, the absence of a clear umbilicus, the presence of a penis and sheath along the abdomen, etc.) can make it difficult to transpose points on the CV Channel.
Earpoints, which are extremely valuable points in man, are not as well researched in animals. Differences in ear anatomy make direct transposition very difficult.
How can we overcome these difficulties?
If one or more points cannot be found, use other combinations. It is important to know that many combinations of acupoints can produce the same result. For instance, human headache may be treated by AP at Hegu (LI04). Lieque (LU07) and Taichong (LV03), points that could easily be found in the dog, but difficult or impossible to find in the horse. However, points Fengchi (GB20), Yintang (between the eyes), Taiyang (in the temple, lateral to the eye) can be effective also and can be located in most animals.
If one doubts the location of a transposed point, one may choose a number of points along the nerve trunk or in the same or nearby dermatomal areas. Research suggests that the nervous system mediates AP effects and that nerve points in the same dermatome exert similar effects, as do points along the same nerve trunk or in nearby dermatomes. Thus, although Pishu (BL20) is the spleen-pancreas Shu point, BL19 or BL21 (Danshu or Weishu) would have some effect also. Similarly, although BL13 (Feishu) is the Lung Shu point, BL12 and BL14 (Fengmen and Jueyinshu or Baoxinshu) have similar effects. Many massage, cupping, spooning, and cautery techniques are applied over the whole area of BL12,13,14.
If the penis is in the way, deflect it to one side. If the exact location of the umbilicus is unclear, estimate its location and use this as the landmark to locate points near it.
Research on the points (and especially Earpoints) will help to define their position and functions. VAP by the transposition method is a new art-science and we must expect improvements in the future. It is our privilege to be among the pioneers who will help to develop this most useful therapy in the West.
Both systems (TVAP and MVAP) have many clinical applications in animals. AP is not a panacea; if used alone, it has little effect in disease with severe organic pathology, or if the normal homeostatic responses of the body are incapacitated. However, AP helps to complement conventional treatment of many serious diseases. It has many uses, notably to treat trauma, wounds, burns, lameness and musculoskeletal pain, some forms of paralysis, epilepsy, and functional disorders. These include vomiting, diarrhea, and hormonal, immunological and neurological disorders. For details of its veterinary uses, see [http://homepage.eircom.net/~progers/vaplinks.htm].
Conclusions
Disease and death are part of life. No medical modality has all the answers. However, AP is powerful; in some cases, it complements conventional therapy, in others, it is an effective alternative. VAP uses traditional and modern methods; both have advantages and disadvantages. Beginners are advised to base their study on the human AP system (MVAP) and to include TVAP methods later.
Two factors limit widespread use of AP: a) skepticism and/or vested interest; and b) refusal of Vets to re-train. If you want to study AP, contact IVAS (International Vet AP Society) or your national Vet AP Society at [http://www.komvet.at/ivadkom/vapsocs.htm] and see [http://homepage.eircom.net/~progers/study.htm] free material.
Colleagues, I urge you to study this ancient and valuable therapy; it will enhance your clinical results and will change your whole approach to medicine and life.
References
See online lectures and bibliographies at http://homepage.eircom.net/~progers/study.htm
1. “The study of AP: Points and channels in animals” [users.med.auth.gr/~karanik/english/vet/ptsmer1.htm]
2. “The study of AP: Sources and study techniques” [users.med.auth.gr/~karanik/english/vet/source1.htm]